Canine Cruciate Ligament Injuries

 

Cruciate ligament tears are one of the most common injuries in dogs. Traditionally, treatment is directed toward surgical correction or conservative care. The goal of surgery is to stabilize the joint. The focus of conservative treatment is pain management and rest. Rehabilitation is complementary to both of these approaches. The goal of rehabilitation is to maintain normal range of motion in the joint and to help with return to normal function and strength.

Below is a protocol for rehabilitation of a dog with a cruciate ligament injury. Note that exercises and treatment modalities will be individualized to reflect each dog’s healing.

Canine Cruciate Ligament Injuries – a Rehab Protocol

First 10-14 days post-op / post-injury: early healing

  • Ice 2-3 times daily, 5 minutes on, 5 minutes off, 5 minutes on. Be sure to protect the skin by placing a towel between the skin and the ice pack.

  • Passive range of motion (PROM) – perform twice daily, within the dog’s pain tolerance.

    • Flex and extend the stifle

    • Flex the hock, allowing the stifle to flex at the same time

    • Extend the hip

  • Home management: no running or jumping, caution on stairs, outside on a short leash only for toileting; no off leash play for at least 8 weeks. Confine the dog to a crate if he will be unsupervised.

  • Note: if your house has slick floors, you may need to put down rubber-backed rugs to help with traction while your dog is healing.

  • Laser twice weekly to help with healing, pain management, and inflammation

  • Joint compressions done by therapist twice weekly to help with pain management, joint health, and proprioception.

  • Electrical muscle stimulation (NMES) – twice weekly, to the glutes and hamstrings to help maintain strength.

  • Continue pain management as prescribed by your veterinarian

  • Advise owner about joint supplements to help maintain joint health.

 

2-4 weeks post-op / post-injury: early strengthening

  • Continue as above
  • Start gentle weight shifting exercises to promote weight bearing
  • Start active range of motion (AROM) exercises
  • Owner can start taking their dog on leash walks. Start with 5 minute walks and extend walks by 5 minutes each week. If the dog shows any signs of soreness, then the walks should be shortened for a few days. It is important that the walks be on the flat, with a good walking surface.
  • Underwater treadmill may be started at this time (any skin incisions must be healed).

 

4-8 weeks post-op / post-injury: progressive strengthening

 

  • Continue PROM and weight bearing exercises daily
  • Leash walks are increased to 15-20 minutes daily. Slight hills can be started during this time.
  • Progress AROM exercises as tolerated
  • Continue underwater treadmill, NMES, Laser as needed
  • At the end of 8 weeks, off leash activity may be started. Start with 5 minutes at the end of a leash walk and progress from there.

 

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