Thursday, July 31, 2014

Physical Therapy Tip Of The Month: Hip Dysplasia - What’s a Dawg Mama to Do?

by Penelope Davis (dog ghost writer for Susan E. Davis, PT)

It’s all about guiding and empowering you to help your pet avoid injury, provide practical solutions and achieve rapid restoration of health and function!   

Our champion blogger, “Dawg Mama Jana”, is experiencing hip dysplasia drama with her beloved JD, so she asked me to focus this month’s PT tip on that topic.

JD getting hydrotherapy with Cookie for moral support

I’ll break it down from a therapist’s point of view and offer practical advice on dealing with the challenges it presents.

So, what is it actually? Lots of people think hip dysplasia is a tight, sore, arthritic hip.  However, it is really a hip that is too loose and lacks stability.

The hip consists of a ball-and-socket joint formed by the head of the femur (ball) and acetabulum of the pelvis (socket). Being designed for movement, these 2 hip structures are formed so that their shapes perfectly match each other, with the socket surrounding the ball.

The dog walks on four limbs with the hip in a flexed starting position (as opposed to human beings who walk upright with the hip in a straight starting position), producing a large arc of movement during gait. It’s very important that the ball and socket make even contact to achieve the quality of movement the dog needs to walk comfortably.

Hip dysplasia is classified as a skeletal disease where the hip socket (acetabulum) is shallow and abnormally formed.  

The femoral head, or ball, becomes misshapen as a result of lack of contact and coverage by the socket not fully surrounding it. This gets worse as the dog develops, the hip becoming loose and lax usually by age 2.  If a   dog isn’t diagnosed and doesn’t receive care for dysplasia it is a high risk to develop secondary arthritis with bone spurs, due to continual wear and tear of the hip.

So to be clear, arthritis doesn’t cause hip dysplasia, but hip dysplasia can definitely cause arthritis!

What causes hip dysplasia to occur? It is a genetic disease having traits which are inherited, being passed to offspring through reproductive cells.  Commonly affected dogs are the large breeds that have rapid growth and weight gain early in their development: German Shepherds, Labs, Rottweilers, and St Bernards.

How do you know it’s there?  

Dogs will show rear limb lameness during running, jumping, climbing, with a bunny-hopping gait. You might also hear a popping or clicking sound. The gait strides will be short and choppy, with the rear end waddling from side to side.  Dogs may pace instead of the normal left-right gait, and have trouble negotiating turns and stairs.

Diagnosis is by vet exam and radiographs. 

Testing methods exist from OFA and PennHip with documentation and registry of the disease, especially within the breeding industry.

What can be done?  

The first step is to learn about the various surgical options, including triple pelvic osteotomy (TPO), the total hip replacement (THR), dorsal acetabular rim arthroplasty (Darthroplasty) and the femoral head osteotomy (FHO).

Next, have a good discussion with your vet, asking their recommendation on which method is best.

Always get a second opinion if you feel the need and consider seeing a board-certified veterinary orthopedic surgeon. 

Surgery, followed by a recovery period and then physical therapy and rehabilitation, can yield wonderful results for your dog.

But what if surgery is not an option? 

There may be reasons against surgery such as financial constraints, medical issues which make anesthesia risky, immunosuppressive diseases that could invite sepsis or widespread infection, etc.

In these cases it is essential to use conservative measures to help your dog such as:
  • Cold Laser treatment provided by your PT or Vet, delivers bundles of light which decrease pain and reduce inflammation.  

  • Transcutaneous Electrical Nerve Stimulation (TENS) obtained through your vet or therapist and applied by you (after instructions are given and waveform parameters are preset) at home.  Adhesive surface electrodes are placed around and on the hip, and gentle current is applied, to reduce pain.  A dog’s coat may need to be shaved to ensure good skin contact for the electrodes.

  • Targeted Pulsed Electromagnetic Field therapy through a pad or loop, delivers a soothing wave frequency which reduces inflammation.  An example of this is Assisi Loop, prescribed and ordered for you through your vet or therapist, and treatments given to the dog at home, in 15-minute doses.

  • Moist Heat: commercial hot packs, wraps and sacks filled with gel, silicon and sand are typically heated by hot water immersion or microwave ovens. These can be applied over the hip, first placing padding (such as a towel) to prevent burns, depending on the length and thickness of the dog’s coat. Moist heat, as opposed to dry forms of heat, penetrates deeper to relieve the pain typical of hip dysplasia and arthritis. Consult vet or PT for specifics and precautions.  

  • Massage: increases blood flow to relax tight sore musculature around the hip.  Position the dog on its side (dysplasia side up), with a rolled towel or pillow placed between the thighs.  Stroking and kneading techniques will work best, gently, for 5-10 minute durations.

  • Range of Motion of the hip with manual joint compressions can be very effective but must be applied by an animal-trained physical therapist or rehab-trained vet.

  • Therapeutic exercise such as standing weight shifting and rocking front to back and side to side, using wobble or balance boards, weaving around cones, supported standing over a physio-roll, are  used by therapists for dogs with hip dysplasia. Some of these can be taught to the dog owner.

  • Regular, controlled leash walks, using a chest harness remains the gold standard. For dogs having greater difficulty walking, consider using a belly sling, 2-handled chest and pelvic harnesses (such as the “Help Em Up” and ‘Walkabout”) harness, gait assists such as “Biko brace”, or Wheeled Carts.

  • Aquatics:  Swimming, standing in water and Underwater Treadmills offer a unique exercise medium, taking pressure off sore painful hips affected by dysplasia.


Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website , or follow on Twitter @animalPTsue.

Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.

Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 
It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery 
Physical Therapy Tip Of The Month: Ideas to Chew on - Can Physical Therapy Help with my Dog’s Digestive Problems?
Wrap It Up: Using Soft Supports For Your Dog
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part I) 
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part II) 
Physical Therapy Tip Of The Month: Safe Summer Boating Tips for your Dog

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