Front Matter

398 Canine Sports Medicine and Rehabilitation

● Promote weight bearing. For example:
❍ Joint compressions (weight-bearing and
NWB positions)
❍ Weight-shifting exercises
❍ Slow walking
❍ Cavaletti walking
● Increase hip extension PROM: PROM into
hip extension with STM of the rectus femo-
ris, sartorius, and iliopsoas
● Improve proprioception. For example:
❍ Standing perturbations
❍ Ladder walking
❍ Wobble board, fit disc, cushion with the
pelvic limbs on the piece of equipment
● Increase strength of hip musculature. For
example:
❍ NMES
❍ Three-leg stands
❍ Therapy band exercises

❍ Backward walking

❍ Side stepping

❍ Incline and zigzag walking

❍ Step-ups.

Patellar luxation: grades I–II medial

luxation; nonsurgical

Common findings on physical therapist’s

evaluation

● Abnormal patellar stability test

● Skipping gait and/or kicking leg into hip

and stifle extension

● Thigh atrophy

● Compensatory tightness of sartorius, quadri-

ceps, hamstrings, and hip flexors

● Compensatory posture (increased flexion of

lumbosacral, coxofemoral, and stifle joints).

Case Study 15.1 Hip pain with secondary muscle impairments

Signalment: 6-y.o. F/S Golden Retriever.

Presenting complaint: Right pelvic limb (RPL)

lameness; refuses to jump into car or onto bed.

Evaluation: Physical exam WNL except:

Gait: Shortened stride length and stance time of

RPL on moderate incline and clockwise circles;

patient stops frequently to sit down.

Transfers: Appears mildly painful and slow with

sit-to-stand and recumbent-to-sit.

Atrophy: Minimal to moderate R gluteals and thigh

muscles.

Palpation: Tender R middle gluteal and pectineus

muscles

PROM: R hip extension 135.

Flexibility: Moderate tightness of the iliopsoas,

pectineus, sartorius, and medial hamstrings.

Strength: Fair grade with three-leg stand test with

inadequate contraction of gluteals, quadriceps, and

hamstrings; poor grade with diagonal leg lift.

Joint play: Grade 2+ R coxofemoral hip traction.

Assessment: right hip pain, restriction, and weakness

likely due to early-onset R hip osteoarthritis.

Problem list:

● Decreased R hip extension

● Tenderness at middle gluteal and pectineus

● Tight R iliopsoas and pectineus

● Weak R gluteals, quadriceps, and hamstrings

● Weight-bearing sensitive

● Decreased endurance.

Goals:

● Improved symmetry in gait in 6 weeks

● Symmetrical sit-to-stand transfers in 6 weeks

● Ability to walk up 10 stairs with minimal diffi-

culty in 8 weeks

● Return to 1-hour hikes in 10 weeks.

Treatment:

(1) Modalities:

● Laser to R gluteal region, coxofemoral joint

region and pectineus.

(2) Manual therapy:

● Grade III coxofemoral joint distractions

● Passive stretch of R iliopsoas, pectineus,

sartorius, and medial hamstrings muscles

with simultaneous STM of the muscle

● STM throughout hip and thigh

● Gentle hip extension PROM.

(3) Therapeutic exercise:

● Hip strengthening (gluteals, biceps femoris,

quadriceps)

● Emphasize underwater treadmill for first

2–3 weeks, and then progress to land-based

exercise

● Include isometric, concentric, and eccentric

exercises, gradually increasing the level of

difficulty, frequency, and intensity.

(4) HEP:

● Instruct client in gentle PROM and stretching

exercises as well as a detailed progressive

strengthening program

● Initiate core stabilization as tolerated.