Front Matter

Chapter 14 Disorders of the Pelvic Limb: Diagnosis and Treatment 355

to an inaccurate suspicion of a cranial cruciate
ligament (CCL) or medial collateral ligament
injury. The authors also see this muscle group
affected in canine athletes evaluated for perfor­
mance issues that have been previously attrib­
uted to nonresponsive iliopsoas muscle strains.
The pes anserinus insertion site can serve as a
source of discomfort following knee surgery, as
tibial osteotomies (tibial plateau leveling oste­
otomy, tibial tuberosity advancement) require
elevation and reattachment of this tendinous
insertion.

Proximal sartorius strain

In performance dogs, proximal sartorius strains
are appreciated as a primary condition or
in  conjunction with iliopsoas strains. In one
author’s (FL) experience the sartorius muscle
is often the more painful culprit and more
limiting factor for comfortable hip extension.
The sartorius muscle, amongst other soft tis­
sues, can also experience secondary strain due
to compensation related to chronic lameness
from other orthopedic or neurological condi­
tions, or in the postoperative period. Within a
sports medicine‐heavy rehabilitation department,
in which canine athletes are seen for mainte­
nance therapies, the rehabilitation therapist
may routinely find this region inflamed and
in need of therapy despite the patient showing
no overt lameness.

Diagnosis

Lameness associated with these muscle strains
ranges from subtle intermittent offloading to
significant even non‐weight‐bearing lameness,
and is typically exacerbated by return to activity.
A shortened stride and stiffness in the pelvis
is a common presentation in fit dogs, whereas
a more severe lameness may be noted in the
companion or geriatric patient. Agility perfor­
mance‐related issues such as knocking bars
with the pelvic limbs, avoidance of tight
handling, and slowing within the weave poles
are common complaints. In working dogs, the
client may report reluctance to jump up for
bite work or scaling heights, as well as fatigue
appearing sooner than expected. With knowledge
of soft tissue anatomy and understanding of

muscle function, specific muscle stretch tests

can be used to help determine pain sources

and appreciate reduced function. The clinician

should palpate gently, being sensitive to muscle

rigidity, prominence, and asymmetry, spasms

or fine fasciculations, and stretch reluctance.

If the patient is amenable to laying in lateral

recumbency, muscle/tendon flexibility testing

may be easier to appreciate as well as being

more comfortable for the patient.

Iliopsoas

Tightening, discomfort, and spasm may be

noted on direct palpation of the myotendinous

unit (Figure 14.2), or when stretching the

muscle by placing the hip in extension with

abduction, or extension with internal rotation

of the limb (Figure 14.3). Soft cupped hands can

apply an upward, medially directed pressure to

assess the body of the psoas. Most dogs will

show discomfort when simply palpating the

affected regions with superficial consistent

pressure, thus heavy or deep pressure to induce

a spasm is not recommended or necessary.

The groin is a particularly sensitive region for

normal dogs and one must be careful not to

overread or create false reactivity. Lower spine

discomfort and pelvic alignment should also be

evaluated for their relationship to these muscle

groups and potential correlation in treatments.

Figure 14.2 Tightness, discomfort, and spasm may be

noted on direct palpation of the myotendinous unit of the

iliopsoas.