Front Matter

402 Canine Sports Medicine and Rehabilitation

Gastrocnemius rupture with intact superficial
digital flexor

● Plantigrade stance, with stifle extension,
and flexion of the two proximal phalangeal
joints
● Toe-down weight bearing to PWB.

Complete rupture

● Non-weight bearing.

Treatment rationale

Efforts are focused on soft tissue nutrition
and managing the delicate balance between
protecting the tendon and minimizing the
damaging effects of immobilization. Gentle
tensile force is used to promote collagen fiber
realignment and healing and to minimize
adhesion formation (Lake et al., 2009). In human
medicine, there has been a shift toward earlier
postsurgical mobilization in an effort to
increase blood supply, improve ROM, and
decrease atrophy (Sorrenti, 2006). Animal
studies have shown that early motion can
safely begin at the end of fibroplasia or about
14–21 days postoperatively (Sivacolundhu
et  al., 2001). Gentle eccentric exercises are
introduced in the subacute phase of healing
(Cook et al., 2002; Pull & Ransonb, 2007).
Gently increase ROM and gradually progress
muscle strengthening.

Treatment by goal

Decrease pain and swelling

● Ice, laser, NMES, TENS, joint compressions,
and STM.

Promote soft tissue nutrition

● Massage gastrocnemius muscle belly with

strokes toward the tendon for increased

circulation.

Promote fiber realignment

● Gentle friction massage

● Gentle PROM into tarsal flexion.

Minimize adhesion formation

● Gentle friction massage.

Gradually increase ROM

● Progressive tarsal PROM

● Progressive AROM exercises such as

walking and sit-to-stands.

Gradually increase muscle strengthening

● In the subacute phase of healing, initiate

eccentric exercises such as backward walk-

ing, and progress to backward walking

downhill

● Progressive gastrocnemius strengthening

(concentrically) such as step-ups and uphill

walking.

Conclusion

In conclusion, the effectiveness of a rehabilita-

tion program depends on several key compo-

nents. First, a skilled and thorough evaluation

should be performed. A solid understanding

of anatomy and biomechanics is required for

Table 15.4 Classification of Achilles injuries

Type Pathological change Clinical signs

I Complete tendon rupture Plantigrade stance; palpable tendon defect

IIa Musculotendinous rupture Increased tarsal flexion; inflammation at

musculotendinous junction

IIb Tendon rupture with paratenon intact Increased tarsal flexion; tense paratenon palpable

IIc Gastrocnemius tendon avulsion, with intact

superficial digital flexor

Increased tarsal flexion; excessive flexion of digits

III Tendinosis and/or peritendinitis Normal stance; thickened Achilles tendon