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Physical Therapy

and Massage for


the Dog
Julia Robertson and Andy Mead

Manson Publishing/The Veterinary Press


Copyright 2013 Manson Publishing Ltd
ISBN: 978-1-84076-144-3

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Contents
Preface ......................................... 4 Chapter 5 Rehabilitation
Techniques.................................113
Abbreviations............................... 5 Julia Robertson
Introduction ....................................113
Chapter 1 Introduction to Physical Exercising........................................114
Therapy and Massage ...................7 Passive movement ...........................118
Julia Robertson and Andy Mead Hydrotherapy..................................122

Introduction......................................07 Chapter 6 Massage in Physical


A brief history of massage.................08 Therapy .....................................125
Current practice ...............................08 Julia Robertson

Chapter 2 Anatomy and Introduction to massage ..................126


Physiology ...................................11 Massage methodology .....................127
Julia Robertson and Andy Mead Massage application ........................134
Massage techniques.........................136
Introduction ......................................11 Assessment of the dog.....................153
Skeletal system..................................12 Treatment .......................................160
Muscular system ...............................22 Contraindications for canine
Fascia ................................................32 massage.......................................164
Nervous system.................................39
Other systems ...................................49 Chapter 7 Common Diseases and
Comparative human and canine Pathologies ................................169
anatomy........................................54 Andy Mead and Julia Robertson

Chapter 3 How a Dog Moves.....59 Investigation of canine lameness .....169


Julia Robertson Common joint diseases causing
lameness ..........................................174
Introduction ......................................59 Disorders of muscles and
Muscle placement and action............60 tendons .......................................191
Initiation of movement .....................62 Neoplasia ........................................193
Development of the puppy...............76 Spinal disease ..................................194
Peripheral neurological disease ........197
Chapter 4 Exercise and Activity
Preparation..................................79 Glossary of terms.........................198
Julia Robertson and Meg Robertson
Further Reading ..........................201
Exercise and conditioning .................79
Performance areas and their Appendix - The muscles of
stresses..........................................87 the dog their placement
Warming up and warming down .....104 and actions...................................202
Warm-up and warm-down for the
handler .......................................108 Index............................................219
4

Preface
This book is intended for canine physical UK, with agility being one of the fastest
and massage therapists, veterinary nurses, growing sports. The demand is great for
trainers, hydrotherapists, and other resource material to cover this subject,
professionals connected with veterinary especially one from both a veterinary and
referral. The level and content could also specialist canine sports physical therapist
be appropriate for informed dog owners perspective. The book includes case studies,
who are keen to learn more about what is sequential photographs depicting move-
under their dogs skin. ment, detailed diagrams to demonstrate the
Currently, canine massage and physical topic, and clear methods of depicting and
therapy are growing markets within the describing muscle position and actions.

Acknowledgements
Sincere thanks to the dogs and their owners Norgate, Lezleigh Packer, Archie, Ale,
who kindly agreed to their inclusion in this Lexy, and Liz Pope, Yogi Tucker; thanks also
book: Copper, Dexter, Digby, George, Jess, to Henry Robertson for additional
Monty, Tally, Tia, Tiggi, Lisa Bishop, Jasper photographs.
Bolton, Archie Govier, C. Kisko, Oscar
5

Abbreviations
ACh acetyl choline NMJ neuromuscular junction
ADP adenosine diphosphate NSAID nonsteroidal anti-inammatory
ANS autonomic nervous system drug
ATP adenosine triphosphate OA osteoarthritis
CDRM chronic degenerative OCD osteochondritis dissecans
radiculo-myelopathy OTC over-the-counter (medication)
CNS central nervous system PNS peripheral nervous system
CT computed tomography POM prescription-only medication
DJD degenerative joint disease PPS pentosan polysulphate
GSD German Shepherd dog TCM traditional Chinese medicine
GTO Golgi tendon organ TFL tensor fascia lata
HD hip dysplasia TPLO tibial plateau levelling
LCPD LeggCalvPerthes disease osteotomy
LMN lower motor neuron UMN upper motor neuron
MRI magnetic resonance imaging
7

1
Introduction to Physical
Therapy and Massage
Julia Robertson and Andy Mead

Introduction
A brief history of massage
Current practice

Introduction
Physical therapy is concerned with the prevention,
management, and treatment of movement and allied
disorders. It encompasses detailed assessments and treatment
programmes that involve hands-on therapy, along with
dynamic remedial and strengthening techniques using
exercise plans. As far
as dogs are concerned,
this is an evolving
therapy (1), but one
that has been used for
centuries. It was ex-
pounded by a famous
Greek practitioner,
Arrian, who wrote
about how massage
would help horses and
dogs, asserting that it
would strengthen the
limbs, render the hair
soft and glossy, and
cleanse the skin.
1 Physical therapy in the dog.
(Courtesy of Henry Robertson.)
8 Chapter 1

Medical breakthroughs by many shell shock were treated with massage. By


famous historical gures have been 1900, the Society had acquired the legal
documented over the centuries; and public status of a professional
Hippocrates, who is known as the father organization, and became the Incorpo-
of medicine and who was the originator rated Society of Trained Masseuses. In
of the Hippocratic Oath, was a 1920, the Society was granted a Royal
documented practitioner of massage and Charter. It amalgamated with the Institute
physical therapy, developing their use of Massage and Remedial Gymnastics,
through his teachings. Centuries later, forming the Chartered Society of
Claudius Galenus of Pergamon (circa AD Physiotherapy. St Thomas Hospital,
129) further developed Hippocrates London, had a department of massage
anatomical knowledge and surgical skills, until 1934. However, later breakthroughs
and continued the incorporation of in medical technology and pharmacology
massage in his work at the school for eclipsed massage as physiotherapists
gladiators, to aid healing and pain control. began increasingly to favour electrical
He is thought to be the rst sports instruments over manual methods of
therapist. stimulating the tissues.

A brief history of massage Current practice


Massage is one of the oldest forms of Recently, some physical therapies used in
therapy. Egyptian tomb paintings show humans have been extended to horses, yet
people being massaged. In Eastern the transfer to dogs has not been explored
cultures, massage has been practised as fully. Therefore, little research has been
continually since ancient times. A Chinese conducted into muscle dysfunction in the
book from 2700 BC, The Yellow dog. Only recently have the canine health
Emperors Classic of Internal Medicine, benets of physical therapy and massage
recommends breathing exercises, massage been identied, as the popularity of sports
of skin and esh, and exercises of hands such as agility, increases.
and feet as the appropriate treatment for There are a few modern practitioners
complete paralysis, chills, and fever. In and teachers of the art of canine massage
India, the traditional healing system of who have been responsible for quietly
Ayurvedic medicine also prescribes mass- projecting the therapy to many through
age for a variety of medical conditions. high-quality professional teaching. One
Physicians of ancient Greece and Rome who stands out is Patricia Whalen-Shaw,
also utilized massage as one of the primary who practises and teaches in Columbus,
methods to treat pain. Ohio in the USA. For many years, she has
In Europe, doctors such as Ambroise been developing the art and transferring
Pare, a 16th century physician to the her skills to many, not only in the USA, but
French court, praised massage as a in all corners of the globe. Many of the
treatment for various ailments. Swedish techniques shown in Chapter 6 have been
massage, the method most familiar to adapted from, or taken from her book
Westerners, was developed in the 19th Canine Massage the Workbook.
century by a Swedish doctor named Per With canine sports growing, it is a
Henrik Ling. His system was based on a travesty that most of the people competing
study of gymnastics and physiology, and with their dogs, and their trainers, are
on techniques borrowed from China, ignorant of the basic indicators of a
Egypt, Greece, and Rome. compromised muscular system. Due to a
With the foundation in 1894 of the dogs fundamental instinct to protect itself
Society of Trained Masseurs, World War I and maintain the security of the pack, it
patients suffering from nerve injury or will not overtly inform us of a problem
Introduction to Physical Therapy and Massage 9

until suffering from obvious physical have been conditioned to condemn touch
dysfunction. Thus we will often have to for many reasons, many animals are aware
second guess muscular and myofascial of the power of physical manipulation to
disorders, as the dogs, more often than not, ease the soreness of muscles. This is evident
do not show any obvious signs. when treating dogs, as they are more in
Following an injury or strain, the body touch with their bodily requirements than
will become altered by its efforts to we are, and know what they need to ease
compensate, which then means that a problem. It is, therefore, the duty of
biomechanical changes will occur. If these handlers to be more aware of their dogs
are allowed to remain untreated, the so- overall health, including awareness of its
matic appearance will also alter as the body muscular system. This will, then, improve
adapts to the stress; sometimes pathological the relationship between man and dog.
changes will also become evident, and can The purpose of this book is to provide
be traced back to the initial injury. Such an insight into this subject, and to
changes usually end up being treated in demonstrate that damage of one part of
isolation rather than together; sometimes, the body, no matter how small, will affect
therefore, the effects are being treated the whole. Even a small repetitive injury
instead of the cause. can have the same long-term effects as a
The canine body, like any living body, massive acute injury. Recognition of this
requires balance, or homeostasis, to thrive; concept can help to prevent injury, enable
without this, systems can suffer. To the handler to know when to seek
maintain balance, all the bodys systems professional assistance and treatment, and
have to work together. For example, pain in give the dog the opportunity to have a
the muscular system can affect behaviour long and pain-free life.
patterns (as any form of pain will affect
behaviour), the digestive system (stress
from pain can have an effect on digestion), Dew of the morning,
and compromise the peripheral neuro- Meet the warmth of the early sun;
logical system. The colours mix as milk and honey in a
The repeated postural and traumatic bowl,
insults of a lifetime, combined with the They nourish and heal;
tensions of emotional and psychological When poured, they fall as ice,
origin, often lead to a confusing pattern of When they touch the earth, they become
tense and contracted brous tissue. This water,
may appear to the uninformed handler, for Cleansing where they pool.
example, as an obvious lameness. This
complexity of initial trauma mixed with Anon (2007)
compensatory factors can present an (A handlers poem describing her
extremely misleading set of symptoms. It experience of her dogs treatment and
seems that, sometimes, the dog is shouting subsequent return to health.)
to us for an appropriate response to its
crisis, and we seem to be unable to listen.
Sara Wyche, in her book entitled The
Horses Muscles in Motion puts it very well:
If its the body that speaks the language,
then it is the muscles that supply the
words.
Mutual grooming and touch therapy is
an important component of animal pack
and herd behaviour. Unlike humans, who
11

2
Anatomy and
Physiology
Julia Robertson and Andy Mead

Introduction
Skeletal system
Muscular system
Fascia
Nervous system
Other systems
Comparative human and canine
anatomy

Introduction
A balance is required in the body on a cellular level, as it is
in every part of nature. The basic requirement of every cell
must be met in order for it to survive, in the same way that
soil must be correctly balanced in order for a plant to grow
well. If one part of a system is not working properly, it will
have an effect on another part of the system and the overall
performance will be compromised. This chapter will aim to
show how the body works in this holistic way and how each
system interacts with another. In order to understand how
massage and physical therapy affect the body, it is important
to understand the systems within the body, how they
function, and, most importantly, how they inter-relate.
12 Chapter 2

Skeletal system It is not the intention to describe the


The skeleton can be dened as the stiff anatomy of the canine skeleton in great
hardened tissues that form the supporting detail here, as there are many other texts
framework of an animals body. The on the subject. Instead, an overview is
skeleton is often divided into three distinct presented.
portions: the axial, the appendicular, and Bones are a vital part of the skeletal
the visceral skeletons (2). system. They provide support and give
shape to the body, as well as protecting
The axial skeleton comprises vital organs including the heart and
the bones of the skull, the the brain. Above all, bones enable
hyoid apparatus (larynx), the movement.
vertebral column, and the ribcage. Bones comprise semi-rigid connective
It principally performs a tissue and a mineral component, hydro-
protective role. xyapatite. The connective tissue is formed
The appendicular skeleton comprises of type 1 collagen, the most common
the bones of the limbs and the bones protein of connective tissue, which is
that connect the limbs to the axial made up of three polypeptide strands
skeleton, e.g. the pelvis joining onto interlinked by hydrogen bonds into a left-
the sacrum. handed helix. This provides an essentially
The visceral skeleton comprises the brittle matrix of bone; what little capacity
bones that develop in soft tissue it has to withstand compressive and
structures. In dogs, this includes only tensile forces is provided by weak
one bone, the os penis. hydrogen bonds between strands.

Axial
Appendicular

Visceral

2 Major divisions of the canine skeleton.


Anatomy and Physiology 13

Hydroxyapatite is essentially calcium Maintaining calcium homeostasis.


and phosphorus (Ca10[PO4]6[OH]2) and Detoxifying heavy metals.
constitutes approximately 70% of bone. It Producing blood cells within the
usually crystallizes in a very organized marrow.
hexagonal pattern, providing rigidity to Transferring sound though the bones
the structure of bone, as well as giving of the ear.
bone its smooth, white appearance. Bone The structure of bone can be categorized
also contains many different types of cells into two types, compact and trabecular.
supported within the matrix, which allow
the structure to grow, repair, and, perhaps Compact bone
more importantly, provide a scaffold for This forms the hard outer layer of bone,
the performance of vital functions, such as which is both smooth and well-ordered.
red and white blood cell production. There are minimal gaps here between
Bone is the bodys mineral store, collagen bres and the mineral matrix.
providing a reservoir of, for example, Compact bone is often referred to as
calcium and phosphorus, which can be cortical bone (3).
mobilized for the purposes of:

Osteone

Blood vessels Osteocyte

Haversian canal

3 Diagram of cortical bone showing osteones and structural organization.


14 Chapter 2

Trabecular bone Cellular structure of bone


This forms the rather more disorganized, It is necessary to discuss in some detail the
spongy, central portion of bone (4, 5). cellular structure of bone in order to
Trabecular bone reduces the total weight understand better the process of bone
of a bone, as well as providing a development, and thereby understand
framework for blood vessels and nerves. how, if disturbed, these processes can lead
Without the presence of this type of bone, to malformation and disease which may
mammalian species would be greatly become signicant in later life.
restricted in terms of size, due to the fact The main building blocks of bone at
that greater muscle mass would be the cellular level are osteoblasts,
required to lift and move heavier bones. osteocytes, and osteoclasts. These cells are
Without trabecular bone, bones of the present within bone throughout life. Bone
axial skeleton would need to be as wide as is constantly being remodelled, as it is
they were long in order to withstand the subject to ever-present stresses and strains,
forces put on them. Trabecular bone is even at a microscopic level. Each of these
often harvested surgically to aid with constituent cells of bone has a different
fracture repair. role in the development and maintenance
of its structure, and of calcium homeo-
stasis. All are given the prex osteo,
which pertains to bone.

Osteoblasts
These are bone-forming cells that produce
osteoid, which is principally made up of
collagen type 1. Osteoblasts have roles in
the production of hormones and enzymes,
most notably the enzyme alkaline
phosphatase, which, among other
functions, enables the mineralization of
bone.

Osteocytes
Osteocytes are essentially osteoblasts
4 Trabecular bone showing disorganization which become trapped in the collagen/
of structure. hydroxyapatite matrix and occupy a space
within the structure called a lacuna. These
cells communicate with one another
Periosteum Osteone through special channels and help bone to
manage forces and stress, as well as playing
Cortical a part in calcium metabolism. Calcium
bone homeostasis is imperative within the
mammalian body, in order to allow
muscle contraction, nerve communi-
cation, and maintenance of the correct
Spongy
structure and rigidity of bone.
bone
Osteoclasts
5 A section through bone showing the These are cells engaged in the remodelling
position of trabecular and cortical bones. of bone during growth or after injury.
Anatomy and Physiology 15

Bone development
The process of bone development is Epiphysis
complex, and will not be covered in great
detail within this text. The embryo Metaphysis
Epiphyseal
undergoes the process of gastrulation,
line
which involves the early fetal cells
differentiating into three distinct layers
ectoderm, mesoderm, and endoderm. It is
the mesoderm layer that produces the
rudimentary origins of limbs, and Diaphysis
therefore bony tissue. The process by
which bone develops from this mesoderm
is known as ossication; the process is
subdivided into endochondral ossication
and intramembranous ossication.

Endochondral ossication
Metaphysis
Endochondral ossication commences
within the embryo and only nishes when
Epiphysis
the animal reaches maturity. Put simply,
an initial scaffold of cartilage is gradually Area of growth
replaced with both cortical and trabecular (Epiphyseal slot of growth plate)
bone tissue. Such a process accounts for
the development of every long bone of the 6 Endochondral ossication showing the
body. position of diaphysis, metaphysis, and
The cartilage template formed within epiphysis.
the embryo by the mesodermal cells is
replaced by bone at three distinct
ossication centres: the diaphysis (or
middle) of each long bone, and two
epiphyses, one at each end of the long
bones. This process occurs from the centre
outwards; long bones end up capped by
cartilage which has not been ossied. This
forms the articular cartilage of joints. Two
discoid areas develop between the
epiphyses and the diaphysis, known as
growth plates or metaphyses (6).
Lengthening of bone always occurs at the
side of the growth plate that is closer to
the epiphysis. centres, allow long bones to lengthen as
As previously discussed, the inner core the animal grows, long after it has left the
of a long bone is spongy or less solid. It is womb. This process only stops once these
the osteoclasts that remodel and reshape growth plates close, i.e. are also ossied, a
bone which results in the presence of a process that occurs only when an animal
cavity in the centre of long bones known reaches maturity. However, these growth
as the medullary cavity. plates vary in the age at which they close.
The growth plates, which remain after To the untrained eye, they can often be
the differentiation of the ossication mistaken for fractures on radiographs.
16 Chapter 2

Intramembranous ossication Classification of bones


This differs from endochondral
ossication in that there is no cartilaginous Long bones
scaffold, bone being formed directly from Long bones are longer than they are wide,
brous connective tissue. This occurs in and consist of two epiphyses covered in
bones such as the frontal bone, and others articular cartilage and a diaphysis (7).
that form the skull. These are the main bones of the limbs and
their shape means that they act as levers.
Bone construction
The form/shape of any long bone is Short bones
determined by the cortex, the outer strong These are roughly cube shaped and consist
layer of the bone. The cortex is arranged of a core of cancellous bone covered by a
in a uniform manner comprising a central layer of compact bone. Short bones are
channel, the Haversian canal, through only found within the carpus and tarsus
which blood vessels, nerves, and lymphatic (8).
vessels ow. Around this, a matrix of
hydroxyapatite and collagen form con- Flat bones
centric tubes known as lamellae. The Flat bones consist of two plates of
whole system is known as an osteone (3). compact bone with a core of cancellous
Within the lamellae are spaces (lacunae) bone. Examples include the majority of
which are home to the osteocytes. The bones in the skull and the ribs (9).
whole system of lamellae, lacuna, and
Haversian canals is referred to as the Irregular bones
Haversian system, which, as previously These are similar to at bones, except that
discussed, can be densely packed, as in they are far more complex in shape and
compact bone, or separated by much arrangement. The vertebrae are examples
larger spaces, as in cancellous bone. of irregular bones (10).
The entire surface of bone, apart from
the joint capsule, is covered by a tough Sesamoid bones
connective tissue, the periosteum, which These are small bones buried within
has the primary role of forming attach- tendons. They reduce friction and,
ments for muscles, tendons, and ligaments. therefore, tendon damage, by altering the
The periosteum also has bone-forming angle at which a tendon passes over a
properties which may be called upon on joint, allowing greater ease of movement
in the event of a fracture. and acting as a pivot. These specialized
Like any other cells of the body, the bones prevent tendon wear and increase
cells of bone require nutrients and the leverage. The most obvious example of a
removal of waste products. These are sesamoid bone is the patella (11).
supplied and removed by an extensive
skeletal blood supply which comprises 5%
or more of the cardiac output. Such blood
vessels, known as nutrient arteries,
penetrate the cortex of bone via nutrient
foramina and go on to form the tiny blood
vessels of the Haversian systems.
Anatomy and Physiology 17

7 Diagram of a long bone, showing


Epiphyseal cartilage portions of spongy and cortical bone, and
articular and epiphysial cartilage.
Articular cartilage

Spongy bone

Cortical bone

Frontal bone

Carpal bones
1: Accessory carpal
1
bone
2 3 2: Ulnar carpal
3: Intermediate carpal

8 Short bones of the carpus. 9 The frontal bone of the canine skull, a
at bone.

Fabella
(Sesamoid)
Patella
(Sesamoid)

10 A lumbar vertebra, an irregular bone. 11 Sesamoid bones such as the patella and
fabella in the canine stie joint act as pivots
and allow exion and extension.
18 Chapter 2

Biomechanics of bone Different types of joints allow different


When weight or stress is applied to bone, amounts of movement. Indeed some
it acts like a beam of wood or steel the joints allow no movement at all; for
force is concentrated in the outer surface, example, the joints of the skull; these are
which explains why the medulla need not called synarthroses. For the purposes of
be solid like the cortex. Similarly, this physical therapy, the movable or synovial
accounts for the fact that bones are often joints, by far the most common joints of
tubular in shape. The cortex has the ability the body, are the most important (13).
to recover from considerable deformation; The structure of the joint determines the
however, should the osteones bend or type and direction of movement allowed.
stretch too far, stress fractures will soon This provides a logical system for
appear, even if there is not enough force classication: they can be either plane, ball
to break the bone in two. The majority of and socket, hinge, pivot, condylar, or
fractures are caused by excessive bending, saddle joints.
stress being applied to both sides of the
bone equally. However, different types of Movements of joints
forces will affect opposite sides of the These are divided into the following
bone: one side will be affected by tensile categories:
forces pulling the cells, lamellae, collagen,
and mineral components apart, and the Flexion decreasing the inner angle
other will be affected by compressive between two bones, or bending the joint.
forces pushing structures together and Extension increasing the angle, or
crushing them (12). Generally speaking, straightening the joint.
the former are more easily dealt with by Abduction pulling away from the
bone. centre or axis; for example, moving
the pelvic limb laterally.
Joints Adduction pulling towards the
Joints are dened as the junction between centre or axis; for example, moving
two or more bones and are classied as the pelvic limb medially.
simple or compound. Joints provide Rotation movement around an axis.
motion and exibility to the skeleton and, Circumduction circular movement
perhaps most importantly, allow growth. of a limb.

Force (weight) Articular


exerted cartilage Synovial
membrane
Joint
capsule

Compression Tensile Fibrous


forces forces layer
Joint
cavity

12 Forces involved in the bending of bone. 13 Synovial joint.


Anatomy and Physiology 19

Protraction in this context, moving a become clear when discussing diseases


limb forward. associated with synovial joints in sub-
Retraction pulling a limb backwards. sequent chapters.
In a synovial joint, the two articulating
In the case of the elbow, a hinge joint bones are divided by a uid-lled
permits exion and extension (14). In the structure, the joint cavity. The uid
hip, a ball and socket joint allows exion, (synovial uid) is found within the joint
extension, abduction, adduction, rotation, capsule and is surrounded by a thin layer
and circumduction (15). of synovial or joint uid-producing cells,
known as the synovial membrane. This is
Joint structure a weak structure and is often, but not
For the purposes of this text, we shall always, given strength by various
concentrate on the structure of synovial additional ligaments and tendons, which
joints. The importance of structure will are designed to prevent movement in

14 An elbow joint
undergoing exion
and extension,
medial view.

Extension Flexion

15 Dog pelvis and


femora cranial
view. Rotation,
adduction, and
abduction of the
hip joint.

Rotation

Abduction Adduction
20 Chapter 2

certain directions and limit the amount of Crest a ridge of bone, e.g. the
movement that can be achieved by a joint occipital crest of the skull.
(16). At either end of the opposing bones Condyle a rounded projection of
and within the joint capsule is articular bone at a joint, e.g. the femoral
cartilage, a specialized form of cartilage condyle.
that reduces the friction and compressive Epicondyle a separate, smaller
forces of locomotion. The purpose of prominence close to the condyle.
articular cartilage is to cushion the bones Foramen a natural opening through
and prevent wear and tear. It is smooth, a bone, through which muscles,
elastic, and thick in the areas which nerves, blood vessels, etc. pass, e.g. the
require it most, i.e. the points at which the obturator foramen of the pelvis.
compression and friction forces are Fossa a hollow or depression, e.g.
greatest. the olecranon fossa of the elbow.
In dogs, the articular cartilage is only Head a rounded articular surface,
1mm thick in places; therefore, it is fragile e.g. the head of the femur.
and subject to damage from an early age. Tuberosity a protuberance of a
Articular cartilage has no nerve or blood bone, e.g. the tibial tuberosity.
supply and only receives nutrient support Trochanter a type of tuberosity
by diffusion from the surrounding specic to the femur and a large
structures, particularly the synovial uid. rough process, e.g. the greater,
Surrounding the articular cartilage within lesser, and third trochanters of the
the joint capsule is the synovial uid, femur.
which is derived from the synovial cells of Trochlea a depression in the bone
the synovial membrane. The synovial where major tendons lie forming a
membrane is a connective tissue sheet type of hinge, e.g. the trochlear groove
that produces the lubricant of the of the knee joint.
joint, called the glycosaminoglycans. The Tubercle a small rounded process,
synovial membrane has a rich vascular e.g. the greater tubercle of the femur.
supply and innervation. The uid it
produces is very viscous, its viscosity often For the practitioner, it is important to
being measured to establish the cause of be able to identify the palpable
various disease processes. The synovial bony prominences of the canine, for
uid acts as a lubricant, reducing the example, the greater trochanter of the
friction between joints, and as a nutritional femur (17), the vertical spinous processes
source for the surrounding articular the ilium of the pelvis, and so on. These
cartilage. points of reference are far easier to palpate
Surrounding and encapsulating all in the t athletic patient and within
of the above is the joint capsule, a brous certain breeds, for example the
layer. This attaches to the bone on either Greyhound. These landmarks are
side of the joint and provides congruity. best described diagrammatically (18).
Proprioceptive nerves innervate these
structures. The ligaments provide strength
to the joints themselves.

Skeletal terminology
In order to describe the position of bony
lesions accurately, it is important to use
the correct anatomical terminology. The
various parts of a bones surface are called:
Anatomy and Physiology 21

Patella tendon Femoral head


Greater
Cruciate ligaments
trochanter Fovea of
Collateral ligaments femoral
head

Neck of femur

Sesamoid
bones (fabellae)
Lateral
16 Cranial view of a simplied stie joint, epicondyle
showing ligaments and tendons. Medial
Lateral condyle
condyle

17 Palpable points of the canine femur,


caudal view.

Anticlinal Dorsal border


Transverse process of
Spinous process vertebra of the scapula
the cervical vertebra
of the lumbar
vertebra Spinous
process of Atlas
Iliac crest/cranial the thoracic
dorsal iliac spine vertebra
Greater
trochanter Spine of the
scapula

Acromion process
Manubrium
Ischiatic
Greater tubercle
tuberosity Patella of the humerus
Deltoid
tuberosity
Lateral epicondyle
of the humerus
Lateral (medial aspect,
condyle of Olecranon
medial epicondyle
the tibia process
of the humerus)

Calcaneous and Carpus


Lateral epicondyle of the femur calcaneal tuberosity
(medial aspect, medial
epicondyle of the femur)
18 Palpable canine bony landmarks.
22 Chapter 2

Muscular system bre, or cell, is the basic unit of


The muscles of the body are incredibly contraction and it is made up of two types
powerful and are designed to act on the of protein laments, actin and myosin
levers or joints of the bodys skeletal (19). Thousands of these laments group
system to initiate, drive, and sustain together to form myobrils and a cluster
movement. It is important to understand of myobrils form one muscle bre.
how this system is designed and operates, Muscle bres are then bound together by
as it directly inuences the positioning and connective tissue called endomysium to
balance of the whole skeletal system. The form a fascicle, which is, in turn, contained
skeletal muscular system is one of the within more connective tissue, the
largest systems in the dogs body and its perimysium, to form the whole muscle.
purpose is to provide movement. There Nerves and blood vessels run through and
are muscles which initiate movement and along these layers of connective tissue.
others which control and stabilize. All of Muscles form overlapping layers in an
these must work together for the intricate pattern over a dogs entire body.
muscular system to operate effectively as The rst layers of muscles immediately
a whole. Therefore, it is important to view under the skin are called supercial
muscles as an entity and not in isolation; muscles, with the layers lying beneath
they form groups that are working being known as deep muscles. Muscles
together, sometimes having common that span one joint are called uniaxial and
origins and insertions. those that span two joints are called
biaxial. The joints they span provide
Muscle anatomy movement through the articulation of the
There are three types of muscle; the main skeletal joints (see Skeletal system).
difference between them is the way they The muscles attach to bones using
are innervated. tendons known as insertions and origins.
The origin of the muscle is generally
Skeletal/striated muscle when situated closer to the body centre and the
applying physical therapy we are insertion, with a few exceptions, is further
primarily working with this type of from the body centre. The insertion
muscle, which can also be referred to generally has the stronger attachment and,
as voluntary muscle. It is involved therefore, is more often the site for stress
with movement of the body as a injuries.
whole and in most dogs it accounts The centre of the muscle and/or the
for about 44% of the body weight, thickest section is called the belly. Muscles
although this rises to 57% in and their grouping can be diverse in their
Greyhounds. anatomy; they can have more than one
Smooth/visceral muscle this type of belly (e.g. the triceps brachii muscle, 20),
muscle is concerned with the control or long tendinous bodies (e.g. the
and movement of internal organs. pectineus muscle).
Heart muscle this is only found in The appearance of muscles varies
the heart. greatly, from large muscles in the legs,
which are used to perform a powerful
Skeletal muscles consist of densely driving movement, through to the smaller
packed bundles of elongated cells known supportive muscles that provide strength
as muscle bres, which are held together and stability. Generally, it can be said that
by brous connective tissue. The muscle the deep muscles provide support for the
Anatomy and Physiology 23

From muscle to myobril Perimysium

Fascicles

Muscle

Muscle bres
Myobril
Z band

Sarcomere

Actin
Myosin

19 Structure of a myolament in muscle.

Lateral view Medial view

Long
head

Accessory
head
Medial
head

Lateral
head

20 The triceps brachii muscle, showing three heads and one insertion, and fusiform type
(medial view).
24 Chapter 2

skeleton and provide strength, while the these is the supercial pectoral muscle.
supercial muscles provide the Smaller muscles, which work to control
movement. Skeletal muscles vary in shape and stabilize the overall movement in
and function; each has evolved to suit its conjunction with the prime mover, are
unique purpose by its origins, insertions, called synergists; for example, the medial
and positioning: gluteal muscle.

Fusiform (spindle shaped) these


consist of muscle bres which run the
length of the muscle belly and
converge at each end. This strap-like,
round shape enables this muscle type
to perform a large range of
movements. This formation is
generally found supercially in
the larger skeletal muscles and
those involved with exion and
extension of the skeletal joints to
provide movement, e.g. the triceps
brachii.
Pennate (featherlike) these
muscles tend to be at with their
bres arranged around a central
tendon. They can be unipennate (21),
bipennate, or multipennate (22),
depending on the arrangement
around the central tendon. This
formation is generally found in deep
muscles that are involved with
stabilizing and postural requirements
for movement.
Postural/stabilizing muscle these
support the skeleton and tend to be
shorter than the movement muscles.
Muscle belly
Some have several origins, and their
arrangement produces the power
required for maximum stability and
to sustain a joint in a good position
during weight transference. These
muscles tend to be in various pennate
bre arrangements and are highly
innervated to provide the varied and
intricate movements required for joint
stability. They generally have a greater
proportion of slow twitch muscle
bres (see Muscle physiology). Single
tendon
The larger postural muscles that hold a
position during a specic movement or
action are called xators; an example of 21 Unipennate muscle.
Anatomy and Physiology 25

Points of origin
spinous part

Spinous head

Point of origin
acromial part
Acromial head

Displaying multi-
tendinous insertion
points

22 Multipennate deltoid muscle.

Skeletal muscles can also be classed as positioned ventrally to the transverse


extrinsic or intrinsic: processes and is involved with exion of
the neck, thorax, and tail.
Intrinsic muscles are positioned
within one area of the body, Muscle physiology
either appendicular or axial, and Voluntary muscles are stimulated to
do not engage with the other division. contract by electrical activity originating
For example, the deltoid muscle is in nerve cells in the central nervous system
intrinsic to the thoracic limb (22). (CNS). These nerves synapse with nerve
Extrinsic muscles cross regions and cells (motor neurons) of the peripheral
act or move the appendicular skeleton nervous system (PNS). The motor nerve
in relation to the axial skeleton, e.g. enters the target muscle or muscles at the
the trapezius muscle. neuromuscular junction (NMJ) (also
known as the myoneural junction),
The muscles that lie dorsally and approximately two-thirds along the length
ventrally to the vertebral column are of the muscle, away from its origin
divided into two groups: hypaxial and towards the insertion, where the nerve
epaxial. Epaxial muscles are a complex forms an end plate. The neural pathway
group that is situated dorsally to the carries a signal from the CNS to the
transverse processes and support, extend, muscle in the form of cellular movement
and facilitate lateral exion of the of sodium and potassium ions. This signal
vertebral column. The hypaxial group is then causes a release of calcium ions from
26 Chapter 2

a part of the muscle bre called the of nerves that serve the bres. These bre
sarcoplasmic reticulum. The muscle bres types each have different functions:
then contract by the protein laments
(myosin and actin) sliding closer together. Slow twitch type 1 these are
This shortens the overall length of the intended for producing lower levels of
bre, leading to a contraction of the speed and power, but can operate
muscle as a whole (23). effectively for a sustained period of
There are three main types of muscle time. This type of muscle bre is
bre, differing in the types and quantities dense with capillaries (bringing in

A muscle twitch from voluntary initiation to contraction

The brain receives Stimulating a crossing ...neurotransmitter


signals to activate of sodium and called acetylcholine
muscle called potassium ions (ACh) required for the
nerve impulse or present in the nerve transmitting and
action potential. cell, promoting an amplifying signals
electrical charge that through the motor or
transmits neuron to efferent nerves to
neuron to the target the...
muscle via a...

...neuromuscular
The binding of the junction (NMJ) that
This signals a
neurotransmitter connects with the target
release of calcium
(ACh) and the muscles motor end
from the organelle
sodium channels in plate.
called
the sarcolemma The sarcolemma at the
sarcoplasmic
depolorize the site of the motor end
reticulum.
muscle membrane plate has an enhanced
facilitating bre surface area for
innervation. neurotransmission
reception.

The calcium triggers the


This creates a muscle
binding of myosin to the
contraction or twitch
actin forming cross
(concentric, eccentric,
bridge between the
isometric) on functioning
thick and thin laments
muscle bres using ATP as
and shortening the
the energy currency.
sarcomere.

