Chapter 13 Evaluation and Rehabilitation Options for Orthopedic Disorders of the Canine Thoracic Limb 349effect on all aspects of function and move-
ment. Treatment plans should consider the
biomechanical properties of cartilage including
the need for manual compression forces to nor-
malize the inherent viscoelasticity of remaining
healthy cartilage (Kiviranta et al., 1987) and the
limited capacity for regeneration of damaged
cells. Treatment plans should also consider the
spectrum of musculoskeletal compensatory
changes related to arthrokinematic anomalies
(Table 13.3).
Peripheral nerve injuriesEach component of peripheral nerves—nerve fib-
ers, connective tissues, and vascular structures—
has specific biomechanical properties that are
considered when developing a treatment plan for
peripheral nerve injury. Axons alone are very vul-
nerable to compression and stretching injuries
(Rydevik & Nordborg, 1980). Three layers of con-
nective tissues, the endoneurium, perineurium,
and epineurium, provide resistance to compressionCase Study 13.2 T8 facet joint and rib dysfunctionSignalment: 3‐y.o. F/I Border Collie, training for
national agility team. Began knocking bars in training
3 weeks ago. No qualifying runs three weekends in a
row. Consistently completes a physical therapy con-
ditioning program.Diagnosis: Thoracic back pain. Thoracolumbar and
coxofemoral radiographs negative.Objective findings: Palpation: from T6 to wings of the
ilium, muscle spasm in spinalis and longissimus;
right iliocostalis lumborum muscle spasm and pain;
thoracic muscle spasms during extension active
range of motion; T8–T9 dorsoventral glide joint play
restriction 2/6; right rib 8 and 9 dorsoventral glide
restriction with discomfort; right latissimus dorsi and
serratus ventralis decreased flexibility.Assessment: Precipitous decline in jump quality of
unknown etiology beginning 3 weeks ago. Possible
T8–T9 facet joint hypomobility and rib dysfunction
causing decreased thoracic active range of motion
into extension and soft tissue restrictions which may
be limiting jumping quality.Plan of care:
Acute phase:(1) Normalize mobility of T8–T9 facet joint and
ribs: grade III and IV mobilizations to normal-
ize joint arthrokinematics.
(2) Normalize flexibility of latissimus dorsi and
serratus ventralis: laser 4 W, 8 J/cm^2 to mus-
cles from origin to insertion followed by
stretching, hold 30 seconds, repeat × 2
(3) Spine mobility home exercise program (HEP):
concentric spine extensors exercise to maintain
facet and rib mobility, 20 repetitions, twice
daily; eccentric latissimus dorsi exercises topromote natural deceleration of glenohumeral
joint extension required for jumping, 10 repeti-
tion, twice daily; stretch latissimus dorsi and
serratus ventralis, one repetition, hold 30 sec-
onds, twice daily.
(4) Activity restriction: no agility training, in par-
ticular jumping, until follow‐up appointment
in 1 week.Subacute phase: Reassess and modify plan of care as
needed. If facet and rib mobility remain normalized,
begin subacute treatment. If joint mobility is not nor-
malized, treat with joint mobilizations again and
reassess HEP.(1) Strength training HEP: continue concentric spine
extension exercises adding rotation and side
bending with spine extension, 20 repetitions,
twice daily; eccentric latissimus dorsi exercises
with spine in extended position to prepare for
jump training, 20 repetitions, twice daily; stretch
latissimus dorsi and serratus ventralis, one rep-
etition, hold 30 seconds, twice daily.
(2) Activity restriction: resume agility training,
low jump height, until follow‐up appointment
in 1 week.Chronic phase: Reassess and modify plan of care as
needed. If joint mobility remains normalized begin
chronic treatment.(1) Resume physical therapy‐based conditioning
program continuing eccentric latissimus dorsi
exercises with spine extended.
(2) Educate client to palpate for paraspinal pain,
which may indicate a joint mobility issue and
need for follow‐up treatment.
(3) Activity restriction: none, resume agility train-
ing without restriction.