September 22, 2017

Ortho Case – elbow replacement

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

Rehabilitation after elbow replacement

Daffodilly, a mixed collie breed, had struggled for more than 2 years with pain in her left forelimb. Despite much veterinary input over the years, her final 3 options were amputation, arthrodesis of the joint or elbow replacement. Dilly’s owners opted for the elbow replacement which was performed at Fitzpatrick Referral Hospital. Dilly started physio a couple of days after her operation with the resident ACPAT physio team at the vets and was discharged home after a few days but returned for physio over the next 3 weeks. Dilly’s owner then saught a local ACPAT Vet physio and her physio continued at home with me seeing her twice a week for half hour sessions.

Dilly had lost confidence in using the limb over the years of pain and her muscles were very weak, especially important weight bearing musculature around her scapula and her triceps muscles. Dilly was also sore and stiff though her back and hindquarters from so long of moving in an adapted way.

Physiotherapy focused on
1) Improving the range of motion of the elbow joint by stretching soft tissue with hands on therapy and relevant exercises; 2) Increasing Dilly’s confidence in using her leg to walk. (see video link for some of these exercises) 3) Removing her compensatory muscle and joint discomfort 4) Increasing strength in her muscles mostly through specific walking exercises.        This was all done in 2 short physio sessions a week combined with a home exercises and walking program for her owner to do.
Dilly was a pleasure to work with and especially open to bribery with cheese.

After such a long time of not using her leg Dilly really did not trust that it was ok to do so – her brain and body had forgotten that it was worth using. But gradual static exercises and snail pace walking exercises triggered the start of her gaining confidence. Over the next 3 months she increased her confidence in using her leg and it slowly strengthened.

She returned to the referral centre for a 6 month update and the surgical team were very pleased with her progress. She was tested walking on force plates and she had increased her use of her leg more than any other case they had had at that time.

Dilly now leaps off the sofa ready to go for walks with her owner and her buddy whereas before the operation she did not want to go for a walk. Her owners comments : “Nycky devised all sorts of interesting and fun exercises, each one to work on a different area. Not only was she highly professional in her approach, but she also made her visits exciting and enjoyable for Dilly. I believe this was important as it meant that she was always happy to cooperate and would greet Nycky’s arrival with wags of delight. Nycky showed me exercises that I could do with Dilly and this gave me the confidence to take charge of her recovery myself.