23 Algorithm for muscle contraction.


Anatomy and Physiology 27

oxygen) and has many mitochondria muscle bres become shorter, fatter, and
(the energy factories of a cell) and assert a force on the fascia, tendons,
much myoglobin (the oxygen- periosteum, and the joint. Each bre is
containing component of muscle); either fully contracted or fully relaxed. If
therefore, it can sustain aerobic the muscle as a whole is applying 50%
activity. These bres are involved in effort, then half of its bres will be
stability and core support and contain contracting and the other half will be
smaller motor neurons. relaxed. Then, as the contracting bres
Fast twitch there are many different begin to experience fatigue, the relaxing
divisions of this type: type 2, type 2a, bres will be employed.
type 2x, and type 2b; they are divided When a dog is t and conditioned (see
into groups according to their Chapter 4) for the exercise or activity in
contractile speed, numbers of mito- which it is participating, the time between
chondria, and how much myoglobin optimum muscle function and fatigue will
they contain. These have higher ring be greater than that of a dog that has not
frequencies than slow twitch bres to been prepared appropriately. For muscles
produce the contractile speed, and to function healthily, they must be in
with their larger bres produce more balance, like the rest of the body, and have
force per motor unit. adequate functioning bres, innervation,
Fast twitch type 2 these bres nutrition, oxygen (from the blood supply),
have the capability to contract combined with a balanced excretory
quickly, but have poor endurance. process (Table 1). With these in balance,
They are involved in skeletal the chemical interplay between the CNS,
movement and are supplied with PNS, and the individual muscle bres will
larger motor neurons. function effectively. When any one of
Fast twitch type 2a these are a these factors fails to operate, the muscle
small group of muscle bres that cell or bre will be adversely affected.
fall between the two other
categories, providing a more even
combination of speed, power, and
endurance.
Fast twitch type 2x and type 2b
these have an even higher power
potential but are less resistant to
fatigue and have poorer endurance Table 1 Requirements for muscle
than type 2. contraction (or twitch)
Direct innervation
The main difference between muscle
bres is in their innervation, or type of Intracellular chemical balance and
nerve supply. For example, the fast twitch feedback mechanisms:
possesses a larger motor neuron which sodium/potassium/calcium
enables it to contract faster. The Functioning muscle bres/cells
proportion of fast and slow twitch bres Adequate glycogen store
will be determined by the required action Adequate oxygen supply
of the muscle, which means that a deep Adequate nutritional supply
postural muscle will have a greater (arterial supply)
proportion of slow twitch bres. The Adequate by-product removal
distribution of these different bres is (venous return)
generally hereditary and cannot be altered
with training. When muscles contract,
28 Chapter 2

The energy provider of muscle requirement of bre recruitment and


contraction is a chemical called adenosine force is controlled by the afferent
triphosphate (ATP) that is produced and (sensory) nerves, running from the muscle
stored in the muscle cells. The bonds to the CNS, and efferent (motor) nerves,
between adenosine and phosphate are running in the opposite direction. The
strong and produce much energy when sensory structures within the muscles
the bonds are broken. Release of one (muscle spindles) lie parallel to the muscle
phosphate results in the formation of bres and relay constant messages back to
adenosine diphosphate (ADP) plus the CNS on the length of the muscle bre
energy. This energy source can only sustain required to maintain proprioception (see
a contraction for a matter of seconds. Nervous system).
Creatine phosphate, which is also stored This system is coupled with the Golgi
in the muscle, then provides a source of tendon organs (24) that are located within
phosphate to replenish the depleted ADP, the tendons; these report on the tension
so it once again becomes ATP. However, or force being exerted through the muscle
this further replenishment of the to the tendon. This information is
phosphate component of ADP can only constantly transmitted back to the brain,
provide the energy required for muscle so there is appropriate bre recruitment
contraction for a further few seconds. for the force required. This is important
For more sustained and prolonged to understand when trying to enhance the
muscular contraction, glycogen derived range of movement during rehabilitation;
from dietary carbohydrates and stored it is often called muscle memory.
within the cells of the muscles, is broken Most movements require a force far
down through a method involving smaller than that a muscle could
anaerobic (oxygen-lacking) glycolysis. This potentially generate and, therefore, muscle
process produces a source of ATP that can bre fatigue, or a reduction in muscle bre
be used to sustain prolonged continued ability to produce the required force, is
contractions of muscle bres. The by- unusual in normal situations. However,
product of this continuing process is when muscles tire, due to a reduction or
pyruvic acid, which is broken down by the restriction of the requirements for
oxygen supplied to the muscle bres from contraction (Table 1), they cannot
arterial blood delivery and is converted produce the required force. This is
into glycogen by the liver. The glycogen is generally through a lack of conditioning
then transported back to the muscle cells (see Chapter 4), general tness, or
by the arterial blood supply. If muscle cells inappropriate muscle phasing through
are in an oxygen-decient state, pyruvic injury. Chemical imbalance is thought to
acid is metabolized to lactic acid, the be one area that can cause fatigue in cases
presence of which can cause discomfort. of excessive training or exercise. When
It is now thought however, that rather muscles are worked hard and trained hard,
than lactic acid being detrimental to the calcium channels that supply calcium
performance, it could also be converted to the muscle for the myosin to bind with
into a valuable source of energy by the actin bres can start to leak. However,
mitochondria within the muscle cells. if the muscle is rested for a day or so, this
The neural process involved in internal leak can repair and normal
muscular activity plays a signicant role in function can resume.
muscle recruitment, relaxation, and, thus, A major cause of a lack of, or reduction
the state of activity. Nerves are responsible in, muscle function is microtrauma to
for controlling the contraction of muscles single muscle bres. This can be caused
and determining the number, sequence, through over-exertion over a period of
and force of muscular contraction/s. The time, repetitive strain, or minor injury. It
Anatomy and Physiology 29

Patella

Femur
Nerve endings

Tibia
Tendon

Patella tendon
Afferent nerve

24 Diagram of a Golgi tendon organ.

can lead to post-event lameness that can agonist, whereas the muscle that
either ease off with gentle exercise or, if simultaneously relaxes is called the
ignored, lead to severe inammation. This antagonist. This coordination operates
type of post-exercise stiffness or lameness through a process called reciprocal
was once thought to be due to a build-up inhibition, which is a neurological reex
of lactic acid; however, it now seems that response. During movement, messages are
it is probably due to microtrauma within transmitted through the CNS that the
the muscle bres. agonist is under tension; the reex
Inability to contract a muscle is response to this is to inhibit the nerve
generally due to lack or reduction of input to the opposing muscle, or the
excitement through the motor end plate antagonist, which causes it to relax, thus
from the serving peripheral nerve. This allowing full extension or exion of the
can be a permanent or temporary joint. This process helps prevent
condition and can be caused by injury or hyperextension of a joint, which can
disease. happen when there is an uneven or added
force asserted through the joint.
Muscular coordination A muscle that is tight or shortened will
In order for a muscle to contract and move transmit the same message as that of one
a joint, the opposing muscle has to relax. in constant contraction, therefore placing
Those that cause the joint to bend are the antagonist in a state of continuing
called exors, while those that straighten neural inhibition and causing a continued
the joint are called extensors. To create weakening. This is important to recognize
movement, the muscles are normally when treating chronic cases involving
paired and opposing; the one that shortens somatic change (see Chapter 6).
or contracts is called the prime mover or
30 Chapter 2

Although muscle bres can only or restriction. Thus the tone of muscles
contract and relax the muscle as a whole, can reveal a signicant amount of
a muscle can develop a force in more than information about the bodys state of
one way: injury or chronic dysfunction. The tone of
a muscle can denote its condition (Table
Isotonic contraction this can be split 2). Muscle can feel toned, through
into two categories: exercise, or tight through spasm,
Concentric contraction the myopathy, or thixotropic build-up within
muscle shortens as it works, e.g. the bres. This nal problem can be
when walking or running on caused by chronic injury, compensatory
the at. issues, over-training, or even a lack of
Eccentric contraction this is used sufcient warming-up. Toned muscles feel
for developing tension while soft and plump.
lengthening, e.g. when landing after
a jump, and walking or running
downhill. It is used to form
antagonistic tension before a
movement. Every movement in the
direction of gravity is controlled by
eccentric contraction.
Isometric contraction this is where
no movement is made and the muscle Table 2 The feel of different
length remains the same when a force muscle tones
is applied; this can also be called static
contraction, e.g. during prolonged Healthy toned muscles soft yet
upward head movement in obedience full muscle belly, good
tests. vascularization, with good
potential bre recruitment
Muscle tone Hypertonic bres in a constant
Assessing muscular health can be state of contraction to protect a
extremely complex. This is due to the fact joint/s
that muscles and their tone are affected by Hypotonic a lack of obvious
numerous circumstances. Tone (or tonus) muscle belly, a distinct deated
is the partial contraction of muscle bres balloon feel. Lacking innervation
to retain posture. Even when the body is through injury, lack of use, or
asleep it retains a certain degree of tone reciprocal inhibition
through an autonomic neural state of Thixotropic or brous can be
balance between the motor and sensory engorged and lacking the soft
nerves. Muscle tone is also affected by the and smooth feel of a healthily
environment and the perceived danger or toned muscle due to additional
excitement experienced by a dog. If the forces being constantly exerted
dog has no perception danger, the muscles (repetitive strain), making the dif-
are relaxed and the bodys focus is on ferentiation of separate muscles
sustenance and rest. However, if there is within groups difcult
any kind of positive stimulation, the
Damaged irregular, with a
muscle tone will be enhanced. This is
bubble wrap feel
accentuated when the dog feels his
response to any impending danger is
compromised, e.g. when his ability to run
or ght is reduced due to muscular pain
Anatomy and Physiology 31

Physical disorders can result in the shortening of the bres, greatly


abnormally low/poor performing reducing their usefulness (see Chapter 6),
(hypotonic) or high/over developed as the muscles are being recruited out of
(hypertonic) muscle tone (25). Muscles phase of their working pattern. For
can also become hypotonic or atrophied example, if the semimembranosus, semi-
when neural impulses have been tendinosus, and biceps femoris muscles
compromised either by injury or damage. have been injured and shortened, they
In some extreme cases, an almost instant assert a massive force on the pelvis rather
atrophy can occur; this is where the than extending the hip and providing
affected muscles cannot provide any tone propulsion; this then impacts on the hip
and are unable to provide support or exor group, including the quadricep
mobility for the surrounding joint/s. group, which is then put under a constant
Muscle tone can also be affected by state of stretch and is therefore unable to
skeletal imbalances caused by injury and contract or relax effectively. Conversely, if
conformational problems. For example, if the lumbar region is tight, in some
there is a dorsal tilt of the pelvis, the situations the hamstring group can feel
quadricep muscle group will be stretched, hypertonic through its overuse due to the
(also can be classed as hypotontic due to sacroiliac joint suffering reduced exion;
excessive loading) the abdominal muscles therefore, more drive has to come from
could feel accid, and the hamstring and the hamstring group.
adductor groups would feel tight through

A B

25 Comparison of muscle tone between two siblings. A: Poor muscle tone (hypotonic);
the arrow is pointing to the line of the femur. Note the lack of gluteal and hamstring
development and the protrusion of the femur; B: normal muscle tone; arrow pointing to
biceps femoris muscle.
32 Chapter 2

If a dog has a lack of mobility through and contiguous properties, it enables us to


illness, muscular or skeletal pain, or post- view the body as a system of continuous
operatively, this will also cause a reduction networks of tissues, and not merely an
in muscle tone. Such reduction will occur assembly of separate parts.
much less rapidly, and is due to a In veterinary research, fascial connec-
reduction of neural stimulation rather tions are still fairly unexplored. Even
than compromised neural stimulation. within human scientic research, the
Massage and passive movement (see study of fascia as an organ of support has
Chapter 4) can help to retain the neural been largely neglected, and its role in
communications and improve the musculoskeletal function and dysfunction
circulation, so as to reduce the occurrence has received relatively little attention. This
of a chronic state of atrophy. may be due to fascias far-reaching effects,
Knowing how muscles are phased and which make it difcult to study; it cannot
having good palpation skills are extremely be easily divided into units and subunits.
important when assessing the condition of Even within the elds of dissection and
a muscle or muscle group (see Chapter 3). surgery, fascia has always been viewed as
This is crucial when trying to ascertain obscuring the anatomical structures of
whether a muscle is toned, thixotrophic, interest, such as muscles, nerves, and blood
stretched, damaged, or in spasm. vessels. However, we must remember that
Experience enables the practitioner to the tissue removed is responsible for the
learn how muscle behaves in different support, connection, separation, and, most
situations and conditions, and to diff- importantly, the interdependence of the
erentiate between a well-developed and structures being investigated (26). We can
healthy muscle and one that is unhealthy. only look to human research to see how
Good palpation and assessment skills are bodies are connected by these fascial
essential for identifying the site of injury chains; this can help us to answer many
caused by a chronic insult, as surrounding questions when treating dogs. Thus, it is
muscles and fascia can provide misleading necessary to think of fascia as a complete
information. An accurate assessment can supportive system. Tracing and linking the
only be made by an experienced muscles by following the chain of these
practitioner (see Chapter 6). fascial connections to an original point of
injury is an important skill for a
Fascia practitioner.
Fascia is a brous connective tissue that
permeates and interpenetrates tissues, Anatomy of fascia
enveloping the entire body. It forms a The two main areas of fascia that are
continuous network that is responsible for relevant are supercial and deep:
the supporting structure, form, and
intercellular communication, all of which Supercial fascia lies just below the
are needed to aid tissue repair. Fascia is skin in most of the body.
uninterrupted, and because it extends The supercial fascia of the trunk
through muscle, bones, nerves, and blood corresponds to the subcutis, envelopes
vessels, it forms an extremely effective the cutaneous muscles, and lies
communication matrix spanning the directly under the skin of most
whole body. It also assists tissue repair regions of the body. It contains mainly
through the complex intercellular com- areolar and adipose connective tissue,
munication network. Through its physical and therefore can support and store
construction and connective properties, it fat, providing insulation and
also supports and aids protection for protection. It also supports blood,
internal organs. Due to these continuous lymph, and nerve vessels.
Anatomy and Physiology 33

Deep fascia encloses individual wide brous, tendon-like structures


muscles. It forms loose connections that increase the area of muscle
with adjacent muscles, forms attachment and the anchorage of
attachments to bone, directs muscle muscle to bone. These fascial
contraction, and supports and secures attachments form uninterrupted
internal organs. It is a dense brous chains supporting much of the body.
connective tissue that permeates This continuous network has an
muscles, and separates groups. It active role in cellular innervation,
provides physical connection and which regulates activity. It is also a
neural communication between the matrix for these highly organized
muscles through fascial linking structures, including pathways
of tendons and fascial attachments for nerves, capillaries, and lymphatic
called aponeuroses. These are vessels that serve the muscle.

26 Fascial bands
separating the
hamstring group of
muscles in a leg of
lamb.1: Fascial
bands.

1
34 Chapter 2

Thus, the practitioner must not view cause either far-reaching or local problems,
muscular functions individually, but think forming adhesions to adjacent structures.
more of interrelations and connections When damaged, fascia can rupture, tear, or
between one muscle and another, and the become inamed and painful. It has a
fascial relationship between them. This smaller blood supply than many tissues,
continuous structure, when damaged, can which can lead to poor healing.

CASE STUDY 1

Tia, an extremely active Border Collie that competed at a high level in


agility, suffered an accident that led to pelvic limb ataxia during exercise.
Her handler took her to her veterinary surgeon, but by this time she was
regaining limited movement of her pelvic limbs. She was then referred for
a magnetic resonance imaging (MRI) scan, but it gave no explanation for
her condition. Therefore, no solution could be offered. Tia was then sent
for myotherapy treatment 4 weeks post-accident. She presented as a dog
that had the look of a jack-kning lorry: her front end was moving forwards
and her back end was following its own disunited course. Following
palpation by the Galen myotherapist, a tear was found within the fascial
connection of the left side of m. latissimus dorsi; the tear was about
1.5 inches (3.5 cm) wide and presented like a circular indent with raised
edges. Could this have been the reason for the temporary loss of use of
the limbs? More importantly, could this be the reason for her lack of
pelvic stability (27)? The m. latissimus dorsi joins the thoracic limb to the
pelvis through the thoracolumbar fascial plane, and therefore has a
stabilizing role.
After 5 months, Tia is following a course of rehabilitation exercises (see
Chapter 5) and regular treatment from a myotherapist; the scar tissue is
being managed and her core stability is being enhanced. Her quality of life
is very good, but she obviously misses her agility classes.
Anatomy and Physiology 35

27 Tia, showing her typical stance, compensating for a lack of structural stability. The
arrow indicates the position of the fascial tear.

Fascia and muscle How do the combinations of muscles


The role of fascia in relation to and fascial planes impact on the
muscle tissue is that of constraint, biomechanics of the dog? This can be
containment, and connection, to allow the answered by looking at anatomical trains.
energy produced from the bres Within the human form, anatomical
to remain concentrated and focused trains, or the myofascial planes, are well
or, conversely, distributed to surrounding documented; considering the similarity of
tissues as required by biomechanics. This our musculoskeletal system to that of the
avoids any power dissipation during dog, we can view the dog in the same way.
activity, through tensile strength and Thus, we can achieve a much more three-
elasticity of the outer fascial sheath. This dimensional feel for body patterns,
keeps the muscle in its correct position, compensatory effects, and strain
whether in contraction or not, and sustains distributions; these would otherwise be
the loose fascial connection with adjacent treated in isolation.
muscles to maintain alignment and
orientation in both situations. Any form of The anatomy train is a line of tensional pull,
fascial tear will compromise the muscles not compressional push therefore, it must,
or muscle groups integrity (see Case like any functioning tensile apparatus, follow
study 1). the most straight lines, both in direction and
depth.
Tom Myers
36 Chapter 2

Dissection has demonstrated human 28 Based


anatomy trains (28); ve of the same trains on Human
have been postulated to occur in the dog Anatomy
through observation, and appropriate Trains.
treatment programmes (29). These areas (Courtesy of
are worthy of note and can challenge Tom Myers.)
traditional methods of assessment.

Myofascial stress
The stresses of movement have a piezo-
electric effect on the surrounding
molecules, which causes the bonds
between them to be stretched. This slight
electrical ow is communicated and
interpreted by the cells in close proximity,
causing them to respond and reorganize
the intercellular elements in the area. This
includes bone formation and density due
to exercise, and the stress lines in each
individual (see Skeletal system). This can
be affected by the stresses caused through

Supercial back
arm line

Supercial back
line

Lateral line
Medial aspect
Supercial front
line

29 Postulated canine fascial trains (based on human Anatomy Trains, courtesy of Tom
Myers). Not all the trains are featured; all four legs should have four lines each: cranial and
caudal for mobilization and lateral and medial for stabilization.
Anatomy and Physiology 37

injury, overuse (especially in puppyhood), Within the dogs skin, fascial changes
or chronic repetitive strain. Osteoblasts lay can be clearly felt and assessed. The degree
down new bone anywhere within the of change can be calculated (especially in
periosteum, and osteoclasts are controlled a young dog) by the degree of elasticity
neurologically only to clear new bone that displayed. When a dog is older (>10
is not piezo-electrically charged. years), the collagen is less elastic; however,
Therefore, over time the stresses caused there should still be a visible pliability in
through a myofascialskeletal dissonance the skin and in surrounding tissues. If the
could have a long-term effect over the supercial fascia is not demonstrating
stress distribution of bones and, therefore, pliability, the dog will be displaying
over joints and their application. symptoms of somatic dysfunction,
While not overemphasizing their whatever its age.
importance in treatment considerations,
these possible canine anatomical maps Fascia and posture
may prove to be the missing link There are certain specialized forms of
in a nonreceptive case of persistent deep fascia that stabilize and maintain a
intermittent lameness. In many cases, the dogs posture during movement (30).
release of fascial tension can prove to be a They form part of the bodys fascial
highly successful treatment. network (29).

Spinotransverse Cervical
Thoracolumbar
Gluteal

Omobrachial
(Lateral)
Fascia lata
(tensed by
m. tensor
fascia lata)
Medial
femoral
Antebrachial
Crural
Abdominal

30 Canine deep fascia involved in posture.


38 Chapter 2

CASE STUDY 2

Digby, an agility dog damaged the left thoracic palmar surface of his leg
on glass, and was left 9/10 lame on this leg. Being a lively dog, this was not
going to hold him back, despite being cage rested. When he did have
exercise, the activity levels were high. When the leg healed, he was left
with a chronic stiffness within the pelvic region. This was not unexpected,
due to the compensatory issues he had received, but the unusual factor
was that the main problem arose from the same side and not, as is the
usual case, from the opposite side to the original injury (compensatory
issues tend to cross diagonally or criss-cross the body). Again, this can
occur, but the signicance was that, when the neck was treated, there was
an obvious and major skin reex that imitated the fascial supercial front
line. It travelled at a mid-point in a transverse direction across the ribs
where it continued from the iliac crest in a ventral direction to his stie.
After this treatment, all stiffness eased and he resumed his agility career.

CASE STUDY 3

Jess, a 12-year-old Beagle was becoming stiffer (over the whole body) and
grumpier with every week that passed. She had been treated in the same
way as other successful cases by targeting hypertonic muscles, but to no
avail and remained chronically lame. As a last resort the practitioner
applied some thorough and very painful skin-rolling. All the skin across the
thoracic and pelvic region was adhered, so this process was more than a
little uncomfortable; however, a few days later, Jess was a changed dog
and resumed being her affectionate self. The stiffness eased to such a
point that she could resume walks and did not require any further
treatment.

Consider the gravitational and mobility being the ligaments; this is anything but a
stresses that a dog puts its body through. The stable structure against the aforementioned
twisting, turning, and pivoting by far exceeds forces. But, then add the muscles, which can
most human capability and sustainability be considered to be the struts or cables that
(see Chapter 3). This has always been a connect this bridge-like structure, and then
phenomenon the author has found hard to think of a dog performing leaping and
understand when treating different dogs for twisting movement (31).
various injuries. It can help to consider the The ligaments, cartilage, and bursae of
skeleton, with the only soft tissue in place a joint form a very resilient compression
Anatomy and Physiology 39

and resistance mechanism, but there are


also forces in a lateral/medial direction to
contend with. The myofascial net, in its
tensional state, resists this lateral move-
ment and pulls inwardly towards the
centre, providing both the required
stability and practical mobility.
This is just the beginning of our dis-
covery of the amazing qualities and
importance of fascia as a connective tissue,
and I hope that this section has in some
way begun to explain and demonstrate the
qualities of connective tissue and how it
should be viewed when assessing a dogs
injury pathway. 31 The combined concussional and
twisting effect of a dog jumping.
Nervous system
The nervous system is the control centre of
the body. It processes hundreds of
thousands of pieces of information every
second in order to respond to external
stimuli, and thus ensure the appropriate
response to a situation or environment. terminology is, however, required and will
Neurology/neuroanatomy is a discipline be covered in some detail by this text.
often feared and ignored, due to the The nervous system consists of the
complicated structure of the nervous brain, the spinal cord, and the myriad of
system, the myriad of tracts, nerves, peripheral nerves that branch from these
divisions, and their varying terminologies. structures, transmitting impulses to the far
An in-depth knowledge of spinal tracts and reaches of the body. The brain and spinal
microscopic neuroanatomy is commend- cord comprise the CNS (32), and the
able, but not essential, here. Basic peripheral nerves make up the PNS (33).

Brain 32 Schematic
diagram of the
Spinal cord
central nervous
system.

Peripheral nervous system (to limbs, skin, etc.) 33 Schematic


diagram of the
peripheral nervous
system.
40 Chapter 2

Imagine that the CNS is similar to a nerves going from the brain to the spinal
computer, sending, storing, and evaluating cord, which then synapse with the LMN,
information. The PNS is represented by connecting muscles, glands and the rest of
everything connected to the computer, the periphery of the body and effect
e.g. the mouse, keyboard, and so on. Each (cause) a response. Returning to the
is useless without the other; the CNS analogy of the computer, should the LMN
cannot transmit impulses to the periphery (e.g. the keyboard), become detached,
of the body without the PNS, and the there will be no pathway to pass sensory
PNS has no purpose without the information back to the CNS. Pathology
CNS sending it information. Indeed, the that affects the LMN can therefore be just
nervous system consists of super-fast as devastating as damage to the CNS. In
communication channels that allow fact, damage to the LMN will often result
stimuli to be detected and an appropriate in catastrophic and rapid muscle atrophy,
response to be implemented rapidly. which may well lead to inability to walk
Furthermore, just as a computer hard or weightbear.
drive retains photographs or documents, A distinction is also made between the
the brain stores this information so that portions of the nervous system which allow
previous experiences can be drawn upon voluntary movement and interaction with the
and learned from. This enables both environment (the somatic nervous system)
animals and humans to be better prepared and those that carry involuntary information,
to deal with similar events in the future. about which we have little conscious control,
A further distinction is made according the autonomic nervous system (ANS). The
to the type of nerve impulse carried by the ANS which is further divided into the
nerve: parasympathetic and sympathetic nervous
systems. Sympathetic bres are more
Sensory (afferent) nerves carry numerous; every spinal nerve and most cranial
information regarding the nerves carry these bres.The parasympathetic
environment, e.g. position or system is restricted to a few cranial nerves,
temperature. Such information is such as the vagus nerve (cranial nerve X),
relayed to the CNS to process. The which carries information to the thoracic and
information ascends from the abdominal region, and, as the pelvic nerves,
peripheral nerves via tracts in the supplies the bladder and rectum.
spinal cord to the brain. The fundamental difference between
Motor (efferent) nerves carry these two nervous systems is in their
information from the brain and spinal functions: the parasympathetic promotes
cord to the periphery in order to a state of rest, increasing secretion of
adjust to the information provided by enzymes for digestion, slowing the heart
sensory nerves, adapt to surroundings, rate, and slowing peristalsis of the gut.
and react to various stimuli. Efferent Conversely, the sympathetic system
nerves travel away from the CNS. Put causes an active state, initiating a ght or
simply, the motor system instructs ight response in adverse situations. It
and allows muscle to contract and increases blood ow to the muscles and
relax. increases the heart rate.

The motor system is then further Anatomy of the nervous


divided into the upper motor neuron system
(UMN) and lower motor neuron (LMN)
systems, depending on where these motor Neurons (nerve cells)
neurons send information from and to Neurons consist of a cell body, nucleus,
(34). The UMN system consists of motor and two types of nerve process, called
Anatomy and Physiology 41

Upper motor neuron


(brain and spinal cord)

Lower motor neuron

34 Lower and upper motor neuron systems.

Dendrites
Nucleus

Cell body

Myelin
sheath

Axon

35 Schematic diagram of a neuron.

axons and dendrites (35). Axons carry of dendrites allows communication


information away from the cell body. The between several nerve cells, and ensures
dendrites, which are more numerous, that any signicant stimuli can be
receive information from adjacent accurately relayed. Neurons have been
neurons and transmit it to the cell body in considered unable to divide, so once they
order to cause a response. The multitude are damaged, function is lost.
42 Chapter 2

Neuroglial cells majority are inhibitory, ensuring that the


These are more abundant than nerve cells; neurological response to situations is nely
they are binding cells, and also provide tuned. The nervous system is the control
nutrients to neurons, especially during the centre of the body. It processes hundreds
process of repair. of thousands of pieces of information
every second in order to respond to
Nerve cell communication external stimuli, and thus ensures the
Communication between adjacent nerve appropriate response to a situation or
cells and between nerve cell and target environment.
organ is made possible by way of a
structure known as a synapse (36). The CNS
gap between the cell receiving The CNS consists of the brain and the
information and the cell imparting it is spinal cord. The brain is the portion of the
bridged by neurotransmitters, namely CNS contained within the skull. It has
acetylcholine, noradrenaline, and adren- three main parts: the cerebrum,
aline. These substances bind to receptors cerebellum, and the brainstem (37). Each
and stimulate an impulse in the post- part has a fundamental function:
synaptic cell via the release of calcium.
Synapses also allow this information to be The cerebrum performs the highest
passed to muscle cells via a specialized function: it is the thinking portion of
type of synapse, known as the neuro- the brain in the human, interpreting
muscular junction (see Muscular system). messages and computing the
Nerve impulses are an all or nothing appropriate response. Voluntary
phenomenon; in other words, a full movement is controlled by the
impulse is either created, or not at all. cerebrum.
Importantly, however, the degree of the The cerebellum is positioned behind
response can be nely tuned by the cerebral cortex. Its job is to
concentrating the nerve impulses to coordinate motor reexes and
particular areas, or by reducing the responses. It computes information
number of impulses sent. It is also that allows ne tuning of movement
important to realize that not all nerve and balance. It also aids in
impulses are excitatory; in fact, the proprioception.

Acetylcholine Cerebrum Mid brain

Thalamus Cerebellum
Pre

Synaptic
cleft

Post Olfactory Pituitary


Receptor for Pons Medulla
bulb gland
acetylcholine oblongata
36 Schematic diagram of a synapse. 37 Schematic diagram of the brain.
Anatomy and Physiology 43

The brainstem is further divided The CNS continues from the brain in
into the diencephalon, the a long column, the spinal cord, within the
mesencephalon, the pons, and the protective bony structure known as the
medulla oblongata. These portions vertebral canal. It extends to
contain centres to detect smell, sight, the lumbosacral region. The vertebral
and taste, release hormones, and column is divided into the cervical,
bridge the gap between the nervous thoracic, lumbar, and sacral regions. The
and endocrine systems. For example, number of vertebrae within each region
the hypothalamus controls the varies by species; the dog has seven
autonomic nervous system, regulating cervical, 13 thoracic, and seven lumbar
heart rate, temperature, water vertebrae (38). From a spinal cord
retention by the kidney, and so on. segment, a pair of spinal nerves originates

Cervical
Thoracic

Lumbar

38 The divisions of the spine in the dog.


44 Chapter 2

and innervates structures within the parasympathetic bres to heart, lungs,


vicinity; for example, the cervical spine liver, and so on, slows heart rate and
serves the forelimbs, the lumbar spine allows digestion).
serves the pelvic limbs; one nerve travels XI Accessory (movement of the neck,
left, the other right (39). The spinal nerve swallowing, vocalization).
is itself divided into the dorsal and ventral XII Hypoglossal (movement of the
roots: the dorsal root carries sensory bres tongue, swallowing).
toward the spinal cord and the ventral
root carries motor bres away. Reex arcs
A spinal plexus is a network of spinal Reexes are the bodys immediate
nerves. For example, the brachial plexus responses to stimuli which occur uncon-
supplies the forearm and contains, among sciously; they are involuntary and
others, the radial and ulna nerves. If a immediate. A reex is built in to the
plexus is damaged by trauma or neoplasia, nervous system and does not require
the results can be catastrophic as many thought. The distance between sensor and
nerves will be affected. effector is as short as possible, in order to
reduce the time taken for the impulse to
PNS travel. Fundamentally, these are local
The PNS consists of the myriad of responses to local stimuli. A reex arc
peripheral nerves that join the CNS to all requires three components: a sensory
of the bodys structures, such as muscles, nerve to convey the stimulus (carrying
glands, and the vital organs (see 33). information from a specialized receptor to
detect, for instance, heat, cold, moisture,
Cranial nerves pain), an interneuron to communicate
Twelve cranial nerves exit the brain to with it, and a motor neuron to carry
supply nearby peripheral structures. These information regarding the response (40).
can receive sensory impulses and supply For example, should sensory neurons
motor impulses simultaneously. They detect excessive heat near a nger, the
form part of the PNS and are named correct response would be to withdraw
according to their function. All, save the the nger from the source of the heat.
optic and olfactory cranial nerves, exit Sensory information about an unpleasant
from the brainstem, and they are all given stimulus, such as a toe pinch, will thus
a roman numeral to indicate the order in travel to the CNS of an animal; as a result,
which they exit, from cranial to caudal: not only might it attempt to remove the
I Olfactory (smell). toe from the noxious (unpleasant)
II Optic (sight). stimulus (a reex response), but it may
III Oculomotor (eye movement). also be tempted to bite (a conscious
IV Trochlear (ne movement of eye). decision)! Reexes can be tested by a
V Trigeminal (sensory to the forehead, veterinary surgeon to examine the state of
nasal cavity, and cornea; motor to the nervous system when assessing the
mandible, chewing). cause of lameness. The presence or
VI Abducens (motor to eye). absence of such reexes is indicative of
VII Facial (facial expression, taste, the position of damage to the nervous
salivation, and tear production). system.
VIII Vestibulotrochlear (hearing and
balance). Sensory receptors
IX Glossopharyngeal (taste, The body is able to identify, measure, and
swallowing, salivation). respond to various stimuli which affect
X Vagus (swallowing, vocalization; the internal and external environments.
Anatomy and Physiology 45

Changes in the internal and external a source of intense heat or cold, of which
environment of the body must be we are aware, to those internal events of
monitored closely so that the appropriate which we are not, such as changes in
and justiable action may be taken. These blood pressure or joint position
responses may be required to protect the (proprioception).
body; for example, removing a limb from

Dorsal horn Central canal


Dorsal root
Lateral horn

Dorsal root
ganglion

Spinal
nerve

Ventral root Ventral horn


Ventral ssure

39 A spinal cord segment.

Sensory neuron Interneuron


Receptor
Stimulus

Motor neuron
Grey matter

Target organ White matter


(e.g. leg muscle)

40 Schematic diagram of a reex arc.


46 Chapter 2

The types of stimuli which are CNS. These cells are able to transmit the
detected by sensory receptors within skin, magnitude of the stimulus applied; a
muscle, and tendons are: pain (41), larger stimulus excites more of these
temperature, touch (pressure, vibration, higher areas in the CNS. Thus, these cells
and texture), and proprioceptive stimuli. act as transducers, converting the stimuli
Proprioception appears to be the odd one to an action potential, an electrical signal
out in this group; we are aware of many that is transmitted to the CNS, where it
other stimuli, but not of the constant can be interpreted.
subtle movements of muscle tendons and The site of the stimulus must also be
joints going on behind the scenes that conveyed. Each receptor has a receptive
allow vertebrates to stand or move (42). eld, a region of sensitivity within which
In order to detect these stimuli, a stimulus will activate the receptor and
specialist receptors are required, designed trigger a response. The impulse then
to respond only to a single type of travels via a nervous pathway to reach the
stimulus. These receptors transmit sensory cortex of the brain at a specic
information in order to trigger reexes or location related to the position of the
responses from higher levels within the stimulus.

41 Reex response to a painful stimulus. 42 Proprioceptive decits are tested by


The limb will be withdrawn. turning the foot over. A normal animal
should immediately replace the foot in a
normal position.
Anatomy and Physiology 47

Muscle
bres

Motor bres Sensory efferent


allow spindle to nerve bres
contract/relax
43 Schematic
diagram of a
muscle spindle.

