September 22, 2017

Ortho case – CCL

See testimonials page for other examples of orthopaedic cases recently receiving physiotherapy

Rehabilitation after CCL repair

Murphy, a black lab ruptured his cruciate ligament and required surgery. He had a TTA MMP procedure and as usual after surgery required being kept controlled, quite and restricted exercise. Murphy is an excitable chap who bounces more than he walks and lives with a few cats that he is apt to chase just for fun at times.

Murphy was referred 3 days post op for physiotherapy assessment and treatment. On initial assessment  Murphy had very little swelling around the operation site, was partially weight bearing on the limb and fed up of trying to be quiet in his movements. An energetic dog is of course at risk of damaging the operation site and causing failure of the implant but also they are at risk of choosing to not use the operated limb placing more strain on the other limbs (risk of ccl rupture on the other leg increased) thereby causing loss muscle bulk, strength and orthopaedic joint proprioception.Murphy Moddy stand

Physiotherapy plan focused on reducing swelling, easing discomfort , stifle range of movement and correct placing and use of the limb. I treated Murphy with pulsed Magnetic Therapy (increases cell metabolism to reduce swelling, discomfort and promote healing), hands on physio to his sore back muscles (from compensatory movement) and started static standing work to improve joint proprioception, circulation and use of the limb by isometric contractions of the muscle supporting the stifle. I showed his owner some techniques to use at home to help Murphy relax and to mentally stimulate him in such a way that was therapeutic to his rehabilitation.

Murphy progressed very well with continued physio assessments and treatment weekly. The main focus of physioMurphy Moody 7 was correct use of the limb. I progressed his therapeutic exercise program to include quality correct sits, movement shapes on slow walks such as circles, shallow loops. By week 3 we were using low wobble cushions for his front legs to be on to promote joint proprioception and focused pelviclimb movements.

Murphy Moody polesHis xrays at 5 weeks showed fabulous healing and his vet was happy for us to progress his therapy. We started using the higher wobble cushion so that he transferred more weight onto his pelvic limbs, side stepping, backwards walking and walking of raised poles – these all work on joint range of movement, joint proprioception, muscle strength particularly the muscle fibres close to the stifle joint. He continued with therapeutic walking activities at home staring to vary terrain, sharper changes of direction, speed (still within the walk) – this prepares the operated area for the forces that will come into play once he returns to offlead.

Murphy was discharged from physio at 10 weeks post op with very correct use of the limb in all functional activities, symmetrical muscle bulk and doing some off lead time during his walks.

His owner was very pleased to have physiotherapy support to help her and Murphy cope with the restricted activity. She liked actively  helping his recovery with therapeutic activities and care at home in between physiotherapy appointments. Physiotherapy input means the dog gets beneficial therapy 7 days a week as he has a home therapy program. Dogs make a safer, quicker and improved recovery when they receive physiotherapy soon after CCL repair operations.