Each veterinarian seems to have their own theories regarding how soon physical therapy should be started after ccl surgery and what techniques work best. Other veterinary surgeons will write off physical therapy all together, preferring for the dog to remain quiet for the first 6-8 weeks after the repair, gradually returning to exercise. While it is always best to go along with the instructions of your vet, I do want to point out that studies done by the American College of Veterinary Surgeons have shown that dogs beginning rehabilitative therapy within 48 hours of the procedure tend to heal faster and have greater range of motion than dogs without any physical therapy.
The best way to assure your dog is on the right track after his cranial cruciate ligament repair surgery is to incorporate a varied regimen of passive range of motion, balance exercises, and slow, controlled, leash walks. Range of motion exercises, also referred to as “ROMs”, should be demonstrated to you by a professional before you undertake them on your own, as you can do damage to the healing tissues in the knee with the wrong technique. There are canine physical therapists skilled in ROMs, and if you are unsure of your skills it is best to seek the help of a professional to ensure the safety of your dog. Balance exercises can also be tricky for unskilled owners, and it is best that a qualified veterinary physical therapist perform balances exercises with your dog; think placing your dog’s belly on a ball while helping him to bear weight and flex the knee.
Swimming is an excellent non-weight bearing activity, but only after the incision site itself has had time to heal. All therapies should always be cleared through your veterinary surgeon, prior to their implementation. If you have access to a pool and a dog that loves to swim, this can be a great way to help them regain lost muscle mass while working on ROM exercises in a zero resistance environment (decreasing the likelihood of injury).
Some owners have also chosen to go a more holistic route with their dog’s post operative therapy, seeking out the assistance of a professional skilled in acupuncture. The use of animal acupuncture, and similarly acupressure, in a dog recovering from ccl repair surgery may help alleviate post op discomfort, which can help your dog to heal more quickly from surgery. A growing number of veterinary clinics are now integrating western techniques such as acupuncture and massage into their practices, with many offering these services on site. Acupuncture and acupressure can be used in conjunction with ROM exercises and hydrotherapy under the supervision of your veterinarian.
The long term prognosis for animals undergoing surgical CCL repair is good, with clinical reports of improvement in 85-90% of the cases. Unfortunately, degenerative joint disease or osteoarthritis progresses regardless of treatment. Long term outcome includes a decrease in activity over time, an increasing level of disability, an adverse response to cold weather, and stiffness after inactivity related to progressive degenerative joint. Weight loss, an exercise regime of daily moderate activity, and the use of joint supporting supplements like glucosamine and chondroitin can help to improve these adverse clinical symptoms.