The sensations of touch, pressure, and soon as a tensional force is applied, the
vibration are transmitted through four nerve endings of the GTO are laterally
different receptors within the skin: compressed, giving rise to an action
Meissners corpuscles, found in nonhairy potential and propagating a nerve
skin such as the foot pads; Pacinian impulse. The GTO cannot differentiate
corpuscles, found within facial tissues and between passive and active contraction,
which are stimulated by rapid movement; and are less sensitive than muscle spindles.
Merkels discs, cells that respond to the The stretching of collagen bres within
vertical displacement of skin; and Rufni the GTO causes an action potential of a
endings, which detect vertical and lateral magnitude relative to the stretch applied,
movement of skin and deep brous tissue. to be transmitted from the muscle to the
The sense of position relies upon CNS for interpretation (see 24).
further sensory receptors found in
muscles, tendons, and on joint surfaces. In Muscle spindle
muscle, they take one of two forms, either Muscle spindles are located within a
muscle spindles or Golgi tendon organs capsule deep within and parallel to muscle
(GTOs). Each has a distinct role: the bellies. They contain intrafusal muscle
muscle spindle gives sensory information bres, which are specialist muscle bres
pertaining to stretch, and the GTO relays innervated by both sensory and motor
information about the tension within nerve bres, in a spiral conguration (43).
tendons. These intrafusal bres are able to stretch
and contract just like those of normal
Golgi tendon organ muscle, so the receptors are able to
When a muscle is relaxed, the collagen respond to forces of contraction and
bundles of the tendon have no tension. As relaxation. This is enhanced by motor
48 Chapter 2

efferent nerve bres, nerve bres that differentiate signals from different limbs.
carry impulses from the spinal cord. If this The planning of the next movement, the
were not the case, should surrounding alteration of contraction of certain
muscle bres contract, the muscle spindle muscles, and the exion or extension of
would become unloaded, be unable to joints is all undertaken by the cerebellum.
contract in sympathy, and therefore This can be a likened to a chess game, but
impulses generated by the stretching of one where each move is played out in a
the spindles would cease. Sensory split second.
information would subsequently only be
generated once the muscle was stretched Nerve damage
almost to capacity once more. Damage to either part of the nervous
In addition, mechanoreceptors, called system will result in characteristic clinical
Rufni endings, are present within every signs. A veterinary surgeon will observe
joint, their role being to detect and test for various reexes, which will be
compressive forces. These are similar to discussed in further detail later in the
GTOS and are found within ligaments chapter. Information gleaned from various
surrounding the joint. They signal the reex tests, together with an animals
position of a joint, as well as its velocity demeanour, mental state, and clinical
and direction of movement. history aid in the diagnostic process and
Sensory information from these give prognostic indications.
receptors is transmitted via one of two Usually, CNS damage cannot be
special pathways. In order to maintain repaired. LMNs leave the spinal cord to
balance, signals are sent constantly via innervate muscles. Damage to these
these pathways to alter muscle tone. nerves results in accid paralysis/paresis.
Indeed, we or our canine friends would Muscle tone is either absent or reduced.
fall victim to gravity without this Spinal reexes are also therefore reduced.
input from sensory receptors in skin, As previously mentioned, muscles atrophy
muscle, and joints. Usually, this is very quickly with LMN damage.
combined with information from the Damage to UMNs results in an
visual cortex clarifying ones position in inability to initiate voluntary movement;
space and a sense of acceleration, however, the reexes are usually intact,
transmitted by the vestibular apparatus in e.g. if pinched on the toe the dog can ex
the inner ear. its limb, often in an exaggerated manner,
but it cannot walk or stand. Inhibition of
Cerebellum LMNs is also reduced, meaning muscle
It is the job of the cerebellum to interpret tone is often normal to increased. Atrophy
the huge volumes of sensory information is slow, and, therefore, it is often more
received from the peripheral receptors, difcult to spot than LMN damage. If the
the vestibular apparatus, and the visual UMN system is damaged in the region
cortex, in order to coordinate a response between the sixth cervical vertebra and
by efferent impulses transmitted from the the second thoracic vertebrae or between
cerebral cortex to the muscles. A lesion the fourth lumbar vertebra to the second
within the cerebellum will not cause sacral vertebrae, different symptoms are
paralysis, but it will lead to tremors apparant. Between these points, peripheral
or poorly controlled, exaggerated nerves (LMNs) leave the spinal cord
movements. The cerebellum can (UMNs) to innervate the thoracic and
Anatomy and Physiology 49

pelvic limbs respectively. In such cases, of glands. One is sebum, secreted by


reexes will be absent; this aids in the sebaceous glands; this can be used as
diagnosis of UMN and LMN damage. an antiseptic against microorganisms.
Brain lesions vary in their effects; this It can also have a distinct odour which can
depends on the area that is damaged: indicate imbalances within a dog.
The skin consists of two layers:
Lesions of the forebrain result in
behavioural modication, blindness, The epidermis, which is the surface
and seizures. layer, consisting of stratied squamous
Lesions of the brainstem result in cells.
weakness, ataxia, and, potentially, The dermis, which is the deeper layer;
paralysis. its structure is more complex: it is a
Lesions within the cerebellum result connective tissue layer, consisting of
in poor balance, intention tremors, dense brous, collagenous tissue. The
and often there is a wide-based stance. dermis rests on an underlying layer of
Damage to the spinal cord may cause connective tissue called the
paralysis, depending on the position of subcutaneous layer or subcutis.
the lesion. This, along with the fatty layer below,
called the panniculus adiposus, forms
The very last sensation to be lost after the supercial fascia; this gives skin its
spinal cord trauma is the deep pain exibility (see Fascia). Both layers
response. This is normally tested by support blood and lymphatic vessels,
squeezing the web between the toes with nerves, and adipose tissue (44
forceps, causing withdrawal of the limb in overleaf).
the normal dog. This is often used as a
prognostic indicator post-trauma. In dogs, The skin also produces sweat from
loss of deep pain is usually indicative of a specialized sweat glands in the footpads. It
poorer outcome than if it were still can also produce vitamin D from a
present, i.e. there will be reduced component in the sebum that, when
likelihood of a return to normal function. activated by the kidneys, can increase the
uptake and metabolism of dietary
Other systems calcium. The skin is also an efcient
energy storage organ: adipose tissue, or
Skin subcutaneous fat, can act as an energy
The skin, or common integument, is said store or thermal insulating layer,
to be the bodys largest and most sensory depending on the needs of the dog. Even
organ. It covers the entire outer surface of though sweat is not the primary method
the dog, except for various natural of cooling in the dog, the skin acts as a
openings, e.g. the mouth and anus. The highly effective thermoregulatory
integument also includes the hair, instrument by either affecting vaso-
footpads, and claws. The functions of the constriction or dilation, diverting blood
skin go further than just supporting the away to insulate against the cold, or
coat; it also forms a physical protection dilation to assist core heat removal. This
from bacteria, water, chemicals, and, in works in conjunction with the dogs
pigmented skin, ultraviolet radiation. It panting, which is the major method of
produces various secretions from a variety heat removal.
50 Chapter 2

Sebaceous gland
Hair

Merkels tactile
disc
Nerve terminal
Epidermis

Erector pili
muscle
Dermis

Subcutis

44 Cross-section of canine skin.

The skin is highly innervated, the epidermis at multiple sites. There are also
function of which is to constantly other receptors that detect heat and cold
maintain contact with the outside world, (thermoreceptors) and stretching
and then communicate this information (mechanoreceptors) (see Nervous
back to the internal body systems so they system).
can react appropriately to maintain The cooling mechanism must be
homeostasis. It contains both sensory and respected if a dog becomes excessively hot
motor nerves and records pressure, the skin must not be covered by
tension, pain, itching, vibration, stretching, anything, especially anything cold, as this
heat, and cold. The most common neural will reverse the bodys cooling process and
receptors are Merkels tactile discs; these cause vasoconstriction and drive the
detect touch and vertical displacement of escaping heat back to the core of the dog.
skin. There are others that serve as The physical therapist operates with this
receptors to pain; these penetrate the complex and far-reaching network; via
Anatomy and Physiology 51

these neural receptors the masseur can blood to their target organs, and waste
command a degree of cellular control over products are carried to the liver and
the dog. The therapist must, therefore, kidneys.
clearly understand the treatment
methodology they are employing. Capillaries
The feel of the skin is an important Capillaries consist of a single layer of
assessment tool for the practitioner. It endothelial cells that are permeable and
should be free and loose enough to make exist in a complex network. Due to a
another dog in most cases, but this pressure gradient, they allow diffusion of
depends on the age and breed. Tight areas oxygen and nutrients from the blood into
or a cutaneous reex will be indicated by the surrounding tissues. These capillary
a quiver, either locally or spreading beds form the conduit between the
distally, indicating that there could be a arterial and venous systems. Capillaries
minor neural and/or fascial problem (see facilitate intracellular waste removal
Chapter 6). through diffusion, returning waste
products back to the venules and veins.
Cardiovascular system
The cardiovascular system contains the Veins
heart and blood vessels (arteries and Veins carry blood back to the heart.
veins). These divide into smaller vessels Venous blood is deoxygenated, and
called arterioles and venules, respectively, contains toxins from cell metabolism. It
which then divide again into a system of needs to be detoxied and reoxygenated
capillaries. The heart acts as a pump, quickly to help maintain homeostasis.
transporting oxygenated arterial blood Blood returns to the heart through vessels
through the body, and deoxygenated of increasing diameter, with no active
blood back to the lungs to be pump to facilitate this venous return. To
reoxygenated. compensate for the tendency of the blood
to pool in the most distal palmar and
Arteries plantar areas, the venous vessels instead
The arteries carry blood from the left contain semilunar valves that have anti-
ventricle of the heart under very high gravitational action, supporting the ow
pressure; the strong muscular walls of the proximally. They also have compressible
arteries facilitate dilation and constriction, qualities, so they can tolerate the pressure
depending on the pressure levels. These exerted by the surrounding skeletal
large-bore vessels then branch off into muscles. In fact, the movements of the
arterioles, whose function is to regulate skeletal muscles act to compress the
the blood ow to the capillary beds. The vessels, assisting and facilitating venous
arterial blood contains a high percentage return. This is a feature replicated by some
of erythrocytes (the oxygen-carrying of the techniques used in massage. The
cells), leukocytes (cells that ght veins are often situated in close proximity
infection), and thrombocytes/platelets to the main arterial vessels, whose
(cells involved in blood clotting). The pumping action can also facilitate blood
remainder is made up of plasma, which ow to the heart through the veins.
contains the nutrients and minerals that However, the speed of ow of the blood
are delivered to the tissues. Hormones returning via venous return is restricted by
produced by the body are carried in the the bore size of the vessel.
52 Chapter 2

Changing internal pressures in the Lymphatic system


thoracic region as a result of the action of The function of the lymphatic system is to
the diaphragm and intercostal muscles provide defence and ght against infection
facilitates inhalation and exhalation, and and disease. It is a vast network of
also assists the ow of the venous blood capillaries, thin vessels, nodes, ducts, and
back to the heart. This, too, can be affected organs that helps to drain tissues and
positively by appropriate massage, return uid to the cardiovascular system
assisting deep lateral breathing, and via major veins near the heart. Unlike the
aiding efcient and signicant pressure circulatory system, it is not a closed system,
changes. Thus massage can play an as it begins peripherally in a network of
important role in enhancing delivery of blind capillaries, and ends centrally at the
pain-reducing hormones, such as thoracic duct. It acts as a supporting
endorphins, by aiding venous ow (45). system for the circulatory system, or as a
secondary cleansing system. The only

Lymphatic vessel

Arterial vessel

Venous vessel

45 Diagram to show the positive effect the muscular walls of the arteries have on the
return ow of both the venous and lymphatic systems. The arrows depict the ow within
the different vessels. (Note the semilunar valves within the lymphatic and venous blood
vessels.)
Anatomy and Physiology 53

46 The lymphatic system of the dog, showing the main nodes.

direct connection between the two occurs certain amount of waste products. Excess
when the lymphatic system drains uid waste drains into the lymphatic system
into the venous system through two ducts where the pressure is lower than that of
near the heart; however, the two systems the blood system. If waste particles are too
usually run in parallel. large for the blood system, they are
The uid that the lymphatic system extracted by the lymph vessels, which
transports is called lymph. Lymph is have larger pores. The lymph collected
similar to blood plasma, although it does throughout the body drains into the
not contain red blood cells. Among other venous system through the thoracic
things, it contains waste materials, white and jugular ducts (46). Lymph originates
blood cells, and cancer cells, if these are from the blood, passes through the venous
present. The system has numerous nodes capillary walls and is situated interstitially;
which lter the lymph. The nodes also it is then absorbed through the cellular
produce lymphocytes, a type of white walls of the lymphatic capillary network
blood cell, which ght disease. The and into the lymphatic system, where it is
circulatory system can only cope with a returned to the venous circulation.
54 Chapter 2

Lymph nodes, where the lymph is In conclusion, the lymphatic system


ltered, play a crucial part in the bodys plays a very important role in the bodys
immune system. Harmful substances defence system. Working alongside the
which are not neutralized in one node can venous system it forms a vital cleaning
be carried to the next successive node, system for the body, without which
where the lymph will again be ltered. homeostasis would not be possible and
Lymphocyte activity in the nodes other systems, such as the musculature,
increases when an infection is present; would be compromised.
hence, the lymph nodes become swollen
and painful. Phagocytic leucocytes remain Comparative human and
in the lymph nodes, destroying harmful canine anatomy
substances in situ. Also, antibodies Comparative anatomy of the human and
produced by different lymphocytes are dog is an in-depth and precise science;
released into the lymph and circulate in however, for the purpose of this chapter,
the lymph and the bloodstream. it has been simplied into areas that are
As in the venous system, the lymphatic relevant to our area of study. Although
system does not have an intrinsic pump studying the differences between the
and, in similar fashion to the venous human and the dog is not essential, it is
system, relies on secondary mechanisms to widely accepted by many practitioners as
elicit effective drainage. Again, the skeletal being extremely interesting and helpful. In
muscles play a large role in effecting this. fact, studying and treating humans can
Like the venous system, the lymphatic provide a greater insight into applying
system contains small semilunar values to physical therapy and understanding
prevent back ow. Also, the adjacent physiology and anatomy. A human can
arteries and veins assist with the distal to provide verbal feedback and can be
proximal ow. As with blood ow, requested to lie still; also, so much more is
pressure changes within the thoracic visible when the skin is not covered in fur.
cavity are important for continuing By looking at both the human and dog,
lymphatic movement. Therefore, when a one can learn the many similarities
dog is active and there is good skeletal between the two species and how they
muscular movement, the system can work differ. For example, skeletally, all mammals
efciently, aiding adequate detoxication. look quite similar. However, a dog can
Massage can inuence the lymphatic jump proportionally much higher than a
system effectively, especially in the veteran horse; to understand how this is possible,
dog, or one with impaired mobility. This and how a dog moves, can give a
could be used to great effect post- practitioner a greater knowledge in order
operatively, when movement is restricted; to provide effective treatment.
also, the effective removal of post- The easiest way to visualize the
anaesthetic toxins could aid a fast differences between a canine and a human
recovery. In some cases of lymphoedema, skeleton is to crush the human ribs to
appropriate massage can ease the form an angulated sternum and then place
symptoms by assisting drainage, using the scapulae adjacent and opposite on the
gentle massage over the most proximal sagittal plane (47). The obvious difference
lymphatic node to where the swelling is between the two is that a human has a
at its most exaggerated, and then applying plantigrade stance (we take the bodys
light and gentle efeurage (a form of weight on the plantar surface of our feet),
massage), working proximally from the whereas a dogs stance is digitigrade,
isolated lymph node. meaning they bear weight on their
Anatomy and Physiology 55

Scapula or
shoulder Clavicle
blade or collar Scapula or
bone shoulder
blade
Pelvis

Femur
Pelvis
Knee/stie Femur

Knee/stie

Hock/ankle
Hock/
ankle

47 Comparison between dog (digitigrade) and human (plantigrade) skeletons.

phalanges or digits. Due to the dog being than one plane; however, the dogs most
a quadruped and the human a biped, obvious limitations are through the joints
weight transference and mobility is providing movement through the dorsal
reected within the foundation and and ventral planes (adduction and
supporting structures of the body. Most abduction), and some rotational move-
joints allow movement through more ments through the transverse plane.
56 Chapter 2

Appendicular skeleton stability. This is a problematic area for


many breeds, as this is a contributory
Thoracic limb factor in elbow dysplasia; the humerus in
the achondroplastic breeds is often bowed
Scapula to facilitate the shoulder assembly.
The scapula in the dog supports the main There are basically three types of front
muscles used for support, mobility, and assemblies in the dog, and these can be
weightbearing while in motion and when used to dene the use of a dog. The
static. It also receives and dissipates achondroplastic type are short-legged dogs
concussion. The potential movement of such as a Dachshund or some Jack Russell
the scapula can be dened by its terriers; these have shortened limbs, often
orientation and angulation with the with valgus or varus lower limb (bowed
thoracic cage. The spines of the scapulae through carpal growth discrepancy) but
lie at an angle of approximately 35 on the have a good angulation between scapula
transverse plane, which naturally differs and humerus required for digging.
according to breed or type, and therefore Greyhounds and Lurchers have a less
intended use. Its attachment to the axial pronounced shoulder angulation than the
skeletal is solely by soft tissue and its achondroplastic dog, lending itself to
design and role constitutes a major speed. The third type is the dog intended
difference between the two species. for retrieving or herding work, where the
The human scapular spine lies on the most distal part of the humerus should
same relative transverse plane, at 45; align with the most caudal aspect of the
however, due to the free movement dorsal scapula region. This angulation is
required of the arm in the transverse intended for good muscle attachment to
lateral/medial plane, extra stability is provide balance and strength.
required which is facilitated by the
clavicle. The dog does not possess a Ulna
clavicle in the form that a human does and The ulna in most breeds is the longest
instead, for shoulder stability and strength, bone in the dog. It possesses a large
it possesses a truncated clavicle in the and prominent olecranon process, forming
form of an oval cartilaginous structure that the point of the elbow. This is designed to
does not articulate with the rest of the hold the powerful and supporting triceps
skeleton. It spans approximately 1 cm and brachii muscle group, which are stabilizing
is located at the tendinous intersection of and anti-gravitational.
the brachiocephalicus muscle, in approxi-
mately the same anatomical position as Carpal joints
the human clavicle. The carpal joints in the human and canine
contain the same number of bones, but in
Humerus the canine, two are fused and they have a
In relation to its human counterpart, the slightly differing construction. In the
dog has an altered thoracic limb structure human, the retinaculum across the palmar
to manage its weight and any concussion side of the wrist draws the outer bones of
properties required. The proximal the wrist together, thus forming a well-
humerus has a more attened head than dened tunnel; this forms a housing for
that of the human, and distally has a well- the tendons and median nerve (when the
dened olecranon fossa and supratrochlear median nerve is compromised, carpal
foramen for securing the anconeal process tunnel syndrome ensues). The dog
of the ulna; this is crucial for shoulder possesses the same number of carpal
Anatomy and Physiology 57

bones but the arrangement is altered, with Pelvic limbs


the radial carpal bone parallel to the fused The femur is the heaviest and largest bone
scaphoid and lunate bones. in the dog, whereas the ulna is the longest;
in the human, the longest bone is the
Axial skeleton femur. The stie is constructed in the
same conguration as in the human knee,
Vertebral column both relying on good conformation for
The vertebral formula is different in the stability. Muscular stability is provided
human and the dog: through the pelvis, plus tendons and
Canine: C7, T13, L7, S3 (fused), caudal ligaments that provide integrity to the
(CA) or coccyx 1521. joint. The calcaneous of the dog is almost
Human: C7, T12, L5, S5 (fused), coccyx identical to the human ankle (calcaneous)
34. bone, both supporting the Achilles
tendon. The canine tarsus contains the
Costals same number of bones as the humans,
The costals are small bones that articulate being similar to the human ankle.
with the thoracic vertebrae in both the However, as with the palmar surface of
dog and the human, providing protection the thoracic limb, the plantar surface of
for the heart and lungs within the thoracic the pelvic limb is the phalanges.
chamber. In the dog (to a greater extent
than in the human), they also help
support the shoulder assembly through
extrinsic muscular connections; in the
dog, this provides stability and uidity
through costal movement when it is in
motion.

Pelvis
The fused ilium, ischium, and pubis bones
comprise the pelvis, with the ischium
providing a wide and broad projection
caudally to support the massive hamstring
muscle group that is required for
propulsion and elevation. The pelvis of the
dog is a different shape to that of the
human; it is smaller and narrower, and lies
within the transverse and dorsal planes.
The commonality between the species
is that they both possess a muscular
system to suit their function. This means
that they both have deep supporting
muscles that ensure the stability of the
axial skeleton, which enables the
appendicular skeleton to be appropriately
supported and stabilized too. This can also
ensure that the joints become efcient and
economical levers, providing sustained
movement to the whole.
59

3
How a Dog Moves

Julia Robertson

Introduction
Muscle placement and action
Initiation of movement
Development of the puppy

Introduction
In order for a dog to move, the body relies on an effective
interrelationship between its systems, including: a functional
muscular system, innervation from the nervous system, the
support and articulation of the skeletal system, together with
the metabolic transport of the vascular systems. These form
the coordination required for a dened patterning and
phasing of muscles. If any part of this chain breaks, the
movement loses its integrity.
An understanding of myology, with regards to the
placement and action of the individual muscles and muscle
groups, is a vital part of the knowledge required when
assessing a dog for treatment. It is also important to
understand how muscles work together to provide the
different actions. This is signicant because, in order to treat
a dog successfully, an assessment has to be made to identify
where a break in that chain may have occurred and what the
resultant effects may be.
60 Chapter 3

The kinetic chain can provide both exion and extension and
To look at the system from an engineering a degree of adduction and abduction.
or mechanical perspective, it is a complex Therefore, the integrity of this joint has to
pattern of simple levers and pulleys which be at an optimum state to receive and
needs to accommodate a wide variety of transmit the forces, together with the
movement and maintain stability through extreme pressures being exerted.
the movement. These levers or joints are The muscular power and drive provided
then pulled at slightly different angles, to these levers and joints comes from the
according to the insertions and origins of hip exors and extensors. However,
the articulating muscles. Therefore, for without all the moving structures being
them to phase together to form a stable adequately supported by the postural
and coordinated action, and cope with the muscles, they will not withstand the energy
additional stresses caused by gravity and forces created, and optimal range of
(downward pressure), is an intricate and movement and versatility will not be
exacting process. achieved.
Biomechanics is an extremely complex The deep postural muscles of the hip
area of science, and this section does not joint (49) are:
intend to describe it in detail, but to give
an overview on how basic movement is m. obturator internus and externus.
initiated and executed. This chapter will mm. gemelli.
not specify the list of muscles and their m. quadratus femoris.
involvement with different actions, just m. middle gluteal (50).
the main individuals and/or groups. m. deep gluteal (50).
m. piriformis.
Muscle placement and
action These muscles are critical for stability
and balance within the coxofemoral joint.
Pelvic region Even with perfect joint congruence,
The main drive of the dog comes from the imbalance can result from inappropriate
pelvic limbs, relying on the power of the development, exercise, injury, or all three.
hip exors and extensors to power the dog The resultant imbalance from this joint
forwards. The forward momentum travels may not remain within the joint itself; it
through the lumbar and thoracic regions, can also, through a chain of disparity, lead
then uses the thoracic limbs to steer and to weakness within the stie. There may
direct, while receiving the concussion also be the further complication of
through the recoil system of the shoulder thoracic limb compensation. Stability of
and carpus. Like any nely-tuned engine, this joint will naturally occur if a young
the dog requires a huge degree of balance dog is offered the appropriate amount and
and stability. When looking at the skeletal type of exercise, if it has no other injuries.
aspects, the impetus drives through the Conversely, excessive or inappropriate
sacroiliac joint together with the ventral exercise can also cause problems, both
exion of the lumbar region (48). This skeletally and muscularly. Consequently,
works in unison with exion and extension as far as any kinetic chain is concerned, full
of the femur, which acts as a massive lever stability and balance within the axle (the
through the coxofemoral (hip) joint, pelvis) is profound and, without this, full
driving the forward movement, and at the and consistent function will never be
same time demanding stability and balance reached.
through the pelvis. The coxofemoral joint
How a Dog Moves 61

48 Important joints
in the pelvic region
for movement.
1: Sacroiliac joint; 1 2
2: Area of
coxofemoral joint
(Courtesy of Henry
Robertson.)

Gemelli

Internal Iliopsoas
obturator
Articularis
External coxae
obturator

Quadratus femoris

49 Lateral view of the deep postural muscles of the pelvis and coxofemoral joint.

Middle
gluteal
Supercial
gluteal
Deep
gluteal

50 Cranial view of the croup muscle group


attachments.
62 Chapter 3

Initiation of movement muscle (plus other deep lumbar muscles)


Before any movement is initiated, the provides part of the crucial balance and
region has to be stabilized, or the body support through the lumbar region. It also
will not have sufcient resistance to aids dorsal exion of the pelvis, along with
enable movement. A major stabilizer the other hip exors. On a dog with a
within the pelvic/lumbosacral region is short or close coat, a clear abdominal line
the m. rectus abdominis, which joins the can be seen when the muscle
thorax and the pelvis ventrally. This contracts (55).

CASE STUDY 4
Monty, a 5-year-old Border Collie, was rescued from living in one room.
He had had no exercise during his young and developing years, and had
spent most of his time lying on a windowsill looking out of the window.
His stance suggested that there was some form of pelvic and stie incon-
gruity. The radiographs showed excellent hip and stie formation (51, 52).
However, if his gluteal region is studied, this area is underdeveloped, in-
dicating a lack of juvenile stimulation (53).
With a combination of massage therapy, hydrotherapy, and neural
pathway stimulation, his stability, shape, and balance improved
markedly (54). Please note: In the case of a dysplastic dog, or one with a
femoral head and neck excision, then exercises to create muscular
balance within the joint will assist enhanced joint movement through
stabilization of the ineffectual joint with balanced intrinsic pelvic muscles
(49, 50).
How a Dog Moves 63

51, 52 Radiographs of Monty, demonstrating good pelvic and stie construction.

53 Monty showing lack of gluteal 54 Monty after treatment and physical


development before treatment (arrow). therapy, showing some improved pelvic
stability and gluteal development.

55 Abdominal lift. (arrow)


64 Chapter 3

Planes motion Forward movement in the


A plane in this context is an imaginary sagittal plane (flexion and
straight line drawn between two extension)
points (56).
Protraction of the pelvic joint
Frontal plane divides the body and Protraction is when the limb is drawn
limbs longitudinally into two equal forwards (57). This denes stride length
right and left halves. and involves exion of the hip and stie.
Sagittal plane divides the body and When movement is initiated, the
limbs parallel to the medial plane. abdominals concentrically contract to
Transverse plane divides the body at assist stabilization and exion of the
right angles through the bodys axis. lumbar region. The mm. gluteal assist

Sagittal plane (right and left halves) forwards and backwards movement

Frontal plane
(divides dorsal and
ventral sections)
adduction and
abduction

If a solid sheet were


placed through the
Transverse plane body at these points,
(divides cranial and the movement on
caudal) rotational that plane is the one
movements that is not restricted.
E.g. sagittal, a sheet
dividing the body into
left and right canmove
straight forwards and
backwards.

56 Planes of movement.
How a Dog Moves 65

57 Protraction of the pelvic limb, showing concentric contraction (solid arrows) and
eccentric contraction (broken arrows). (The adductors, lying medially to the pelvic limb,
are not shown.) (Courtesy of Henry Robertson.)

stabilization of the coxofemoral region


through eccentric contraction. The Table 3 Muscles involved in
m. longissimus lumborum stabilizes protraction of the pelvic joint
the vertebrae. Table 3 presents the main
muscles that contract concentrically and Concentric contraction
eccentrically. m. iliopsoas
The m. psoas major and m. iliacus play m. tensor fascia latae (tenses the
a crucial role in pelvic exion, again fascia latae)
forming a linkage between the thoracic m. psoas major
and pelvic/femoral regions. Assisting the m. iliacus
protraction is the quadricep group, quadricep group
together with the mm. sartorius and m. mm. sartorius (caudal and cranial)
tensor fascia latae. The adductors lying Eccentric contraction
medially to the femur also support the
gluteal group
action by preventing the limb abducting
hamstring group (m. biceps femoris,
when on the point of balance and
m. semitendinosus, and
transition. The dynamic ability for eccen-
tric contraction of the gluteal muscular m. semimembranosus)
group and the hamstring muscular group m. gastrocnemius
plays a crucial part in affecting a full range
of movement.
66 Chapter 3

Retraction of the pelvic joint


The pelvic limb is retracted when the foot Table 4 Muscles involved in
hits the ground and the body is projected retraction of the pelvic limb
forwards and there is extension in the hip,
stie, and hock (58). This action requires Concentric contraction
integral stability through the pelvis to m. biceps femoris
both support the weight of the dog and m. semimembranosus
enable the body to thrust forward. The m. semitendinosus
stability is supplied by eccentric con- m. gracilis (to a degree)
traction of the m. rectus abdominis, the m. supercial gluteal
adductor group, m. gracilis, and the deep m. gastrocnemius
and medial gluteal muscles. Table 4 adductor group (to a degree
presents the main muscles involved in depending on the plane of
retraction of the pelvic limb. movement)
This movement is performed
Eccentric contraction
effectively if the eccentrically contracting
muscles perform optimally. In order to m. iliopsoas
perform a maximum range of movement, m. tensor fascia latae (supports the
stability is the key. Any lack of integrity is fascia latae)
not going to allow a dog to gallop, which m. psoas major
is where one foot is needed to complete m. iliacus
the follow-through; at a gallop, before quadricep group
initiation of protraction, there is one pelvic mm. sartorius (caudal and cranial)
limb fully weightbearing. The gluteal mm. adductor group (to a degree,
group is also stabilizing and concentrically depending on plane of movement)
contracting, assisting protraction along
with the adductor group and gracilis.

Thoracic region
The thoracic limb is held onto the main limb, the thoracic limb protracts, retracts,
part of the body by muscle alone; there and can perform abduction and adduction
are no bony attachments assisting to a limited degree. Most of these
the stability (59). The vulnerability is movements involve the scapula and its
evident, however, as although require- muscular attachments (60). The size and
ments for the absorption of concussion are shape of the scapula indicate the
well met in normal situations, the muscles importance of this at bone; its large at
are highly susceptible to overuse. surface allows the pennate muscles to
The thoracic limbs are intended to give attach. It also has exaggerated processes,
direction, receive concussion, and support which are required for the strong fusiform
the proportionally heaviest part of the dog muscles to attach to.
through all types of movement, including
jumping. Their structure accommodates
the many different movements and
direction changes required through the
soft tissue attachments and the recoil
action of the carpal joints. Like the pelvic
How a Dog Moves 67

58 Retraction of the pelvic limb showing concentric contraction (solid arrows) and
eccentric contraction (broken arrows). (Courtesy of Henry Robertson.)

