Different goals will be set depending on each specific case, such as: Eliminate pain and inflammation, reduce lameness, maintain and/or improve the range of movement, maintain muscle tone, mass and strength, minimize or slow the effects of joint degeneration –osteoarthritis-, avoid compensations and provide the animal with maximum capacities so that it is functional and can have a good quality of life.
Stage I: Control of pain and reduction of inflammation and swelling. If the animal is in pain, it will not accept being handled and you wil not be able to achieve the desired objectives. During the first few days it’s important to treat the inflammation and pain, as well as prevent muscular atrophy from appearing and a decreased joint arch. Different passive techniques are used to reduce inflammation, producing analgesia and helping to maintain the muscle tone, mass and range of motion. These techniques include electrotherapy (analgesic currents, TENS), massages, passive movements and cryotherapy (cold), magnetotherapy (magnetic fields), ultrasounds that reduce inflammation and swelling, and laser. At the beginning of recovery these applications must be combined with the drug therapy that the referring veterinarian has prescribed as necessary.
Implementing these methods is beneficial because they produce analgesia and therefore the intake of pharmaceutical drugs can be reduced; which is a big advantage for animals that cannot take certain medications because their system will not allow it.
Stage II: Increase range of movement and flexibility of the soft tissues. As long as there are no veterinary contraindications it is important to massage and move the injured area from the beginning, always respecting the healing period and union of the stabilized parts in the case of internal fixation. Massaging or moving the affected area or limb will help to maintain mobility, prevent the loss of muscle mass and tone and will work the proprioceptors.
Gentle mobilization combined with different massage techniques will help reduce inflammation and pain.
Once the acute stage has passed, 48-72 hours, and without risk of infection or inflammation, heat can be introduced that will help elasticize the tissues, reduce pain and increase blood supply.
At the beginning and end of the session cold is used due to its properties that act on reducing the inflammatory response, swelling and pain.
Phase III: Increase muscular mass and strength. Muscular electrostimulation helps prevent atrophy from occurring and maintains muscle mass and tone. With electrical stimuli we can stimulate nerve conduction.
Other exercises such as walking in water or walking on carpet can also help increase mass and strength.
Stage IV: Gait training. On the fourth day and during the following two weeks, when the inflammation and pain have disappeared, it is time to introduce simple active exercises. For the forelimbs the exercises will use light objects, such as a duster, feather… to make the animal move the affected limb. For the hindlimbs, you can place a harness on them and start to take them for short walks within a closed space so that the animal is forced to support the four limbs equally, thus preventing imbalance among the limbs due to an improper support on the ground. The walking exercises will increase in length until the end of recovery. It seems strange to force a cat to walk around a room, however it is a very rewarding exercise, especially during the first few days of recovery. Once the initial stage has passed, you can let the cat walk on its own or with help from a toy that will force them to move.
If there are no veterinary contraindication and the wounds have properly healed without any stitches, the animal can be introduced into water, granted the feline permits it. The benefits of water are used to improve recovery. Hydrotherapy (underwater treadmill) helps the animal’s stance without losing balance, and thanks to flotation, without having to support all of its weight. Furthermore, flotation allows us to work with animals with bone pain and reduced muscle mass. The water pressure exerted on the animal’s body increases sensitivity and reduces inflammation and swelling. The work done in water, underwater treadmills or swimming, will increase as the animal recovers. In addition, we can use the water to recover the motor pattern, increase muscle mass, tone and strength, work on breathing capacity and maintain and/or improve mobility.
Stage V: Return to normal life. Already in the last stage, when two weeks have gone by and the cat has integrated its gait pattern, exercises are used to improve the quality of movement. These are more complete, active exercises that integrate the affected limb/s. With the active exercises and proprioception, the muscle tone, mass and strength increase; coordination and balance are worked on as well as the range of movement. Tracks with different surfaces are used, such as cones, bars and circuits.
It is important to monitor the animal’s weight during and after recovery. An excess of weight will hinder recovery and can contribute to the development of secondary problems, in addition to damaging the joints.
Marta Subirats Laguarda
Dog physical therapist graduate of the University of Tennessee
Technical Specialist Ortocanis.com