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Charlie the Superstar! Physio following CCL surgery

This blog is inspired by one of my recent patients who I have now finished the initial course of treatment on. I feel it shows well how a short burst of physio input can have a dramatic effect on your dog’s pain levels and function after weeks of not improving following CCL surgery.

Meet Charlie. He is much loved by his owners who contacted me as they felt his walking wasn’t improving as quickly as they would have liked after surgery for a cranial cruciate rupture (a common issue causing hindlimb lameness and operated on by vets routinely with varying methods). The vets and the owners felt that physio may help Charlie so a referral was made.

On the initial assessment Charlie wasn’t very keen on putting much weight through his operated leg, would place it out to the side (a clever trick to keep the load off) and when walking he was obviously lame and trying to keep the weight off of the leg. He had also lost a lot of muscle bulk around the leg. Pain in the stifle (knee joint) was minimal with good range of movement so I felt it was more weakness of the limb that was affecting his function rather than it being painful. Due to the altered way he walked he now also had muscle soreness in his back (this is common following this kind of surgery due to altered biomechanics – anyone who has ever worn high heels on a night out can emphasise with this!). He also had additional issues to cope with of osteoarthritis in his hips on both sides and was over-weight (currently going to the vets version of slimming world so the owners were working on it!).

My treatment included low lever laser to the spine and knee joint for pain relief and tissue healing and I advised the owners to use a hot water bottle on his back to help with the muscle soreness – again most people can probably relate to how nice this feels when you are sore. I also performed some joint mobilisations and stretches on his hips and back to reduce stiffness and pain.

However the main part of treatment was exercises! As any of you who have had the “pleasure” of seeing a physio for any injury we love giving exercises…they are great to encourage range of movement, weight-bearing and of course strengthening. So his lovely owners were shown a few simple exercises all aimed at improving the way he used his poorly leg – really easy to perform but they make such a difference. These included gentle weight shifts in standing, sit to stand practice, and some balance work on a wobble cushion to build up his core stability and proprioception (body awareness).

After one week there was a huge difference! His owners have obviously been working really hard on his exercises and you could tell. There was noticeably better loading of the leg, less lameness and his back was a lot more comfortable. Over the next 4 weeks I continued to progress his exercises by making them more challenging aimed at strengthening the muscles in the leg and strengthening his core. We continued with the laser and joint mobilisations and I was actually really surprised at how well his hip pain improved – now having full range of movement and no pain. So it just goes to show that osteoarthritis on x-ray does not necessarily mean irreversible joint pain and the initial pain was due to muscular tightness from him adapting the way he walked – “Use it or lose it!”.

So I hope this shows that physio can make a lot of difference to simple routine surgeries. Historically vets have felt that dogs will recover on their own given time, which can be true in some cases, but clinical evidence shows that physio can increase the speed of their recovery and this case has definitely shown that! Left to their own devices dogs may continue to off-load their operated leg, so never really regain their strength and can then develop secondary issues. So if you have a dog who has recently had cruciate surgery (or any orthopaedic surgery actually), or there is plans to in the future – then please ask your vet for a referral to me (referral form found on this website). Vets are normally more than willing as it can only be of benefit to your dog and means you will hopefully get them back on track and doing the things they love sooner!

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