popping puppy

[rita]

Hi! Thank you for your help and opinion on a 4 month old female Aussie puppy. She is a live wire! The family is a bit cautious and concerned as their previous 2 Aussies have had shoulder issues (MSI, one with a grade 3 tear of the bicipital tendon).

The family is currently doing foundation work with the puppy, suitable for her age. There is the observation that on occasion, she holds the leg in question slightly ahead of the other. And when positioning to void, she rotates that particular leg externally (although not consistently). The owner noticed that one day as she was positioning her for something, that she felt a "pop" at the shoulder in question. Upon examination, there was no perceivable discomfort anywhere, good ROM. At her shoulders, her abduction angles were within a normal range. I did, however, feel a subtle grind at full extension on the one shoulder (again, no hesitation on her part).

My recommendation was to start using the wrap that is described in your video training for MSI (mostly to get her used to the idea of a wrap but also to help improve her proprioceptive input). We are not doing any strength training at this point. The wrap is to be used as she is doing her foundation training. We will be getting rads shortly. I'm just concerned that I should be doing more for this pup at this time (both diagnostically and therapeutically). Any suggestions?

Rita

[lehughes]

Hi Rita,

My apologies for taking a week to get back to you! All is busy there days!

Okay... so I will often get a 'pop' in dogs shoulders. Mostly in sporting dogs (but of course, I mostly see sporting dogs). I believe it is a consequence of hypermobility in the shoulder. Some breeds are more prone to hypermobility (i.e. herding breeds).

So, I think that this could be the case with your pup. Early medial shoulder hypermobility... likely because she's a live wire.

So, I see where your head is going with the bandage for MSI. See how it goes. I tend to use it for acute injuries... which at 4 months, it can't be terribly chronic. My gut says, it might be overkill in this case... but see how it goes!!

I would (as best possible) start some exercises. I'm thinking, Rear feet up, cookie between the elbows to get active end range extension. Then also add push ups. I think if you can get her to start using herself correctly, it could help for the long run. Oh, and 3-leg stands, then diagonal leg stands.

I'd also recommend limiting any crazy off leash play (at least for the short term).

See how it goes. It's the best you can do at this point!

Best of luck!

Laurie

[rita]

Thank you for your help!
Rita

[David Lane]

I thought I would chime in, as this is a topic about which I am curious…. How do we interpret these popping shoulders? I have broached this conversation with multiple colleagues, and have yet to find anyone who feels they have an answer. My thoughts/observations (whatever those are worth) include the following:

• I have seen cases of forelimb lameness in which, during the course of a normal physical examination, there is a palpable clunking shift, followed by immediate relief and often permanent resolution of the lameness
• I have experienced that same clunk/shift on forelimb lameness patients, and have seen it have no effect on lameness – this is the far more common scenario
• I have experienced that same clunk/shift on patients with no forelimb lameness
• I initially thought it might reflect abnormal muscle tone causing the humeral head to ride asymmetrically within the glenoid fossa, however I have experienced this clunk/shift in fully sedated or anesthetized patients that don’t have muscle tone at the time.
• I wondered if it reflected soft tissue laxity or instability, but subjectively do not find it to be a predictor of MSI/MSS or any other specific shoulder pathology.

Does anyone else have thoughts or observations that they would like to add to the above?

[lehughes]

Hey David,

I believe it to be a result of shoulder hypermobility, some degree of ligament laxity. I can crack my back every day, and my neck too... even first thing in the morning! I have hypermobility in my spine. If we are hypermobile, I believe we can get abnormal pressures in the joint - and subsequently a relieving of the pressure (click or pop) is just that, the relieving of pressure.

I too have seen all of the scenarios you describe David. So, perhaps we could categorize the hypermobilities into:

Functional hypermobility (dog wasn't lame)
Dysfunctional hypermobility (dog is lame)
the latter could be sub-classified:
Hypermobility with cartilage / labrum damage
Hypermobility with capsular inflammation
Hypermobility with tendinopathy / muscular overuse (subsequent to overwork in order to stabilize)
Hypermobility with increased ligament damage... really, you could look at which / how many / what degree of ligament tear (i.e. from mild hypermobility to instability)

My 2 cents... It's a big range of problems that could occur.

Laurie