Scapula
m. Trapezius Lateral view Medial view
m. Rhomboid Thoracic
vertebrae 4
Deep 2 4
11
supporting Scapula
muscle 1
Rib 3 5
Thoracic 6
6
cavity
8 12
Pectoral 7
Humerus muscles 14
10 9 13
10
60 Lateral and medial aspects of the
scapula showing areas of muscle
59 Muscles attaching the thoracic limb to attachment (in grey block or black solid
the thorax (the shoulder sling). lines). 1: Supraspinatus; 2: trapezius and
deltoid; 3: infraspinatus; 4: rhomboideus; 5:
teres major; 6: subscapularis; 7: teres minor
and long head of triceps; 8:
omotransversarius; 9: deltoideus; 10:
biceps brachii; 11: serratus ventralis; 12:
long head of triceps; 13: teres minor; 14:
coracobrachialis.
68 Chapter 3

As with the pelvic limb, the postural bearing potential is greater. There is much
muscles play an active and crucial role in talk of shoulder angulation, especially
the whole function of the limb (Table 5). within different breed standards; however,
These muscles are both medial and lateral this is something that is not of real
to the scapula and are extrinsic to the concern to the kinetic chain, as, whatever
limb. The thoracic limb also has an the angle movement, it can present similar
important relationship with the neck, as problems. However, if bad conformation
much of the thoracic limb movement or disproportionate angulations are
involves muscular connections within the present, it will impact negatively on the
cervical region. Therefore, the afore- robust quality of the gait.
mentioned stresses and strains will also
affect the cervical region. Many of the Protraction of the shoulder
postural muscles are also involved with Protraction of the shoulder occurs
exion, extension, adduction, and when the scapula is drawn caudally
abduction of the limb. and the limb is drawn cranially (61).
The main xing of the scapula is to the Note the extreme bulge over
thoracic cage; this is not a static m. supraspinatus. Table 6 presents the
attachment, as has been demonstrated main muscles involved in protraction of
cineradiographically by Rachel Page the shoulder.
Elliott. Also, the scapula is expected to
swing, at a moderate trot, through a
movement plane of 30 (measured by the
degree of movement from the cranial to
dorsal border of the scapula); at a gallop
or canter, this angle would increase.
Unlike the pelvic limb that has a rm Table 6 Muscles involved in
xing through the pelvis, the thoracic limb protraction of the shoulder
does not have this rm xing, yet the
exibility and the planes of movement Concentric contraction
expected are equal. Also, the weight- m. trapezius (thoracic)
m. rhomboideus major and minor
(elevating and drawing scapula
towards the trunk)
m. subscapularis
m. serratus ventralis thoracic
Table 5 Deep postural muscles of pectoral group (during weight trans-
the scapula ference)
m. subscapularis m. cleidobrachialis
m. serratus ventralis m. supraspinatus
m. rhomboideus (to a degree) m. omotransversarius
m. pectoral (deep, in conjunction Eccentric contraction
with the m. serratus ventralis) triceps group
m. infraspinatus m. latissimus dorsi (initially)
m. supraspinatus m. trapezius (cervical)
m. biceps brachii m. serratus ventralis cervical
triceps group (form tension and mm. teres (minor and major)
stability through the joint when m. infraspinatus
standing)
How a Dog Moves 69

61 Protraction of
the shoulder
(note the
hypertonia within
m. supraspinatus)
showing
concentric
contraction (solid
arrows) and
eccentric
contraction
(broken arrows).
(Courtesy of Henry Robertson)

To initiate protraction of the thoracic


limb, the scapula has to be elevated so as
to lift the leg off the ground. This is
facilitated by the m. trapezius and
m. rhomboideus, supported by the
m. serratus ventralis, m. subscapularis,
and m. deep pectoralis. The dorsal
portion of the scapula then is drawn
caudally by the m. trapezius (thoracic
section); the m. omotransversarius and m. 62 Long claws.
cleidobrachialis consequently draw the
ventral section of the scapula cranially,
producing the angulation of the scapula
required for protraction.
To ex the shoulder so that the leg can
extend involves mm. teres major and
minor, m. infraspinatus, the scapular and
acromial sections of the m. deltoideus; the
m. latissimus dorsi draws the trunk
forwards and assists exion of the
shoulder. Flexion of the elbow is instigated
by the m. biceps brachii and m. brachialis.
The shoulder and elbow then extend into
full protraction; this involves m. supra-
spinatus, m. infraspinatus (to a small
degree), m. cleidobrachialis, m. omotran-
versarius, and the extensor group of the Excessively long nails (often
limb. The paw will hit the ground using overlooked) (62).
the metacarpal pad, then roll forwards Pain in the phalanges.
into a point of break-over where the line Amputation of a digit.
of balance is driven forwards onto the Carpal trauma or chronic disease.
digital pads before they leave the ground.
This should be a smooth, rounded, and Long nails assert an upward force on
level movement, but it can easily be the phalanges and inhibit a smooth break-
compromised by: over motion of the dogs foot.
70 Chapter 3

Transition from protraction to and then the recoil actions of the carpus is
retraction critical to the smooth conversion from
During the transition between protraction protraction to retraction (see 61). For full
and retraction, the extended limb forms a retraction, the m. latissimus dorsi and m.
solid column to support the weight of triceps brachii are at full contraction,
the dog. The triceps brachii group is supported by the extrinsic muscles of the
initially in eccentric contraction, then, as scapula (the rhomboideus and the cervical
the limb drives forward, it transfers into section of the trapezius muscles). These are
concentric contraction to extend the assisted by the m. serratus ventralis and the
elbow, assisting the forward drive action, pectoral group of muscles.
along with the m. pectoralis (deep and
supercial parts), m. serratus ventralis, m Retraction of the shoulder
infraspinatus, m. supraspinatus, m. Retraction of the shoulder is when the
deltoideus, and the teres group (63). scapula is drawn cranially and the limb
This transition, and the propulsion of the caudally (64). Table 7 presents the main
trunk cranially, requires a complex system muscles involved in retraction of the
of support, coupled with an almost locked shoulder.
pivoting mechanism. This is provided
through the shoulder and elbow joints; The neck
these will maintain balance and provide Much of the support of the head and neck
enough strength to sustain forward comes from the ligamentum nuchae or
trajectory. Flexibility of the hyperextension nuchal ligament, which consists of paired

63 Transition between
protraction and retraction.
Locking of shoulder and
elbow (solid arrow).
Hyperextension of the
carpus (broken arrow).
(Courtesy of Henry
Robertson)

64 Retraction of the
shoulder, showing
concentric contraction
(solid arrows) and
eccentric contraction
(broken arrows). (Courtesy
of Henry Robertson)
How a Dog Moves 71

elastic funiculi nuchae that bridge the


Table 7 Muscles involved in cervical vertebrae; it extends from the spine
retraction of the shoulder of the axis to the rst thoracic spinous
process (65). Here, it joins with the less
Concentric contraction elastic supraspinous ligament; this attaches
triceps brachii group to all the spinous processes of the more
m. latissimus dorsi caudal vertebrae, up to the third sacral
m. trapezius (cervical) vertebra. The nuchal ligament assists in
m. serratus ventralis (cervical) opposing exion by its reexive strength
m. infraspinatus (depending on point and retraction, saving the dogs muscle
of shoulder extension, providing energy by sustaining the level of the head
stabilization) and greatly easing the muscular effort of
pectorals lifting the head when the neck is
mm. teres (minor and major) lengthened, especially when the nose is on
mm. rhomboideus major and minor the ground (during scenting).
(elevating and drawing scapula
towards the trunk)
Eccentric contraction
m. trapezius (thoracic)
m. subscapularis
m. serratus ventralis thoracic
pectoral group (during weight
transference)
m. cleidobrachialis
m. supraspinatus (depending on
point of shoulder extension,
providing stabilization)
m. infraspinatus (to a small degree)
m. omotransversarius

Supraspinous
ligament
Nuchal ligament

65 The nuchal and


supraspinous
ligaments.
72 Chapter 3

Cleidomastoideus Sternocephalicus

Cleidocephalicus

Clavicular Supercial
intersection pectoral
muscles
Cleidobrachialis
Deep
pectoral
muscle

66 Deep muscles of the neck, cranial view.

This remarkable modied apparatus Lateral exion of the neck when the
contains more elastic components than neck moves the head to the left or the
other ligaments, as it is a muscle-saving right, the following muscles contract:
device that is especially important when m. cleidocephalicus.
reacting in a ght or ight situation. Its m. omotransversarius.
reexive qualities save a huge amount of m. splenius.
energy that will be needed for running.
The muscles that are used in neck Vertebral column
movements are (66): Figures 67 and 68 shows some of the
muscles involved in vertebral extension.
Neck extension when the neck is Unilateral concentric contraction of these
stretched upwards with the nose in muscles is a major contributory factor to
the air, the following muscles lateral exion of the vertebrae. Flexion is
contract: assisted by the concentric contraction of
m. rhomboideus. several abdominal muscles:
m. trapezius cervical section.
m. splenius. internal and external obliques.
Neck exion when the neck is bent major and minor psoas.
downwards, allowing the nose to go to m. iliacus.
the ground, the following muscles intercostal muscles (to a small
contract: degree).
m. sternohyoideus (crucial role, due to pectoral group (to a small degree).
its inuence on the tongue).
m. cleidocephalicus.
m. sternocephalicus.
m. omotransversarius.
How a Dog Moves 73

Spinal and semispinal


Splenius muscles

Longissimus Longissimus thoracis and


capitis lumborum
Longissimus
cervicus

Thoracic iliocostal Lumbar iliocostal

Note: mutidus and rotator muscles are deep to muscles seen


and are present between the vertebrae

67 Muscles of the back and neck.

Multidus Short rotator


Semispinalis Long rotator Spinalis Interspinalis
T6 7
8 9 13 L1 2 3 4
1011 12 5
6 7

Ilium

Iliocostalis thoracis Intertransversarius Longissimus lumborum


Longissimus lumborum
Iliocostalis lumborum
Transversospinalis system
Longissimus system
Iliocostalis system

68 Lateral view of the epaxial muscles.


74 Chapter 3

Movement in the frontal


plane (adduction and Table 8 Muscles involved in
abduction) abduction of the pelvic limb
The frontal plane includes both abduction
and adduction; a very obvious and typical Concentric contraction
example of abduction is that of a male dog supercial gluteal
cocking his pelvic limb; this is abduction middle gluteal
of the pelvic limb. Adduction is when the m. piriformis
dog draws its pelvic limb closer to the Eccentric contraction
centre line of its body. adductor group
m. gracilis
Abduction of the pelvic limb m. pectineus
Table 8 presents the main muscles
involved in abduction of the pelvic limb.
When the pelvic limb moves away from
the centre line of the body, the sartorius
(caudal and cranial) and tensor fascia lata
(TFL) initiate the movement by adding Table 9 Muscles involved in
tension to the stie. Tensing of the m. adduction of the pelvic limb
sartorius and TFL draws the stie laterally,
allowing the supercial and middle gluteal Concentric contraction
muscles to continue the movement. adductor group
m. gracilis
Adduction of the pelvic limb m. pectineus
Table 9 presents the main muscles Eccentric contraction
involved when the pelvic limb moves supercial gluteal
towards the central line of the body. The middle gluteal
muscles of adduction are more dened m. piriformis
than those for abduction; this is because
the lateral forces when running in the
sagittal plane are great and the need for
stability and the restraint of extreme
abduction are constant.

Abduction of the thoracic limb Table 10 Muscles involved in


This is when the thoracic limb moves away abduction of the thoracic limb
from the central line of the body. When a
dog moves through a set of weave poles in Concentric contraction
agility or turns quickly, abduction of the m. trapezius (both cervical and
limb is employed as part of the steerage thoracic sections)
mechanism through this limb. Great m. supraspinatus (initiates)
stability and exibility is needed in the m. infraspinatus
front assembly to carry out this manoeuvre. m. deltoideus (acromion head)
Table 10 presents the main muscles m. rhomboideus
involved in abduction of the thoracic limb. Eccentric contraction
The dew claw or medial phalanx gives m. subscapularis (59)
further stability when the limb is abducting m. supercial pectoral
at speed (69). When a dog is turning at m. coracobrachialis
speed, the lateral force on the thoracic limb
is great, and preventing the limb from
How a Dog Moves 75

violently abducting takes a massive amount


of static contraction and eccentric
contraction by the pectoral group of
muscles. Meanwhile, the dew claw acts as
an anchor to stabilize the limb.

Adduction of the thoracic limb


Adduction occurs when the thoracic limb
moves towards the central line. Adduction
and abduction are shown in Figure 70. 69 The dew claws acting as a crucial
Table 11 presents the main muscles anchor during a tight turn.
involved in adduction of the thoracic limb.
A key point to remember is that the dogs
body will adjust to the current situation
with its musculoskeletal system. The eyes
should always be looking forward;
therefore, whatever happens in the rest of
the body, the eyes will, as far as possible,
remain on a horizontal plane. For efcient
movement, the working legs will be
drawn to the centre line of the body,
whatever the breed, whatever the length
of leg. Figure 71 shows a dog with
unbalanced movement, in which the
stronger leg is moved onto the centre line.

70 Abduction (solid arrow) and adduction


(broken arrow) of the thoracic limbs.
(Courtesy of Tony LeSigne.)

Table 11 Muscles involved in


adduction of the thoracic limb

Concentric contraction
m. subscapularis
m. supercial pectoral
m. coracobrachialis
Eccentric contraction
m. trapezius (both cervical and
thoracic sections)
m. supraspinatus (initiates)
m. infraspinatus
m. deltoideus (acromion head)
m. rhomboideus 71 Unbalanced movement, in which the
dog moves its stronger leg onto the centre
line.
76 Chapter 3

Development of the puppy


Early days
When a puppy arrives in its new home
and begins its new solitary existence away
from other pack members, problems can
start developing. In a primal pack, a puppy
would not stray far from the den. It would
spend its time playing with other
members of the pack, exploring the
terrain, and slowly developing physically,
and also developing a sense of spatial 72 Puppies playing naturally, developing
awareness, through climbing on and their spatial awareness and postural
playing with others (72). Food would be stability. (Courtesy of Liz Pope.)
brought to it until it was adolescent. Thus,
a puppy should not be given a programme
of exercise that exceeds its requirement
for normal physical development.
Unfortunately, some puppies are
exercised inappropriately and allowed to
perform extreme movements, such as
walking up and down stairs, jumping on
and off furniture, and in and out of cars.
The concussional effect of these activities
on immature joints, joint capsules, and
bones is profound. Other, less often
considered, forms of inappropriate
exercise occur on lead walk: being made would act differently, but, unfortunately,
to conform to the gait and speed of the they do not appear until a dog is about 7
handler and, therefore, being unable to or 8 years old. If a breed has a propensity
develop its own natural gait and speed. to any skeletal conditions, e.g. elbow or hip
This also applies to some working dogs or dysplasia (see Chapter 6), it is extremely
those that are preparing for other advisable to keep high impact exercise to
disciplines, such as agility. The type of an absolute minimum (see Chapter 7).
training the puppy has will have a
dramatic effect on its future health and Spatial awareness
the length of time it can spend in a sport Spatial awareness is innate but develops
or discipline. Many owners, especially through a complexity of actions and
those who have not owned dogs before, or working through different planes of
are not educated in puppy development, movement to develop muscular stability
may be unaware of how fragile puppies through the stimulation of appropriate
are at this age and how any disruptions in muscle patterning. This will include the
a puppys physical development can result neural stimulation and proprioceptive
in a future life of diseases, such as awareness of skeletal muscles, especially
osteoarthritis. those involved in postural stability.
Puppies should not be exposed to all The requirement for spatial awareness is
the rigours of our environment, as they are not just for stability, it is also important for
developmentally and physiologically general responsiveness to the surround-
unprepared. If the effects of their early ings. Many dogs, mainly the giant or large
activities were immediate, perhaps owners breeds, grow so quickly that they seem
How a Dog Moves 77

unaware of where they start and nish.


This can be endearing to humans, but
seeing your puppys legs splaying on the
oor indicates that a mobility problem
is being stored for the future. Spatial
awareness and heightened proprioception
are important survival tools and enables a
dog to feel secure within its body, which
is a signicant stress suppressant with
psychological and physiological benets.
To stimulate or re the appropriate
muscles requires specic exercises that
encourage activities through various
planes of movement; it is critical to start 73 Puppy being encouraged to work in
these when the puppy is still developing the frontal plane adduction and
(73). These exercises must be carefully abduction.
managed, using knowledge of what the
puppy is capable of without being
overstretched or overtired. 74 Puppy
massage
Puppy massage class.
Puppy massage is an area that has been (Courtesy of
underdeveloped and one that can serve to Lezleigh
benet puppies and handlers alike (74). Packer.)
Massage can facilitate greater bonding and
connection between puppy and handler.
The owner is able to develop an awareness
of their puppys body map, and will learn
what is normal and what is abnormal, e.g.
the effects of heat and cold, and so on. The
puppy becomes used to being touched,
which creates a bond of trust; this is
particularly important when veterinary
attention is required.
Massage has many direct health
benets. It gently encourages venous
return, which in turn encourages arterial
delivery to help with growth and cellular
development, mineralization of joints, and
hormone delivery. It also promotes
lymphatic stimulation, which supports the
immune system, which is especially
important when puppies are in contact
with viruses, bacteria, and so on. Massage
helps puppies to relax, which aids
digestion. Indeed, a study of the encourages the use of neural pathways
biochemical and clinical responses to through physical stimulation and
massage in pre-term human infants promotes good coordination and spatial
showed that post-massage cortisol levels awareness through neural and muscular
were decreased consistently. Massage synergy.
79

4
Exercise and Activity
Preparation
Julia Robertson and Meg Robertson

Exercise and conditioning


Performance areas and their stresses
Warming up and warming down
Warm-up and warm-down for the
handler

Exercise and conditioning


With the canine athlete, training is the part that the majority
of dogs and handlers enjoy the most and they devote many
hours to it. Teaching a dog to run or jump for performance,
even though it is a natural activity, is more complex than is
often understood. When preparing for exercise, an area that
is not often fully considered is muscle conditioning. There
are many activities in which dogs are expected to carry out
complex routines with or without apparent high impact, at
speed, or with stamina. In many instances, this is done
without the benet of appropriate preparation.
80 Chapter 4

Muscle conditioning This is when an appropriate massage


Muscle conditioning and training is key with passive movement can be
groundwork for any competition or incorporated (see Chapter 6).
activity. Simple conditioning exercises can Sets: groups of combined exercises
promote physiological and organizational with rest in between.
changes in the body that will maximize Repetition: performing an exercise
performance and maintain soundness. several times.
Appropriate dynamic training will deve- Progression: choosing the number of
lop neuromuscular coordination and sets and repetitions that is appropriate
mental discipline. This is a complex for the age, condition, and tness of
subject that involves the appropriate the dog.
preparation of individual muscle bres for Warm-downs: a dynamic warm-down
the onset of sustained activity. Correct facilitates the gentle redistribution of
conditioning assists the body through blood away from the muscle to the
enhanced circulation to the muscles core, assists lactate removal, and assists
which helps to: muscle microbre repair. This should
also include gentle suppling exercises,
Avoid muscles prematurely fatiguing. such as passive movement to ease
Cleanse and replenish the bres post- muscle tension and assist any
activity. realigned or displaced bres;
Remove any residual anaerobic by- again, an appropriate massage
products. can assist with this process
Re-establish mineral balance. (see Chapter 6).
Repair microtrauma in muscle bre
resulting from exercise. Length of pace
The range employed by the joint to
Conditioning includes cardiovascular facilitate movement can also make
conditioning (or the enhanced vascular- a signicant difference to muscle
ization of muscle bres), where performance, and this also has a great
appropriate training regimes helping to effect on the strength that can be exerted
improve blood supply to the muscles by a muscle.
required for an intended activity, strength Long, or outer range is when a joint
training for increasing power or endurance moves through its full range, with the
to targeted muscle groups, and suppling agonist and antagonist working at full
exercises, for developing a range of stretch, using elastic recoil and forward
movement within all joints, creating motion to form rhythm and momentum
muscular balance, and reducing the risk of at speed. This is a highly economical
injury. function, and it is easier for the t dog to
Good conditioning is developed by maintain for speed, but not so much for
well-designed programmes involving endurance, e.g. agility dogs, racing
appropriate: Greyhounds, and luring Whippets.
Middle range is when the joints are
Warm-ups: dynamic exercises that working at their most efcient for both
will engage the main global muscles, strength and motion, e.g. Huskies
gradually increasing in activity levels sledding, and Staffordshire Bull Terriers
that also incorporate the warming of weight-pulling.
deeper areas and stabilizing muscles.
Exercise and Activity Preparation 81

Inner range is where the angle of Muscular balance postural and


movement is small and forward motion is core stability
limited and controlled; this is highly To ensure optimum performance from a
fatiguing due to the stability through core dog, its muscles must be balanced.
strength and the control through eccentric Muscular balance relates to all the muscle
contraction required, e.g. in obedience groups having the ability to contract and
work. relax, allowing controlled coordination of
Understanding the types of movement the muscles, with full range of movement.
that a dog needs to employ is a vital part One important factor to consider when
of training and conditioning; the fact that assessing balance is the dogs core stability.
a slow pace has a high energy requirement The core muscles are those that hold
is often widely overlooked. Considering the core the thoracic and lumbar
the planes of movement (see Chapter 7) vertebrae, in a secure balanced position,
that dogs have to use is another factor that yet allowing exibility.
is often overlooked. For example, in the In the authors opinion, the core
case of the agility dog, consider the types muscles in the dog include:
of movement, and the rapid changes that
are expected from the sagittal to the Epaxial system:
transverse planes. Repetitive strain injuries longissimus group (paravertabral).
may result from many activities during Hypaxial system:
training, competition, and exercising. transverse abdominals.
Flexing of the whole vertebral column in m. rectus abdominus.
a sustained controlled manner may result internal obliques.
from many activities, such as obedience m. multidus (see p.79).
tests, continual jumping and turning, or external obliques.
exercise and training programmes using
ball or frisbee throwing and tugging. Core strength is the balance and inter-
realtionship between these two groups.
Muscular leverage Postural muscles are there to support joint
Performance levels are greatly affected by action, but they can only do this if the core
muscular strength, power, and endurance, of the body remains stable. In other words,
which are themselves dependent on the unless the main frame of the dog is
amount of leverage produced by the supported well by the core muscles, any
muscles through the joints. Strength is subsequent movements will not be
the greatest amount of force that a muscle balanced or adequately supported.
can produce in a single maximal effort, e.g. Therefore, if hard exercise or training
when performing a jump, agility, working continues with a lack of core strength, the
trials, and so on. Power is the rate of force balance will be severely compromised
generated in pulling exercises, e.g. weight through lack of foundational strength.
pulling, and Husky sledding. Endurance Consequently, this lack of core strength
is the ability to perform repeated and stability will be apparent by the subtle
contractions before the local muscles changing of movement patterns. This is
fatigue, e.g. during Husky sledding and when overuse of joints and muscles starts
Canicross. to take its toll, caused by the ensuing
82 Chapter 4

incorrect phasing, leading to compen- injury. Without this core strength, the
satory actions and subsequent muscle integrity of the whole musculature would
problems. (75). With a well- developed be constantly challenged (see Chapter 3)
and balanced core, a dog will have the (76).
ability to train hard for a discipline and One of the main causes of core and
will be less likely to endure muscular postural dysfunction is due to the

Lack of vertebral Muscle injury/


stability = injury compensation = reduced
Lack of core
potential, overuse of performance, pain
strength = lack
muscles/bres, perception, further
of vertebral
compensatory issues in compensatory issues,
stability
both the axial and intermittent/chronic
appendicular skeleton lameness

Fig 75 Algorithm for core stability and performance.

76 As the dog jumps an obstacle wider than his own length, strength is needed within
the entire vertebral column, in addition to strength and dynamic force required of the
abdominals and obliques (arrows). If these are strong enough, the dog can hold its body
in a straight line, almost in a lying down position. (Courtesy of Henry Robertson.)
Exercise and Activity Preparation 83

environment. It can happen when the dog they are in a constantly supporting
is a puppy or an adolescent; this is the condition rather than one that is switching
time that the initial core and postural on only when stability in the area is
strength should be established. required. This prevents the normal
Unfortunately, this is when inappropriate patterning and phasing of muscle, causing
actions and exercise prevent proper a massive disturbance to the balance and
development (see Chapter 3). There are subsequent vertebral support through the
many situations that will encourage core. Being inadequately supported leads
inappropriate development; the most to pain, lameness, and general imbalance.
common is excessive exercise. A puppy The rst signs of these problems can be
does not need long walks; however, it does an apparent reluctance to perform. Many
need stimulation, like scenting exercises in times, trainers have said: My dog has lost
a conned area. These will mentally tire it, interest in . It is unlikely for a dog to
but wont put excessive pressure on the lose interest in an activity that previously
joints. Another example preventing most they found physically and psychologically
puppies from developing proper postural fullling; it is more likely that they hurt.
stability and spatial awareness is the lack In some human studies, it has been
of natural exercise that they would get in shown that the nervous system seems to
a pack situation. This type of play would be able to detect a reduced capability to
involve scrambling over and wrestling generate a force from a detailed muscle or
with each other, developing stability group of muscles, and when this occurs,
through recruiting natural movements in more motor neurons are recruited. This
the sagittal, transverse, and frontal planes. apparent compensation can be replaced
Finally, physical problems at home may by recruiting motor units from areas that
cause inappropriate development, like the remain uninjured within the muscle or
dog being given a bed or cage that is from other muscles capable of performing
too small, being allowed to go up and the same tasks.
down stairs, or having inappropriate high- Thus, in humans, the nervous system is
impact training. This behaviour is then extremely efcient at changing the
perpetuated when the puppy becomes an phasing and patterning of muscles to
adult. It is allowed to jump into and out ensure continued movement; this is a
of cars and on and off furniture or other basic survival mechanism. The bodys
high objects. This type of repetitive systems, including the muscles, are
activity can correspond to that of a developed so as to feed back information
computer worker or driver who develops on, and adjust to, the environment,
bad posture through work and, as a result, whether internal or external. The bodys
suffers from neck and shoulder problems. mechanisms are developed so that the
Hodges and Richardson (1996, see eyes remain level with the horizon; this
Further Reading), showed that the allows evaluation and preparation for
cocontraction of the transverse abdominal, what is being presented so that the
multidus, and internal oblique muscles muscles can make appropriate move-
occurs prior to any movement of the ments in response.
limbs. This suggests that these muscles
anticipate dynamic forces that may act on Challenges to core stability
the lumbar vertebrae and stabilize the area Not all humans are built to be athletes,
prior to any movement. For many dogs and neither are dogs! There are obvious
with lumbar problems, this theory is conformational or structural factors which
demonstrated by the fact that the internal can affect overall core stability; these can
obliques and the transverse abdominals be managed by adjusting a dogs exercise
are in a hypertrophic state, which is where routine or the type of exercise.
84 Chapter 4

Another challenge to core balance is hard, dense sand to soft, water-soaked


when a dogs foot hits the ground at an sand. These look the same, but the
unaccustomed angle. This may occur, for resistance of the two is radically different.
example, in the case of an agility dog that This would be unknown before the dog
may be used to working on a turf surface ran over the surface, but very apparent
in the summer, but is suddenly moved afterwards.
into a sand arena when winter starts. In
this situation, the piezo-electric charges Core stability and postural
received through the joints will assert strength
different stresses through joint surfaces. The importance of core stability (axial
Putting different stresses on muscles can skeleton strength and balance) and
set up dramatic changes in the dogs postural strength is key to a performance
biomechanical and kinetic systems; this dog and its ability to continue pain-free
can cause massive problems in the within a discipline for an extended period.
unstable dog. This includes dogs with However, sheer exuberance, loyalty, and
minor muscular issues involving shoulder adrenaline can compensate and mask pain
or pelvic instability, including mild hip or mild discomfort. Without the
dysplasia; their core would be comprised appropriate groundwork promoting the
accordingly. This problem has also been development of good core stability, any
experienced by many handlers who take exercise discipline can result in areas of
their dogs to the beach, to give them a weakness and subsequent injury, or
change of scene. This is something that chronic problems, such as inammation
can cause lameness in an unbalanced dog, resulting from constant low-level
as the sand on the beach can range from injury (77).

Stress or trauma causes muscle tightness resulting in antagonistic weakness


Inammation caused through increased areas of tension (piezo-electric changes)
Areas of tension cause a lack of good circulatory ow resulting in inammation due
to pain receptor stimulation
Viscosity of surrounding fascia alters due to inammation, causing restriction of
movement, leading to adhesions
Tension in muscles causes bre damage, leading to brosis and inammation, then
further damage to adjacent tissue occurs
Microspasm of muscle spindles communicating with Golgi tendon organs act to
restrict movement, with subsequent muscle weakness causing compensatory effects

77 Injury cycle.
Exercise and Activity Preparation 85

If a horse were being trained as a abduction and adduction exercises. These


showjumper or eventer, one of the rst lateral and medial movements are
things to be done would be the ground important for creating neural pathways to
work. A professional rider or trainer many of the core and postural muscles.
would never allow a horse to jump The middle gluteal muscle is one of the
without ensuring their movement over key supporting or postural muscles for the
the ground was of a good standard. This coxofemoral joint. When this is unstable,
would involve basic dressage moves, it creates a pronounced lack of stability
simple grid work, and good postural through the stie and the lower back,
working, so as to encourage the horse to setting up a poor biomechanical
drive from his hindquarters, not from the movement that is not sustainable.
forehand. This is fundamental for anyone Other areas of training should involve
involved in equestrian activities, but it the development of spatial awareness, i.e.
does not seem to hold true for all canine the dogs awareness of where it starts and
activities. Many training programmes only nishes, and, importantly, the ability to
involve working a dog on one plane of lift each of its legs independently and
movement, in other words, in straight effortlessly when moving (78).
lines; but very few integrate gentle

78 A simple exercise where a few poles are laid out in an irregular pattern encourages a
dog to concentrate on where to place each foot and when to lift each leg and step over
the next pole. (Please note this is not intended to develop a gait pattern.) (Courtesy of
Henry Robertson.)
86 Chapter 4

Appropriate training from all perspectives the correct training programmes are used
is critical, whether the dog is a puppy or a for the chosen discipline/s. Like all
rehomed adult. Like all athletes, its athletes, to prolong a successful career, the
muscular health should be continually and canine athlete requires a good team
professionally assessed to establish the supporting it from all areas of develop-
state of balance and tone, and to ensure ment, tness, and remedial care (79).

Myotherapist/
massage
therapist/physical
Chiropractor/ therapist
osteopath/ Hydrotherapist
acupuncturist

Veterinary
surgeon

Dog

Trainer Handler Dog walker/carer

Key:
Two-way communication

Referral/consent from acting veterinary


surgeon if appropriate
Obligatory feedback from referral

Cross-referral via acting veterinary surgeon

79 Operational team for the performance dog.


Exercise and Activity Preparation 87

Within the canine team, the main player Dogs that perform and have a task,
is the dog; everything revolves around its whether it is something true to the breed
needs and wants. The other key player is type, like a gundog retrieving, or a dog that
the veterinary surgeon. No treatments requires the physical and mental
should ever be applied without their stimulation of agility or obedience
consent or referral; this is a legal training, are generally the most satised
requirement and both practitioner and and contented dogs. Because of this
handler will be breaking the law if this is dedication to their work, it is often up to
not adhered to. the handler, veterinary surgeon, or
The team should work cohesively, with practitioner to determine when they are
good communication. If people run their t to perform and when they are not.
businesses well, cross-referral and There is no doubt that when a dogs body
appropriate treatments and therapies will is exercised and is put through stresses and
be made widely available to the dog. All endurance it develops good recovery
practitioners should have a good under- mechanisms, both physiologically and
standing of what other therapies can offer, psychologically, which can benet a dog
and at what stage of a dogs programme throughout its life.
they would be appropriate. Most
importantly, any therapist should know Jumping
immediately when to refer a dog back to The requirement for any dog that is
its veterinary surgeon. involved in any form of jumping is
the same:
Performance areas and
their stresses Good weightbearing requirement and
As with human athletes, different stability from the thoracic limbs to
disciplines in canine performance have support the whole body weight at the
distinct areas of repetitive stress or point of take-off.
potential injury. In some cases, a Flexibility through the lumbar region
practitioner with good palpation skills can for pelvic and lumbar exion and
identify the discipline through the tension extension.
lines and the length of time that the Stability through the pelvic region to
problem has been going on. In the perfect support the upward thrust.
world, tension should not be evident Uncompromised extensors and exors
within a working dogs body. However, to of the pelvic region to provide the full
be aware of where the tension is likely to range of movement.
be within an athlete will help treatment A strong and robust core to sustain
and, more importantly, assist a possible the ight and possible twist.
change or varying of training, exercise Good concussional qualities from the
methods, and environmental impacts thoracic limbs intrinsic and extrinsic
within key regions. This is not exclusive to muscles to cope with landing and
performance dogs; many companion dogs turning.
have classic repetitive-type strains that can The stresses of jumping are dealt with
impact heavily on their musculature, well by a dog, but to achieve high jumping
causing secondary problems such as with ease takes exibility and support
arthritis or laxity within joints. These can from both the thoracic and pelvic areas.
have repercussions in mid- or later life. The whole process of the jump requires
88 Chapter 4

efcient weight transference and transferred to the thoracic region,


uncompromised exibility through the supporting the exion of the lumbar and
action of the hip exors. For the take-off pelvic region. Excellent balance is the key
(80), the thoracic region stabilizes the at this point. For the take-off, power in the
entire thoracic limb through static and lumbar region is the key (81). The lumbar
eccentric contraction of the m. triceps region is extended through the thrust and
group. This, combined with other intrinsic force driven through the pelvis by the
and extrinsic muscles, will form a solid complete extension of the pelvic limbs.
column of strength (similar to the stay This explosive force causes a recoil of the
system of the horse) through the limb, phalanges on the dogs pelvic limb. In the
facilitating a springboard take-off. If there ight over the jump: stability is important
is any form of instability in the thoracic (82). This results from good core strength,
limb or shoulder, the dog will falter and and balance is required to sustain ight
hesitate before take-off. and have the ability to twist and change
Figure 80 shows the dog one stride to another plane mid-ight.
before the point of take-off; the weight is

80 Prior to take-off. Solid arrow: exibility; broken arrow: stability/concussion. (Courtesy


of Henry Robertson.)
Exercise and Activity Preparation 89

81 Take-off. (Courtesy of Henry Robertson.)

82 The ight. (Courtesy of Henry Robertson.)


90 Chapter 4

83 The landing. Solid arrow: exibility; 84 Jumping and landing on the transverse
broken arrow: stability/concussion. plane (rotational). (Courtesy of Henry
(Courtesy of Henry Robertson.) Robertson.)

85 Landing and
turning
immediately;
broken line: turning
using transverse
plane; arrow:
landing and
twisting off one leg.

On landing, the dog must contend with the joints, as well as the musculature of each
strong concussive forces in the thoracic limb of the legs. Constant use of a particular leg
(83). The full impact is received on the due to musculoskeletal problems will
metacarpal pad of one of the thoracic limbs; eventually cause a complete lack of function
this is a momentary event when the full of the region. The shoulder area will receive
weight of the dog is taken by one leg. The the impact and softens the landing through
landing leg is decided by directional its uid qualities. The dog now readies itself
requirement, the mobility and function of to power into the next stride.
Exercise and Activity Preparation 91

When the dog is asked to land and turn obstacles, all in a time-span of about 30
immediately, the requirements are more seconds (depending on the course). The
complex, necessitating the dog to move activity involves jumping; turning; and
through a transverse plane (84, 85). There running up a 45 incline, stopping, then
is a torque effect on the whole body. The running down the other side. Fit dogs
action involves greater impact being relish the challenge and enter into the ring
received through the landing pad and, with huge amounts of excitement and
more importantly, massively increases the enthusiasm. Muscles involved in agility are
stress running through the m. latissimus presented in Table 12.
dorsi that, if compromised, impacts With the complexity of movement at
on the pelvic region. (The reader speed, training and conditioning are
should refer to fascial planes in extremely important. The potential for
Chapter 2.) injury is great, and is exacerbated if the
injury is unobserved or ignored. Dogs red
Agility with adrenaline and devotion to their
This dynamic sport is completed at speed handlers will compete when their bodies
with many different twists, turns, and are injured either acutely or chronically,
and will not necessarily employ any self-
limiting mechanisms. Furthermore, if dogs
were ridden, like horses, we would feel the
imbalance; but we instead rely on
observation, which is not as reliable, and
injuries can be easily ignored.
The likely signs of muscular injury in
an agility dog are:

Table 12 Muscles and muscle Reduction of speed.


groups involved in agility Reluctance to enter ring, jump,
perform over certain obstacles, or
Pectorals perform contacts.
Trapezius Measuring (when a dog approaches a
Brachiocephalic group jump in a staccato manner).
Latissimus dorsi Lack of uidity when jumping.
Supra- and infraspinatus Taking off too close to the jump.
Carpal exors Taking off too far away from the
Biceps brachii jump.
Brachialis Stiffness/lameness post-event.
Longissimus group (especially Sensitivity of the foot.
lumbar) Lack of coordination when running
Lumbar iliocostal down an A-frame.
Hip exors including the psoas When still photos showing points of
and iliacus impact, movement, or power are studied,
Middle gluteal it becomes clear why the areas of tension
are formed (see 84). The importance of
Adductor group
incorporating the development of postural
Hip extensors including quadriceps
and core muscles through exercise and
group and sartorius
training becomes apparent as the gures
Hamstring display how the dog has to move through
different planes of movement (see 92).
92 Chapter 4

Figure 86 shows the typical areas of compulsory feature of agility that requires
stress in the jumping agility dog. Dotted the dog to stop on, or touch with the feet
areas indicate pectoral (cranial) and ad- an allocated area of equipment), but not
ductor (caudal) muscles. The areas running contacts.
highlighted may seem excessive, but when Figures 87 and 88 show a large dog
the range of equipment that is used for (Jasper) and a small dog (Oscar)
agility training is taken into consideration, negotiating old-sized weaving poles. Jasper
the reason why becomes more apparent. is seen negotiating a tunnel in Figures 89
The main areas of stress are in the and 90. The stresses of both tunnel entry
shoulder area, especially the thoracic and exit for a large dog like Jasper can be
regions of the m. trapezius and m. seen, and explain the cause of his
rhomboideus. These are the areas that repetitive lumbar and sacral problems.
receive concussion when landing after a The carpal joints are also hyper-
jump (84), when twisting through the extended each time a dog lands from a
weaves, and when upholding contacts (a jump or stops on an incline (91). These

86 Stress areas in
the agility dog
jumping (on the
sagittal plane).
Dotted areas
indicate pectoral
(cranial) and
adductor (caudal)
muscles. (Courtesy of
Henry Robertson.)

87 Jasper in old-sized weaving poles. 88 Oscar in old-sized weaving poles.


(Courtesy of Jay Photos, Cornwall.) (Courtesy of Henry Robertson.)
Exercise and Activity Preparation 93

joints become extremely tight and the If a dog does not have the postural
retinaculum can start to restrict both support through the coxofemoral joint
exion and hyperextension through the (primarily due to lacking m. middle
thixothopic stresses and fascial tension gluteal development), the pelvic region
(see 88). If this is affected, the will be under additional stress; compen-
concussional effect and fascial tension sation will be found in the deep lumbar
through the shoulder will tighten, causing region, causing hypertrophy in the mm.
a reduction of speed, as well as a internal and external obliques in an
reluctance to jump and hold contacts. This attempt to protect and stabilize the
is further affected by tension of the m. region.
latissimus dorsi caused, in part, by twisting The lumbar region is the other area of
from the sagittal to the transverse plane issue for the agility dog, especially the
when landing and turning (92). Tension in deep hip exors that subsequently shorten
this muscle can further affect the pelvic through overuse and injury. Ultimately,
alignment. this impacts on pelvic angulation and

89, 90 Jasper entering and exiting a standard-sized tunnel. (Courtesy of Henry


Robertson; reproduced by kind permission of Jasper Bolton and Oscar Norgate.)

