Physiotherapy and Rehabilitation

 

Introduction

There are many physical therapy techniques that can be suitable for our pets, some need special training so are only available in the surgery, but many can be adapted for you to use on your pet at home.

Physical therapy can be used in:

Post operative cases for pain management and an improved rate of recovery &  to speed of return to function.

Conservative treatment in arthritic patients again for pain management, but also the maintenance and rebuilding of muscle mass, and improvement of joint function.

Weight control Diet is obviously vital but also physical therapy can help if there are painful problems in  management of that pain, maintaining muscle mass, joint function and cardiovascular training.

 

Thermotherapy

Heat stimulates vasodilatation,  aids in analgesia, can help reduce ischemia and releases  muscle tensions. Use before exercise & where there is a limited range of movement, to increase connective tissue extensibility before stretching exercises.

Can also be used in painful tight muscles. But it will exacerbate  the inflammatory response so do not use within the   first 48hrs of injury.

It must not be used with malignant tumours, vascular disease or extreme obesity.

Cold promotes vasoconstriction, reduces blood flow, reduces cellular metabolism & permeability, decreases sensory & motor nerve conduction velocity, also promotes analgesia.

Use during  the inflammatory phase of tissue healing, to prevent or reduce trauma induced oedema, muscle spasms and after exercise to prevent swelling & for analgesia. Do not use with vascular disease, hypertension and decreased sensation.

To avoid damage  you must wrap hot/cold packs in towels, must inspect skin before application after 4-5mins, 10min & at the end of treatment

 

Massage

Analgesia  is produced by endorphin release. It also helps to reduce muscle tightness and can be used to release trigger points. It increases mobility, improves circulation, lymph flow & reduces stress hormones.

 

Electrotherapy

Can be used for pain control. Low frequency currents through TENS or TSE  machines act via stimulating small fast nerve fibres and blocking the fibres that carry pain signals to the brain.

TENS can also be used for muscle strengthening- before, then in combination with, active exercises.

Range of Motion Exercises

Passive– i.e. Without active muscle contraction from the patient, within available ROM using external force.

Active Assisted ROM exercises-  the therapist guides joint motions and  to some degree the  patient's muscle activity assists joint motion e.g. slings/treadmill/while swimming

Active ROM- active muscle contractions without assistance e.g. swimming, treadmills walking in sand, tall grass, crawling through tunnels, cavaletti etc.

Used  to improve joint motion, increase flexibility, prevent adhesions after surgery or trauma, remodel periarticular fibrosis, improve muscle and soft tissue extensibility.

Maintaining and rebuilding muscle mass, strengthening muscles

Muscles act as 'shock absorbers' & support joint function – so muscle atrophy leads to abnormal stress on joints & risk of further damage. Depending on the  individual  this will range from assisted standing through active assisted standing (Swiss balls, balance boards etc) to lead walking (must be interminably slow to make dog walk using leg) to stair climbing, inclines, cavaletti, wheelbarrowing, dancing, hydrotherapy etc.

 

Proprioceptive training

To improve balance & coordination. Can use weight shifting on different substrates, gym balls, balance boards etc.

Joint Mobilization

When restrictions motion cause pain/stiffness during normal physiological movement, including accessory joint motion (e.g. shoulder flexion produces an inferior movement/glide of the humerus on the glenoid). Contraindications; ankylosis, undiagnosed lesions, malignancy, acute inflammatory conditions, instability, severe sprain/spasm & osteoporosis.

Arthritis

The synovial pump mechanism of the joint  facilitates the  transfer of nutrients & waste exchange by diffusion, but it needs extension/flexion & load bearing to work. Therefore to maintain joint health an appropriate amount of work is needed. This will vary from individual to individual as to whether this is active or passive exercise, and the level that is suitable.

 

Physical Therapy Programs:

As you can see there are many different applications of physical therapy, many of which have only recently been advocated in veterinary practice. Inappropriate use of these modalities can do more harm than good, so it is vital that there is a thorough assessment of your pet so that the appropriate techniques can be employed, and a program devised for you to continue at home.