344 Canine Sports Medicine and Rehabilitation
the care plan includes intensity, frequency, and
duration, and dosing parameters that are based
on anatomic, physiological, and biomechanical
principles. The therapist must consider the
need to modify treatment parameters through-
out the plan of care since the location, tissue
type, and acuity of the injury has a profound
impact on intensity, frequency, and duration of
all types of treatment interventions.
Types of treatment interventions
Treatment interventions can be divided into
three categories: modalities, manual tech-
niques, and therapeutic exercise.
Modalities are the application of technologies
that affect cellular physiology in well‐defined
ways to diminish pain, promote soft tissue heal-
ing, improve muscle extensibility, and facilitate
muscle strengthening. See Chapter 7 for details.
Manual techniques are the application of
hands‐on treatments that mechanically and
physiologically affect tissues to decrease pain,
increase circulation, reduce swelling, increase
soft tissue extensibility, and normalize joint
mobility. Although modalities can generally be
safely performed with minimal education, the
application of manual treatments requires
extensive training, as incorrect application of
mechanical forces through soft tissue can be
detrimental. See Chapter 6 for details.
Therapeutic exercise is the application of
precise movements to recruit specific skeletal
muscles in functional ways and includes bal-
ance, strength, and endurance exercises.
Proper application of therapeutic exercise
requires a thorough understanding of muscle
origins and insertions, type of muscle contrac-
tions, muscle fiber type, motor recruitment,
and motor timing. For example, the exercises
demonstrated in Figure 13.9 are specific for
the subscapularis and superficial pectoralis,
two muscles that provide dynamic stability to
the medial joint line of patients diagnosed
with medial shoulder instability. See Chapter 8
for details. Application of exercises without
consideration of muscle anatomy and physi-
ology can, at minimum, prevent return of
function, and, at worst, exacerbate an under-
lying condition.(A) (B)Figure 13.9 (A, B) Therapeutic exercise planning takes into consideration the origin and insertion of the muscle, the
type of muscle contraction required, and the intensity, frequency, and duration of the exercise. This exercise
demonstrates concentric superficial pectoral and subscapularis contraction of the ipsilateral limb and eccentric
contraction of the same muscles of the contralateral limb. This exercise may be appropriate for the strengthening
(chronic) phase of treatment for medial shoulder instability. (Images derived from video.)