91 Carpal hyperextension on landing. 92 Rotational effect of the turns on the


shoulders. (Courtesy of Tony Le Signe.)
94 Chapter 4

causes problems to the sacroiliac joint. An needed sometimes for catching the ball,
experienced agility dog that has had can impact greatly on the whole of the
plenty of training on the at develops body. The muscles involved in yball are
good pelvic stability and uses the hip shown in Table 13.
exor group appropriately in weaving,
using both concentric and eccentric
contraction with each weave pole (93). If
a dog is not taught to develop good
lumbar and pelvic support through
appropriate exercises, the inclination is for
the dog to roach the back (ex at the
thoracolumbar junction) rather than Table 13 Muscles and muscle
to ex the pelvis. This consequently groups involved in yball
impacts on the deep hip exors, requiring
them to act as stabilizers. This can become Pectorals
evident through heat developing in the Trapezius
mid-thoracic region and a slight roaching Brachiocephalic (group)
effect appearing in the lower back (94). Latissimus dorsi
Supra and infraspinatus
Flyball Carpal exor
Flyball is an unbelievably dynamic and Biceps brachii
frenzied sport which can be played in Brachialis
slightly different ways, depending on the Longissimus group (especially
rules being applied. However, the basic lumbar)
moves are similar. The dog activates the Lumbar iliocostal
trigger for a ball to be propelled from a box Psoas and iliacus
which the dog retrieves by jumping over a Hip exor
line of small hurdles (95). Unlike agility, Tensor fascia latae and sartorius
the variation of the moves and planes of Adductor group
movement are not present as often. Quadriceps
However, the potential impact from Hamstring
hitting the box at speed, or the spin action

93 An experienced agility dog demon- 94 An untrained dog will initially roach or


strating good pelvic stability uses the hip ex its back at the thoracolumbar junction
exor group appropriately, using both (arrow) when going through weaves,
concentric and eccentric contraction with without engaging pelvic drive.
each weave pole.
Exercise and Activity Preparation 95

95 Minty playing yball. (Reproduced by 96 Casey playing yball. Inset shows


kind permission of Lisa Bishop.) hyperextension of the carpus. (Reproduced
by kind permission of grandimages.biz.)

Figure 96 demonstrates the Lack of enthusiasm to hit the box.


exaggerated and extreme concussional Avoidance behaviours.
affects involved in hitting the box. Note Dry nose (see Companion dogs).
the hyperextension of the carpal joint and Sensitivity of feet to the touch.
the exibility required through the
lumbar region. Similar injuries to those of Obedience
the agility dog are typical through the The obedience dog is the canine
lumbar region and involving the entire hip equivalent of the dressage horse. Anyone
exor group. As always, postural and core familiar with dressage will recognize the
strength is crucial, especially through both requirements for tness and conditioning
thoracic and pelvic adductor groups, in order to have the ability and
which support the limbs on the turn. coordination needed to hold the
Another key area is within the shoulders; movements required with a ne degree of
if this area is compromised by poor accuracy. The difference between this type
exibility and support, the carpal joints of activity in the dog and horse is that the
will receive more of the concussion. As a dog has to hold his head up, putting more
result, the recoil action of the carpus will strain on his lower back. This is
be reduced, which greatly affects the joint completely different from the afore-
congruity. It also impacts on the neck, mentioned highly dynamic sports of
causing pain when the box is activated. agility and yball. However, it is equally
The typical signs of muscular problems demanding, and requires the same
in a yball dog are: amount of tness and conditioning. Table
14 overleaf presents the muscles involved
Slower times. in obedience training.
Reluctance to perform.
96 Chapter 4

In some respects, this discipline, Figure 97 shows angulation of the head


practised at a high level, is one of the with the referred stresses reecting
toughest for the dogs musculoskeletal through the thoracic and lumbar regions,
system. The amount of static and eccentric and isolated within the gluteal muscles.
contraction required to hold a position at Figure 98 shows exion of the hock and
a slow pace requires a high amount of stie area. Other effects include:
energy and complete balance control. An
example of the type of pressure which is
applied to the pelvic region would be that
of the classic pre-ski exercise in humans;
here, the person stands with their back
against a wall, slides down until the knees
are exed and the feet are the same
distance away from the wall as the length
of the femur, and holds. This is a static
contraction of the quadricep group (and
other muscles). There is no movement,
the body is held still against gravity. When
a dog is performing at slow pace and
moving through hocks, this is almost what
it is doing.

Table 14 Muscles and muscle 97 Obedience trained dog. (Please note:


groups involved in obedience this head position was freely offered by the
training dog; it was not forcibly trained.)

Pectorals
Trapezius/rhomboideus
Splenius
Psoas/iliacus
Latissimus dorsi
Longissimus group (especially
lumbar)
Lumbar iliocostal
Gluteals
Hamstring group
Gastrocnemius
Quadricep group
Tensor fascia latae
Sartorius
Adductor group 98 The stress points of an obedience dog.
Note the exion of the hock and stie area.
(Courtesy of Henry Robertson.)
Exercise and Activity Preparation 97

The continual spinal curvature to the


right with the head inclined puts huge
pressure on the whole vertebral
system.
Reective stress passes through the
body from the neck, and the slight
curvature will, in some instances,
cause instability thorough the pelvic
region (if the lumbar region is long).
The concentric contraction of the 99 Copper, a working gundog.
hamstring group during the slow pace
will cause stress and overuse problems
if dogs are not conditioned and
trained appropriately. The obedience
dog needs to work using opposite
stresses of the vertebrae, both in
exion of the neck, and opposite
exion of the vertebrae.
The overworking of the hamstring
group and the adductors will cause a
gradual shortening of these muscles,
which will then stretch the quadricep for the job. However, diverse farming
group, and cause the classic pelvic patterns mean that on a drive they could
slide if not treated. be working on a ploughed eld one
The prolonged eccentric contraction moment and then on set aside
of the gluteal muscle group may cause (unfarmed) land the next. The going on
repetitive strain problems. these surfaces is very different, so their
The left shoulder due to continual handlers must be able to supervise them
maintaining of posture and closeness while they are running and possibly
to the handlers leg, and the right carrying their quarry (99).
shoulder being used as a constant Due to the diversity of training
pivot. methods employed and the lack of
repetitive actions during the course of
The likely signs that an obedience dog their work, the gundogs postural
has muscular imbalance are: development is generally quite sound.
They are more likely to suffer accidents
Inability to hold a gait. when negotiating obstacles, such as wire
Deliberating over stance control. fences, stiles, and rabbit holes, but as they
Lateral swinging of the pelvic region. may be working out of sight, these
Reluctance to perform a particular incidents may go unnoticed. Because of
part of a discipline, e.g. not hold a sit. the type of work and the conditions, these
The risk of a chronic neck injury also dogs are more likely to suffer from
means the potential loss of scenting ability, microtrauma, which would not show up
as this has a direct relationship with some on the day, but would be noticed
neck problems. A key indicator is if the afterwards, as post-shoot day stiffness. This
dog has a dry nose (see Chapter 5). would not necessarily be a major issue, but
if left without treatment, the injury could
Gundogs be exacerbated and cause compensatory
Through training and conformation, the problems, leading to reduced working
gundog has the advantage of being built ability.
98 Chapter 4

The main area of strain is in the neck required to perform their tasks efciently,
(100). Sometimes the size of the game can rather than having to keep the dog warm.
be disproportionately large for the size of The dog will also feel more in a state of
the dog. To carry a bird over an uneven readiness; its muscles will be more relaxed,
eld or from water can be an extremely and valuable nutritional resources will be
arduous task that takes a huge amount of available for activity rather than thermo-
static muscular force to perform. regulation. This really applies too during
Although gundogs are bred for the task, break periods, or at the end of the day;
the neck is an area that needs attention keeping the dog warm assists muscle
and can, consequently, cause strain further repair and assists free movement to aid
down the dogs back, especially when it is bre realignment.
fatigued, or if it is retrieving over a long Another area worthy of note could be
distance or over difcult ground. As on how much road work exercise the gun
previously mentioned, a good indication dog receives both on and off season. The
that a dog has an impaired neck is a dry feet are a key stress area that affects many
nose (see Chapter 5), which can mean working gun dogs, suffering osteoarthritic
that the dog will not have the same ability changes that can reduce their working life.
to pick up a scent. This is a potential This may be due to the lack of road
disaster, as the ability to scent is crucial for working that assists the tightening of the
a gundog. integral tendons within the foot, resulting
Another problem area for the gundog in a lack of good stability within the joints.
that retrieves is that, between the drives, As the gun dog covers uneven ground,
there is opportunity for the dog to get often carrying a weight (dummy or bird),
cold. Keeping them warm is key; it may such changes in joint work load could lead
seem excessive for a working dog, but if it to arthritic changes. A small amount of
keeps warm, it will remain in a state of soft road working, gentle trotting and
homeostasis. Consequently, the muscles walking, a couple of times a week for just
will provide the movement and stability 10 minutes could help reduce this
incidence.
Possible indicators of muscular
problems in a working gundog are:

Post-working stiffness.
Reluctance to work over difcult or
uneven ground.
Reluctance and difculty in jumping.
Lack of speed of the retrieval
(dropping and picking up).
Lack of drive.
Reduced scenting ability.

Husky sledding
If a Husky has an appropriate harness
(101), the main pulling effort comes from
the sternal region, a central point in the
dog, resulting from the dog pushing
through the harness. This drives the force
from a low point of gravity up through the
100 The most common areas of muscle thoracic region and through to the pelvic
problems in a gundog. region. This route almost exactly follows
Exercise and Activity Preparation 99

101 Huskies on the way home after exercise. (Courtesy of Henry Robertson; reproduced
by kind permission of C. Kisko.)

102 Stress areas in


the working Husky.
Note also the line
of the harness.
(Courtesy of Henry
Robertson;
reproduced by kind
permission of C.
Kisko.)

the fascial planes, so the muscles are aided side, especially if paired with a dog of
by their tensile strength. This facilitates unequal power or stamina. The stresses
the pelvic region to drive through the would differ if an inappropriate harness
lumbar region, thereby creating an were used.
appropriate kinetic chain of forward Examples of muscular problems in a
action and drive. working Husky are:
Figure 102 shows the similarity of the
stress lines of the working dog and the Paddling (at a standstill).
anatomical fascial lines. These demon- Running off-line.
strate potential problem areas should a Fatiguing prematurely.
dog be constantly put in a position which Slack line (not pulling in line).
would cause it to develop stress down one Running off centre line.
100 Chapter 4

Canicross It is important that the dogs harness


This is a relatively new sport to the UK, but does have a good anchorage point that
it is extremely popular in the rest of remains on the manibrium (the cranial part
Europe. It is open to all breeds, and involves of the sternum) and does not impede the
both dog and handler running a set course pectoral muscles that lie adjacent to it. It
of about 35 km in varied terrain, from must allow good shoulder movement and
open elds to forest trails. Some also facilitate friction-free movement of the
Canicrossers are also covering 10 km to m. latissiumus dorsi. The harness should t
marathon distances, primarily off-road, both dog and handler exactly. The handlers
avoiding concrete, tarmac, and sharp rocky harness should also t well, and it is best if
surfaces to protect the dogs feet and it is put on the lower lumbar/upper pelvic
minimize wear and tear of both dog and region; this would provide most strength
runner. It is growing in popularity, and is without causing excessive stress on the
the complete dog and handler combined lumbar or abdominal regions.
competition. It involves a dog and its Both dog and handler have to be t for
handler being attached by a harness which this event, and the stress areas are the same
has been specically designed for the task. for both (103). Everything depends on the
There is no rule that a harness should be terrain, especially the amount of uphill and
worn, but for safety of both dog and downhill work involved, as this affects the
handler it is the preferred option. It is stresses that would be involved.
desirable for the dog to pull out in front;
heeling is acceptable, although this will Show dogs
have an impact on how the dog moves. A well-muscled dog will attract the judges
The type of harness worn must be eye in its rst circuit around the ring. A dog
considered carefully by the competitor. It that is balanced and can push away from
must be designed for this use, and not an the hindquarters will set itself apart from
adaptation of one that was intended for the rest. When being presented to the
another purpose. An example of this is a judge, whether freestanding, stacked, or
harness that has been designed as a sled top-and-tailed, a dog that can stand four-
harness and is intended for a dog pulling square is what is being sought by good
with the stress being taken parallel to the judges. If the dog is evenly muscled and
object it is xed to (see 102). However, in balanced, this will be natural. The show dog
Canicross, the dog will be at an angle to the that has been prepared with correct ring-
handler, and the angle will differ with each craft activities will have developed good
handler and dog combination. This core stability (104). Appropriate exercises
incorrect angulation could affect the dogs encourage core and postural strength so
lumbar region. The standard length of that a dog can show very well, both
connecting line between dog and runner is through the moving and static phases of
2 m at full extension. If, however, a tall the competition. Massage to help warm the
person is running with a Jack Russell terrier, soft tissue can act as an important tool to
then the line must be long enough; demonstrate the dogs full range and ease
otherwise, there would be unnecessary of movement, as well as acting as a good
upward pull on the dog. This would bonding experience for handler and dog
impinge on the dogs movements and cause (see Warm-up (pre-event) massage and
discomfort. In addition, lines are advised to Warm-down (post- event) massage).
be elasticated to avoid jolting of runners The show dog has no specic problem
backs and dogs shoulders and necks. areas, apart from travelling in crates and
However, too much elastication could lying on benches that do not allow the dog
result in whiplash-type injuries for the dog. to stretch and move for prolonged periods.
Exercise and Activity Preparation 101

However, if it sustains an injury, even a very


small one, this could affect its gait and range
of movement, and this could compromise the
dogs opportunity to represent its true quality.

Companion dogs
Mans best friend is a very true statement
and the role of the companion dog has
made a positive difference to many
peoples lives. The companionship cannot
be underestimated in its value. Most people 103 Stress points of the dog during
want to reward their dogs for their Canicross. (Reproduced by kind permisson
unconditional love; however, unknowingly, of Canicross Trailrunnners.)
we can sometimes present our dogs with
environmental complications that can have
a devastating effect on their long-term
health (105).
The companion dog can be affected by
many different potential problems,
including:

Extensive weekend walks.


Inappropriate jumping.
Excessive ball play.
Slippery oors.
Stairs.

Extensive weekend walks


Maybe one of the most problematic dogs
is the weekend walker. During the week,
this dog is given a 10 minute walk around
the block in the morning and the same in
the evening. However, at the weekend it
is taken on a greatly extended walk lasting 104 Show dog Tiggi and Kerry.
many hours. The exuberance shown by (Reproduced with kind permission of BJ
the dog is obvious, but the potential for Photography.)
injury is great and can start when the dog
is a puppy and not skeletally capable of
dealing with this amount of exercise.
This may not be demonstrated as overt
injury, as the post-walk stiffness would
wear off during the week. A slow somatic
change will ensue, however, probably
starting in the cervical and shoulder areas,
where there will be developing tension
throughout the region. This will be caused
by jumping down from obstacles and
excessive running, and occurs if the dog is
too young, or not warmed up. 105 Companion dogs.
102 Chapter 4

Inappropriate jumping the compensatory process. If the injury is


Another classic scenario is that of putting in the back, the dog will compensate and
the dog in the car to go for a walk. When try not to use the drive muscles in the
arriving at the destination and opening the pelvic limbs and pelvis, and will start to
back of the car, the dog leaps out, rushing power from the front, building and
off from a standing start into a at-out developing these muscles as drive muscles
gallop, or, worse still, being thrown a ball (see Chapter 6 the torpedo).
or Frisbee. The impact of both these In Figures 106 and 107, the strain
activities can be clearly seen on photos. It jumping down from a car puts on the
involves going from a cold muscular state front region of the dog is evident. This area
straight into a high level of activity, red is designed to absorb this kind of impact;
by adrenaline, which is not very good for however, when dogs are cold, the recoil
the dog. These repeated actions will lead and absorption effects of the muscles are
to minor back and shoulder injuries, compromised. If this occurs frequently,
which would probably be apparent as the repetitive action will have an impact
some minor stiffness that would occur on the musculature of the shoulder. The
after any form of exercise, and therefore solutions, as mentioned earlier, include
be disregarded. using a good ramp or a supporting sling,
This is then worsened by the dog or lifting the dog in and out of the car if it
jumping on and off furnishings. These is small enough. (The authors own dog
unnoticed injuries can cause scarring of was used to demonstrate this action and,
the muscles; this reduces their ability to later that evening, there was distinct heat
function properly, and causes them to within the m. trapezius and he was
shorten, putting stress on the joints. The unsound the following day, then ne the
shortening of the muscle will gradually day after. He was subsequently treated and
impact on joint congruity and will start the stress issues have been alleviated.)

106, 107 The stresses on a dogs body as it jumps out of a car. (Courtesy of Henry
Robertson.)
Exercise and Activity Preparation 103

108, 109 Dog chasing a ball. The line in (108) indicates the stress of torque through the
vertebrae; the arrows in (109) indicate the opposing stresses of the rapid turn. (Courtesy
of Henry Robertson.)

Excessive ball play has instability problems, these ooring


Ball play to a dog represents the chase of types can exacerbate them.
a hunt and the subsequent capture of the
quarry. The dog has an intrinsic desire to Stairs and furniture
do this, but some types do more than Both ascending and descending stairs and
others. However, this can be exploited by jumping on and off furniture can cause
excessive ball play how many rabbits the same types of repetitive strain injuries
would a dog really hunt and kill in one as can jumping in and out of a car. These
day, compared to the number of time a continual activities are at their most
ball is thrown? The simple repeated action potentially damaging when the dog is very
of chasing a ball creates a massive amount young or adolescent, with an under-
of stress through the torque effect of developed skeletal system. These
rotation. If Figures 108 and 109 are continual stresses can have a major impact
studied closely, it is evident that the dog on both the muscular and skeletal systems.
twists in two different directions, causing The skeletal system is badly affected
a huge amount of stress in the vertebral by the constant general stress, inapprop-
column. If this is repeated over a long riate stresses involved in landing, and
period of time, it will cause a large amount excessive exion and extension caused by
of insidious low-grade injury, or more the propulsion required. These can all
damaging joint disease. damage the growth plates (see Chapter
2). Regarding the muscular system, these
Slippery oors movements create microtrauma of the
As far as cleanliness is concerned, bres as a result of the propulsive forces
laminate, wooden, or tiled oors have a lot required. Thus, concessional muscles are
to commend them; however, when it recruited; this will create a change in
comes to a dogs stability when walking or directional contraction or reduced relax-
running, the lack of traction can have ation within these muscles that will
some extremely long-lasting effects. Dogs subsequently affect the directional stress
legs can violently hyper-abduct if they are on both the skeletal and muscular systems,
slipping, causing sprains and strains within and therefore cause changes in muscle and
joints and surrounding soft tissue, causing joint patterns and congruence to
long-term damage. Also, if the dog already accommodate the traumas.
104 Chapter 4

Warming up and warming Therefore, it would be fair to think that


down the elasticity, stretch, and recoil would all
The subject of warming up and down is be enhanced. Also, the movement and
contentious, and one that some scientic joint activity of synovial joints will
studies have dismissed as unnecessary. decrease the viscosity of synovial uid,
Interestingly, top athletes, whether they thereby aiding their smooth function.
are runners or team players, always have The warm-up should take around
warming up period as an essential part 10 minutes and consist of gradually
their routine. Rugby players are now often increasing cardiorespiratory activities,
seen on static bikes, pitch-side, warming building up in intensity, speed, and gently
up; racehorses are given the opportunity progressing movement. Gentle and slow
to run before a race; show jumpers, small circling should be introduced, with
eventers, and dressage competition horses, a gradual increase of circumference, in
are all given a practice area in which to both directions; tracing out the letter M
warm up, whatever the level of can then be integrated to encourage an
competition. This is generally viewed to even stretch. Lateral movements can be
be an essential part of any athletes introduced (adduction and abduction)
programme; unfortunately, there are very when the dog is warm. Ball throwing
few canine shows that involve athleticism, should not be introduced until the dog is
and therefore, the importance of warming completely warm, and this should be
up and down is barely considered. restricted to one or two throws. Tugging
Interestingly, the warm-down seems to can be introduced, again when the dog is
have more credence and is more widely warm, but this exercise should ideally be
accepted than the warm-up. restricted to a direct pull, as this helps re
the vertebral postural muscles. Violent
Why warm up? shaking of the neck should be restricted.
The warm-up should be a programme of
exercises that effectively targets the muscle Warm-up (pre-event) massage
groups which are to be used. It does not This can be an important addition to a
necessarily need to be used just in training, dynamic warm-up, but it is not a
performing, or competition; the concept of replacement.
a warm-up and warm-down should apply
to every exercise situation. It usually The massage techniques l was taught helped
consists of dynamic and static elements that prepare my dogs for competition. Particularly
will assist the functioning of the soft tissue, at Crufts with Tally, when massaging him in
so as to maximize the range of movement. the collecting ring denitely helped us both relax
It is also psychologically important, as the and enhanced the connection between us.
routine will focus the mind on the task
ahead, which is extremely important for a Tania Bull (see 110)
dog.
The physiological benets of The warm-up massage produces both
dynamically warming up are, in some quantiable and unquantiable results.
cases, open to conjecture. However, any When a dog is timed on a regular basis for
preparatory increase of oxygenation and a round, or its mobility is being measured,
nutrition from the blood through ne differences can be accounted for.
increased cardiovascular activity is going Chance and coincidence can always be a
to promote and prolong muscle function. possibility, but when the same results are
On a cellular level, if muscle bres are achieved with the same preparation, they
activated with a moderate approach, the can be believed. However, there are times
resulting ease of movement is evident. when a dog seems more focused, and is
Exercise and Activity Preparation 105

111 Dog after a dynamic warm-up only


(lighter areas: cooler; darker areas: warmer).

110 Tania and Tallys rst time at Crufts in


agility they came second. (Reproduced
by kind permission of Steven Bull.)

more at one with the handler. It is a 112 The same dog after the same dynamic
feeling, rather than something that can be warm-up followed by a pre-event massage,
measured. It could even be that by photographed 20 minutes later.
performing a massage there has been a
relaxing and focusing effect on both dog
and handler but it cant be proved.
Pre-event massages can be used in
different ways for different activities. For
instance, the agility dog needs to
be stimulated and alert, whereas an
obedience dog needs to be more
contained and focused. Similarly, a gundog
would need to be continually warmed
between drives to maintain optimum
muscular efciency and reduce the risk of
injury through cold muscles. The rate of
the massage can be adjusted accordingly:
the quicker the massage, the more
stimulatory it is, as the sympathetic
nervous system is being inuenced. If a dynamically warmed and a dog that has
more focused disposition is needed for an been dynamically warmed and then
event, then the rate can be slower. This is massaged, a heat-sensitive (thermal
also applicable if a pre-event massage is imaging) camera was used to photograph
being introduced earlier into the routine. a dog before (111) and after (112)
In an attempt to demonstrate the massage. The massage clearly helped to
difference between a dog that has been increase the dogs temperature.
106 Chapter 4

A warm-up or pre-event massage aims A warm-down, like a warm-up, should


to: be dynamic and, if possible, aided by a
specic massage. Dynamically, it should
Warm supercial tissues by frictional take the form of active but not too
heat and, therefore, to prepare them vigorous exercise. It is best described as
for activity. exercise of an even tempo, a comfortable
Warm deeper soft tissue by active walk or light jog, enough to pro-
inuencing arterial circulation mote the pumping mechanism through
providing increased oxygen and muscular activity, but not enough to be
nutrients. oxygen-demanding. Gentle exion and
Prepare the dog mentally and extension of the vertebrae and the limbs
physically for activity. maintains the mobility of the joints if
Connect and focus both dog and there is tissue damage. This exercise
handler. should last for about 10 minutes.
The warm-up or pre-event massage Like the warm-up, the warm-down is
should consist of: looking to promote capillary function and
the lling of the muscles with arterial
Efeurage, starting gently and blood, by inuencing and aiding venous
building up slight pressure. and lymphatic return. During exercise, a
Petrissage kneading, compression. vast amount of metabolic activity occurs
Cross-bre techniques. within the muscle bres; with the correct
Tendon release. rebalancing of oxygenation within the
Tapotment (dependent on the dog). muscle cells, metabolic wastes will be
Passive movement. removed effectively (see Chapter 2).
(For explanations of these techniques, Aiding and promoting arterial circulation
see Chapter 6.) will assist the delivery of good levels of
For optimum effect, this massage oxygen and nutrition to the muscle bres.
should be performed between 20 and 40 It will also help to remove lactic acid and
minutes before an event, working with the aid the repair of microtrauma;
dog and gauging the response and respect. furthermore, it will ease pain perception
If this is incorporated into the whole from microtrauma or minor injury
routine, it will become second nature to through the realignment of muscle bres.
both dog and handler, and becomes a good
way to prepare, both physically and Warm-down (post-event)
mentally. massage
This is an important addition to a dynamic
Why warm down? warm-up. It provides the handler with the
Warming down is preparing the muscles for opportunity to detect even a small injury.
the next event. Its importance cannot be understated, as
many muscular problems in the canine
Galen Therapy Centre athlete are due to untreated injuries. The
major ones are obvious, as the dog may be
If everyone could view a warm-down lame, stiff, or unsound. However, it is the
and see the way that it can greatly minor injuries that can develop unseen
inuence a dogs performance in the next and cause future problems. To massage the
event, everyone would do it. To perform a dog gently will, to a degree, smooth the
correct warm-down should leave the nerves endings (see Chapter 6 gate
athlete (injury aside) with little or no post- control theory) and, perhaps more
event muscular stiffness and a feeling of importantly, identify areas of
well-being. inammation by the presence of heat.
Exercise and Activity Preparation 107

To gain the most lymphatic return, the not be performed, because if there is intra-
massage should be directed towards the or intermuscular bleeding, more damage
main lymphatic nodes, rather than using can be done; veterinary assistance must be
the long, sweeping strokes of the pre- obtained.
event massage. The warm-down (post-event) massage
Possibly one of the most should consist of:
underestimated aspects of a post-event
massage is the reinforcing of connections Hand placement over the dog to
between dog and handler. This can make isolate areas of heat or inammation.
a massive psychological difference to the If there is heat, massage should not be
dogs outlook and memory of the event. If performed of the area and appropriate
the competition has gone badly, this is cold therapy should be applied.
often due to handler error; however, the Gentle efeurage, directing the
dog will pick up negativity, regarding any strokes towards the main areas of
problems as being of their own doing. For lymphatic drainage.
most dogs, it is a heinous crime to cause a Depending on the dogs condition,
vulnerability to the pack, and they may efeurage with slightly increased
see the situation this way. Therefore, the pressure.
one-to-one massage can reinforce the Compression techniques.
bond between handler and dog. Through Efeurage.
eye contact and touch, the dog receives Gentle cross-bre technique.
signals that all is well. For a dog to have Tendon-release massage.
good memories of a competition, Efeurage.
whatever the result, will bode well for Passive movement.
subsequent events. (For explanations of these techniques, see
A post-event massage aims to: Chapter 6.)
Ideally, this should be done not later
Get hands-on awareness of possible than 4 hours after exercise. This is not in
injury. any way prescriptive, and care must be
Cleanse and re-oxygenate muscle taken at all times, as areas with fractured
bres. or damaged cells can be worsened by
Inuence ow of arterial blood to inappropriate massage techniques. Like
assist with microtrauma repair. the pre-event massage, to perform this 48
Realign muscle bres to help with hours later will assist any cellular repair
muscle function. and bre realignment, and also alert the
Reinforce the connections between handler to any persistent inammation
dog and handler. that should receive veterinary advice.
Even if there is no perceptible injury,
post-event massage must be performed Additional information for
gently and sympathetically, with the handlers of sporting dogs
understanding that there could be areas of If time elapses between classes,
tenderness and soreness that are almost events, or drives, another warm-up is
imperceptible to the handler. Therefore, required; do not let dogs get cold
this massage could consist only of a between disciplines.
moderate efeurage with no other With high impact and dynamic sports,
techniques involved. The rule is that if it is a good idea to get someone to
there is any question of there being an lm your rounds in order to witness
injury, this should not be performed. If any incident, so that the treatment of
there is a possibility of an injury, or if the any accident or injury can be more
dog is clearly lame, then massage should targeted.
108 Chapter 4

Between events, check the muscular them. Stretching is always a subject that
balance of your dog through is open for debate and opinion.
professional therapy and by However, everyone nds a routine
implementing appropriate exercise that suits them, and as long as the muscles
regimes, e.g. incorporating rest days are warmed dynamically before stretch-
with a blend of lead walking, free ing, then the benets should always be
running, and, possibly, hydrotherapy. felt.
Ball throwing, Frisbee throwing, and Warm-up increases:
other high-impact exercise should be
minimized. Cardiorespiratory efciency.
Between activity seasons, develop the Blood ow to the active muscles.
dogs core strength and stability Oxygen transportation and exchange
through correctly designed and capacity.
assisted canine excercise physiology. Muscle contraction and relaxation.
Also, use massage and passive Mental readiness.
movement between Warm-down benets include:
competition/events and training days, Improves exibility.
to assist bre direction and joint It removes waste products by the
congruity. bloodstream.
Incorporate scenting exercises to It minimizes muscular soreness.
encourage a relaxation of the back It prevents dizziness or fainting due to
muscles and gentle exion of the neck blood pooling.
and back vertebrae (see Chapter 5).
Check your dogs soft tissue, muscle Format of the warm-up and
function, and range of movement to warm-down
minimize the risk of further injury The cardiorespiratory portion of the
and the development of future warm-up should last up to 10 minutes at
compensatory problems. a low-to-moderate intensity, with the
Be aware that training sessions tend to warm-down being active but not
be more intensive and have a higher orientated towards the cardiorespiratory
impact than event days. system. This is possibly what one would
Treat areas of heat appropriately, with view as an adequate preparation.
ice and rest (see Chapter 7). However, a complete warm-up and
Seek professional help for any injury warm-down consists of appropriate
even if the dog seems to recover, the stretches as well. The following basic static
injury may remain. stretches can be applied.
Target areas of stress for treatments.
The static gastrocnemius
Warm-up and warm-down stretch (113)
for the handler Stand, facing a wall or another stable
It is just as important for humans to warm object, with both arms extended
up and warm down as it is for the dog. The against it.
body needs to be prepared for physical Extend one leg backwards about half
activity, whether it is a general warm-up a metre. The knee should be straight
or a more specic one for the activity. with the heel on the oor.
Especially in the case of agility, with sharp Draw in the abdominal muscles (draw
turns, acceleration, and deceleration, the the navel inwards).
dog and handler need to be well prepared Bend the arms and lean forward
for the stresses which will be placed upon toward the wall, keeping the rear foot
Exercise and Activity Preparation 109

at and pointing forward. Draw in the abdominals and place the


Contract the gluteals and the hands on the hips.
quadriceps tightly. Slowly, move the body forward until a
Hold for 2030 seconds. mild tension is felt in the front of the
Repeat on the opposite side. hip.
Hold for 2030 seconds.
Static kneeling hip exor Repeat on the opposite side.
stretch (114)
Kneel with the front and back legs
bent at 90 (the kneeling lunge
position).

113 Static gastrocnemius 114 Static kneeling hip exor stretch.


stretch.
110 Chapter 4

Static standing adductor Static gluteal stretch (117)


stretch (115) Lie on the back.
Stand in a straddled stance with hands Cross the chosen leg onto the other
on hips; the feet should be further leg, with the ankle resting just above
apart than the shoulders. the knee joint.
Stand with the toes of one foot in line Loop the hands around the thigh of
with the arch of the other. the stabilized leg.
Draw in the abdominal muscles. Pull towards the chest until stretch is
Slowly transfer weight in a sideways felt in the gluteal muscle of the held
motion towards the leg that is slightly leg.
forward until a mild tension in the Keep the back and neck aligned (do
groin area is felt in the straight leg. not aid the stretch with head
Hold this stretch for 2030 seconds. movement).
Repeat this stretch on the Hold for 2030 seconds.
opposite leg. Repeat on the opposite side.

