Toe touching to mild weight bearing (will put the leg down and bear partial weight).
Our goal is to keep the joint mobile and to strengthen the leg. We usually want to see you and your dog back at the beginning of this stage for the first rehab visit with a technician. These steps should be done 2-3 times daily.
1. NSAIDs: Use as needed. Most dogs will need the full dosage prescribed; the Tramadol should be just about finished during the first few days of this stage.
2. Warm Pack: This is done to improve the circulation at the surgical site and to relax the muscles and tendons of the knee. It is important that warm packing be done immediately prior to the exercises.
You can use commercially available dry, microwavable products, a warm water bottle or a warm washcloth. Moist heat such as a damp towel can also be used. Make sure it is not too warm; it should be comfortable for you to handle.
Do not allow it to get cold; maintain a steady temperature. Never use an electric heating pad. Warm pack for the same duration as the cold packing 2-3 times daily.
3. Massage: This is done to loosen the tissue planes and help prevent fibrous adhesions from developing. Most dogs enjoy this portion of the therapy.
- Gently massage the thigh and calf muscles.
- If your dog allows, massage the area of the incision, too.
- A side-to-side, toe-to-hip, and circular motion should be done.
- Massage for approximately 5 minutes, until the leg seems relaxed.
Do not massage too hard; at this stage just the skin should be involved with no deep tissues being massaged. Light pressure with just the fingertips is best.
4. Flexion/Extension Exercises: Follow the steps listed in Stage 1. Starting with 3-5, gradually increase the number of reps at each session and the amount of flexion and extension in each cycle. The goal should be 10-20 reps and nearly full range of motion.
5. Strengthening Exercises: As early as possible, it is important to begin the process of strengthening the muscles that support the knee.
- Begin by slowly leash walking your dog, encouraging it to bear weight on the leg.
- Make sure you are walking slow enough to force your dog to use its leg.
- Start with 5-7 minutes 3-5 times daily.
- Generally you want to push your dog to use the leg harder and longer each day.
You know you have overdone it if your dog seems to avoid the exercise periods or seems to be more painful after the exercises. If any exercises result in discomfort, stop for 24 hours, cold pack the knee and restart the activity at a lower level.
6. Cold packing: This should be done after exercising your dog, for the appropriate duration.