Front Matter

Chapter 5 Introduction to Canine Rehabilitation 107

the injury, or that might potentiate the risk of
re‐injury or subsequent injury. Movement dys­
function can be defined as incompetent move­
ment that requires compensation to complete a
functional task or that results in an inability to
complete the task. Understanding the causes of
(or impairments leading to) a movement dys­
function is paramount in selection of an interven­
tion (e.g., manual therapy, therapeutic exercise
with neuromuscular facilitation techniques) that
will correct the movement dysfunction.
An example of a movement dysfunction is a
dog who performs a stand to sit or sit to stand
transitional movement with the right pelvic
limb externally rotated and abducted. Further
examination reveals that he has reduced tar­
sal flexion passive range of motion (PROM),
reduced stifle flexion PROM, pain on flexion of
the right pelvic limb (hip, stifle, and tarsus),
stifle effusion, right pelvic innominate caudal
rotation, reduced weight bearing of the right
pelvic limb in standing, and muscle atrophy
(reduced girth or muscle mass) at the right

thigh. This movement dysfunction could have

implications in higher level functioning tasks,

such as stair climbing or jumping. The begin­

ning of a jump requires the dog to function in a

preparatory, spring loaded hip, stifle, and tarsal

flexed position, releasing this potential energy

in an explosive launch out of this position into

one that is extended. In essence, these are the

same joint positions required to sit correctly.

Movement dysfunction in a stand‐to‐sit or

sit‐to‐stand transitional movement will have

implications in the performance of a jump that

requires a higher level of control to manage sig­

nificantly higher ground reaction forces.

Moreover, the muscle tension created immedi­

ately prior to initiation of the jumping motion

creates compressive forces on the joints, espe­

cially the stifle, as the muscle groups cross this

intermediate joint. If the dog cannot sit without

compensation, he will be unable to jump without

compensation, putting the stabilizing ligaments

and musculotendinous tissues at risk for injury

with higher and asymmetric loads.

Case Study 5.2 Rehabilitation Grade 2 medial patellar luxation through collaborative efforts

of a board‐certified veterinary surgeon, massage therapist, and physical therapist

Signalment: 3 y.o. F/S miniature Poodle who com-

petes in agility.

Presenting complaint: Patient intermittently three‐

legged (non‐weight bearing left pelvic limb) lame for

past 2 years, walking it off after a couple steps.

Recently, lameness has progressed in frequency and

interferes with agility training and competition.

Patient has had massage therapy, by a massage

therapist certified in canine massage techniques,

every other month for the past 1½ years to treat tight

muscles from her agility performances and  the

muscle spasm believed to cause the lameness. Patient

presented to surgeon who diagnosed a Grade 2

medial patellar luxation and performed tibial tuber-

osity transposition due to the recent increased fre-

quency of symptoms and client’s desire to return to

agility as quickly as possible. Prescribed Clavamox®,

tramadol, and Rimadyl® upon discharge from the

surgical hospital and referred to physical therapist

certified in canine rehabilitation at suture removal

(10 days post‐op).

Current treatments: Medications as prescribed by

the surgeon.

Rehabilitation evaluation

Gait/stance: Decreased weight bearing on the left

pelvic limb with grade 5/6 lameness at walk, grade

6/6 at trot. Shortened stride on left pelvic limb with

decreased hip extension at terminal stance phase

of gait. Standing toe‐touch weight bearing. Client

reports patient holds limb non‐weight bearing when

going up two steps into house.

Appearance/posture: Incision healing well with no

drainage, heat, or redness. Patient holds left pelvic limb

in slight hip and stifle flexion and tarsal extension.

Postures with kyphotic lumbar spine with pelvis rotated.

Palpation: Mild effusion at the peripatellar region

with tenderness over incision. Moderate muscle ten-

sion/tone at left hamstrings, rectus femoris, iliopsoas,

quadriceps, and lumbar epaxial region. Left anterior

iliac rotation relative to right.

Transfers: To sit and sternal from standing with weight

shifted slightly off the left pelvic limb. Does not use

left pelvic limb to push off when transferring to or

from sit or sternal.

(Continued)