Static upper trapezius All the stretches shown can be done


stretch (116) between events and training to assist
Stand with the feet shoulder-width muscular function, and can help with
apart. repetitive strain conditions. None of these
Take one arm out to one side of the exercises should cause any pain; if they do,
body in a 45 angle, with the palm stop, and seek medical advice.
facing forward.
Tuck the chin in and keep the scapula
retracted and depressed.
Slowly move the head in a sideways
motion away from the abducted arm
(ear to shoulder motion).
Hold this position for 2030 seconds.
Repeat on the opposite side.
Exercise and Activity Preparation 111

115 Static standing adductor stretch. 116 Static upper trapezius stretch.

117 Static gluteal stretch.


113

5
Rehabilitation
Techniques
Julia Robertson

Introduction
Exercising
Passive movement
Hydrotherapy

Introduction
In rehabilitation, it is just as important to know what
activities to prevent the dog from doing as it is to know what
to encourage. Activities such as jumping from cars and the
repetitive throwing of balls (see Chapter 4), can reverse the
effects of treatment when a dog is recovering from a
muscular or joint injury, which may be wrongly interpreted
as the treatment being ineffective. This also applies when
managing a dog that has a permanent condition, such as
osteoarthritis or hip dysplasia. These conditions will deterio-
rate at a greater rate if such activities are encouraged or not
avoided.
The areas covered in this chapter are those that can be
safely carried out so as to assist appropriate muscular
development and aid mobility following advice from a
veterinary surgeon or other specialist. It does not involve the
complexity of intricate post-operative physical therapy;
however, some areas of post-operative care will be discussed.
Previous chapters have identied areas of stress or overuse
within muscles and muscle groups. The exercises that will
now be shown will help to repattern the muscles
appropriately using simple counter-stress and strengthening
114 Chapter 5

techniques that will assist muscle ring, ensure that the dog is warmed up before
realignment, and resumption of muscle running. Then the same 10 minute walk
length to regain balance and symmetry. before going home can assist a warm-
Myotherapy should be integrated reg- down. Other exercises that have been
ularly within the exercise programme to prescribed can sometimes be a little
ensure that the correct muscular difcult to understand, given the circum-
patterning is being established, and it stances, e.g. post-operatively, post-injury,
should also be part of the timed or post-treatment. These fundamental
programme suggested by a therapist to exercises are relatively easy to adapt, and
full the realistic expectations for the dog. can make huge differences for the
Also, it is important that these exercises remedial dog.
should be demonstrated or explained
properly, with a rationale, so that the Lead walking
handler can perform them correctly and Lead walking is a vital method of
understand why they are important. reintroducing or restricting exercise
For the dog that has been, or still is, for the dog. It is probably one of
recumbent, massage, together with some the least understood and, therefore,
of these dynamic exercises, will help to inappropriately performed of all the
inuence the venous and lymphatic return rehabilitation exercises.
systems; this will help the dog by It has different uses for different
replicating exercise and assisting the situations:
removal of toxins. This is something that Post-operatively: depending on the
can be easily administered, but one that operation, it would generally be used
has many positive effects. The inuence to mobilize and promote movement
on the return systems will cause an to aid healing and begin to regain the
enhanced arterial ow that will assist joints range of movement. The post-
cellular repair and division (see Chapter operative recumbent dog will regain
2). If applied appropriately, it can soothe mobility far quicker if appropriate
and calm a dog that is in pain, and can be exercise is introduced into the
especially helpful if the dog is unable to routine.
tolerate nonsteroidal anti-inammatory Post-treatment: this would be to
drugs (NSAIDs). As well as an enhanced contain the otherwise lively dog to
circulatory response, massage and passive obtain the optimum changes from the
movement will help a dog neurologically, treatment. To bring about a controlled
to regain proprioception and re-establish gait allows muscles to pattern in an
neural pathways. appropriate manner without the stress
When a dog is rehabilitating, especially of overexertion. This is generally given
post-operatively, areas which are distal to a timescale according to the dogs age,
those directly affected are also prone to condition, normal activity levels, and
having problems, due to the displacement the treatment received.
of weight and change of gait. Massage can General management of a condition:
be especially helpful in these situations the amount of lead-walking would
(see Chapter 7). depend on the condition; it is used to
ease the strain on areas of damage and
Exercising encourage strengthening of functional
A simple adjustment or adaptation of regions.
usual methods of exercise can make
dramatic changes to the muscular and The type of lead used would be
joint health of a dog. A straightforward 10 dependent on the dog being exercised. If
minute lead walk before a longer walk can it were an active dog, then a harness
Rehabilitation Techniques 115

would be advisable, to avoid any stresses Lateral hill walking


to the vertebrae that a collar and lead may Lateral hill walking (118) can be an
cause. The only problem with a strong or extremely efcacious way to develop
active dog and the use of a harness can be postural vertebral muscles. Walking along
that of control, as a dog could potentially the side of a hill can instigate the use of
drag the handler into a potentially the crucial muscles that support the
dangerous situation. By way of a com- vertebrae. It can also be applied to normal
promise, the addition of a passive collar strengthening programmes or to remedial
and lead, as well as the main lead, can be programmes where muscle tone has been
used. Therefore, if an emergency did lost or reduced in the area. This should not
occur, the collar can add to the restraining be done on very steep hills, but on a gentle
capabilities of the harness. Only in specic gradient. The rationale for these effects is
cases would lead walking include an basic, but they can bring about a good
extension lead. These leads are intended response.
to allow limited freedom; however, they Walking the dog slowly and accurately
can produce a catapulting effect as the along the side of a hill will encourage the
dog suddenly comes to the end of dog to balance through the vertebrae, by
the lead, and this would be totally contracting the muscles on the higher side
counterproductive to any rehabilitation concentrically; conversely, the muscle
programme. groups on the downhill side will be in
The type of surface for walking would
have to be at and smooth, as any form of
irregularity in the surface would exacer-
bate a lack of balance. A at and smooth
surface would take out any extra stresses
and encourage a regular and smooth gait.
The handlers pace should be adapted
to that of the dog, not vice versa,
especially if the exercise is for remedial
purposes, and the dog encouraged to walk
on both sides

Walking
One of the most underestimated
rehabilitation exercises is the walk. This is
different from the jog or trot as it is four
time, meaning each leg touches and pushes
off from the ground independently. If a dog
is encouraged to walk, not jog, it will aid
rehabilitation and encourage enhanced
muscular stability and strength through low
impact. A walk can be performed slowly
enhancing suspension of movement,
therefore encouraging stability, or normal
pace, encouraging balance and even
weightbearing and use. Extended walk is
excellent for helping extension and
improved length of stride. The normal and 118 Lateral hill walking for rehabilitation.
active or extended walk are also excellent Eccentric contraction: arrow; Concentric
inclusions into a warming up routine. contraction: dotted arrow
116 Chapter 5

eccentric contraction, supporting the


vertebrae. By changing direction, the
muscles of the opposite side of the back
will be uppermost, contracting concentri-
cally, while the lower ones are now
contracting eccentrically.
Incorporating a gentle turn will also
encourage slight lateral movement.

Scenting exercises
Scenting could be one of the most 119 Scenting exercise. Nuchal (solid line)
unexploited exercises used with dogs. To and supraspinous (broken line) ligaments.
set a dog exercises where the nose is
encouraged to move toward the ground
can help in many different ways. This is a
natural position for a dog, and to use this
as a form of physical therapy is generally
easy to do.
These exercises ease tension within the
vertebral column and the shoulders. By
putting its nose to the ground, a dog
stretches the nuchal ligament and the
longitudinal bands of its extension along
the back, the supraspinous ligament (see
65). This is especially useful for obedience 120 Pole walking in rehabilitation.
dogs, as it is part of their discipline to do (Courtesy of Henry Robertson.)
much close heel work, which can lead to
neck and back problems because of the
ventral force created. Indeed, for any dog
with shoulder or lower back problems,
this is a gentle and natural way to
encourage it to stretch out and mobilize
the whole vertebral column.
In Figure 119, the supraspinous liga- engaging one of its greatest senses. By
ment is drawn as a solid line. The nuchal doing this, the dogs mind will be
ligament (a broken line) is positioned just stimulated more than with an ordinary
dorsal to the m. multidus cervicis. It exercise. Therefore, for dogs on a restricted
starts at the spine of the axis and exercise regime, a game of nding small
continues caudally to the apex of the rst treats, toys, or even its meals, can be
thoracic spine. The supraspinous ligament extremely satisfying and fullling.
connects to the apex of the spinous
processes of all of the thoracic, lumbar, and Pole walking
sacral vertebrae, and ends at the third Pole walking (120) should be incorporated
caudal vertebra (see also Chapter 3). into the routines of puppies and dogs with
This exercise can have highly benecial proprioceptive problems. A couple of
effects from a physiological, physical, and poles (up to four) are placed on the
psychological perspective. Involving a dog ground at irregular spaces; the dog then
in a game or exercise of scenting will has to concentrate carefully, choosing
generally have a highly stimulating effect, which leg to lift to walk over the next
which will occupy and amuse it by pole. This helps to re-establish and
Rehabilitation Techniques 117

develop the neural pathways that a dog to walk laterally and medially so that
constitute spatial awareness and coordina- it adducts and abducts both pelvic and
tion. The more irregularly the poles are thoracic limbs, which helps to develop
placed, the more complex the exercise these groups of muscles that are also
will be, especially if they are placed at important for general postural stability.
slightly different heights. This causes the (These movements are not easy to
dog to concentrate on both distance and incorporate in the exercise routine of a
height for all four of its legs. dog that is lacking mobility.) It involves
This exercise must be carried out very getting a dog to walk away from your leg
slowly, with the dogs head down and with in a sideways manner so that it is, in effect,
its body weight moving forward. If the dog crossing its legs while walking. Another
is allowed to walk quickly over the poles method is to walk alongside the poles, or
with its head up, the rationale will be lost their equivalent, used in the previous
and no gain will be made. The point of this exercise, and encourage the dog to step
exercise is to encourage the deep sideways over them.
supporting muscles to re or be inner-
vated and, by this, facilitate the dog to use
its hip exors and extensors correctly.
Therefore, to get these stabilizing muscles
to work, they must be gently encouraged
to exert; this exercise, done correctly, will
assist this. The exercise can be carried out
in a wooded area where there are broken
twigs in an irregular format and the dog
can walk slowly between and over them.
Pole walking should only be done at a
walk, with someone attending, especially
if it is happening in an uncontrolled
environment, e.g. woodland, as the dog
must be kept calm and walk at an even
pace throughout. This exercise is best
performed with expert assistance; if
executed correctly it will have huge
benet. However, it is very tiring for the
dog and should only be used two or three
times per day.
In Figure 120, note how the dog is
aware of where his four feet are in relation
to where the irregular poles are lying. Also
note the height of the feet and the ease
with which it is executing this task. This
dog is engaging the correct muscle
pattern, enabling balance and ease of
extension and exion to result.

Lateral and medial


movements 121 Sideways walking over poles
These exercises (121) are extremely good (abduction of the pelvic limbs and
for developing the frontal plane rather adduction of the thoracic limbs).
than just the sagittal plane. It encourages (Courtesy of Henry Robertson.)
118 Chapter 5

These exercises can be carefully be the most effective method


extended to involve the dog walking of maintaining mobility, especially in
alongside a low kerb and with gentle the case of femoral head and neck
encouragement to step slowly sideways excision, where the femur is secured
onto the raised surface. This must only be in place by the post-operative scar
attempted when the dog is condent tissue. This has to be managed so that
about stepping over poles laid on the it can facilitate as close to full range of
ground. the limb as possible, and yet maintains
stability. During this process, the hip
Stretching exor and/or extensors will develop
There is much discussion and literature areas of tension within normal muscle
about canine remedial stretching tissue; therefore, these two must be
exercises. This is an area that needs careful balanced and treated accordingly.
and precise knowledge, and should not be Neurological benet: it can also assist
performed in the general physical therapy the re-establishment of neural
arena. Some of the stretches used, in the pathways and inuence the Golgi
hands of the untrained, are potentially tendon receptors (see Chapter 2) to
hazardous to the dogs health. This is accept an improved range of
because it is possible to manipulate a dogs movement by relaxing the antagonist;
joint beyond its natural range or mobility, this also reduces the pain cycle.
unlike that of a person or horse, whose
personal strength and reex reaction will For the recumbent dog, or one with
outmanoeuvre those of the stretcher. This limited mobility, it is best to perform
is not to say that stretching is not an passive movement with the dog lying on
important part of physical therapy and its side. This is important, as if it were
massage; it is, and the uses within remedial standing, to lift one leg of its already
care are manifold. But it should only unbalanced body could cause it to fall.
be performed by someone with excellent Flexion and extension movements are the
anatomical and physiological knowledge, same as in Chapter 6, but with the dog on
and it should have correct directional its side (122, 123).
application.
Passive movement must not be
Passive movement executed by an open wound, on a
Passive movement is different from a freshly injured site, on any swollen
stretch because it is a movement that is joint, or to a locked joint.
taken up to its natural end feel. If the The dog must be comfortable and
joint is compromised in some way, the stable either standing or lying.
same applies. Passive movement is a highly All the moving limbs must be
inuential technique and one that is not supported above and below the joints.
discussed as much as stretching, possibly It is very important that the joints and
because of the simple reason that the tissues have been sufciently pre-
name does not conjure up a meaning warmed by efeurage.
symbolic of dramatic change as that of a Passive movement involves taking the
stretch. To integrate passive movement joint through its natural anatomical
exercise will assist with mobilization from range of movement it is not a
a physical and neurological perspective: stretch.
The passive movement should be
Physical benet: passive movement conducted slowly so that all the
involves managing the balance of tissues involved have time to adjust
muscle and scar tissue. Scar tissue can without any sudden or erratic
Rehabilitation Techniques 119

122 Extension of the thoracic limb. 123 Extension of the pelvic limb.

movement; if a joint is moved quickly, realignment of muscles if it is done along


damage to the muscle and joint can with deep tissue treatments. When
be inicted. performing these exercises be aware that
The joint should be held in position even though they appear to be specic for
(exed or extended) for at least the neck, they also engage the shoulders
15 seconds. and back. Thus, if a dog has back or
After every movement, the limb is shoulder problems, these neck exercises
taken back to a neutral point and held can potentially impact on these areas. For
there before the next one. this reason, these exercises must be
Usually three passive moves for each performed sympathetically and with
joint are sufcient. recognition that any restriction could
After passive movement exercises, mean a further issue distal to the neck. If
efeurage or light exercise is used to at any time a dog is highly resistant to
re-adjust joints and tissues. these exercises the dog should be referred
for veterinary investigation. Any exercise
Passive movement can also be applied to that involves neck movement must be
the neck region. Muscular neck problems performed with the greatest care and
in dogs can go unnoticed and, as attention to the individual dogs limits.
previously mentioned, a good indicator of An effective neck exercise involves the
a problem can be that of a dry nose. Before dog sitting facing the handler, with the
any neck movement is attempted, there neck and head in a forward position in line
must be utmost care to ensure that there with the dogs horizontal plane. (This
are no underlying serious neck conditions, must be especially encouraged in small
such as any spinal damage or disease. This breeds as the dog is inclined to look up at
must be checked by a veterinary surgeon. the handler, drawing the neck into the
Extension and exion of the neck can shoulders.)
aid mobility and gently assist the
120 Chapter 5

The handler takes approximately four


steps backwards with the dog
continuing to sit and look directly at
the handler. The dog should be sitting
as squarely as possible, with their tail
directly behind them (124).
The handler then walks in an arc
clockwise, from half past to twenty
to, holding the dogs gaze for 1015
seconds (125). If the dog cannot hold
the gaze, or shufes its feet, the
handler moves back to where the dog
can comfortably hold the position and
resumes timing.
The handler then returns to the
starting position in front of the dog,
again encouraging the dog to extend
the neck forwards away from the
shoulders.
The exercise is then repeated, but
walking to the twenty past position,
and is conducted as before (126).

The dogs head should be moving on the


horizontal the rst time; the exercise can
then be repeated with the dog slightly
angling its head up and down, but should
always be encouraged to extend the neck.
In this way, different muscles of the neck
and shoulder will be mobilized and softly
stretched by the dog. This exercise is highly
effective for any dog with neck issues and
for general maintenance of range and
function. As it involves no intervention
from the handler, the dog will only take
the extension or exion to their own range.
To encourage good extension, hyper-
extension and exion exercises (head
moving up and down) the following
exercise should be conducted, starting
with the dog in the same position as in the
previous exercise.

The handler stands approximately


two strides back from the dog.
Holding their hand on the horizontal
to dogs head, the handler encourages 124126 Flexion and extension of the
the dog to elongate their neck and neck. With kind permission of Galen
hold this position for 1015 seconds. Natural Progression .
Rehabilitation Techniques 121

The dog is then allowed to relax, of the balance cushion for conditions
but still encouraging a gentle involving pelvic and shoulder instability is
elongation the handler starts moving highly effective, if used at the correct time.
their hand in the shape of an arc or For optimum gain, the dog should only
through a clock face dimension, receive treatment which is appropriate to
starting at quarter past (in line with the cushion. Conditions like hip dysplasia
the dogs nose), slowly lifting their can respond positively to this, but only in
hand upwards and forwards towards conjunction with professional therapy.
12 oclock but stopping just before The aim of this form of therapy is the
(ve minutes to the hour). stimulation of the deep postural muscles
The position is held for 1015 of the pelvic or shoulder region. These
seconds if the dog is comfortable and muscles, in the course of normal
not shufing or tilting his head to one movement, may not be neurologically
side or the other. stimulated and, therefore, not involved
The handlers hand is drawn down within movement patterns. To stimulate
encouraging the dog to watch, and these using a balance cushion can help to
stops at quarter past (the start develop good core and postural balance.
point), again encouraging the dog to
elongate their neck.
The handlers hand moves down
towards the oor, again following the
line of an arc or clock face, stopping
just before half past.
This position is held for 1015
seconds remember this will
encourage a deep stretch through the
caudal border of the shoulders and
into the thoracic region.
The exercise nishes by resuming the
start position.

This soft exercise could be repeated


once a day in acute and chronic cases. If
the dog shufes his feet, licks his lips, or
starts to look away, it could be the handler
is asking too much movement for the
dogs comfort, so the exercise should
demand less movement.

Balance cushion
This form of exercise can be extremely
benecial if applied correctly, after the
appropriate therapy. However, the author
does not promote the use of many other
types of balance apparatus intended for
human use, e.g. the Swiss ball. This
balance cushion (127) allows the dog to
demonstrate discomfort easily, giving clear
indications of pain that would 127 A dog standing with the pelvic limbs
contraindicate its continued use. The use on a balance cushion.
122 Chapter 5

The idea of the use of the balance cushion 128 The


is that the weaker muscles will be dog is
stimulated rather than the stronger ones; gently
therefore, an equal balance can be moved from
achieved if the cushion is used correctly. the weight-
Like all deep core exercises, this does not bearing leg
give the impression of working muscles to the
hard. However, these small muscles that opposite
are being stimulated are having a full pelvic limb.
workout; care is needed, as if time limits
are exceeded, post-exercise hypertonia
can be a problem. It is important to ensure
that the dog stands as squarely on the
cushion as possible. In Figure 127, note
how the right leg is not weightbearing. As
this is the stronger leg, the exercise should
strengthen the core muscles on the left
side. When performing this exercise, the
dog should be eased gently so that the
opposite pelvic limb is weightbearing
(128). This, then, should encourage a
correction within the intrinsic pelvic
muscles.
This exercise should not be performed
for longer than 1 minute at the start, and
increased daily up to 3 minutes. When the
dog can stand squarely, the exercise should dogs, and the competition can assist a
be used for maintenance once a week for more motivated swim, or give a dog the
3 minutes. This technique should always condence to swim (129). This psycho-
be replicated with the front legs. logical benet can be far reaching, and in
Affected areas (muscles or muscle itself have a wonderful cathartic effect.
groups): In the authors experience, in many
chronic and some muscular conditions, to
m. gemelli. gain best overall results it is advantageous
m. obturator internus. to treat with good myotherapy initially, to
abdominals. rebalance the musculature, thus initiating
obliques. corrective muscle patterning before a dog
m. multidifus. engages in hydrotherapy. Hydrotherapy
gluteal group. can possibly overdevelop problem areas
rather than develop a better overall
Hydrotherapy biomechanical action; in this circum-
Hydrotherapy is a wonderful tool within stance, the appropriate use of buoyancy
the remedial and tness programme for a aids adds to the benet.
dog. For the dog that is paralysed or If managed correctly and used along
severely lacking mobility, to have with other therapies, hydrotherapy can
unimpaired movement while supported manifest great changes in a dogs quality
by water is a great feeling. Not only is of life. From a therapists perspective, the
hydrotherapy of great benet to dogs that best results are achieved when the two
need to regain mobility, but also there is a therapies and therapists can work
social aspect: they may swim with other together. Exercises and massage can
Rehabilitation Techniques 123

ensure that the muscles are released and What help would be available should
functioning, so that, when the dog is the therapist require it?
worked resistively in the water, the range The hydrotherapists at these pools may
of movement and core muscle strength not swim with the dog. Therefore, if
can be improved. specialized care is required when the dog
Before engaging in hydrotherapy, the is swimming, a more one-to-one arrange-
following should be addressed: ment may be required. Veterinary advice
should always be taken before making a
What is hoped to be achieved by decision on which pool the dog swims.
hydrotherapy? Legally, veterinary consent should be
Which type of pool would be required by the hydrotherapist. The
best (130)? subject of hydrotherapy within canine
Should another therapy be physical therapy is complex and detailed.
implemented rst?
How many dogs will be in the pool at
the same time (no more than four)?
What type of dogs will be sharing the
pool? Will they be bumptious or placid
which would suit each dog?

129 Archie swimming in a 130 A canine hydrotherapy pool; it should have a


hydrotherapy pool. ramp and steps for entering and leaving the pool and
be open to allow the dog to swim freely. (Reproduced
by kind permission of White Orchid Hydrotherapy,
West Chiltington, Sussex.)
125

6
Massage in Physical
Therapy
Julia Robertson

Introduction to massage
Massage methodology
Massage application
Massage techniques
Assessment of the dog
Treatment
Contraindications for canine
massage

Societys taboos about touch have kept massage from enjoying


the popularity it deserves.

Dr Michael Fox, The Healing Touch.

Massage is a manipulation of soft tissue structures of the body.


It has both mechanical and reex effects on the body. The direct
form of massage affects the tissues and organs you are working
on and the indirect is the reception of a stimulus that produces
an effect.

Beards Massage. Principles and Practice of Soft Tissue


Manipulation. Saunders Elsevier.
126 Chapter 6

Introduction to massage have great skills of animal husbandry, learn


Massage must never be confused with a to use many of their senses to anticipate
therapy that can be mastered easily by problems during, for example, calving and
reading a book or watching a lm. It is an lambing. The use of smell is one that can
art that has to be practised repeatedly to give many clues as to the condition or
achieve the appropriate reactions that will timing of events; for example, the smell of
facilitate the positive changes that enable impending death is not easily forgotten.
the bodys healing mechanisms to The body exudes odours from many
function, whether human or canine. As places. Illnesses can result in a changed
with many therapies, especially touch odour either through the skin, the breath,
therapies, it has not been entirely or, even in dogs, the feet. Likewise, body
substantiated scientically, but the effects or skin condition is reected through the
of well-executed treatments cannot all coat, giving an overall impression of
be coincidental. However, it is agreed that wellbeing or a lack of wellbeing. Thus, an
our bodily systems interlink. Thus, with abnormal coat, either partial or total, can
the interlinkage and interdependency indicate an underlying health problem
accepted, the holistic approach connected affecting, for example, the neural or
with this form of treatment cannot be circulatory systems.
without some rm foundation. For those Observation of behaviour is also critical
whose dogs have received treatment and to the assessment of health. Stretching is
those who have witnessed amazing an example of this: if a dog gets up after
changes as a result, science does not have rest and stretches shortly afterwards, this
all the answers. The changes, both felt and is regarded as a natural and normal healthy
seen, make it difcult to understand why response. However, if this action is
there are still some sceptics who dispute uneven, e.g. if only the front end or only
its value; however, any therapy is only as the hindquarters stretch, this could signify
good as the therapist and its appropriate- an underlying problem.
ness for the recipient. Massage is generally Touch is also quite often under-
perceived to be of little use, since its estimated as a healing tool. We are all
application and effects are not fully aware of the importance of contact during
understood; however, this can be a any young animals development, but this
potentially hazardous presumption. It is does not stop at maturity. Touch therapy
also not considered by many to be as and massage has proven benets for both
serious as physiotherapy. This is a shame, therapist and patient, causing a lowering
as the information acquired through the of the heart rate, and this can lead to
tactile approach used by massage reduced stress levels and a reduction of
therapists can give a very full picture of pain perception. This can be explained
past events and injuries. It can also offer scientically by the bodys release of
an excellent insight into the whole endorphins and enkephalins, which are
muscular condition of the dog. Unfort- naturally produced chemicals that
unately, it has suffered under the resemble opiates.
misrepresentation of its history, so many Massage encompasses a vast array of
of its benets have been lost. therapies, some of which have been
Observation is invaluable to a good patented and named after a particular
practitioner. It is extraordinary that practitioner. Most appear to date back to
Western therapists do not generally early styles of massage and their
consider hair texture, skin feel, and smell derivatives. Some concentrate on specic
to be as important and informative as areas of treatment, while others are more
visual appearance. Good farmers, who general. All of them take practice to
Massage in Physical Therapy 127

perform correctly and to avoid causing this can help to facilitate muscle
damage to the tissue being treated, release. This is reinforced by further
thereby exacerbating the original prob- treatment and correct rehabilitation.
lem. There are a myriad of newer The amount and length of pressure
therapies available now; it is important to exerted by the therapist needs to be
have an understanding of what they are carefully managed, as too much
supposed to do, and how. Their names and pressure is not only extremely painful
application methods vary from textbook for the dog, but also can inict
to textbook. This uncertainty makes the damage to the underlying tissues.
case for having good tactile and palpation It also reduces blood ow to the area
skills all the more important. and triggers a reexive response, when
the pressure is released, directing
Massage methodology more arterial blood to the area, and
thus facilitating healing.
Trigger point massage
This is also known as neuromuscular Interestingly, even though the therapist
technique. The name trigger point was applies pressure in a manner that creates
coined by Dr Janet Travel in 1942. pain in one area, the body seems to be able
When a muscle is injured or overused, to recognize that this is where the referred
it lays down brous scar tissue, usually pain is originating, and can accept the
within the belly of the muscle/s. This can treatment. When treating a dog using this
feel like a nodule and is extremely painful method, if it is executed correctly, the
upon palpation. Trigger points are the dogs breathing becomes deeper and it
name given to the centre of the muscular relaxes; it seems to become almost
damage, but they refer pain elsewhere in entranced until the tension in the area
the body along neural pathways. In trigger reduces. Simultaneously, it stirs and
point therapy, pressure is applied using a resumes previous behaviours. This
thumb or nger directly over the point of technique must be used only after all the
damage, the trigger point. Working tissues have been warmed and prepared,
directly over this point of the muscle that and mechanical drainage techniques must
is ischaemic (has a poor blood supply due also be applied to the area, to soothe the
to its brous quality) puts pressure on the nerve endings.
area, further restricting the ow of blood.
It has a double effect: rstly, on the trigger Stress point massage
point and, secondly, on the rest of the A stress point is where a mechanical,
affected muscle: isotonic force has been so great that it has
caused a microtearing of muscle bres.
It draws attention to the point of This tends to happen close to the point of
pain, rather than to the referred pain. origin of the affected muscles, as this is the
This concentrates the neural system in anchor point, where most force is
a targeted manner to the trigger reected. The affected muscles then feel
point and area of issue. Due to the hardened and are tender to the touch. This
tension of the affected area and the works very much in the same way as
abnormality within the muscles trigger point therapy. By triggering a
bres, it will have become hypertonic. problem point, it stimulates the natural
By relaying a neural alert through the healing properties that seem to be absent
pressure of the digit onto the point of in brous and damaged tissue. These stress
pain and exact point of dysfunction, points are invariably predetermined.
128 Chapter 6

TTouch states according to its state of health. In a


The Tellington Touch, after Linda state of low hydration, the fascia can
Tellington-Jones, is an awakening of become shortened, and it adheres to
inactive neural pathways and cellular surrounding tissues, feeling thick and
intelligence. This is done by performing dense to the touch. By manipulating the
circular movements, lifts, and slides over myofascial bands both locally and more
most of the dogs body. Most of what we extensively to stimulate cellular change,
do and how we move involves a limited this treatment enables a correction to
pattern of cellular activity. With the develop within cellular lines, and, there-
rigours of time and minor or major injury, fore, creates more balance within these
these pathways become restricted and immensely strong and robust bands. This
blocked; by awakening these cells, induces an overall neural and physical
previous behaviours and movements can equilibrium.
resume. TTouch also encompasses
dynamic exercises and body wraps that Acupressure
are intended to draw the dogs attention Acupressure is often combined with other
to its whole body. Through gentle therapies to work on many levels,
stimulation, cellular function is awakened including dietary therapy, massage,
and the body is motivated to function exercise, meditation, and herbal medicine.
correctly, demonstrating natural healing, It is based on the ancient theories of
coping habits, and behaviour. As this traditional Chinese medicine (TCM) that
treatment is said to be a complete have supported the health and wellbeing
therapy, the learning of anatomy and of animals for over 4,000 years. Some of
physiology is said to be unnecessary. these theories include Yin-Yang Theory,
Meridian Theory, Five Phases of
Bowen technique Transformation, and others that help to
The Bowen technique involves a gentle, distinguish specic patterns or conditions.
rolling motion, with very light touches The basic concept of Chi (also seen as QI,
involving the skin and supercial or Ki), which underlies TCM, can be
structures. This causes stretching and described as vital life-force energy that
heightening sensory awareness of the body ows throughout the human or dog body.
in the area where the technique is applied. When Chi ows harmoniously, the dog
A treatment session frequently results in will experience physical and emotional
a deep sense of relaxation, allowing the good health. When there is any
body to recharge and balance itself. It interruption in the ow of Chi, the dog
stimulates proprioceptors and stretches may experience poor health. Case
reex centres, such as the Golgi tendon work has shown that acupressure (131),
organs, eliciting a reex response. The like acupuncture, can:
practitioner stimulates sets of points, then
often pauses to allow the body to Build up the immune system.
compute neurologically what has been Strengthen muscles, tendons, joints,
stimulated. and bones.
Release natural cortisone to reduce
Connective tissue massage swelling and inammation.
(Rolfing) Release endorphins which increase
This treatment concentrates on energy or relieve pain.
inuencing the underlying bands of Enhance the mental clarity and the
connective tissue called fascia (see calm required for focus in training and
Chapter 2). Ida Rolf identied that fascia performance.
seemed to adopt different biochemical
Massage in Physical Therapy 129

Repair injuries more readily, by Mechanical: the tissue is physically


increasing the blood supply and manipulated so as to aid drainage and
removing toxins. increase uid movement and cellular
exchange.
The raison dtre of massage is to facilitate Reexive: the reex actions of the
change within the body that will elicit neural and endocrine system are
healing; this means that a clear incorporated; for example,
understanding of anatomy and physiology proprioception is enhanced or
is paramount. The two types of technique endorphin release is stimulated.
used are mechanical and reexive:

GV 26

LI 11
GB 34

St 36

Ht 7

Lateral Medial
Medial Lateral
Points Location
LI 11 With elbow exed, located at the lateral end of the cubital crease.
Ht 7 Found on the lateral aspect of the front leg, in the large groove, at the
transverse crease of the carpal joint.
St 36 Located just lateral to the tibial crest on the lateral aspect of the hind leg.
GB 34 In a depression behind and below the head of the bula, lateral side of
hind leg.
GV 26 Found in the intersection of the T formed below the nose.

131 Key canine acupressure points. (Reproduced by kind permission of Amy Snow,
Tallgrass Animal Acupressure Institute, Colorado, USA.)
130 Chapter 6

These techniques have evolved from compromised. By nourishing these cells


Swedish massage which, in broad terms, with the constituents that are required for
uses long owing strokes which are metabolism, they can then resume normal
divided into several methods of delivery. activity. By providing this to inactive cells,
These are intended to run in parallel with whether caused by damage, physical
the ow of two of the bodys systems: the restriction, or neural restriction, the body
venous part of the vascular system and the can begin its self-healing processes.
lymphatic system. This has various Throughout this book, the benets of
physiological and psychological effects on massage are discussed in relation to
the body. Massage works on a cellular inuencing venous return and the
basis, and this must be fully understood by importance of enhancing the removal of
the masseur. Moving the hands over the toxins within the venous blood. This
skin, which is highly innervated, has an encourages arterial blood to ush the area
immediate impact on the connective with oxygenated blood that is required for
tissues. These tissues are contiguous healing. All cells require a stimulus for
throughout the body. Understanding this, healthy metabolism. This can be achieved
and the contraindications to the use of through physical, chemical, or electrical
massage, is crucial before any treatment (neural) means; with magnetism; or
can take place. Skin is the conduit through other forms of electrotherapy, like
between the therapist and the recipient. ultrasound or low-level laser beams.
Peripheral nerves in the skin carry Interstitial uid is a solution which
impulses from sensory receptors such as bathes and surrounds the cells of the dogs
pressure, pain, temperature, and stretching body, providing another mechanism for
(see Chapter 2) to the brain, which in turn nourishing the cells and removing waste;
causes a reaction to occur in an this is done through its interrelationship
appropriate system or receptive tissue. with the lymphatic system. This system is
During massage, these sensory neurons controlled through osmosis. Many of the
carry stimuli from the skin to the CNS surrounding tissues have tiny pores in the
and a response is then transmitted back cells that this uid passes through; these
from the brain to the peripheral nerves can become thick and brous with wear
and thence to the targeted muscle. In and injury. Through mechanical massage,
appropriate situations, massage inuences these structures can be kept pliable and
cellular exchange that benets recovery maintain good osmotic conditions.
and positive change within the recipients Scar tissue is formed in muscle tissue in
body. In fact, massage can take over certain a similar way to its formation in skin.
cellular responses and render others less However, the scarring in muscle is
active, e.g. during recovery from obviously not visible, and the effects can
overexertion, illness, or even maldigestion. be both short- and long-term. If the scar
tissue is excessive, a chronic inammatory
Mechanical techniques condition can result, which creates yet
By incorporating mechanical techniques more scar tissue. The muscle then
into treatment, the therapist hopes to: becomes calcied, and this can make it
feel as hard as bony tissue. The use of
Enhance venous ow. more direct manipulative methods, i.e.
Enhance lymphatic drainage. mechanical massage, plus that of reexive
Realign muscle bres. techniques, can assist the process of
Adjust tissue tension. breaking down the calcied muscle cells
into smaller particles that will be viewed
These principles have a direct effect on as toxins by the body. They will then be
muscle and fascia that may be removed by phagocytes within the
Massage in Physical Therapy 131

lymphatic and circulatory systems. adhesions. Rolling and lifting techniques


Adhesions and brous tissue are can assist the separation of adhered
another product of injury; again, they can muscles within groups by physically
either be acute or chronic (repetitive separating them. This can cause serious
strain). The healing process of the muscle pain, and should only be attempted with
has several phases during which the tissue caution. Passive movement will assist with
can take on a sticky consistency, very regaining the proper range of movement.
similar to a cut hand pre-granulation. Fibrous tissue is caused by injury
During this stage, damaged tissues may and/or chronic insult to a muscle or
adhere to adjoining tissues, especially if muscle group. It can be caused by injury,
mobility within the area is limited. in which there is a serious muscle bre
Adhesions can occur in most structures tear, or continual damage from repeated
within the body, e,g. muscle to fascia (132, untreated microtrauma or overuse. In the
133), muscle to adjacent bone, muscle to case of acute injury, bres will begin
adjacent muscle, or muscle to adjacent healing, but the new bres will not
ligament or tendon. resemble the original ones. These bres
Within all these situations, the prospect will, to varying degrees, lose their
of reduced mobility is high, resulting from contractile quality, because their gliding
reduced range of movement or reduced function will be severely impaired. This
contractility of one or both structures. gliding function allows the contraction
Mechanical methods of massage can and relaxation of a muscle and, depending
gently start to break down these on how many bres have been damaged,

132, 133 The pinch test, used to indicate restricted skin mobilization due to adhesions.
132 Chapter 6

will directly affect the appearance and in isolation. Likewise, the endocrine
function of that area. The effect will be system is always trying to achieve
the bunching of bres in an irregular homeostasis; therefore, this is constantly
formation that will take on the feeding back information via the nervous
characteristics of a hard lump or knot. The system to achieve these ends.
lack of pliability and exibility within the On a sensory level, the mechano-
area will lead to a restriction of movement receptors respond to touch, pressure,
and function. During this process, warmth, and stretching. These have a
secondary adhesions can also form, reexive effect which modulates tissue
thereby adding to the dysfunction of the tension and reduces pain. When a body is
surrounding tissues. experiencing pain through tension, the
Transverse stroke and friction can help body reacts by promoting an overactive
with this condition; it is worth noting that state (survival technique) and the
the process is painful, as by causing sympathetic nervous system becomes
friction, the intention is to aggravate the dominant, placing the dog in a constant
area; therefore, the pain will be great. This state of stress. By releasing the tension, the
is required because compacted and neural response is to stimulate the
entwined tissue does not have a good parasympathetic system; this con-
circulation. Therefore, to assist with the sequently encourages digestive processes
return of good blood ow and to promote and gaseous exchange.
a separation of structures requires a deep By incorporating reexive techniques,
mechanical and reexive technique so the parasympathetic and sympathetic
that the tissues can begin to regain nervous systems (sedating or stimulating)
mobility. are balanced and positively inuence
Microtrauma is where small areas of neural receptors, including proprioceptors,
muscle bre have been damaged. Repair within the musculoskeletal system.
is encouraged by strength training to Balancing the parasympathetic and
develop cellular potency through the sympathetic nervous systems helps to
breaking down (in a measured way) of the restore the body to a state between
damaged bres and the subsequent relaxation and excitement. Relaxing the
remodelling of stronger and more resilient dog through reexive measures or the
muscle bres. It can almost be relief of underlying pain, allows the
unperceivable to an observer that any autonomic nervous system to function
trauma has occurred. However, more appropriately. Stimulating the
microtrauma is now thought to be the motor neural system or inuencing the
greatest cause of post-event soreness. This sympathetic nervous system can help in
trauma, if it is on a small scale, can be fairly the preparation for activity (see Chapter
innocuous, but if performance dogs are 4). By easing pain perception, and by
not managed with the correct post-event releasing the pressure on nerves or
treatments, these can escalate, causing reducing damage to them, we can
chronic problems. facilitate the re-establishment of neural
pathways that will help to improve tone
Reflexive techniques and spatial awareness. This can lead to
Reexive techniques are ones that are huge improvements when the neural
aimed at inuencing the nervous and activity has been impaired. The release of
endocrine (hormonal) systems. The contorted muscle bres surrounding
nervous system is affected by everything nerves can cause a massive improvement
in the dogs environment, so cannot be put in proprioception.
Massage in Physical Therapy 133

It is also said that by using techniques Self-preservation should always be


involving a form of vibration such as considered when working in a professional
tapotment, the pain pathways can be capacity! Although working at a table, as
interrupted. This is known as the gate discussed, would be easier for the
control theory of pain. therapist, due to safety aspects for the dog,
working on the oor is more likely.
The environment and Therefore, it is important that the
therapist positioning therapist:
For a successful treatment, the environ-
ment has to be correct. It has to be Ensures that the most appropriate
conducive for a dog to feel both safe and techniques can be applied.
comfortable. Many have not enjoyed their Avoids taking a dominant stance over
experiences at veterinary surgeries, so it is the dog.
ideal if the environment does not smell or Ensures that their position does not
resemble that of a surgery. If the treatment incur repetitive strain injuries.
has to be performed in a veterinary Breathes properly while treating a
surgery, then it is recommended that dog, so as to help their own muscles
changes are made; for example, a large to function and not become fatigued.
mat could be put on the oor. This may Positions themself as comfortably as
be a fairly subtle change to us, but it can possible, so that the position is
be profound to a dog. sustainable for anything up to
Safety is one of the key objectives 10 minutes of uninterrupted
when designing an environment. Some treatment.
therapists prefer to work at a table;
however, the dog may not remain Before beginning to treat a dog, it is
perfectly still and could leap or fall off the important to have the right mindset and
table. Also, when working with inrm or that a positive intention is displayed.
veteran dogs, putting them on a surface Showing intent is the equivalent of a
that is not rm causes them to be polite welcome and introduction to the
extremely anxious, and therefore unable treatment. Speaking directly to the dog in
to relax. A good compromise is to use a front of the handler can induce an
low sofa or something else that will be extremely positive response from a dog,
both comfortable and safe for the dog and forming a direct connection with it, and
practitioner. For those dogs that have the showing very deliberate intention and
privilege of sleeping on a sofa at home, it honesty.
helps them to relax, and for those that are
not allowed to, it feels like a treat. The
other advantage is that if a dog should fall
off the surface, the distance is minimal and
no injury should be sustained. The oor
should be both rm and level so that even
the most unstable dog can get a good foot-
hold and stand comfortably. The
temperature of the room should be
approximately 20C (65F), and the size
of the room should allow for all sizes of
dog to fully extend the thoracic and pelvic
limbs.
134 Chapter 6

Massage application objectives are. To sedate the dog for


remedial purposes, one stroke per second
Pressure would be reasonable and the therapist
There is no denitive answer as to how should look to work slightly more slowly
much pressure should be applied during than a normal heart rate (70120 beats per
treatment, as there is no xed equation minute) to encourage relaxation. However,
(134). It depends on the size of dog and to excite the dog, pre-exercise, then a rate
each dogs own tolerance and situation. of twice that would sensible. Again,
The golden rule is to start with one watching for signs from the dog will inform
pressure, then check for reactions. If the whether the rhythm is correct or not.
dog is happy and working with the
therapist, depending on the conditions, Number of applications
slightly more pressure may be applied. If If efeurage is the technique being used,
the dog leans in, that indicates that a little then the recommended number of
more pressure is required. It is incorrect to repeated applications over one area is
think that the greater the pressure, the three. However, this is not denitive, as
greater the effect, more often than not, there are so many variables that come into
less is more. The therapist should always the equation, such as:
look to the dog for feedback, as the dog
will feedback more than anyone can write How tender is the area?
on the subject. Will the dog remain still?
Is the area one that the dog wants to
Rhythm be worked over?
A good rhythm is vital when applying a Is it an area the dog is keen to guard?
massage; the rhythm and speed are
completely dependent on what the As with many aspects of treatment, the
correct answer is decided by the recipient
and the therapists own intuition and
experience.

