Thursday, March 17, 2016

The Pet PT Pit Stop: Full Ligament Tears (Part 4 of Cranial Cruciate Ligament Series)

by Susan E. Davis, PT “pull in for a helpful refuel!”  

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

After surgery, PT should begin upon removal of the sutures, at 10-14 days post-op.

You should get instructions from the surgeon on what to do during those first two weeks. 

During weeks two through six, the dog should start to bear weight on the limb and take short leash walks of 5-10 minutes one to three times per day.

The vet may allow your dog to go up and down a few steps, but only on a lead. Running, jumping, playing with other pets should be fully restricted during this time.

Range of motion for flexion and extension of the stifle and hock should be performed with the dog lying on its side.

This is the point (if not before) at which most dog owners decide whether to do the therapy on their own or hire a physical therapist or canine rehabilitation practitioner. 

Most owners are prompted to seek professional care when the dog isn’t putting the limb down to bear weight and some are just squeamish about touching and moving the limb. Whatever the reason, using a trained therapist is optimal and helps your dog get the fastest results with the best chance of avoiding re-injury or long-term complications.

Therapy will often consist of functional electrical stimulation, cold laser, massage, range of motion for the stifle, hip and hock joints, stretching to the thigh and calf muscles/tendons, plus exercises. 

These exercises will help to build strength, reduce post-op muscle atrophy, and encourage weight distribution onto the operated side. The therapist will also help train your dog to walk properly, in a reciprocal (left-right-left-right) pattern.

After the sixth week, your dog should be at or very near full weight bearing in standing and walking, with daily leash walks to about 20 minutes twice per day. The dog may be allowed on the stairs off-leash depending on the advice of your vet.

Strengthening and functional exercises will become more advanced and involve resistance, foam rollers, balance discs and balls, figure of 8 movements, hi-stepping over rails or hurdles, tunnel walking,  treadmill (land or underwater) walking, etc.

At 12-16 weeks the speed and distance of leash walks increases and may include trotting. 

Active play and jumping across/over low objects is now permitted, progressing to full running and jumping by 16-20 weeks post-surgery.

These are general guidelines only.

You must follow the particular surgeon’s protocol and your therapist should be in close collaboration with them as well. 

Consult your vet and therapist about lifetime precautions to avoid injury to the surgery site and help to prevent a tear on the opposite limb.

Always strive to keep the dog’s weight at a reasonable level.   


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 
Physical Therapy Tip Of The Month: Hip Dysplasia - What’s a Dawg Mama to Do?
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part I)
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part II)
Staying in the Loop with Targeted Pulsed Electromagnetic Field Therapy
Addressing Frailty Syndrome in Geriatric Dogs 
The Pet PT Pit Stop: "Where's The Evidence?"
Physical Therapy is Great, Except When It Isn’t 
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part I)
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part II) 
What's in a Dog's Gait? 
A Practical Method to manage your Dog’s Care Plan 
Wound Care 101 (Part I The Basics) 
Wound Care 101 (Part II Wound Management)
Prevention and Management of Hip Dysplasia in Puppies: Attention all Breeders!
Support and Braces
Vaccinosis - A Vexing Conundrum 
The Pet PT Pit Stop: Blame it on the Weather, Really!
Relief for Laryngeal Paralysis using Physical Therapy 
Is the Treatment Necessary? Is It Working? 
Preventing CCL (ACL) Tears (Part 1 of series on Cruciate Ligament Tears) 
“All or None, or Partial?” (Part 2 of  series on Cruciate Ligament Tears) 
Full Ligament Tears (Part 3 of series on Cruciate Ligament Tears)

Related articles:
How The Oddysey Started: Jasmine's ACL Injury 
Talk To Me About ACL Injuries
ACL Injuries in Dogs: Non-Surgical Alternatives?
ACL Injuries in Dogs and Stem Cell Regenerative Therapy
Newest Surgery For Ruptured ACL In Dogs
Preventing ACL Injuries In Dogs
ACL Injuries In Dogs: Xena's Story 
ACL Injury Conservative Management: Sandy's Story
Surviving The Post-Op: After Your Dog's ACL Surgery
Talk to Me About Arthritis
Don't Forget the Physical Therapy 
My Love Is Sleeping At My Feet: ACL Surgery Complications 
Coco's TPLO Post-Op Diary 
Small Breeds Can Hurt Their ACL Too: Star's Naughty Knee 
One Thing Leads To Another: Why The Second ACL Often Goes Too 
Dog Knee Injuries: Should You Say Yes To Pain Management?


  1. As you know, we're going through this right now with Haley and tomorrow will be three weeks after her CCL surgery. I've read a lot of different PT schedules, and what our vet recommended was much more aggressive.

    She's putting full weight on her leg while walking slow and we're scheduled to begin longer (20-30 minute slow) walks this coming week along with Sit/Stand exercises and figure eights.

    She seems to be doing very well so far but I hope we're not pushing her too much. Are there different PT schedules depending on the type of knee surgery? Haley had the extra-capsular suture stabilization type.

    Our biggest issue right now is keeping her from moving too fast inside the house. Sometimes she'll spring up quickly and trot to the window to look outside or try to trot ahead of us when walking through the house. I hate to keep her on a leash 24/7 inside the house, but I might have to do that for awhile.

    1. Yes, each type of surgery has a somewhat different rehab schedule. Plus it also depends on the individual dog and adjustments need to be made along the way.

      20-30 minute walks and all that you're doing three weeks post-op does sound rather aggressive but as I said, it does depend on the individual dog and their response. Regular checks should be done to monitor how the rehab plan is working. She should be able to tell you, or the vet, whether she's being pushed too hard or just enough.

      Yes, controlling what they do, particularly in the house is a challenging bit. Often, crating is recommended but that's hard on the dog emotionally.

      Teathering to yourself might help some, though there are challenges with that also.

      Did you ask your surgeon about Trazodone? It's a good option for "chemically restraining" a dog post-op. Cookie has been on this to facilitate her recovery as well. It does take the edge off.

  2. Thanks so much Jana for your input. So far, it seems like she's doing well and there are times that I cut the walks a little shorter when she seems to be dragging a little bit so I have been taking some cues from her too.

    I will definitely ask about Trazodone to see if that might be helpful. In the meantime, I think Haley's starting to learn a new command "Slow Down" for when she tries to move any faster than walking speed.

    Thanks so much for the tips and I hope Cookie has great success with her treatment.