rWhat a treat that today is Saturday and we are blessed with perfect spring weather. We had great weather a few days this week, but also two full days of rain. The grass has sprouted several inches over the course of the week. Another great thing about today is that Ben is back from his conference. I’m excited to spend quality time together and show him how Comet is doing.
Comet continued to progress well yesterday. The biggest concern now is keeping her quiet and calm enough so that she doesn’t overstress her still newly-healing leg. She’s welcome to walk around the house as much as she desires and is supposed to take at least 5-6 walks lasting five minutes or so. Her animal surgeon recommends more frequent short walks over fewer longer ones. For example, in this phase of her rehab, she can do three walks of 5-10 minutes, but it’s more ideal to do six walks of five minutes each. Since at least Ben or I are around most of the day, we have the luxury of going the optimal more frequent, but shorter, route.
Around the home, it’s easy to ensure Comet walks nice and slow, but outside, it’s harder. The reason that slow walking is better is because it helps encourage her to start some degree of weight-bearing on her repaired leg without allowing too much weight or any sort of powerful or rapid push-off movement (like that during running or jumping), which is far too much force going through that limb at this time.
I’m pleased that Comet has finally started dropping the surgically-repaired leg down to the ground to participate at least marginally in ambulation and balance while she’s standing. Because her knee was injured for so long, and completely useless and painful during that time, Comet became accustomed to always carrying it up in its fully flexed position under her torso and hopping along on her other three limbs. This actually can cause contractures in the musculature of that hind leg, which essentially means the muscle fibers physically shorten and become permanently less extensible. Humans get contractures too. For example, I have various musculoskeletal and connective tissue disorders that can predispose me to flexibility and strength imbalances and hypermobility and hypomobility. I have contractures of my adductor muscle group. These are the muscles that run along the inner thighs. As a result, I physically cannot separate my legs (as if straddling a wife horse) nearly as far as they should go. I can only get my feet about 32 inches apart, which is far shy of what is expected in a healthy body. Because Comet’s injured leg was chronically flexed up tight against her torso, the extensor muscles, which help straighten the leg to the standing position, have become exceedingly tight. Fortunately, it seems she doesn’t have true contractures. Therefore, though difficult to stretch her leg out (and probably uncomfortable), it’s still possible. With contractures, the tissue has actually shortened and it cannot be fully extended, even if under anesthesia (where the brain can’t interfere and “protect” the limb by blocking extension).
Comet has started toe-touching that leg down to the ground around the house, which means it makes contact and she puts a percentage of her weight on it when she limps along. It seems to go best when she’s distracted by food and not thinking about it. When she’s more deliberately walking about, she still favors her three-legged hopping walk, but if she’s mosying slowly along the floor as a dog vacuum, searching for randomly dropped morsels or intentionally planted treats, her mind is too occupied in the hunt for edible treasures that her brain’s conditioning to avoid using that painful limb is overridden by her desire to move along sweeping the floor surface with her nose and eyes for snacks. It’s quite cute. Since she’s traveling so slowly, in an effort to not miss a single crumb of potentially edible food, the forces going through the repaired leg, even if she uses it naturally like her healthy limbs, are low enough to be safe, and in fact, ideal. We want her to start loading that limb with her body weight; we just don’t want high forces and impulses on it yet, but those are only experienced in high impact, high speed activities. Doggy roomba-ing isn’t going to elicit excessive forces!
It’s harder to ensure she will keep leg forces within safe bounds outside. She generally hops along more quickly on her three good legs and then, as she slows to scope out a place to go to the bathroom and sniff around, she extends the healing leg down. Again, I think it’s partly because she’s distracted, this time not by scavenging for treats, but by scouring the blades of grass for the perfect tuft to pee on (what constitutes this quality from an odor standpoint is beyond me!), that she “forgets” to guard her painful leg and instead allows herself to use it. Again, this barely-moving pace is ideal for starting to use and strengthen that leg. We want it to occur as much as she can tolerate. However, the problem comes when she’s trying to bound along on her three legs, despite my attempt to control and contain her speed via my hold on the leash, and then suddenly uncurls the repaired leg and brings it to the ground. This seems to occur as she’s preparing to slowdown. In this transitional zone where her speed is decelerating from a fast walk or near jog to a slow walk, the forces through the healing leg can be excessive, especially if she’s just beginning to decelerate. Therefore, the goal is not to permit her to get too excited and ramp up her speed to the point that she naturally only relies on her three legs because although that fair is safe for the healing leg since she’s not even using it, it’s virtually impossible to control the point where she will resume use of the injured leg when she slows down. If she self-selects to drop it prematurely, the forces through it will be greater than what is currently safe. I try and prevent this issue by pulling back on the leash like reins as if to restrain her and repeating the phrase, “easy, easy, Commie, go easy.” It’s somewhat effective.
We are using the crate now whenever I step out or have reason to believe she might jump around. She hates it, but it’s for her safety. Overall, I can feel her excitement and happiness. She may not be able to comprehend her injury, surgery, and rehab, but she can definitely experience the benefits of being on the upside of the healing process. Stay patient, my love. You will one day walk with me again!