The benefits of physical therapy for people are well established. While studies into its effect on veterinary patients are less comprehensive, the goal of treatment—to optimize a patient's mobility and comfort level regardless of their underlying health status—is equally relevant.
Conditions Amenable to Treatment with Physical Therapy
Any health condition that adversely affects a pet's ability to move and be comfortable can potentially benefit from physical therapy. Examples include:
- Injuries to joints, bones, or soft tissues
- Post-operative rehabilitation
- Osteoarthritis (degenerative joint disease)
- Intervertebral disk disease
- Degenerative myelopathy
- Hip or elbow dysplasia
- Other diseases affecting the nervous system and/or musculoskeletal system
Any pet that is willing to participate in physical therapy exercises can benefit from a program tailored to his or her individual needs.
What is Physical Therapy?
Physical therapy is defined as "therapy for the preservation, enhancement, or restoration of movement and physical function impaired or threatened by disability, injury, or disease that utilizes therapeutic exercise, physical modalities (as massage and electrotherapy), assistive devices, and patient education and training." The focus of intervention is on promoting a pet's strength, flexibility, body position awareness, balance, and endurance. Medications or surgical interventions are not considered part of physical therapy, but can certainly play a role in the overall management of a patient's condition.
In some cases, the bulk of a pet's physical therapy needs can be handled by the animal's owners under the supervision of a primary care veterinarian. Relatively simple procedures that can usually be performed in the home environment include:
- The application of cold packs to reduce swelling, pain, and other signs of inflammation
- The application of warmth to promote blood flow to an area and relieve stiffness
- Massage to increase blood flow and alleviate stiffness
- Passive range of motion exercises—the caretaker gently flexes, extends, and/or rotates the patient's joints to the point where mild tissue resistance is felt
- Passive stretching—the caretaker pushes the joints a little more than occurs with passive range of motion exercises
- Active range of motion exercises and stretching—the patient performs activities that move joints and stretch soft tissues
- Walking in hand—walking a pet using a short leash or lead rope is an important and commonly used form of veterinary physical therapy. Initially the pace should be kept slow, the time limited, and the terrain relatively even and flat. Slippery surfaces should be avoided. As the patient recovers, longer time periods, faster gaits, and/or the addition of inclines, declines, and stairs can be added to the regimen.
- Sit to stand, lay to stand, and similar exercises
- Weaving between poles or cones set in a line or walking in a figure eight pattern
- Stepping forward, backward and side to side
More complicated cases benefit from the involvement of a veterinary physiotherapist who is trained in the of physical therapy equipment such as:
- Cavalettis—poles set on blocks of varying heights and distances apart over which patients must step
- Physioballs—large, slightly flattened, inflatable balls that pets can stand on or drape their bodies over
- Rocker or Wobble boards—unstable platforms on which pets stand
- Balance blocks—blocks that can be slid in various directions while pets are standing on them
- The addition of weights or resistance to any exercise
- Underwater treadmills—exercise on an underwater treadmill allows animals to move their bodies as they do during normal activity while the water supports a large proportion of their body weight
- Swimming—this is a very strenuous activity and most pets rely primarily on their front legs while swimming. While it can be helpful in certain situations, it can be ineffective or even contraindicated in others.
- Transcutaneous electrical nerve stimulation (TENS)—the application of electrical current to nerves to promote muscle contractions and/or alleviate pain.
Expectations of Physical Therapy
The benefits of physical therapy can't be overlooked. After illness, injury, or surgery, some veterinary patients have trouble regaining satisfactory function and/or comfort levels without it. For example, a study published in 2006 found that six weeks after dogs had surgery to repair a ruptured cranial cruciate ligament, multiple physiological and anatomical parameters had returned to normal when the dogs received intensive physical therapy but not with hand walking alone. Without physical therapy, even the most flawlessly performed surgical procedure may not be fully successful.
"Any health condition that adversely affects a pet's ability to move and be comfortable can potentially benefit from physical therapy."
For chronic or progressive diseases like osteoarthritis, physical therapy may not result in a full return to normal function. However, it is certainly one of the best ways to help pets maximize their ability move and their quality of life.
The downsides of physical therapy are limited. It should not be painful. Typically, pets look forward to their appointments and seem to understand that the exercises are making them feel better. If a patient does appear uncomfortable during or after a therapy session or seems to resent the activity, the animal's owner, veterinarian, and therapist should confirm the diagnosis, alter the physical therapy protocol, and/or determine whether additional pain relief would be beneficial. Anti-inflammatory medications (e.g., Rimadyl, Etodolac, Deramaxx, Metacam), other types of analgesics like tramadol or buprenorphine, nutritional supplements (e.g., Dasuqin, Cosequin, Glyco-Flex), weight loss, therapeutic low-level laser therapy, acupuncture, and other interventions can all work in concert with physical therapy to promote patient well-being.
Feline physiotherapy and rehabilitation: 1. principles and potential. Sharp B. J Feline Med Surg. 2012 Sep;14(9):622-32
Feline physiotherapy and rehabilitation: 2. clinical application. Sharp B. J Feline Med Surg. 2012 Sep;14(9):633-45
Effects of caloric restriction and a moderate or intense physiotherapy program for treatment of lameness in overweight dogs with osteoarthritis. Mlacnik E, Bockstahler BA, Müller M, Tetrick MA, Nap RC, Zentek J. J Am Vet Med Assoc. 2006 Dec 1;229(11):1756-60.
Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. Monk ML, Preston CA, McGowan CM. Am J Vet Res. 2006 Mar;67(3):529-36.
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