Gastroc Disease

[Kriszty]

Hi Laurie,
Help again needed with my own dogs please.
5yo agility Border Collie, sore on gastroc palp, off weighting at stance, was 2/5 lame a few weeks ago.
Treatment so far:
Shock wave on the gastroc and surrounding muscles (had 2 Txs 1 week apart,started 2.5w ago, 2 more booked)
Lying on PEMF mat 1 hour BID
Massage and gentle stretching BID
Started strengthening exercises- backing up, 3 leg standing with front legs elevated, sit to stands with front legs elevated.
Shes doing a fair amount of swimming as its hot +++++ here and she needs to be exercised.
The above exercise isn't making her noticeably worse, but shes also not really improving, still off weighting and its been about 6w now.
Any thoughts about what I should be doing differently?
Thanks!
Kriszty

[lehughes]

Okay... so I have not had the opportunity (in 28 years) to see a gastrocs origin issue / gastrocs disease / fabellar osteophytosis...

It sounds like you are doing things right! Have you access to laser or ultrasound? Maybe acupuncture or dry needling into the gastrocs.

Is she on any meds? I did find a few articles suggesting NSAIDS. Normally with a soft tissue injury, I don't recommend NSAIDS, but this isn't a tendinopathy, it's more of an inflammation around the fabella... perhaps we should think about it like sesamoiditis, which would do better with an NSAID.

Sorry for the tardy reply. Between being so busy and the website-transition cutting out the forum, I just didn't get to this in a timely manner - my apologies.

Laurie

[Kriszty]

Thanks for the reply Laurie, I know how busy you are and I appreciate it.
Interestingly, she was looking a bit better, so I did some agility ground work stuff with her and she pulled up lame again, and as well as being painful on gastroc palp she was also sore on hamstring palp as well
Not really sure what is going on the with. I could definitely try a NSAID course, she hasnt had any for the reasons you state and interesting you recommend dry needling as I was putting pressure on her gastroc this morning after stretching and thought about putting a needle in (although I am not trained in this yet!)
We are doing lots of walking backwards down a hill and have an U/S scheduled for next monday to try and give more information with what is going on.
No laser or U/S access unfortunately.

[lehughes]

Do you have / have access to / could purchase a PEMF - i.e. Assisi Loop?
Also perhaps adding in 'heal raises'... (which I would train by having the dog stand with front feet up on a stool / step and have them reach a wee bit higher for a treat.)

I'd add massage and trigger point releases.

Then, I have to admit, I can't wrap my head around why this suddenly happens. So I think I'd look for some reason why your dog may have compensated and may have ended up using the gastrocs more than previously.

Keep me posted!

Laurie

[Kriszty]

Help please Laurie,
So Zen has been doing really well, totally sound, performing well in agility (just got AgCh and dog of the year ). Yesterday I thought she looked a bit off but couldn't localise and gastroc was fine. Today, 4/5 lame after she got up tonight Pain on gastroc palp again. Aaargh. I suspect too much crazy chasing of the horses. I feel like I rehabbed her really well last time and it took forever, about 12 weeks. If I give her a nsaid course and she comes sound, would you run her? Or do you think she needs the full rehab again? Did shockwave x5 last time as well as PEMF and exercises, massage etc.
Obviously I won't be running a lame dog, just not sure if the whole thing is warranted again, given what you said about the inflammatory nature of the disease.
Thanks!
Kriszty

[lehughes]

Hi Kriszty,

Well, that doesn't sound quite right. If there was an injury... you would have seen it 'same day'. So next day soreness is more indicative of DOMS (Delayed Onset Muscle Soreness).

Could you find trigger points?
Nothing else? SIJ, Iliopoas, Achilles, Stifle Swelling in the postero-medial joint line sulcus, toe injury?

To me, this needs you to take a step back and evaluate your dog like she's not YOUR dog!

So before going down the path of worrying about how long rehab for a gastrocs disease... have another look and a re-think... it seems strange.

Laurie

[Kriszty]

Thanks. She pulled up lame at night but was just off the last few days. Routinely chases the horses, unfortunately. Can’t find anything else at all. Will take her to the chiro again but it’s definitely her gastrocnemius she is reacting too on palpation.

[David Lane]

I agree with LEH that this is an unusual situation... I personally have never had to wrestle with a recurrent gastroc issue like you are describing. If this were my case, I would be ultrasounding that muscle from origin to insertion, as well as the caudal stifle, looking for some sort of macroscopic damage that would change the treatment strategy. I would also radiograph that stifle (a/o arthrocentesis depending on imaging findings and level of suspicion) to rule out a low grade partial CrCL tear that is manifesting in a really weird way.

[Kriszty]

Thanks for the reply, David.
I will book her in for an u/s. Her knee feels absolutely normal.
Interestingly, one of my agility friends had a flare up of her dogs gastroc disease as well, similar sort of time frame.

[Kriszty]

Hi again Laurie and David,
I hope you are both well. Once again can I please have your thoughts about my troublesome dog! Latest update:
Pulled up not right/running much slower at the last 2 trials of the year (around 2m ago). Once again seemed to be painful in R gastroc and also hamstrings. Not lame, but reluctant to jump, pulling off front end. No offweighting. I was getting very suspicious re referred pain /coming from elsewhere as her back felt niggly, so I took her back to the chiro. Asked him specifically to check SIJ- which he said was fine. He did some minor adjustments and she did seem happier briefly, sped up back to normal in the 1st run of the day, but then slowed right down again in the next run, so was scratched.
I re-shockwaved her gastroc and hamstrings (5 sessions) but although she has not been lame, and is on her summer holidays so therefore not jumping, I was still not convinced she was right.
Today I took her to Deb Nook, a vet who does acupuncture/dry needling and chiro and is very experienced (and finally back in the country). She put needles in her back which was really, really sore (she was crying ++++). Interestingly she lifted her RH with some of the back needles. She said her R SIJ was jammed, her sacrum felt awful and she needed adjusting in L7 and L4. She feels the RH issues are from referred back pain, and, watching her today, I am inclined to agree. My questions are:
1) does this sound feasible? Maybe the gastroc stuff was a red herring and its been intermittent referred pain from her back? Is it likely, being only unilateral?
2) how useful do you think a back MRI would be. She is scheduled to see the orthodox next week, and I could get one done. I am hesitating because I am not sure what it will change in terms of treatment, although it would be nice to know for sure. I doubt they will be intervening in a dog with zero neurological deficits
3) what would you do with her? Currently she's on lowish impact and I was going to review all your stuff on sore backs.

Thanks!!
Kriszty