Hi Laurie,
I am seeing a dog on Monday with a sprained FCU diagnosed by a board certified surgeon with CT. The dog presented in April limping on the RF. The surgeon recommended laser therapy and support. I don't think there is hyperextension-they thought there was a bone chip and were about to do surgery.
I have searched my notes, books and your sight-as you can tell, I like to have specific recommendations while I'm still gaining confidence in rehab and I'm always very leery that I'm going to do more harm than good.
After a thorough exam which will include looking for compensatory issues, I will address pain with laser, acupuncture, massage, stretching, ROM. Is it okay to start slow and easy in the treadmill and simple exercises on the wobble board, 3 legged stands/perturbations? Is a carpal support recommended? and if so, should it be hinged? My understanding is that NSAIDS may not be indicated now b/c it's probably not inflammatory. Is cryotherapy the way we should handle inflammation at home/post exercise? The brace won't be on in the treadmill, but if client is doing slow/short walks at home I assume it would be on? And how do you know when to remove it? Perhaps gradually after a period of a few weeks, and taking a few weeks to wean off of it?
Any other recommendations, things to be cautious of would be greatly appreciated.
Thanks so much Laurie,
S
FCU case
Re: FCU case
Hey S,
So, you can do this!! If you read the shoulder tendinopathy article... that's your best info from which to proceed.
yes to brace, but a hinged brace may be overkill in this situation. I'd do a neoprene brace (such as the carpoflex from Therapaw) with 'moderate' support (extra padding and straps, but no thermoplastic). Perhaps order a custom one - we have the various sizes for over the counter purchasing... but harder to do without different sizes to try on.
ON for walks and supervised times. Dog should be confined / crated / quiet otherwise.
Off for treadmill.
Exercise progression: walking with support, static balancing with support... when okay with that... THEN add perturbation (i.e. wobble board).
No NSAIDS
No need for ice unless there is pain &/or increase in lameness after a session. It could be presented as an option for owner if they think their dog is sore.
If the dog is not lame / minimally lame with the the brace on... then you go with walks with it off - on flat surfaces.
When you want to progress, you might allow walks on uneven surfaces with it on... when that is okay, progress to the same with brace off.
When you want to progress from there, then you allow short bouts of trotting with it on... when that is okay, progress to the same with brace off.
When you want to progress from there, then allow short bouts of off leash with it on... when that is okay, progress to same with brace off.
When you want to progress from there, then allow short bouts of off leash play with other dogs, with brace on... then progress to off.
You go like that... when you add something more challenging - do so with brace on - especially things that require greater forces.
I hope this helps!
Cheers,
Laurie
So, you can do this!! If you read the shoulder tendinopathy article... that's your best info from which to proceed.
yes to brace, but a hinged brace may be overkill in this situation. I'd do a neoprene brace (such as the carpoflex from Therapaw) with 'moderate' support (extra padding and straps, but no thermoplastic). Perhaps order a custom one - we have the various sizes for over the counter purchasing... but harder to do without different sizes to try on.
ON for walks and supervised times. Dog should be confined / crated / quiet otherwise.
Off for treadmill.
Exercise progression: walking with support, static balancing with support... when okay with that... THEN add perturbation (i.e. wobble board).
No NSAIDS
No need for ice unless there is pain &/or increase in lameness after a session. It could be presented as an option for owner if they think their dog is sore.
If the dog is not lame / minimally lame with the the brace on... then you go with walks with it off - on flat surfaces.
When you want to progress, you might allow walks on uneven surfaces with it on... when that is okay, progress to the same with brace off.
When you want to progress from there, then you allow short bouts of trotting with it on... when that is okay, progress to the same with brace off.
When you want to progress from there, then allow short bouts of off leash with it on... when that is okay, progress to same with brace off.
When you want to progress from there, then allow short bouts of off leash play with other dogs, with brace on... then progress to off.
You go like that... when you add something more challenging - do so with brace on - especially things that require greater forces.
I hope this helps!
Cheers,
Laurie
LAURIE EDGE-HUGHES