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THE PET HEALTH LIBRARY
By Wendy C. Brooks, DVM, DipABVP
Educational Director, VeterinaryPartner.com

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Physical Therapy for Arthritic Patients

Life with a dog with mobility issues is a challenge and it would be wonderful if there was a magic pill that could be given to make a stiff older dog as supple as a youngster. Unfortunately, despite advances in arthritis medications for dogs, there is more to therapy than giving pills. The more advanced the mobility problems are, the more important physical therapy becomes in maintaining function.

The following are some general suggestions that may be helpful at home. In reality, the more time you are able to spend with physical therapy, the better the results. A formal program for a pet's specific issues is ideal and is best based on the pet's individual joint extension/flexion measurements, force plate analysis, muscle circumference measurements, etc. If possible, a professional veterinary physical therapist should be consulted for a formal program.

Exercise should never be performed to the extent that it is painful for the patient.

The Pre-Exercise Warm-Up

When we talk about a warm-up before exercise, we literally mean warming the muscles. Warmth decreases stiffness and increases blood flow to the muscle. It also directly reduces pain. A warm wash cloth in a plastic baggie makes an excellent warm compress (test it on yourself to be sure it is not too hot) to put on stiff joints. The joints can be flexed and extended passively and the muscles gently massaged. A good five minutes of this is helpful prior to exercise.

Regular Low Impact Exercise: Daily

Arthritic joints rely on strong muscles for support yet arthritis pain leads to disuse and poor muscle conditioning. For this reason, regular exercise is an important foundation. Short walks or swims which do not leave the pet unduly sore the next day should be part of the daily exercise routine. Exercise helps reduce excess weight and keeps joints flexible. Exercise should avoid sudden spurts of speed and should be done at a steady pace, even if that pace is slow.

If the pet is sore after exercise, do not exercise until the pain seems to be resolved. Re-start the exercise at 50% of the duration. Fifteen minutes of ice packing can be applied to an acutely painful joint.

If you want to try increasing the exercise, try a 20 percent increase.

The Cool Down

At the end of the exercise period, a reduced pace of exercise is done as a cool down. Ideally, a five-minute slower pace of the exercise is followed by five minutes of massage.

What Is Passive Range Of Motion Exercise?

During warm-up and cool down, one of the techniques that can be used to assist flexibility is passive flexion/extension exercise, also called passive range of motion. Here the patient lies on his or her side with the side to be exercised up. Starting with the foot, the joints are flexed and extended through their natural range of motion moving up the leg all the way to the shoulder/hip. If the exercise causes discomfort (for example, dogs with bad hips are quite painful when the rear leg is extended backward), do not continue to a painful point. Ideally 10 to 15 flex/extensions are performed on each joint and this is done two to four times daily.

MedVetOhio, a large referral center, has put together these videos demonstrating PROM.

Rear Leg Passive Range of Motion

Front Leg Passive Range of Motion

How To Do Massage

There are many hand motions that can be used in massage:

Stroking
This is done with the palm of the hand on the pet moving from head to tail or from shoulder/hip down to toe.

Effleurage
This is also done with the hand on the pet and even pressure on the hand. Effleurage follows the opposite direction of stroking (toe to body). Over-lapping strokes are used to cover the entire body area.

Percussion
This involves tapping of the body with a cupped hand with light brisk contact. The hand can be positioned for a “karate chop” for percussion.

Friction
This uses the tip of the fingers to make small rotary motions.

There are, of course, many other techniques that can be used. Benefits of massage include increased circulation to the area, increased lymphatic flow, improved mobility of tissues, and relaxation. Any combination of these techniques can be used on the pet as time allows. As for more specific exercise, tilting boards can be used as can a stability ball. Swimming or a water treadmill is helpful as the water supports weak joints (though a proper pet life jacket is important). Sometimes agility exercises are in order. As always, the program is geared towards the lifestyle of the patient.

We hope these tips are helpful in keeping the poorly mobile pet functional. If your pet seems unduly painful or is not responding as expected, please contact your veterinarian.

If your veterinarian does not have a physical therapist on staff, ask for a referral.

 

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