Hi everyone,
I saw this dog last week. His history is that he has had this gait since he was 4 months old, he is 3 years old now. Last year, the owner began doing agility with him and decided to have the limb looked at. She was expecting a luxating patella diagnosis, but instead he had a torn CCL and a TPLO done. I don't know when it is thought the CCL tore, not at 4 months of age I am guessing but I don't think anyone knows.
He is now 11 weeks post TPLO. The surgeon has rechecked him and is happy with his progress as far as the TPLO, but he is still hopping. I did not find a luxating patella, the gastroc tendon does not seem to slip, and I don't think the long digital extensor is slipping--although I still don't know if I am doing that test right. Pelvis seems OK, his quads on his R hindlimb seemed really tight as did TFL. I got some flinching with DV glides of his lumbar spine.
He would not let me do a Trendelenburg test--he pulls away his foot and kicks as soon as I begin to slide it caudally. Hopefully that means he needs some motor control and timing work, because that's what I sent him home with exercise wise.
I also needled his lumbar epaxials, quads, TFL, sartorius and did some laser.
The last "hopper" I had responded to motor control and timing exercises, but I'm worried this one won't be so simple since he's been doing it since 4 months of age.
Any thoughts are appreciated!
Diane
Here is a link to a video of a walk with owner, hope it works:
https://youtu.be/Joc20zW7px8
Hopping gait since puppyhood. now post TPLO
Hopping gait since puppyhood. now post TPLO
Diane M Paster, DVM, DABVP, CCRT, CVPP, cVMA
Re: Hopping gait since puppyhood. now post TPLO
Oh, these crazy hopping dogs!!!
Yes, I am of the opinion that it's a motor control & timing issue with all of them. And in the chronic cases, you likely have to work it for quite some time to get the pattern to change. I like tying a bandage / theraband around the abdomen when out for a walk as a cheater way to work abdominals while simply walking.
HOWEVER... in some of the cases that are longstanding, I'm thinking that the missing link has to be myofascial & neuromyofascial as well... due to the long standing compensation / altered gait pattern.
So look for tightness that you can stretch (sartorius, TFL, iliopsoas, abdominals).
Check those same muscles for myofascial trigger points (also quads and glutes).
Check broader fascial bands / trains (i.e. stretching out front leg - rear-leg simultaneously - ipsilateral & then contralaterals). Stretch out both rear legs and hold the chest. Stretch out the lateral fascia (i.e bend the dog around your leg - with a home program of cookies that the hip.)
Work each nerve root or rather the multifidus & epaxial regions - stretching/pulling from the spinout process down and out in a caudolateral manner with 1) just skin, then 2) deeper into fascial layers, then 3) engage the muscles as well.
Try gliding the nerves - (see the fourleg videos 118-120).
Throw in skin lifts.
My next through processing... but I've not had a chance to work with it or fully move in this direction is Visceral manipulation. We'll save that for another day!
I hope these help to get you started or crank up your brain juices to look at this case / these cases in a new way!
Keep us posted!!!
Laurie
Yes, I am of the opinion that it's a motor control & timing issue with all of them. And in the chronic cases, you likely have to work it for quite some time to get the pattern to change. I like tying a bandage / theraband around the abdomen when out for a walk as a cheater way to work abdominals while simply walking.
HOWEVER... in some of the cases that are longstanding, I'm thinking that the missing link has to be myofascial & neuromyofascial as well... due to the long standing compensation / altered gait pattern.
So look for tightness that you can stretch (sartorius, TFL, iliopsoas, abdominals).
Check those same muscles for myofascial trigger points (also quads and glutes).
Check broader fascial bands / trains (i.e. stretching out front leg - rear-leg simultaneously - ipsilateral & then contralaterals). Stretch out both rear legs and hold the chest. Stretch out the lateral fascia (i.e bend the dog around your leg - with a home program of cookies that the hip.)
Work each nerve root or rather the multifidus & epaxial regions - stretching/pulling from the spinout process down and out in a caudolateral manner with 1) just skin, then 2) deeper into fascial layers, then 3) engage the muscles as well.
Try gliding the nerves - (see the fourleg videos 118-120).
Throw in skin lifts.
My next through processing... but I've not had a chance to work with it or fully move in this direction is Visceral manipulation. We'll save that for another day!
I hope these help to get you started or crank up your brain juices to look at this case / these cases in a new way!
Keep us posted!!!
Laurie
LAURIE EDGE-HUGHES