Laurie's Blog

25 Jun 2017

Mobilizing the hypermobile joint

Joint Laxities

Laurie Edge-Hughes, BScPT, MAnimSt (Animal Physio), CAFCI, CCRT

 

This blog topic comes from a blog I found about whether or not it is appropriate to mobilize a painful lax ankle sprain.  http://www.themanualtherapist.com/2017/04/mmt-q-should-i-mobilize-painful-lax.html

 

And the answer I think is interesting, and should be thought about for both humans and our canine companions.  

 

So firstly, let’s think about where pathologic laxities might occur in our canine patients:  Full ACL tears; Medial Shoulder Instabilities; Carpal Hyperextension; Hip dysplasia; Lumbosacral Instabilities & Other Spinal Hypermobilities (non-surgical).  Secondly, it’s important to also note that mobilizations have effects not only on mobility (i.e.  stretching of tight ligamentous or fascial structures) but also on neural imputing and blood flow.

 

If in the case of a ‘lax’ joint, the patient (animal or human) is fearful of loading the joint (i.e. off-loading or making postural compensations), then return to function and appropriately strengthening isn’t possible.  Manual therapy gives us a window into the nervous system in order to reduce fears of loading a limb (i.e. as in a full CCL tear) or moving into certain postures (i.e. extension of the lumbosacral junction in dogs with lumbosacral disc disease), or to reduce pain signaling from a joint.

 

A bonus is that research studies have found that mobilizations have been able to increase strength in adjacent muscles and improve limb stability (i.e. single leg standing) as well.  So, mobilizing may actually affect proprioceptive awareness and balance in a limb.

 

Some of the real neurophysiological magic happens when joints are mobilized nearer to end range (i.e. grade 3 or 4 mobilizations).  So, the original blog post states, we shouldn’t fear mobilizing into these ranges so long as there is no pain or apprehension experienced by the patient.  (If there is, then stick with grades 1 - 2's.)

 

What would I do with each of the following scenarios?

 

Full ACL:  Cranial and caudal glides

Medial Shoulder Instabilities: Medial and lateral glides

Carpal Hyperextension:  Cranial glides of the carpal bones

Hip Dysplasia: Lateral glides

Lumbosacral Instabilities:  Flexion mobilizations, Side-bend glides in flexion, & Tail pulls

 

Mobilizing a joint might even be best before you do exercises.  Not hours of mobilizing, but perhaps 1 – 3 minutes’ worth.  (Note, I spend more time on spinal mobs than I do on extremity joint hypermobilities… the affected joint itself and a couple of adjacent segments.  This seems to setting things down nicely.)

And with that, Happy Mobilizing!

 

 

 

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18 Jun 2017

The old, the fat, the black & the hairy

Old fat black dog

I’m repurposing this blog.  I just put it out on my clinic website… but I like it enough to repost it for all of you!  (Things to think about!)

 

This blog has been inspired by a few different experiences I’ve had lately: Three client stories, and one personal experience.  Basically, we four dog owners are concerned about the health of our dogs.  Our dogs don’t want to walk.  Our dogs are lethargic.  Something must be wrong!!!  (And since I started writing this, I’ve had this conversation with at least half a dozen more clients who are having similar concerns about their dogs.)   

 

I’ll start with the story of my dog.  It’s my rescue Borzoi, Syri.  She’s about ten years old, mostly black, and carries a bit of extra ‘padding’ as well.  She’s also is a bit of a ‘head case’.  She can be weird for all sorts of reasons!  Well, one day I decided to take all 4 of my dogs for a walk.  It was 9 am, there was a bit of a breeze and it was about 17 degrees C.  Perfect, I thought!  I could get all of my white dogs enthused about going, but not the black dog.  I did manage to get her out of the house, and down to the end of the drive way, but no further. There was no way she was going into the field.   I even tried pushing her for a bit!  She was standing there shaking like a leaf (and I felt like an ogre)!  I gave up and walked her back to the house and the white dogs and I went for a walk.  I’ve been noticing that she is a bit more lethargic than normal.   She’s fussy about going outside.  However, if I wait until 8:30 or 9pm, then she’s like a puppy!  Happy, bouncy, yeah-I’ll-go-for-a-walk fool! But during the day, she’s a pancake!

 

The first of my canine patients is fuzzy, black, well padded, senior dog.  Her owner has been noticing that she doesn’t want to walk and isn’t as enthusiastic about eating either.  The third dog is a densely-coated (not-black, she’s tan) dog and the owners are noticing she’s not so interested in going for walks.  On questioning, the 4pm walk in particular.  And the last dog was a small senior dog, and the owners have been finding him to simply be more lethargic than usual and he pants more too.

 

Naturally, we’re all freaking out a little bit!  Our brains go to the worst-case scenario right off the bat.  What if it C…?  And while that is always a possibility, perhaps we should think about all of the factors.  Slow down a bit, and just be rational. 

 

1. My black dog heats up like a frying pan when she’s out in full sun!  She will ‘hold her urine’ ALL DAY and not go outside other than first thing in the morning and then right after dinner in the evening in the Spring / Summer.  When she does go out into full sun, it takes just a few minutes before her hair coat is hot.  Not just warm, but hot!  Conversely, even if the temperature is in the 20’s but overcast or late enough in the day that the angle of the sun is different, then she’s fine with going outside!

2.Dogs (and people) that carry extra weight tend to be warmer, especially in warmer weather.  Fat = insulation, and too much insulation on a hot day is like wearing your snowsuit to the beach!  Dogs likely have it worse than people, because they don’t sweat.  They have to pant to cool down.

3.A thick coat of hair may then have the same impact as excess weight.  It may act as an insulator for some dogs, making them heat up faster and then have difficulties dispersing the heat.

4.Lastly, age can play a factor.  There are some reports in human literature that humans (45 +) may suffer more physiological strain during heat acclimatization than younger individuals.  This may be related to aerobic fitness, levels of dehydration in the older individuals, and environmental humidity.

 

So, what should we take from this?  There are a few things you could try.  Firstly, try going for your daily walk(s) either early or late in the day, when the sun is low.  Secondly, you may need to reduce your dog’s body weight (and we can help with our Fluffy to Fit program).  Thirdly, keep your dog well brushed out to remove dead hair, contemplate a ‘summer haircut / trim’, use a ‘cooling jacket’ (they are wetted and have gel beads that can keep the dog cool when it’s on), reflective jacket, or wet terrycloth jacket, or spritz your dog with cold water (the ‘mist setting’ on your garden nozzle) before heading out to walk might combat the heat issues.  Fourthly, the age of your dog may be a factor, so perhaps you could do some indoor exercises with your dog in your basement instead, or bring him / her in for an underwater treadmill session as a different means of exercise.   And I’m going to add in a fifth thought as my finale, maybe you need to encourage your pooch to drink a bit more fluids.  Low sodium (or home-made) broth could be provided or added to food to increase water / fluid consumption.  

 

You likely want to try a combination of these suggestions and see how your dog responds. And naturally, if you still have concerns or see other unusual or troubling signs in your pet, it’s best to book an appointment with your vet!

 

 

Posted in: Tags: old , fat , black , hairy , lethargy

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