Hi Laurie,
I keep up on your end with your site updates (which I love by the way). I hate to feel like I'm asking for answers but a dog has crossed my path that I've never experienced before. 2 year old pointer with a complete achilles laceration and subsequent repair by a surgeon. The screw was just removed Friday and he is weight bearing no problem but the owner is a bit concerned that the injured leg sits lower than the other (they had to use a longer graft to do the repair as the tendon had retracted too much). I haven't physically seen the dog but just chatted with the owner. For now the dog is leash only, 5 minute intervals and pretty restricted for next 4 weeks. I plan on seeing him early next week when he comes off the Metacam and see if he is developing any compensation and get started on some beginning strengthening.... any advice?! This isn't one that I've come across in the next books a lot either. We know the trouble with achilles repairs in humans, is it similar in dogs?? Should I be doing friction massage?
Appreciate any help at all,
J
Post Op Achilles Laceration
Re: Post Op Achilles Laceration
Hi J,
So I tend to get nervous with these ones as well.
I would use slow and steady strengthening for the most part:
Hill walking
Step ups
Squat blocks
Sit to stands down to an elevated surface or facing DOWN hill first, then on a flat surface, then perhaps on a wobbly surface, and progressing to facing up a small hill
Backing up
3-Leg stands with e-stim on gastrocs
You might want to order them a tarsal brace - I'd go with a Therapaw tarsoflex (over the counter - size med or large... call or e-mail them to ask... or check out their website (www.therapaw.com). It's a good product and less expensive than a custom thermoplastic one. (I think if surgery hadn't been done then a rigid non articulating brace would be smart).
So with this brace you could start (eventually):
Trotting
Destination jumping
Tug of war
Short retrieves
Off leash
And when that goes well, then they can do the same without the brace.
I'd not do friction massage, but I'd add some form of modality in conjunction with your exercise therapy / prescription.
And of course check spine and proximal musculature for compensations.
I hope this helps a bit.
So glad you are busy with dogs! That makes me happy!
Cheers,
Laurie
So I tend to get nervous with these ones as well.
I would use slow and steady strengthening for the most part:
Hill walking
Step ups
Squat blocks
Sit to stands down to an elevated surface or facing DOWN hill first, then on a flat surface, then perhaps on a wobbly surface, and progressing to facing up a small hill
Backing up
3-Leg stands with e-stim on gastrocs
You might want to order them a tarsal brace - I'd go with a Therapaw tarsoflex (over the counter - size med or large... call or e-mail them to ask... or check out their website (www.therapaw.com). It's a good product and less expensive than a custom thermoplastic one. (I think if surgery hadn't been done then a rigid non articulating brace would be smart).
So with this brace you could start (eventually):
Trotting
Destination jumping
Tug of war
Short retrieves
Off leash
And when that goes well, then they can do the same without the brace.
I'd not do friction massage, but I'd add some form of modality in conjunction with your exercise therapy / prescription.
And of course check spine and proximal musculature for compensations.
I hope this helps a bit.
So glad you are busy with dogs! That makes me happy!
Cheers,
Laurie
LAURIE EDGE-HUGHES
Re: Post Op Achilles Laceration
Hi Laurie
I have a question to add on regarding Achilles post injury rehabilitation. As soon as the cast comes off, can you start some gentle hamstring stretching (within comfort)? I imagine most dogs stay in the cast until the repair phase is primarily complete (about 4 weeks?) and the cast comes off when the surgeon thinks the remodelling stage is about to happen. Anyhow, I am assuming once the surgeon deems it appropriate to take off that cast that gentle stretching, ROM, weight shifting exercises should all be good to start.
I appreciate your input
Jennifer Stelfox
I have a question to add on regarding Achilles post injury rehabilitation. As soon as the cast comes off, can you start some gentle hamstring stretching (within comfort)? I imagine most dogs stay in the cast until the repair phase is primarily complete (about 4 weeks?) and the cast comes off when the surgeon thinks the remodelling stage is about to happen. Anyhow, I am assuming once the surgeon deems it appropriate to take off that cast that gentle stretching, ROM, weight shifting exercises should all be good to start.
I appreciate your input
Jennifer Stelfox
Re: Post Op Achilles Laceration
Hey Jennifer,
I think Hamstring stretches are absolutely fair game.
And I would agree with weight shifting, ROM etc...
In the case of a 'newly out of cast' case... I'd go slow. From the perspective of fundamental healing: Things might be knitted together, but they won't be strong. So I'd be very cautious especially in the first 2 weeks after cast removal... 'normal loading' but don't 'push it'. If the first two weeks are okay, then gradually increase load on the tendon.
Good luck!
Laurie
I think Hamstring stretches are absolutely fair game.
And I would agree with weight shifting, ROM etc...
In the case of a 'newly out of cast' case... I'd go slow. From the perspective of fundamental healing: Things might be knitted together, but they won't be strong. So I'd be very cautious especially in the first 2 weeks after cast removal... 'normal loading' but don't 'push it'. If the first two weeks are okay, then gradually increase load on the tendon.
Good luck!
Laurie
LAURIE EDGE-HUGHES