178 Canine Sports Medicine and Rehabilitation
Overview
The principles of exercise physiology have been
well described in Chapter 3. The goal of this
chapter is to introduce the concepts of thera
peutic exercise as applied to the injured patient
as well as to the canine athlete needing to refine
fitness. Once the patient is discharged from the
therapeutic exercise program, it will progress to
a conditioning and/or retraining program as
described in Chapter 10. Therapeutic exercise
programs for dogs initially borrowed from
human therapeutic exercise research and
applied these principles to dogs. The field is
now describing how these techniques have
provided canine patients with successful return
to independence, competition, and work. In
addition to improving general conditioning for
any patient in a rehabilitation practice, the
employment of therapeutic exercise programs
also provides the often‐ overlooked benefit of
streng thening the human‐ animal bond
(Westgarth et al., 2014).
The basic principle that pain leads to muscle,
tendon, and ligament atrophy, which in turn,
causes instability of the joints with progressive
pain is well understood. What are the tech
niques that can be applied to the aging or
debilitated canine patient to prevent or reverse
this cycle? A Canadian study in humans found
that moderate exercise does not lead to accele
ration of knee arthritis whether or not there is
pre‐existing disease. Exercise improved physical
function and reduced pain, and was considered
an underused modality in the management of
osteoarthritis pain (Selten et al., 2016).
Therapeutic exercise programs focus on
proprioception and balance, weight shifting,
muscle strengthening, re‐education of normal
posture, and gait training. Proprioception and
balance work is important for puppies, athletes,
and for the neurologically impaired patient.
Weight shift training is used post‐injury or
postoperatively, initially training the patient to
use the affected limb, and later encouraging
appropriate weight distribution during acti
vities of daily living (Saunders, 2007).
Strengthening can focus on an isolated muscle,
limb, or body region. Posture re‐education
addresses the static postures (stand, sit, down)
as well as the transitions between these pos
tures. Gait retraining addresses the patient who
does not properly use one or more limbs or
who has developed an abnormal gait behavior
or pattern.
When planning a therapeutic exercise pro
gram, it is important to be aware of the differ
ences between two types of muscles: those that
tend to stabilize joints and those that create
motion. Stabilizing muscles tend to be shorter
bellied muscles that are situated closer to the
bone than mobilizing muscles, and they insert
closer to the joint. Stabilizers have more type
I fibers, and have a relatively short excursion
length. Type I muscle fibers are more readily
affected by disuse than type II muscle fibers.
Mobilizing muscles are more superficial,
generally with longer bellies and tendons,
creating a longer lever arm and excursion, and
they have more type II fibers. Type II muscle
fibers atrophy in the geriatric dog by up to 25%,
simply as an aging change.
Stabilizer muscles are less commonly diag
nosed with strain injuries than their mobilizer
counterparts (Newsholme et al., 1988; Latorre
et al., 1993) but in the author’s (L.M.) experience,
they are more likely to have myofascial trigger
points leading to diminished function and
altered active range of motion. A lack of harmony
between the stabilizers and the mobilizers can
result in muscle imbalances and injury.Need for exercise
All healthy working dogs, including competi
tive sporting, hunting, and service dogs, need
regular exercise to maintain optimal health.
Even conformation dogs need regular controlledtain client and patient motivation. The progression of the exercises depends upon the
patient response, which is evaluated during each session. Categories of exercises include
proprioception, balance, speed, endurance, focal strength, pelvic limb‐specific, thoracic
limb‐specific, neurorehabilitation, and land treadmill endurance training.