Palpation
To treat is comparatively easy; it is diagnosis
that is difcult.
Palpation, James Cyriax MD (widely
regarded as the father of Orthopaedics).

To learn sensory perception through


the hands and its interpretation is one of
the most important parts of the education
of any practitioner, and one that needs to
be developed. Palpation is a real skill and
one that can be learnt, but not by
everyone. It takes time and practice to
develop the skills accurately so that one
can assess what is happening beneath the
hands. Identifying tissue changes by
texture, tension, or irregularity when the
surface is covered by a thick layer of hair
and skin is not easy. This difculty is made
134 Good efeurage technique. worse if the recipient is not courteous
Massage in Physical Therapy 135

enough to stand, sit, or lie still. At least original insult could be in another area
with a human patient, there can be some altogether. At other times, the lightest
verbal feedback, and the request to keep touch can detect what is happening below
still is usually obeyed! For a new the surface. Irregularities of texture or
practitioner, learning to read correctly the temperature can indicate the problem, but
slight temperature changes that occur there may also be excessive fascial tension
with tissue dysfunction takes time and within an area. Having the ability to
practice; this frustrates many students. identify this, together with the direction
Also, a holistic examination must also be pull requires good tactile skills.
part of the process, taking in every slight The story below, although ctitious,
movement or reaction when the hands demonstrates the importance of palpation
pass over each area. skills, and how being able to identify
The pressure used must be approp- where the source of the problem is, is the
riate; sometimes it is necessary for deeper key to good results.
examination to be performed, and then Once the therapist has developed their
the overlying tissues must be warmed and palpation skills, the best effects are
prepared. Lameness or tenderness pre- achieved by those who can feel their way,
senting in one area may not necessarily using their intuition. Once mastered, this
mean that is where the problem lies; it is invaluable to a practitioner.
could be the true site of the trauma, or the

A FAVOURITE STORY

A factory producing millions of high value widgets per hour suddenly


came to a crashing halt, resulting in zero production and amounting to
massive accumulative losses. The machinery failed to work and the fac-
torys maintenance man could not nd the problem. The factory owner
stated that if anyone could nd someone who could repair the machinery
he would pay that repair man 100,000.
One employee made a call to a friend who duly arrived at the factory
with just a small tool-carrying belt and demanded a ladder to ascend the
offending inoperative machine. When he reached the top, he stopped,
looked, listened, moved very slightly, and hit the machine a hefty blow with
his hammer. The machinery churned into action and resumed producing
the widgets. He descended the ladder and made his way to the factory
owners ofce.
Here is a bill for 100,000 to repair your machine, said the repair man.
What! said the factory owner, I am not paying you 100,000 just to sim-
ply hit my machine with a hammer!
Ok, said the repair man, here are two bills: one for 10 for hitting your
machine with my hammer, and one for 99,990 for knowing where to hit it!
Anon
136 Chapter 6

Massage techniques dog, and is key to the formation of a


The divisions within massage technique positive relationship and trust between
are explained differently in practically the two. It is also used as a joining
every textbook on massage; this is why it technique, and can be used in many
is not necessarily important to remember situations.
the names, but it is essential to know what One of the main intentions when
they do and what the effects are. performing efeurage is to inuence
Techniques include: venous and lymphatic return. It has a
mechanical effect of assisting their
Efeurage.
Petrissage.
Friction.
Tendon release.
Tapotment.
Passive movement.
Passive touch.

Please note: massage should not be


attempted without practical tuition.

Effleurage
The word efeurage derives from a
French word, effeurer, meaning to touch
lightly. It is a gentle sweeping stroke
made with the at of the hand. Within a
Swedish massage routine, it is the
technique used to open and close; in other
words, to begin and end a treatment. For
this, the hands must contour over the
underlying tissue, and sweeping
movements are used that are slow and
rhythmic, with a condent touch that can 135 Efeurage.
be applied by one or two hands.
The pressure being exerted (135) must
be even over the whole of the hands
surface, with the ngers remaining
together and the thumb following the
direction of the ngers. The strokes
generally run the full length of the
muscles with a speed to enable
recognition of tissue texture and tension.
For smaller dogs, two or three ngers can
be used instead of the whole hand (136).
Equal pressure should be used, without
more asserted through the ngertips.
Slightly more pressure can be applied
after the initial routine has been
established. The uses and advantages of
this technique are many; not least, it forms
the initial contact between therapist and 136 Efeurage for a smaller dog.
Massage in Physical Therapy 137

movement, by apparently replicating the massage in conjunction with


muscle movement, and also targeting additional massage techniques.
problem areas. By inuencing venous It can inuence the movement of
drainage, arterial ow in the area is blood in the dogs body and promote
enhanced, bringing an increase in the venous and lymphatic return and
amounts of oxygen and nutrition that are cellular interchange.
brought to the area; this will also It can be applied to the cheeks, ears,
enhancing warming of the area. The top and sides of the head, trunk, back
inuence on the lymphatic system can aid and pelvic region, thoracic and pelvic
lymphatic drainage and return (see limbs.
Chapter 2). The speed or rhythm of the It is applied with the palms of the
stroke can also have an effect of relaxation hands, ngers, or ngertips (depending
or calming, if applied slowly, or a more on the size of the dog).
invigorating effect, if applied faster. The hand, ngers, or ngertips should
It is possibly one of the most versatile slide readily and evenly over the dogs
of all the techniques as many aspects of coat.
the basic technique can be varied, Even pressure should be maintained
including pressure (supercial or deep) for the entire stroke and from one
and direction of application, according to stroke to the next; the pressure
the muscle bre direction (longitudinal or can slightly increase as muscles warm
transverse). Supercial efeurage is used and if the recipient is happy.
for the introductory strokes, and works on It is an excellent assessment tool for
a supercial level, using light pressure. identifying change/s in tissue before
Deep efeurage follows supercial or light and after supercial tissues have been
efeurage, when the pressure is adjusted warmed.
to work more deeply, to inuence the
deeper tissues. It does not mean more Petrissage
force is applied, just a smaller working Petrissage comes from the French word,
area may be used. Longitudinal ptrir, meaning to knead or rub. This
application, together with supercial stroke forms a name for a collective group
pressure, is the technique most treatments of techniques, and has the overall
begin with. This can be repeated over an objective of manipulating tissues by
area several times. In transverse rubbing and kneading, using the pressure
application, the strokes are applied across of the hands or ngers to break down any
the direction of the muscle bres. This is tension. This technique is only used when
a good diagnostic method, as at times the tissues have been warmed, and not on
brous tissue can run with the line of the bony or delicate areas.
muscle bre, and it is not until it is crossed The rationale for this group of
that the area can be identied. techniques is to produce a local
compression followed by a release
Key points for application that can inuence both the supercial
of efeurage and deep tissues on the dogs body.
The technique applications include: By constricting blood ow to the
one-handed, hand-over-hand. local area, then releasing it, the body reacts
It can be applied supercially or by ooding the area with fresh arterial
deeply. blood. The pressure employed when
It can be applied longitudinally or applying this technique should begin very
transversely. lightly and can then be increased as the
It is used as an opening technique at tissue warms and the patient becomes
the start of a massage or throughout accustomed to the procedure.
138 Chapter 6

The primary objective of supercial Plucking


petrissage is to stimulate all functions of If applied correctly, this can be extremely
the skin, e.g. to inuence venous return relaxing and useful as a calming
and to empty and rell the lymph spaces technique:
beneath the skin. Deep petrissage has a
good effect on releasing supercial fascial A few hairs of the coat nearest to the
adhesions; this, however, must be done hair follicle are grasped between one
using care, as it can be extremely painful. or two ngers and the thumb.
Supercial kneading is applied to the coat The ngers are slid up the shaft of the
so as to inuence the skin. It can be hair fairly quickly (not pulling the
applied in a random pattern all over the hair); the hair is then released the top
coat, or upwards or downwards. of the hair is reached.
Alternate hands are used to work an
Supercial kneading entire area of the dog, grasping,
Skin rolling sliding, and releasing, to simulate a
This supercial technique can be plucking motion.
extremely relaxing for a dog; however,
caution should be used if it is used over
areas of fascial tension, as the area will be
tender. It can be applied anywhere, but
mainly over the cranial and dorsal regions
where the skin should be loose and can be
grasped easily (137, 138); other good
target areas include sites of old wounds.
However, care must be taken not to pinch
the skin and, if the skin is tight or sticky,
not to lift too much, as this feels the same
as pulling a sticking plaster off exposed
esh.
In this technique:

The skin is grasped gently


between thumb and the at of
the ngers. 137 Skin rolling with loose skin.
The ngers are moved forward
in small incremental steps as if they
are walking, followed by the thumb
walked up behind the ngers.
The skin will respond in a wave-like
motion.
With tight skin, the technique should
be performed slowly and
sympathetically.

If this is done over loose skin (137), it is a


relaxing and enjoyable treatment.
However, if the skin is tight and adhered
to the tissue below (138), it will be
painful; care must be taken in choosing
where and when the technique is applied. 138 Skin rolling with tight skin.
Massage in Physical Therapy 139

Care should be taken not to pinch or


pull the hair too rigorously.
Plucking should be applied slowly at
rst, then increased to a fairly quick
rate, adjusted to each individual dogs
comfort level.

Deep kneading
The primary objective is to bring blood
and nutrients to the belly of the muscle,
to release toxins, and to relax muscle
spasms trapped within a specic muscle
or group of muscles. It can also be used for
muscle bre realignment, affecting muscle
length and congruity. It is applied with the
hands, ngers, or nger tips, relatively
quickly and lightly to cover the entire
muscle.

Friction
Like many anatomical words, this derives
from a Latin word, fricare, which means
to rub or to rub down (139), and
sometimes is classed as petrissage. Friction
is a variation of rubbing, and work by
locally compressing tissue against bone,
using a single ngertip to irritate the
underlying tissues by using short cross-
bre movements. This, too, should never
be used before all the surrounding tissues
have been thoroughly warmed. Friction is
an excellent technique for working
around bony protrusions, e.g. either side of
the vertebrae, the head, face, and any
irregular shape:

The ngertips are placed on the tissue


and moved in a circular constant
motion, while lightly pressing 139 Digital kneading (friction).
inwards.
The ngers are held close together to
maintain control while the thumb is
used as a stabilizing point.
To go deeper into the bres, a slower
rate is used but not heavier pressure; a
light touch is maintained throughout;
then the pressure is released.
This technique can be applied
transversely, longitudinally, or
circularly.
140 Chapter 6

Friction should be applied extremely Gently lifts the tissue, slightly rolling
sympathetically, as the areas that will the hand away from the body, and
require a frictional technique will be the releases it.
most tender and sensitive. The idea of Alternate hand are used to build up a
friction is to cause an irritation by causing rhythm.
a minor inammatory effect; therefore, it is
an acute response. By provoking this Finger stripping or thumb glide
reaction, the area will become mildly Finger stripping or thumb glide (142, 143)
erythemic, causing an increase of heat can be performed longitudinally following
within the area. Frictional techniques are the length of long muscles and alongside
intended also to break down contorted the vertebrae of the dog. The therapist:
muscle bre that surrounds nerves. The Places the ngers or the pad of
nerves will be restricted or heightened in the thumb on the muscle.
perception, so care should be taken at all Gently presses inward and glides
times. Important: this technique should along the entire length of the
only be applied for a few seconds at a time. muscle in the direction of the muscle
bres.
Compression Continues the passes until all the
Compression (140) is good for the larger bres have been covered, starting
muscles or muscle groups; the therapist: lightly and increasing the pressure.

Locates the belly of the muscle and


places the palm of the hand, ngers,
or ngertips on the belly of the
muscle.
The muscle is gently pressed in a
rhythmic pumping action, holding the
compression for approximately 12
seconds.
Additional pressure is applied
progressively as the tissues warm and
soften; the dogs reaction should be
monitored during this time.
When one area becomes warm and
softens, another area is worked on, or
another technique is used.
The limb being worked on should
always be supported.

Picking up
Picking up (141) can be applied to any
muscle or muscle groups that can be
grasped, lifted, or rolled. This is generally
mostly appreciated by the dog when it is
used over the neck, shoulder, and over the
loose skin of the back. The therapist:

Grasps the muscle, compressing the


tissue lightly between the thumb and 140 Compression technique.
the at of the ngers.
Massage in Physical Therapy 141

141 Picking up is especially


welcome over the neck and
scapula regions.

142 Thumb glide, working


longitudinally down the m.
triceps brachii.

143 Finger glide, working down


the paravertebral muscles.
142 Chapter 6

Cross-bre working
Cross-bre working (144146) is exactly
as its name implies, so this must be used
with care over any possible sites of chronic
injury. It should only be applied to the
large articulating muscles. A variety of
techniques can be used in this method:

Single-handed:

The back of the ngers are placed


on the dog so that the ngers line
up with the direction of the muscle
bres. 144 Two-ngered bre spread.
The muscles are compressed and
then the hand is rotated up to a
90 position.
The knuckles will be moving in
an outward direction, the right
thumb will travel in a clockwise
direction.
For smaller dogs or muscles,
the same technique as above is
used but with just two ngers
rotating (144).
For single-handed bre spread the
palm of the hand is placed against
the dogs muscles with the ngers
aligned with the muscle bres, and
the technique is executed by
rotation of the base of the hand in
an outward direction against the
line of the bres. 145 Fibre spread on a larger dog.
Two-handed bre spread (145,
146)
Using the at tips of the ngers or
thumbs, the hands are moved in
opposite directions (apart) across
the muscle bre.

Tendon release
Tendon release (147, 148) is a technique
which is benecial for muscles and
tendons of the thoracic and pelvic limbs.
The technique uses one hand while the
other supports the limb in an extended
position. The working hand grasps the
eshy portion of the muscle and works
along the axis of the limb with short up
and down motions. The movement should 146 Fibre spread on a smaller dog.
Massage in Physical Therapy 143

be continuous and smooth, being careful wrist. If the technique is being conducted
not to pinch the muscle or skin. correctly, a very slight slapping of fingers
will be heard. Cupping is also applied with
Tapotment loose wrists and hands, forming a cup,
Tapotment covers a number of techniques which is intended to trap air between the
which consist of a light vibration, hand and the dogs body. This is again
e.g. hacking and cupping, to produce applied in a random pattern and, if applied
stimulatory signals to the tissues of the correctly, a hollow clapping sound will be
body. This is perhaps the technique that is heard.
used least; however, it is highly effective Please note: all of these tapotment
in the correct situation. Hacking is applied techniques should only be applied over
by the outside surface of the little finger dense muscle or muscle groups, and only
of one or both hands, striking the muscle after instruction; incorrectly used tapot-
in a random pattern, with loose relaxed ment can feel like a slap or a punch.

147 Tendon release technique.

148 Photo showing the gentle ease and


release required in tendon release.
144 Chapter 6

Passive movements Cartilage changes; it changes from


This is the movement of an articulating being a stiff gel, and becomes more
joint without active participation by the brittle as it loses water.
dog. The use of passive movement within An increase in the amount of friction
a massage routine is extremely important between bones, leading to the
both for the active and less active dog; it destruction of articular cartilage.
can be both part of the assessment and of
the treatment (see Chapter 4). The aim is If passive movement is performed cor-
to take the target joint through its natural rectly, it will also help with neural
anatomical range, or to the end feel. If the reprogramming of all the soft tissue adja-
joint is compromised in some way, the cent to the joint. To execute this safely
same applies: the joint must only go without causing problems, all the
through its possible range, not the articulating joints must be carefully
potential range. The joint works in close supported before and during the move-
collaboration with the adjoining soft ments being made. It can also be
tissues that facilitate its stable and smooth incorporated into warm-up and warm-
articulation. down routines, but there are some very
For full range of function, the following strict rules that have to be adhered to. In
structures are necessary: remedial cases, it is advisable to perform
with the dog lying supine, but in any case,
Cartilaginous surfaces: should be the dog must be fully supported and
smooth and concussion-receiving secure.
surfaces.
The synovial uid: should provide When using this technique:
lubrication of the moving structures.
The external and internal ligaments It is crucial that the joints and
that restrain and contain the joint. tissues have been sufciently warmed
Muscles that provide the force to by efeurage.
allow the joints to become levers. The dog must be comfortable and
stable, either standing or lying.
This programme stimulates the neural Passive movement involves taking the
pathways of the joint as a whole. It joint through its natural anatomical
actively promotes increased movement movement. It is not a stretch.
and exibility, by inuencing the Golgi The passive movement should be
tendon receptors within the tendons and conducted slowly so that all the
the muscle spindles within the muscles, tissues involved have time to adjust
plus all the stretch reex receptors within without any sudden or erratic
the ligaments. It is also believed that movement. If a joint is moved quickly,
replicating movement of the joint assists damage to the muscle and joint can
the formation of synovial uid, which can be inicted.
help prevent: The joint should be held in position
(exed or extended) for at least 15
Cartilage erosion, through the loss of 20 seconds.
lubricants (proteoglycans) and a After every movement, the joint is
change of structure. taken back to a neutral point and held
The release of free radicals, leading to there before the next passive
further change and damage. movement is applied.
No more than three passive moves for
each joint should be performed.
Massage in Physical Therapy 145

149 150

151 152

149152 Passive movement of the thoracic limb. Tape showing angulation of


the scapulohumeral and elbow joints (149), showing the change in these angles.
150: Flexion of the scapulohumeral, elbow, and carpal joints: the exion is achieved by
easing the elbow dorsally and medially. The carpus is gently exed; 151, 152: protraction
of the shoulder and extension of thoracic limb showing the increased angle of the
scapulohumeral joint, and extension of front leg at carpus.

All the moving limbs must be Please note: this can be used on arthritic
supported above and below the joints. joints, but only to the range of movement
Passive movement must not be used of that particular joint. Passive movements
by an open wound, on a freshly of the thoracic limb are shown in Figures
injured site, by any swelling, or to a 149152. Note that the elbow is the joint
locked joint. where the leg is eased forwards from, not
After passive movement, pulled from the carpus. Note that the leg
efeurage/light exercise is used to is drawn directly in front of the dog,
readjust joints and tissues. neither adducting nor abducting.
146 Chapter 6

Passive movements of the pelvic limb the dog to touch. It has a calming and
are shown in Figures 153156. The stie warming effect as tension is released, that
is gently extended (in a large dog, the hock initiates a trust-building environment. It is
must be supported), not pulling through done with no pressure or movement, just
the hock. The hand must support the stie a gentle touch using the palm of the hands
in all dogs, and the limb is extended in a or ngers placed lightly on the body. Some
direct line with the dogs body. dogs who are extremely resistant to touch
nd it less intrusive if the back of the hand
Passive touch is used. It can be used anywhere on the
This is a valuable technique for the body, and hands or ngertips are left in
nervous dog or one in pain. It can be used place for about 3090 seconds (Table 15).
as an opening technique as it introduces

153 154

155 156

153156 Passive movement of the pelvic limb. 153: Normal angulations of the pelvis,
femur, and tibia. 154: exion of the stie and pelvis. Note how the stie and hock are
protected and the femoral pelvic joint eased into a exed position through gentle
pressure through the stie. 155, 156: extension of the stie and pelvis, executed by
easing the stie through the extension.
Massage in Physical Therapy 147

Table 15 Summary of massage techniques, purposes, and effects


Technique Purpose Mechanical effect Reflexive effect
Superficial To adjust the Warms the tissue Works on the
effleurage dog to touch and muscle parasympathetic
(superficial and to fibres through nervous system
stroking) demonstrate frictional warmth, and relaxes
A smooth intent influencing muscles
gliding action Used at the start venous Venous and
using the whole of a treatment: return, then arterial capillary
hand to cover a To warm the area promoting circulation is
large surface To relax the arterial enhanced
area muscles interchange Endorphins are
Two hands may To assist Stimulates released, giving
be used, or drainage of the the lymphatic pain relief; this
alternate hands venous blood system by also aids
in a slow To assist replicating relaxation
rhythmic drainage of the gentle muscle Soothes nerve
motion lymphatic system movement endings within
Working on the To evaluate Gently eases the skin
superficial current and myofascial
muscle layer changing state connections
with the hand/s of tissue
following fibre Can also be
direction of the used as a
underlying transitioning
muscle stroke between
The pressure other techniques
should be to maintain
light initially, relaxation,
gradually particularly
increasing as following deep
the underlying tissue massage
tissues warm

Deep effleurage Used to work Warms


(deep stroking) deeper into the superficial
As above but tissue and mus- tissue, enhances
following light cle fibres on vasodilatation
effleurage specific, local- and causing
working slightly ized areas mild erythema
more deeply of tension or Warms tissues
with slightly injury sites to allow for
more pressure, Can be used as deeper
both a stretching techniques mild
transversely or mechanism for erythema
longitudinally to the muscle
the muscle fibre fibres
direction

(continues)
148 Chapter 6

Table 15 Summary of massage techniques, purposes, and effects (continued)


Technique Purpose Mechanical effect Reflexive effect
Deep effleurage Assessment tool Assists Promotes
(deep stroking) for palpation of further the homeostasis
Smaller surfaces deeper tissues removal of by creating
of the hand are metabolic waste a more
used (or larger and can reduce relaxed dog,
areas with oedema by influencing the
greater influencing parasympathetic
pressure) in venous and nervous system
order to lymphatic return Can be used to
concentrate the and assisting promote
pressure, using the flow of excitement by
thumb pad; arterial blood influencing the
finger pads; Assists cellular sympathetic
ulna surface of exchange nervous system
the fist; palm and thus health
heel Assists the
The tendons nutritional status
and attachment of the tissues
points should Sheds the outer
be included as layers of dead
well as the belly skin, and can
of the muscle, stimulate sebum
with strokes production
directed Realigns muscle
towards the fibres to
belly of the promote correct
muscle in healing/
order to stretch placement
the tendon;
this also induces
muscle
relaxation
Transverse
stroking is used
primarily as a
diagnostic
technique to
identify
localized
muscle tension;
it is conducted
across the belly
of the muscle
using the flat
area of the
hands or fingers
Massage in Physical Therapy 149

Table 15 Summary of massage techniques, purposes, and effects (continued)


Technique Purpose Mechanical effect Reflexive effect
Petrissage Often used after Stretches and Relaxes the
(deep kneading) effleurage: realigns muscle nervous system
Both hands are To relieve fibres, with slow
used to apply congestion stimulates movement
kneading in a To reduce muscle tone Stimulates
rhythmical way swelling Breaks down the nervous
Using alternate To help prevent adhesions system with
hands the muscle Circulation and fast movement
muscle or shortening elimination Affects
muscle group through of waste is proprioceptive
is lifted away excessive use enhanced sense
from the Drainage through release
underlying of excess of neural
structure interstitial fluid pathways
is assisted

Picking up:
Hands gently encircle an area (typically the neck) and in a rhythmic wave action
the fingers are drawn up and lifted through the muscle tissue, alternating the
hand at the top and the hand at the bottom of the area.
To relieve muscle fibre congestion
To ease tension through shortening of muscle fibres
To ease tension of overload muscle fibres
To assist the separation of congested fibres
To apply a direct stretch over the muscle tissue
To help break down scar tissue
Relaxing effect through easing of pain perception

(continues)
150 Chapter 6

Table 15 Summary of massage techniques, purposes, and effects (continued)


Technique Purpose Mechanical effect Reflexive effect
Friction Used to break Separates Stimulates
The pads of the down scar tissue adhered fascial appropriate
thumbs or or treat hard planes Golgi tendon
fingertips are muscle bands (myofascial reflex activity
used that have release) by reducing
Application is resulted from Realigns muscle tension in
only on overuse or injury fibres opposing
localized Treatment of Breaks down muscles
problem areas hypertonic adhesions Increase
once the tissues muscle spasm Helps break circulation and
have been Remedial down scar tissue blood flow
warmed up treatment of and promotes
There are acute injuries the formation of
different Deep tissue more tolerable
techniques work; often used elastic fibrous
used in around the tissue
applying friction joints to break
massage: down fibrosis
Circular, and stimulate
applied using circulation
the thumb or Also used to
individual break down
fingers in a inflexible scar
transverse tissue
or circular
motion to give
a slow frictional
movement

Cross-fibre To re-align Aids the Influences


muscle fibres separation of positively
and break down muscle fibres the muscle
scar and fibrous and fibrous spindle stretch
tissue tissue receptors
within the
muscle
Massage in Physical Therapy 151

Table 15 Summary of massage techniques, purposes, and effects (continued)


Technique Purpose Mechanical effect Reflexive effect
Finger/thumb To realign Realigns Positively
glide muscle fibres, superficial influences
aid and deep fibres the muscle
vasodilatation, spindles,
and promote assisting a
elasticity within resumption of
the fibres appropriate
muscle
contraction
and relaxation

Compression To encourage Compression Has a mild


venous of the fibres relaxation
exchange gently within the effect and aids
belly of the homeostasis
muscle,
facilitating
a mild venous
drainage and
promoting the
flow of arterial
blood to the
area

Plucking To relax the dog Gently Stimulates the


superficial and superficial manipulates the parasympathetic
tissues hair follicles nervous system
Causes mild
vasodilatation

Skin rolling To ease To ease Stimulates the


superficial superficial superficial parasympathetic
adhesions adhesions nervous system
Can be used Can be used Helps tighten
when other when other myofascial
mechanical mechanical bands
techniques are techniques are
too too
uncomfortable uncomfortable
To ease fascial To ease fascial
connections connections

(continues)
152 Chapter 6

Table 15 Summary of massage techniques, purposes, and effects (continued)


Technique Purpose Mechanical effect Reflexive effect
Tapotment To stimulate Will influence Will excite the
(percussion) muscles vasodilatation sympathetic
A rhythmical To relax nervous system
technique hypertonic
using both muscles
hands in a rapid Helps to
action: promote good
Hacking (with muscle tone
the ulnar
surface of the
hand)
Cupping (using
the hands in a
cup-type hold,
enabling
the trapping
of air)
Wrists must
always be kept
loose

Tendon release To maintain Eases the


carpal flexibility retinaculum
of the carpus to
facilitate smooth
tendon
movement
Eases extensor
tendons

Passive To maintain or Eases joints Influences the


movement enhance range through their Golgi tendon
of movement natural range receptors
Influences
the muscle
spindles
Enhances the
activity of
subchondral
cell production
to improve
viscosity of
synovial fluid
Massage in Physical Therapy 153

Assessment of the dog one that can be overlooked or, at worst,


discounted. This is the dog that
Introduction is harbouring problems for the
A strong, even gait is desirable in all breeds future, problems that will start to
no matter the size, the shape, or purpose. accumulate through a process of somatic
Rachel Page Elliott change, and which the dog will ultimately
start compensating for, however small the
When a healthy, balanced dog moves, it initial problem. These changes will
ows. The movements are seamless, develop exponentially, and are not
connected, and pleasurable to watch. The sustainable in the long term.
muscles are moving in phase
appropriately, which means that the dog Evaluating a dog
efciently uses its natural balance, and When a dog is brought to a practitioner
moves in a sustainable and rhythmic for treatment, it must have had a full
manner. physical examination by a veterinary
Dogs are in a multitude of different surgeon. In many cases, this examination
shapes and sizes, which produce a diverse will have given a clear diagnosis of the
range of gait patterns. Even though the problem or a good steer towards
gait sequence is the same, the footfall will something that involves the soft tissues,
differ, e.g. a trot of a short-legged or either primarily or secondarily, and an
achondroplastic dog is not capable of indication of the possible cause. At any
tracking up, in comparison to that of a time, when a practitioner is not happy
larger, longer-legged dog. There are many with the dogs response to the treatment,
variables that affect gait and, more the dog should always be referred back to
importantly, balance; the art is to the veterinary surgeon. In all cases of
determine what can be treated to aid lameness, whether the dog is overtly lame,
movement, and that which is inherent. intermittently lame, or just unsound, there
Along with the many variables the are many different possible causes, and
therapist needs to consider, certain this is where careful holistic evaluation is
shoulder and stie angulations are so important.
desirable in certain breeds, as well as It is all very well having a hit list of
length of back and the shape of the top areas to evaluate, but what do they mean,
line. As a practitioner, the question: does and how will they help in the assessment
this shape serve the dog well? should be and, therefore, treatment of any client? In
considered rst and foremost, the all assessments, the external factors
therapist should be looking for presenting and how they relate to
congruence and where the point of breed/type, conformation, lifestyle, and
incongruence lies. environment must be taken into
An overt lameness is easy to assess; one consideration. Visual evaluation a dog
can clearly say the dog is lame if, for prior to treatment could include:
example, it was between 5/10 and 10/10
lame. However, the difcultly comes Apparent lameness.
when the dog is unsound but not overtly Breed/type.
lame, lacking ow and natural balance, and Age.
is anything from 1/10 to 5/10 lame. This Overall condition of the dog.
may only present in walk, trot, or canter, Balance and footfall.
and may even only occur when the dog Shape of the dog.
rises from rest or at the beginning or the Weightbearing.
end of exercise. The unsound dog is the The look in the eye.
154 Chapter 6

Apparent lameness limb lameness is presented, there is a


If the dog displays an apparent lameness, strong possibility that this is a joint issue;
this may not be where the origin lies. The therefore, if the dog does not respond very
therapist is constantly analysing cause and quickly, it should be swiftly referred back
effect; in other words, is the lameness the to the veterinary surgeon. Usually, age is
main or only problem, is it due to referred not a particularly important factor, but the
pain, or is it a compensatory factor from a majority of chronic or intermittent cases
problem in another area? Lameness is a do seem to fall into the 68-year-old age
good starting point, but it is important to bracket. This is more than likely to be the
follow through with the rest of the result of referred pain from a series of
evaluation so as to gain as full a picture as microtraumas that has had a slowly
possible before starting any type of progressive detrimental effect. This is a
treatment. For example, very often an classic problem in the middle-aged dog,
intermittent lameness in the thoracic and is one that affects both the working
limbs has origins in the pelvic region. dog and the companion dog. A classical
case is that of the companion dog that has
Breed/type had a life of minimal weekday
Breed/type is not going to give any direct exercise, then 4-hour marathons at the
indications as to the cause of a problem, weekends. This scenario is one that is not
but information on the dogs activities and conducive to good muscular condition
its breed or type, may give a clue; for and health.
example, if a miniature Dachshund is If a dog has had a t and relatively
presented, the fact that it has been doing healthy life, it will respond exceptionally
agility may suggest possible causes. This is well to treatment, even if it is 12+ years
not to say that a Dachshund should not old. Sometimes, this category of dog is
compete in agility, but merely to suggest almost discounted for treatment, because
that its build is more suited to digging and they are old or arthritic and, therefore, it
hunting than jumping. This example is is assumed nothing can help. This may be
extreme and seems obvious, but so, but pain from muscular problems
sometimes the obvious is missed; all the could be a primary or secondary cause of
factors that impact on any dog should be any joint problem, and easing this joint
considered prior to treatment. pain will support the primary condition,
Alternatively, breed stereotyping should and also alleviate the stress involved, both
also be avoided, in that every Labrador seen physiological and psychological.
with a pelvic limb stiffness does not
necessarily have hip dysplasia (without any Overall condition of the dog
supporting radiographic evidence), or every This is a broad statement, but it goes back
German Shepherd dog with compromised to the congruence question. Is the dog
proprioception within the same region overweight? What is the coat telling us?
does not have chronic degenerative Obviously, if the dog is overweight, the
radiculomyelopathy (CDRM). These are possibility of mobility-related issues is
indicators, but they should not lead a increased. Regarding the coat, it is a
practitioner solely in that particular reection of what is occurring beneath the
direction. surface. A classical example is the dog that
presents with a healthy coat, but over a
Age particular area there is some dullness or
Age is sometimes, but not always, relevant; inconsistency. This abnormal area is a
again, it is necessary to go back to the helpful pointer as to where the problem
veterinary diagnosis. If a 69-month-old may lie, or, at least, where the stress point
giant- or large-breed puppy with thoracic may be.
Massage in Physical Therapy 155

Balance and footfall similar skeletal structure to that of the dog.


