fourleg.com

Hi!

I am a Norwegian veterinarian, physiotherapist and Chiropractor who is running my own rehab-clinic. I recently joined your forum, and I am so happy I did! So much useful information.

I do have one question... I have an Irish setter, 1,5 years old who ruptured his left biceps tendon 2,5 weeks ago. He had surgery two days later where the tendon was fixated with a screw to the the bone.

So far the rehab has been NSAIDs, laser treatments, careful standing exercise with front legs on a low balance pad, PROM all 4 legs 3 times a day and leash walking for 5 minutes 5 times a day. In the house the dog has to be on cage rest, because when losoe he jumps up and down the furniture.

The owner is very impatient and wants to get going with more rehab and to let the dog lose. I am sceptical and thinking that it is a bit to early.

I do not have a Water Treadmill, but I do have a swimming pool, cavalettis, vibrating plate and balance balls.

What would be your reccomendations?

Thank you in advance!

Best regards
K.

Hello K,

I glad you are finding FourLeg to be a useful resource… that’s why I created it!

Okay, now as for your patient. You are right, this dog can’t be let lose just yet. Primary fibrous healing / attachment of tendon to bone hasn’t occurred (I know it’s been fixated, but I still think there should be some fibrous tissue that needs to form to recreate the teno-osseus junction). As well, now that biceps is attached distal to the shoulder joint (my assumption), that leaves only supraspinatus to do the job of preventing the shoulder from collapsing. So supraspinatus needs some time to build up tolerance to it’s new full time job… otherwise you will be treating a different tendon lesion in a month or two.

I think what you have been doing sounds good. I’d want him to be off of the NSAIDS by now, they can delay soft tissue healing. To keep the owner happy, you may need to give a more difficult home program.
You could add some hill walking (or stairs).
Increase regular walking time (this will help the dog’s brain as well).
3-leg standing - flat surface and if good, then progress to an unstable surface.
Walking figure of 8’s around objects
Since the dog is a bit crazy, you need to think of activities that the dog will find FUN but won’t damage the surgery.
Tug of war might work here.
Maybe playing catch with a soft (not bouncy) toy (in a small area).
Maybe getting the dog to learn to sniff out food (as a mental stimulation)

The vibrating platform I think would be okay at this stage. And swimming too, as the incision is likely healed - it could be a great way to burn off steam.
And keep on lasering!

The owner won’t like it, but I would think that he needs to have restrictions for likely 8 weeks. (See what you think at 6 weeks.) Owners often need to be reminded that the alternative to keeping their dog calm is to simply start saving up for the second surgery when the first repair fails!!

Best of luck!

Laurie

Oh, and walking over cavalettis (low) can start any time as well.