396 Canine Sports Medicine and Rehabilitation
● Adults may appear slow to rise from lateral
recumbency or sitting, using the forelimbs
to pull themselves into the standing posi-
tion. During gait, diminished stride length
and stance time is noted on the involved
side(s)
● Transfers, gait, and activity may be painful
● Puppies may require multiple attempts to
get from sit to stand and display poor muscle
control in transitioning between gaits
● Coxofemoral joint laxity (puppies)
● Positive hip subluxation test(s) (puppies).
Treatment goals—adult
● Decrease pain
● Decrease hypertonicity of pectineus
● Maintain/improve ROM
● Increase flexibility—iliopsoas, pectineus
● Increase strength—gluteals and thigh
● Increase joint proprioception
● Improve core stabilization
● Manage weight
● Develop home exercise program (HEP).
Treatment
Treatment options will depend on patient age,
current level of function and extent of arthritis.
Treatment rationale
● Puppy: slow the progression of growth
and weight gain, modify activities, and
strengthen hip stabilizers and core muscu-
lature. Address pain, if present.
● Adult: address pain, modify activities,
address weight management, strengthen
hip stabilizers and core musculature, and
maintain/improve ROM and flexibility.
A multimodal approach to the osteoarthritic
patient should be established and frequently re-
evaluated. Human research emphasizes the
importance of skilled manual work, suggesting
that it is more effective than exercise in treating
hip function and pain (Hoeksma et al., 2004).
The authors of this study correlate high intra-
articular pressure due to restriction of the joint
capsule in osteoarthritis, with pain intensity
and reduced hip ROM. Their study found that
manual therapy (manipulation and stretching)
aimed at increasing the elasticity of the joint
capsule and surrounding muscles was most
effective in reducing pain and increasing ROM.
Additional research in humans has shown that
aquatic therapy had some short-term benefits
for the osteoarthritic patient but no long-term
effects were demonstrated (Bartels et al., 2007).
Therefore, aquatic therapy may be best utilized
in the early stages of rehabilitation. An individ-
ualized approach to treatment of this common
condition should include frequent modification
as the animal progresses through the treatment
process.Treatment by goal
See the chapters covering modalities (Chapter 7),
manual therapy (Chapter 6) and therapeutic
exercise (Chapter 8) for details regarding imple-
mentation of the following treatments.Pain management
● Laser
● Heat
● Joint compressions at hip performed in
slight hip abduction and flexion
● Grade I and II coxofemoral joint distraction
● Transcutaneous electrical neuromuscular
stimulation (TENS).Decrease hypertonicity of pectineus
● Ischemic compression.Maintain/improve range of motion
● PROM: all motions with emphasis on hip
extension as tolerated
● Soft tissue mobilization (STM): to promote
circulation; increase ROM restricted by
soft tissues with particular attention to the
gluteals, quadriceps, hamstrings, and par-
aspinals; and address trigger points and
myofascial restrictions
● Joint mobilization: grade III coxofemoral
joint distraction traction.Increase flexibility
● Passive stretch: iliopsoas and pectineus
● STM: cross-fiber and effleurage to iliopsoas
and pectineus.