West Highland White Terriers are amongst a small group of breeds prone to ligament problems. Cruciate disease is the most common reason for orthopaedic surgery being performed and the most common reason for referral to a specialist orthopaedic surgeon. Unfortunately, ligament injuries can often take a very long time to repair, largely down to the naturally low volume of blood that ligaments receive. In this article, we hope to improve your understanding of this condition and enlarge on some potential complementary or alternative treatments available to you starting with hydrotherapy and massage.
The cranial cruciate ligament is a band of tough fibrous tissue that attaches the femur (thigh bone) to the tibia (shin bone), preventing the tibia from shifting forward relative to the femur. It also helps to prevent the stifle (knee) joint from over-extending or rotating.
Cranial cruciate ligament disease is either treated surgically or conservatively, depending on the overall stability of the stifle joint.
The benefits of hydrotherapy
When managed conservatively through hydrotherapy with a registered and qualified hydrotherapist, the aim is to reduce weight loads, build the muscle around the joint and increase stability. The main muscle groups that are essential to maintain throughout recovery and maintenance are the quadriceps and hamstrings. The aims of conservative management of cranial cruciate injuries are to:
- Increase strength by having controlled exercise to increase limb loading
- Return to the normal gait pattern and a moderate level of range of movement.
The hydrotherapist will generally use the underwater treadmill (UTM) for treatment especially in the early stages as they can have more control of movement and exercise intensity. During this time, they can use the properties of warm water to aid pain reduction and to support the patient to allow normal movement patterns, and the hydrostatic pressure to reduce swelling and increase circulation.
Using the UTM for rehabilitation and management of ligament disease is beneficial as it reduces weight bearing and impact through the joints whilst adding resistance which enables the strengthening of the joints and muscles. The UTM works by setting it to the correct speed and water level and then encouraging the patient to walk at the desired pace. Hydrotherapy can be used pre- and post- surgery to get the surrounding muscle groups able to stabilise the stifle joint.
The benefits of massage
Massage promotes fresh blood flow to the site of injury or weakness, delivering valuable nutrients for the damaged ligament to repair itself or to contribute towards prevention where you suspect potential weakness. Massage also aids in the removal of cellular debris caused by the injury, thereby decreasing the swelling, relieving pain and promoting a quicker recovery time.
When an injury occurs, in the case of a cruciate ligament tear for example, the dog uses other areas of the body to overcompensate. The musculature in these areas becomes tight and develops ‘knots’ of muscle that can be debilitating and slow down recovery time. Massage looks at the dog’s body as a whole and so treats the overcompensating musculature, enabling the dog to be more mobile and comfortable as they recover from injury. Healing rate is increased, and recovery time is shortened. With a cranial/caudal ligament tear, quicker use and weightbearing on the limb is seen. Rebuilding of atrophied or wasted musculature is also quicker, when used alongside other therapies, such as hydrotherapy and physiotherapy.
Massage can also help by releasing compensatory tension leading up to surgery and then on into rehab where, with the ability to control pain levels, strengthening exercises can begin.
It should be remembered that you can only do rehab after surgery once ~ the early stages are vital to secure the longevity of the ligament with a 12-week healing period which can easily be delayed through reinjury. Managing this recovery period is vital, you have to be patient!
An integrated approach
Canine massage therapists and hydrotherapists frequently work as part of a multi-disciplinary team overseen by your vet. A treatment might be used individually, or it might be beneficial to utilise more than one. Every dog is an individual with unique needs and the beauty of true integrated veterinary care is that a specific plan can be put together drawing from an array of holistic therapies to suit your dog as appropriate. Treatments may help in recovery, rehabilitation and reducing the need for pain relief. Other treatments which might offer beneficial results in the recovery and maintenance of ligament damage and disease include physiotherapy, acupuncture, osteopathy and homeopathy which we will examine in a future article.
Therapeutic equipment may also help including laser light therapy which your vet may offer, or Photizo Vetcare which your practitioner may offer, or you can use at home. Photizo is a form of light biomodulation therapy and can be used for pain relief and to aid the recovery of ligament damage. More information can be found here https://cam4animals.co.uk/photizo-therapy/ .
SCENAR is a bio-electrical non-invasive medical device used by healthcare professionals which works by stimulating the body’s inherent self-healing mechanisms, with no undesirable side effects. It provides pain relief and can be used for treatment, rehabilitation and maintenance including the treatment of ligament injuries. A more detailed explanation with case studies including a dog with ligament problems can be found here https://cam4animals.co.uk/scenar/ .
We hope that this may have excited your interest in available options for cruciate ligament disease and are grateful to our contributors:
Sam Wooldridge from Cornwall Canine Massage Therapy. 07585 338968. firstname.lastname@example.org
Steph Ridout from Duchy Canine Hydrotherapy, South East Cornwall https://duchycaninehydro.co.uk/
Danetree Health Products – https://www.danetrehealthproducts.com/
Holistic Vet Roger Meacock on Scenar – https://lasthopevet.co.uk/
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