Embedded Files
Page 6
Laser therapy, joint mobilization and compressions, soft tissue massage, and range of motion exercises may be performed initially. Balance exercises are imperative to the stabilization of the shoulder and consist of similar exercises described above with the biceps tenosynovitis cases. Stabilization through conservative treatment may take any where from eight to twenty weeks depending upon the severity. Some cases may require surgery to stabilize the region. Postoperative management of MSI surgeries is specific and the surgeons’ protocol should be adhered to. Elbow Dysplasia Elbow dysplasia is a fact of life in many breeds and is the most common cause of elbow lameness and pain in the dog. Elbow dysplasia may be caused by asynchronous growth of the radius and ulna, Osteochondritis dissecans, a fragmented medial coronoid process, or an ununited anconeal process, or a combination. Diagnosis is typically made between four and eighteen months of age. Treatment of the elbow dysplasia – regardless of surgical or non-surgical treatment – stabilization of the elbow and forelimb complex should be the key concept in treatment. Pain and inflammation should be treated appropriately – a multimodal approach is the best approach and involves a course of pain medications, nonsteroidal anti-inflammatories, and appropriate physical rehabilitation modalities. Modalities very beneficial to these cases include laser therapy, ultrasound, and possibly electrical stimulation for pain control. Moist heat and cyrotherapy are also appropriate for both chronic and acute pain, respectively. If the pain and inflammation are not appropriately addressed, strength and stability will not be regained. The goal with this approach will be to slowly decrease the pharmaceutical interventions and possibly the modalities as well. In some cases, this may not be possible. Range of motion will need to be addressed through active and passive range of motion exercises, as well as possibly joint mobilization or specific movements to increase the range of the area. Range of motion exercises should be performed to the shoulder, elbow and carpal joints. Stabilization exercises include balance and proprioceptive exercises on balance discs, boards and foam, walking in the underwater treadmill, walking on a land treadmill, cavaletti exercises, swimming, theraball work, and walking on uneven surfaces. Balance and proprioceptive work is very beneficial to build up the large core muscles of the shoulder and elbow complex. Walking in the underwater treadmill allows the practitioner to exercise the dog while reducing the stress on the elbow. The water height should be filled up at least to the level of the elbow, and in some cases higher, to reduce the stress on the joint. This allows the muscles to function and strengthen while reducing the stress on the joint itself. Core work should be added for the shoulder and elbow stabilizers but also the rest of the body. Weight loss and weight control play a significant role in rehabilitation of the dysplastic elbow. Once the area begins to function more appropriately through the alleviation of pain and restoration of function, exercise for weight loss is better managed.
Google Sites
Report abuse