Comet had her first post-operative check-up appointment with her surgeon yesterday to assess the healing from her ACL repair. The surgeon was pleased with her progress at this point and reassured us that the two observations we were concerned about (her reluctance to bear weight through the operated leg while standing still and the external rotation and abduction of her hip on the operated side) are totally normal at this point. The range of motion on her repaired knee is lagging a bit behind ideal, though it is considered fine. We will be focusing more on gradually pushing her more in these passive mobility exercises and holding the end range of the flexed and extended position for five seconds per repetition. This will be a step forward in difficulty for Comet because up until this point, the passive range of motion exercises have just involved gentle moving of the limb through her comfortable range without pushing the “stop points” further and without maintaining a hold for five seconds in each maximal position.
After Comet met with her surgeon, she was introduced to the dog physical therapist who focuses on rehabilitation exercises for injured dogs. It sounds like a cool job; you get all of the rewarding benefits of helping restore a living creature’s mobility and function without the grumbling and resistance that resentful or sore humans tend to dole out during PT. That said, there’s certainly a lot that can be gained and the work facilitated when your patient can clearly communicate with you, the therapist. Like working with babies or non-verbal human patients, a dog physical therapist must interpret facial expressions or yelps and barks and feedback beyond this is minimal. Moreover, it’s not easy to instruct a dog to move in certain ways or explain to him or her the benefits or body cues for an exercise or the program at large. Therefore, it’s obviously not without its challenges, but it still seems fun.
The dog rehabilitation therapist was very organized. She not only ran Comet through all the exercises for demonstration purposes and explained them to Ben, but she provided clear written descriptions, drawings of the motion or starting position, and a flash drive containing videos of each exercise in the rehabilitation program. I find the videos to be especially helpful at translating the written descriptions into something replicable at home without her assistance.
Comet is to continue with her walks, gradually increasing the length by five minutes added on to her longest daily walk per week, but still refraining from hills or stairs for a few weeks. As mentioned, the PROM exercises are to be ramped up in intensity and occur twice per day. She should also do her weight shifting exercises every day, which aim to encourage her to bear more weight through that injured limb and let go of her habit of relying more on her three healthy limbs. In additional to all of this, out of the total dozen or so different exercises demonstrated and prescribed in her protocol, Comet is to do 2-3 of those per day in the specified number of repetitions in a rotating fashion so as not to overstress her knee. Massage and ice should be applied twice per day as well. In three weeks from now (five week post-op), she can tackle stairs, bigger hills, and swimming (though she doesn’t like to swim).
Coming from a background in sports rehabilitation for humans and fitness training, my opinion is that it seems like a sensible, sound program. The individual exercises seem appropriate for her level of healing and like they have been carefully designed to be safe but challenging, so that they effectively progress her towards better function. Some of them are difficult in terms of getting Comet to understand what we are trying to get her to do and then comply, so that she properly executes the motion. Treats are incorporated to help guide her in the right direction by steering her with the enticing treat. Still, I think it will take a week or so to get comfortable with all the exercises and confident in my ability to lead Comet through them without referring to the written or visual directions. Particularly because there are quite a few on the list and she’s only going to be doing 2-3 per day, it’ll take a week or so to conduct a given exercise on two separate occasions.
I’m excited for Comet; I’m proud of how she’s progressing and looking forward to working hard with her on this next set of rehab exercises and increasing her walking tolerance. Perhaps it taps into my first career passion, personal training, and lets me exercise that expertise, and perhaps I’m just finally optimistic again about her return to health after it seemed like she was going to be permanently mobility-impaired to the point that she would always be unable to walk. Either way, I’ll be careful to follow the protocol and spend the time and care on her rehabilitation to give my pup the best chance of a full recovery.