How the dog moves through the gaits The lumbar region, like any bridge, will
should be assessed, observing from the side reect imbalances in its supporting
the dog moving away and towards the structures along its entire length. In Figure
therapist, and moving on the circle. The 157, the cables represent the myofascial
whole dog should be observed; are there system and the main hard structure of the
any areas that lack smoothness, or show an bridge represents the skeletal system. If any
unusual gait pattern? Is there any lateral or one of the suspension cables is tightened,
medial deviation, or circumduction of the it will contort the main structure.
limbs? The stride length should be even In a dog, this region is intended to
and, at a trot, most dogs should track up; facilitate the extraordinary ventro-cranial
in other words, the back foot should land exion that produces the uplift for a jump
exactly where the front foot was, on both and the projection forwards; in a
sides. This, obviously, does not occur with Greyhound, Whippet, and similar breeds,
achondroplastic dogs, such as Dachshunds this is particularly exaggerated. If the
and Basset hounds. Look for any lumbar region is compromised, it will look
weaknesses in the joints; some stie stiff and produce a restrained gait. The
problems will cause a medial deviation of height of the head is important: does it
the joint. A common fault in the show ring drop when it engages in movement? This
is weak sties; this is a weakness that could indicate a neck problem. A nodding
generally displays no lameness, but can action can also denote lameness, as a dog
indicate a lack of pelvic and lumbar will lift its head when an injured or painful
support. The therapist should watch for thoracic limb strikes the ground, in an
any stiffness that is affecting the attempt to keep weight off the limb, and
movement. Lower lumbar stiffness can it will dip when a lame hindleg strikes the
make the dog look as if it is wearing a lled ground. The tail is also worth observing, for
nappy/diaper; in other words, the legs do as part of the vertebral system it can
not look comfortable in any way. Observe indicate issues of imbalance or discomfort
the hip joints; a stiffness in the hip exors within the pelvic region, or a lack of overall
can make a pelvic limb look as if it is being balance. It can deviate to the left or right,
cranked, and not gliding. hang like an inverted L, or be clasped to
The lumbar region is the bridge that the hindlegs. All of these indicate inbalance
joins the back end to the front end. This is or a problem within the croup or the lower
a vulnerable part of any animal with a back.

157 A suspension
bridge.
156 Chapter 6

Shape of the dog These groups are only intended as a


With all the breeds and crossbreeds, the guide to assist the training of the eye to
size and shape of dogs seem to be almost look for characteristics that will help
innitely variable. However, for ease, there detect the source of the problem. These
seem to be some distinctive body types formulated shapes can, in some cases, be
that can be described: further divided into chronic, acute, and
The torpedo (158, 159). subacute:
The half-moon (kyphosis or roached
back) (160). Chronic: the chronic cases of shape
The banana (161). changes are those in which the
The pelvic slide (dorsal/posterior muscle patterning has been so
pelvic tilt) (162). disturbed that the dog has developed
The mist (163). a unique way of moving and may or
may not display an overt lameness.

158, 159
Torpedo
body
shape. 158:
lateral view;
159: dorsal
view.

160 Half-
moon body
shape.
Massage in Physical Therapy 157

Acute: in the acute case, the dog is


protecting a current injury or
persistent pain/discomfort.
Subacute: this is a situation where an
untreated injury is being irritated by
an activity and is, thus, causing pain.
This may be when jumping or
performing some other dynamic
action, getting up in the morning or
after a period of rest, before or after
exercise, or for no apparent reason.

161 Dorsal view of a dog with a mildly


banana-shaped back. The line indicates
shortened muscles.

162 Pelvic slide


with reduced pelvic
muscles (arrow).

163 The mist


(more apparent
through
movement).
158 Chapter 6

Torpedo shape midline rather than on the diagonal. It is


This is one of the classic chronic shapes easier for a dog with a roached back to
and can be observed from the lateral (158) employ a pace which produces less stress
and dorsal (159) aspects. The neck and across the diagonal, so the dog can adopt
shoulders are thickened, and the pelvic a rolling action to aid propulsion, rather
region is tapered, a classic case of total than having direct drive from the back
incongruence. These changes have slowly end. As previously mentioned, dogs with
developed because the dog has been this body type fall into three categories:
nding that propulsion from the front end
is less uncomfortable than from the pelvic Chronic; this can be viewed as the
region, the designated engine, and, monster lying beneath, being just as
therefore, it has adopted front wheel insidious as the subacute. One must
drive. This shape is like a ticking bomb. It wonder how long the stress on the
is only a matter of time before the T1013 region can be sustained. Is it a
overworked thoracic region, mainly coincidence that many dogs with
intended for the absorption of concussion either induced or inherent thoraco-
and directional control, breaks down lumbar disc disease present with
under the load of supporting 60% of the similar symptoms? It is well
body weight as well as having the documented that disc disease most
unaccustomed responsibility for mobility. commonly occurs in this region, the
onset being gradual or acute with the
Half moon dog showing reluctance to run, jump,
Figure 160 shows a dog with a roached or climb stairs.
back and slack abdominal muscles, making Acute: this could be displayed as a
it look like a half moon. The shape can be guarding device against a lower
less marked than this. It is demonstrated lumbar pain, from a dynamic injury,
both at the stand and during movement. from a fall, or even post-operatively.
This shape can be chronic, subacute, or Some dogs which are cryptorchid and
acute. It is generally caused by a deep then castrated (leaving one retained
lumbar problem that gives the impression intra-abdominal testicle) will portray
that the dog has a roached back. This is this shape post-operatively, possibly
not to be confused with the natural shape due to deep lumbar muscular
of the Greyhound, Whippet, or Italian disturbance; this can continue as a
Greyhound and other such breeds, that chronic problem.
are built with a rather pronounced Subacute; this can be intermittent and
curvature of the lumbar region to facilitate only portrayed when the dog is tired,
enhanced propulsion. In these breeds, the when it gets up in the morning, or
normal dog appears almost to have a after exercise and rest. The lifting of
roached back. This shape displays obvious one leg can also occur with this.
pelvic and lumbar stiffness and will also
produce premature fatiguing (as with The kyphotic dog, especially if in a chronic
most of these shapes), owing to the phase, can quite often be overlooked by
muscles working inappropriately. Obvious the handler due to the slow progression of
heat is often felt emanating from the the condition, and because the various
T1012 area, as this is the typical stress symptoms associated with the condition
point. It is also often connected with a dog are easily ascribed to old age. Another
pacing. This is a gait where the two right typical example is a performance dog is
legs protract and then retract together, lacking its former ability, or is habitually
followed by the two left legs, splitting the measuring before a jump (a stuttering or
pace into two equal halves down the shortening of stride in front of the jump,
Massage in Physical Therapy 159

as if it has measured its stride incorrectly the size and shape of the two sides,
and is having to make adjustments) that is individual muscles, or muscle groups. This
not typical behaviour. includes dogs that, in vehicular terms, may
be described as cut and shut, i.e. the front
Banana shape end does not match the back end.
This, too, can t within any category, but
it is generally seen in the acute phase, as it Weightbearing
is often accompanied by a lack of This is an observation of how the dog
weightbearing by one or other pelvic limb. stands. It can be the most revealing of the
This can also give the impression of a assessments. A dog should be
ligament problem. It, surprisingly, can be weightbearing equally through each
very easily missed, as assessing the dorsal corner; therefore, each foot should have
aspect of a dog is not usually done; also, it the same area of pad on the ground, and
is not easy for a very nervous dog to stand there should be the same amount of
still long enough for the practitioner to exion or extension of each joint in all
make an accurate observation. This shape four legs.
can cause shortening of the back on either The therapist should consider whether
side. Again, this is generally a deep lumbar comfort is displayed in the stand, or if
issue, and it can be caused by action that there is paddling, a change of
results in extreme abduction or weightbearing by shufing or subtle
hyperextension of the coxofemoral joint. movements. Some dogs are trained
Figure 161 shows a mild case that only so precisely to stand squarely, that
displayed a slight lack of weightbearing in this, coupled with their constant desire to
one of the pelvic limbs. please, means it is sometimes only the
slightest of movements that differentiate
Pelvic slide between a comfortable or an uncomfort-
This must be viewed with a degree of able stance. Weightbearing is most easily
breed knowledge. A German Shepherd assessed by standing the dog on a at hard
dog (GSD), or GSD cross, will probably surface and viewing it from behind,
have what could be dened as an looking at the amount of weight that is
accentuated angulation of the pelvis; being taken by the metatarsal and
however, this is normal for the breed, and metacarpal pads of all of the legs.
is not the intended meaning of this However, this can be difcult when the
pathological appearance. It is generally dog has hairy feet!
chronic, and the beginning of this A good test for the assessment of
condition can be traced back many balance is the diagonal hold (164 overleaf).
months or years. The shape can produce a A perfectly balanced dog should be able
very poor gait that displays no ow or to stand on two diagonally opposite legs
uidity, with a very limited range of without wobbling. When this test is
movement in the pelvic region. The pelvic performed, it is surprising how a dog
muscles just fall away; the dog is bearing showing very little imbalance (or, indeed,
weight behind through the hocks and lameness) can be seen to be completely
sties not the pelvis (162). A dog with this unbalanced. This test can indicate which
shape usually becomes torpedo-shaped of the diagonals is the weaker, and will
as drive from the pelvic region gradually help to locate the problem area further.
diminishes. This is also a good way to check the
progress of treatment. Very occasionally, a
The mist dog may be equally wobbly on both
As the name implies, this is when there is diagonals.
a complete lack of congruence between
160 Chapter 6

During this exercise, the placement of


the dogs feet should be observed (165):
do they point medially or laterally? Do the
front feet match? Do the back feet match?
Do the nails have equal wear? Are the
phalanges relaxed or tight, as if it were
standing on tiptoe?
Weightbearing is not just assessed at
the stand, it should be observed at the sit
and down positions. The puppy sit is
generally not acceptable in a mature dog.
If the dog shows an inclination to sit or lie 164 Lifting diagonally opposite feet is a
to one side, this may be considered to be good assessment tool of approximate total
due to a problem that is worth investi- balance.
gating.

The look in the eye


This can give psychological rather than
physiological information, and pain
perception may be reected in the dogs
look. The dead behind the eye look is
disturbing and can be difcult for the
handler to interpret (166). However, some
suggest that the dog does not react to pain
in the same way as humans. Nevertheless,
although this is subjective, a change in the
look in the eye may be apparent after
treatment, when the pain has been eased
(167). 165 Observation of the hind feet in the
assessment of weightbearing when
Treatment standing.

The torpedo
Typically, the source of the problem is in
the pelvic region. The dog has had to
compensate for pelvic problems and has
developed front wheel drive to assist its
mobility, thereby completely changing its
kinetic chain resulting in lameness in the
thoracic limbs, or pain detected in the
cervical region.
Dogs with this condition can develop
massively hypertonic necks, recruiting all depressed, craving darkened corners, and
the dorsal/ventral exion and extension being photosensitive. The shoulder region
muscles, plus all of the lateral exion will be involved, with the likelihood of
group. The neck hypertonicity can gravi- hypersensitivity in the dorsomedial
tate to the occipital region and to the m. borders of the scapulae and caudal section
frontalis, which develops heat and tension. of the m. trapezius, probably bilaterally.
This can give symptoms similar to a The m. brachiocephalicus (m. cleido-
human having a headache: being cephalicus and m. cleidobrachialis) is
Massage in Physical Therapy 161

painful during retraction of the thoracic accumulation of scar tissue result in


limb. The pelvic area becomes hypotonic reduced function of the muscle bres in
and weak due to lack of appropriate use. the pelvic region (168, 169).
This is seen in all groups of dogs, but A programme of intensive shoulder
mostly in companion dogs, where minor and neck therapy, together with passive
pelvic injuries have perhaps not been movement, should be introduced. There
picked up so quickly as in other groups. should also be physical therapy to assist
Microtrauma, and the slow but sustained pelvic muscular and lumbar development.

166, 167 Changes in the look behind the eyes before (166) and after (167) three
treatments.

168, 169 Muscles affected by the torpedo shape. Black: hypotonic; red: hypertonic.
162 Chapter 6

Half moon quadricep group and m. tensor fascia latae


This is a deep lumbar problem, with will become involved, greatly affecting the
massive shortening of m. psoas, m. iliacus, dogs range of movement and exibility.
and m. quadratus laborum. There is This is seen in all groups, generally
stretching of the gluteals and atrophy in m. caused by a torque injury at speed, and
rectus abdominus; this causes the usually because of a lack of core and
transverse abdominal and external oblique general stability.
muscles to be hypertrophic. Again, due to The hip exors should be rebalanced
the lack of pelvic drive, there will be and passive movement should be used.
shoulder involvement, too. This is particu- Resistive exercises, e.g. hydrotherapy, are
larly seen in agility, yball, and companion indicated, as are core stability strengthen-
dogs with underlying problems such ing techniques.
as undiagnosed cruciate disease, osteo-
arthritis, or subluxating patellas. Pelvic slide
Passive movement should be used, Figures 174 and 175 depict a typical
easing the lumbar and gluteal regions. At pelvic slide shape and the problems this
times when the condition is not too severe, type of shape will present. Due to the
the addition of resistive exercise, e.g. stress caused from the shortening of the
hydrotherapy, may be helpful (170, 171). hamstring group of muscles there will be
massive pivotal pressure in the pelvis,
Banana causing all of the intrinsic and extrinsic
If this is caught as early as the example in soft tissue to be involved. In response to
Figure 161, the compensatory effects can the shortening of the hamstring group,
be reduced, and the initial problem can be some muscles will be constantly stretched:
kept to a minimum, with unilateral the quadricep group, mm. sartorius, and
involvement of m. psoas major, m. iliacus, m. tensor fascia latae; this will also cause
and m. quadratus laborum (172, 173). stress over the cranial aspect of the stie.
However, if it is left untreated for some Stress develops at the thoraco-lumbar
time, the other hip exors, especially the junction as a result of stress in the

170, 171 Muscles affected by the half-moon shape. Blue: hypotonic muscles; red:
hypertonic. The red circle represents the typical heat point or stress point.
Massage in Physical Therapy 163

172, 173 Muscles involved in the banana shape. Red circle: stress point.

174,175 Muscles affected in pelvic slide. Blue; hypotonic; red: hypertonic; white: joint
angulation.

mm. iliopsoas on both sides. The already compromised. This is mainly seen
m. latissimus dorsi will also be involved, in obedience and agility dogs. Contracture
drawing fascially-related stress through of the m. gracilis can look similar; this is
from the pelvic region to the humerus, most common in the GSD.
involving the thoracic region and reducing These dogs are typically in a great deal
the range of movement. Due to of pain due to the stresses and counter-
compromised drive from the pelvic stresses put on their skeletons. An easing
region, the thoracic region will be required of the shortened muscles will assist the
to provide the forward motion, but it is pressure put on the whole body. This takes
164 Chapter 6

time, with good handler participation and harm. That in itself is a potentially
continuing basic efeurage at home in harmful statement! As stated previously,
order to ease and soothe the nerve endings massage works on a very deep holistic
and to assist vascular exchange, thereby cellular level, meaning that a topical
enhancing muscular repair. Physical treatment can be felt far beyond the point
therapy can commence when the issue is of application; thus, massage will inuence
no longer acute. many body systems. It cannot be stated
strongly enough that the advantages and
The misfit disadvantages of the use of massage must
By denition, this type of dog looks as if be properly considered before treatment
one end does not match the other, and is started. The rst and most important
there seems to be a denite dividing line precursor is to gain veterinary approval,
between the two regions. A lack of consent, or referral. Not having this would
stability between the thoracic and pelvic be a contraindication.
regions can be due to a variety of myo-
fascial issues; a unilateral fascial tear at the Categories of
myofascial junction of the m. latissimus contraindication
dorsi is a possible cause. There can also be Some contraindications are absolute,
a deep pelvic problem surrounding the when a dog is in such a poor physical state
ligaments, but there is also a lack of hip that any type of manipulative intervention
exor or stie stability, manifested as a that affects the bodys healing processes
lack of good medial gluteal support. It and the reinstatement of homeostasis
may just be a result of poor conformation. would be harmful, e.g. clinical shock or
This is particularly seen in dogs with poor dehydration. Other contraindications are
core strength. All groups may be affected, relative, meaning that the patient is at
but it is especially seen in the more lively higher risk of complications than others,
breeds, or dogs that have been over- but that these risks may be outweighed by
trained or allowed over-exertion from a the potential pain relief offered by
young age. the treatment, e.g. in some forms of
Treatment varies according to the cancer. Some relative contraindications
original problem. may also be of a local nature, where
a particular area should be avoided, e.g.
Contraindications for directly over a wound in its early stages of
canine massage healing. Finally, some contraindications
Massage is contraindicated in situations can be considered to be environmental,
where using the therapy may cause meaning when massage would be
further injury or exacerbate the existing inappropriate in a normal healthy dog, e.g.
condition. There are two key tenets that just before or just after eating.
should always be remembered by However, whatever the situation,
therapists: Do no harm; if you are in any massage is not a substitute for veterinary
doubt, dont. care.
With those statements in mind, there To formulate a full list of
are additional crucial factors to remember. contraindications is not possible, as it
Practitioners are offering secondary care; would not be denitive; Tables 1618 are
therefore, it is important to ensure that merely a guide to the typical situations in
the dog has rst been given a health check which massage is contraindicated. As all
by a veterinary surgeon. cases will have veterinary consent, any
Due to many misconceptions, it is questions about treatment and its
stated too many times that it cant do any suitability must be discussed with a
veterinary surgeon.
Massage in Physical Therapy 165

Table 16 Absolute contraindications for massage


Situation Explanation
Without veterinary approval, Without an appropriate veterinary health check,
consent, or referral underlying health conditions may not be known
about, e.g. heart or circulatory conditions such as
low blood pressure, anaemia, and so on

Clinical shock or fatigue This can be a condition that can arise after an
accident or when the dog has been, or still is,
extremely stressed. In this case, the body
switches off and concentrates on maintaining the
core organs: the brain, the heart, and so on.
Massage would deflect heat and energy from
these sites

Fever and infection (local The immune system will be working to resolve
or general) and nullify the effects of the condition and needs
to do this without manipulative intervention that
could prevent a natural healing process

Immediately after an accident Without any knowledge as to the extent of the


or injury, or if a serious injury is injury and possible internal bruising or
suspected haemorrhage, more damage can easily be caused

Any form of undiagnosed pain Without knowing the cause, more injury, or
worsening of the condition, can be the result

Over an open wound, Apart from the risk of causing pain or infection,
bruising, or oedema massage would hinder healing

Over a lump (diagnosed or There is a risk of causing spread of a cancerous


undiagnosed) tumour by the encouragement of increasing the
blood supply

If a dog is in any way unwell, or There may be an underlying condition that would
indicating an uncharacteristic be contraindicative
dislike for touch or massage

Undiagnosed acute or chronic Without any knowledge as to the extent of the


pain, e.g. spinal disc disease injury or condition, serious damage can easily be
caused
166 Chapter 6

Table 17 Relative contraindications for massage

Situation Explanation
In some types of cancer Depending on the type of cancer, the risk of
metastases can be the deciding factor when
evaluating the potential beneficial effects of
massage

Skin conditions This depends on the condition: whether or not it


can be spread through touch. If the cause is known,
if it is not contagious, and if touch does not cause
any discomfort, massage can be used as an aid to
ease symptoms

Some post-operative cases This depends on the type of operation.


Professional advice must be sought

Some heart conditions Different heart and circulatory conditions present


with different symptoms: massage may be helpful
for some, but not all. Professional advice must be
sought
Massage in Physical Therapy 167

Table 18 Environmental contraindications for massage

Situation Explanation
Immediately before being fed The dog needs to be relaxed before eating. Thus,
or less than 2 hours after it should be in the correct neurological state for
treatment eating. Because the digestive system requires an
enhanced blood supply to digest food successfully,
massage will interfere with this process and will
redirect the blood towards the muscles, possibly
causing serious digestive problems. Also, massage
should be avoided if the dog has just had head,
neck, or jaw work

After strenuous exercise The body needs to regain homeostasis; wait until
the dog has resumed normal breathing

If the dog is excessively cold, The body needs to regain homeostasis


hot, thirsty, or hungry
169

7
Common Diseases
and Pathologies
Andy Mead and Julia Robertson

Investigation of canine lameness


Common joint diseases causing
lameness
Disorders of muscles and tendons
Neoplasia
Spinal disease
Peripheral neurological disease

Investigation of canine lameness


The diagnosis of any lameness often presents a challenge.
Diagnosis must be made by a qualied veterinary surgeon
who, if unsure, will refer the case to an orthopaedic
specialist. It is preferable that the primary cause of
the lameness can be diagnosed and treated as early as
possible in the disease process, as this will result in a more
favourable prognosis. It is easier to make a diagnosis if the
disease is more advanced, but this makes it more difcult
to treat, and this will lead to a poorer prognosis.

Taking the history


One of the most important parts of the consultation and
diagnostic process is taking a thorough history; this will
precede the examination, which is also very important. This
is true for both veterinarian and physiotherapist alike.
170 Chapter 7

The following questions should be put to lameness being in the distal limb, whereas
the handler in order to obtain a thorough lameness that is worse on soft ground is
and accurate signalment and history: more likely to be due to proximal limb
problems, as the dog has to increase the
What is the dogs signalment (age, range of motion of the upper limb.
breed, and sex)? Next, the whole of the dog is
How long has the owner owned examined, but special attention is given to
the dog? palpation of the affected limb/s. Palpation
How long have the clinical signs been is possibly the single most important part
present? of the physical examination of the dog.
Was there any traumatic event Touch provides information regarding
associated with the onset of lameness? heat, pain, swelling, joint effusion, and any
Which limb or limbs are affected? notable differences between left and right.
Is the lameness worse at a particular Thus, normal anatomical features of the
time of day? patient can be ruled out from being the
Is it worse at particular times of year cause of the pathology. Flexion and
or in certain weather? extension of the joints of the affected
Is there any change before or after limb/s should be conducted, bearing in
exercise? mind it is impossible to isolate all of the
Has the owner given any medication, joints completely, such as the elbow and
or joint supplements, and did they shoulder. Flexion of the elbow would
help? result in some exion of the shoulder,
Have any previous diagnoses been making it difcult to localize the affected
made? area. Care should be taken, as the aim is
not to exacerbate the condition, nor
The examination should the patient be aggravated. It should
In a case of lameness, the dog should be be remembered that different dogs will
observed from afar to conrm the nature manifest discomfort in different ways.
of the lameness, its severity, and to look for Salivation, a sideways glance, shifting
swelling, symmetry, or any obvious weight onto different limbs, vocalizing,
pathology. It is important that the clinician and obvious shows of aggression can all be
remains open-minded at this stage, as the indicative of pain.
owners perception of lameness cannot be Information gathered from the
guaranteed to be correct, nor should it be signalment (age, breed, and sex), history,
assumed to be complete. Also, the veterin- and clinical examination can then be
arian must be careful to avoid focusing in pieced together in order to form a
on the obvious and miss the less obvious tentative diagnosis, to direct further
problems. If time allows, the patient diagnostic procedures to conrm the
should be observed in motion, if possible suspected diagnosis, or to assist the
at the walk and trot, over different commencement of appropriate therapy.
surfaces (both hard and soft ground),
coming towards and going away from the Diagnostic techniques
observer, and moving on a circle. This
approach is adopted from the world Sedation
of equine medicine, to give clues as to the It may be impossible to examine the fully
likely position of the lameness of a horse. conscious patient properly, due to the
Lameness that worsens on hard or uneven nature of the condition, or the inability to
ground may be indicative of the site of convince the patient to relax! Often,
Common Diseases and Pathologies 171

veterinarians will enlist the help of conscious patient, but which is more
sedative drugs, or even induce general reliable if it is anaesthetized, is the cranial
anaesthesia in order to fully manipulate drawer test, a test to measure the
the limbs and joints. This allows a more congruity of the cranial/anterior cruciate
thorough examination of the dog, and ligament of the stie (176, 177). Anterior
removes the inherent stabilization of and posterior movement of the tibia with
joints provided by the larger muscle respect to the femur is diagnostic of
groups. One example of a technique of anterior cruciate ligament injury.
manipulation that is attempted in the

Pressure
applied

Pressure
applied

176, 177 The drawer test; with the dog lying in lateral recumbency, the hands grip the femur
and tibia at the stie. The tibia is slid cranially and caudally relative to the femur. (Arrows
show direction of forces applied.)
172 Chapter 7

Radiography several radiographs are made of slices of


The most commonly used diagnostic tissue in a particular region of the body in
technique in private practice is radio- order to generate a computerized three-
graphy. Radiography relies upon the dimensional image. The major difference
generation of X-rays, a form of electro- to radiography, however, is that soft tissues
magnetic radiation, and the phenomenon can be differentiated and examined far
by which they are absorbed by the better with CT scans than with conven-
structures of the body at varying rates. The tional radiography. Nevertheless, in cases
electrons that are not absorbed hit the of lameness, CT scans are best employed
photographic plate placed behind the to examine bony structures of the body in
desired object and turn the photographic ner detail.
lm from white to black. The image
(radiograph or X-ray) is then developed Magnetic resonance imaging
much like a photograph, or converted to Magnetic resonance imaging (MRI)
a computer-generated image (178). involves the use of a very large magnetic
Radiographs provide excellent images eld and radio waves to form images,
of the bony structures of the body, but which show very good soft tissue detail.
offer little assistance in the diagnosis of As with CT, thin slices of tissue are
soft tissue injury, due to the fact that imaged. MRI scans are of particular
bones absorb high levels of the relevance when injury to soft tissue is
electromagnetic radiation and soft tissue suspected, e.g. muscle, tendon, or
structures do not. Therefore, all soft tissues ligament. By taking images of several
appear grey if they appear at all on a closely opposed slices of a particular joint,
radiograph, depending on the exposure. limb, muscle, or area, the images generated
However, bony structures appear white can be analysed in great detail, allowing
and are, therefore, clearly visible. One may even the most minute abnormalities to be
uncover lesions that do not seem to relate detected. Furthermore, both CT and MRI
to the lameness. In such situations, these provide a signicant advantage to
should be assessed in relation to the radiography in the evaluation of structures
clinical signs of disease in order to that are superimposed.
determine their signicance. Accurate
positioning and the application of the Ultrasonography
correct exposure are vital if one is to This is only occasionally used in a canine
obtain radiographs of diagnostic quality, lameness work-up; its use is restricted due
although, to a degree, this has been to the small size of dogs, and therefore the
reduced by the advent of digital radio- high resolution that is required. Within the
graphic imaging software. equine world, ultrasonic scanning of
tendons is considered routine.
Further imaging techniques Piezo-electric crystals contained within
More technologically advanced imaging a probe emit ultrasonic waves that can pass
techniques are becoming more widely through most structures apart from bone,
available to aid in the diagnosis of before being reected back to the probe
lameness. Although they are expensive at (179). The wavelength of these ultrasonic
the moment, it is widely accepted that beams can be altered to increase the
these techniques will become more penetration of the wave, with lower
accessible in time. frequencies travelling further than higher
frequency waves. Also, the wavelength
Computed tomography should be reduced to provide a more
Computed tomography (CT) is similar to detailed image but without penetrating
standard radiography save for the fact that deep structures. As joints tend to be close
Common Diseases and Pathologies 173

178 An X-ray machine. 179 Ultrasound scanner and probe


(510 MHz) typically available in general
veterinary practice.

to the surface of the body, with little soft small incisions known as keyholes.
tissue coverage, very high-frequency probes Damaged cartilage is often removed or
would be required to produce images of repaired at the same time through these
diagnostic quality in cases of lameness. incisions. Arthroscopy is an extremely
These are expensive and, therefore, rarely valuable tool when investigating lesions
available to the general practitioner. identied by radiography further, in order
to ascertain their signicance.
Arthroscopy
Small cameras can be placed into joints to
examine their interior surfaces, through
174 Chapter 7

Further diagnostic techniques Common joint diseases


Arthrocentesis causing lameness
Arthrocentesis is often performed along
with radiography, under a single Osteoarthritis (OA)
anaesthetic. The technique involves (arthritis, degenerative
the aseptic placement of a needle into the joint disease [DJD],
joint. Samples of the joint uid are secondary joint disease)
collected in various containers for micro- Arthritis is the inammation of a joint;
scopic examination and/or bacterial there are, however, over 100 types,
culture, in order to provide information depending on the cause, including
regarding the cause of the joint disease, bacterial, degenerative, enteropathic
but it is also examined by eye and touch (associated with bowel disease), neonatal,
rst to observe the quality, viscosity, and rheumatoid, septic, and traumatic. The
quantity of the joint uid. The molecular word osteoarthritis is derived from the
weights of the compounds present within Greek osteo, meaning of the bone, arthro,
the uid can also be analysed. It is a meaning joint, and itis, meaning
relatively simple procedure to perform, inammation. OA is the end stage of
and not only provides information several disease processes, and each name
regarding the disease process, but also the used has different merits. DJD is a
efcacy of treatments given (180). particularly descriptive term, suggestive of

180 Arthrocentesis
technique for the
canine stie.

Joint capsule

Lateral Medial
Common Diseases and Pathologies 175

deterioration, or change to a less DJD results in the loss of substances


functional form. The term does not called proteoglycans or glycoproteins,
discriminate between different ages or which consist of chains of complex sugar
species. The suggestion is, however, of an molecules all linked to an amino acid
end-stage condition; this term best repre- molecule, amino acids being the building
sents the latter stages of a collection of blocks of protein. The loss of proteo-
joint diseases. glycans from the articular cartilage
OA is defined as a noninflammatory collagen matrix causes weakening and it
degenerative joint disease marked by becoming brittle. As a result, the cartilage
degeneration of the articular cartilage, becomes less elastic, leading to ssuring.
hypertrophy/sclerosis of the bone at the When a joint is loaded, some of the water
margins of the joint, and changes in the from the matrix is squeezed out of the
synovialmembrane.This seems some- articular cartilage, thereby reducing
what contradictory. Such definitions friction and, it is proposed, providing
cause intense debate, as it is widely nutrition to the surface of the cartilage. If
accepted that in the early stages of the the proteoglycans structure is altered, the
disease, inflammation certainly plays a attractiveness to water (via osmosis) will
critical role in producing the clinical be reduced. Consequently, not only is the
signs of joint pain, and reducing the structure of the cartilage weakened, but it
inflammation seems to be a crucial part also becomes less rigid. The friction in the
of its treatment. It is implied, therefore, joint is increased, further destroying the
that the term OA is more suggestive of cartilage in what becomes a vicious cycle.
the chronicity of the disease. Indeed, The destruction of glycoproteins and
pro-inflammatory cytokines (mediators increase of friction forces within the joint
of inflammation) have been found in lead to destruction of the synovium, a thin
high numbers within joints, and these layer of cells dedicated to joint uid
contribute to OA and inflammation. In production. Therefore, the affected joint
contrast, another less commonly used suffers not only from increased friction,
term, secondary joint disease implies but also from a reduction in joint uid
that the inflammation/joint disease has required to reduce its effects.
occurred as a result of a predisposing The mechanism by which new bone is
issue or has derived from a previous laid down at the articular margins is not
condition. This term has restricted use well understood. However, it is surmised
today, however. For the purposes of that osteocytes, bone-producing cells, are
this text, the terms OA and DJD will stimulated by damage of the articular
be used. cartilage, leading to an inammatory
DJD is one of the oldest diseases cascade. Movement of the joint exacer-
known to man, evidence of the disease bates the development of new bone
having been found in the fossilized around the margins, and therefore the
remains of early dinosaurs. It is also all too deposits become more pronounced. It
common, accounting for the vast majority could be considered that the body is
of cases of arthritis in both dogs and attempting to fuse, or arthrodese, the joint
humans, and, indeed, it has become one of in question in order to reduce pain and
the most prevalent and disabling chronic friction associated with the degenerative
diseases. process. In summary, the pathological
176 Chapter 7

changes associated with OA include


cartilage loss, sclerosis, or thickening, of
bone directly adjacent to the joint, new
bone formation at the margins of the joint,
and inammation of the synovium (181,
182).
As a general rule, patients with
OA/DJD will have a long history of
insidious lameness, possibly exacerbated
by sudden trauma or by a particularly long
walk on the preceding day. However, the
progression of OA is variable, some cases
remaining subclinical for many years.
The predominant causes of DJD
include trauma, leading to mal-
formation of a joint, wear and tear, 181 Radiograph of a dogs stie with OA.
congenital deformities that predispose an Note the irregular periosteal new bone
animal to abnormal wear and tear, (arrow) and subchondral sclerosis
cartilage malformation, nutritional de- (arrowheads).
ciencies, growth abnormalities, infection,
immune-mediated disease, and neoplasia
or tumours. Several of the most common Articular
causes will be discussed in detail cartilage
subsequently. Fundamentally, all of the Synovial
above will result in instability of the joint membrane
and, therefore, abnormal movement. OA
should not be confused with other, Joint
rarer forms of arthritis which also lead to capsule
DJD. These include septic arthritis Fibrous
(infection) and rheumatoid arthritis (an layer
immune-mediated condition). Fortun-
ately, both are extremely rarely diagnosed Joint
in animals. The upshot of the degenerative cavity
process is that the animal begins to feel
pain (presumably due to the ssuring of
the articular surface setting off an
inammatory reaction) when mani- 182 Diagram of the synovial joint.
pulating the joint, or during normal
movement, and shows progressive
stiffness, leading to the exhibition of an
awkward gait. With time and progression
just rising or standing can become
exceedingly painful for the sufferer.
The impact of DJD is not usually therefore be placed upon adjacent
restricted to just one joint. Even if it were, muscles, ligaments, and tendons, for which
it is only natural that if a particular joint they were not designed, leading to further
becomes painful, every attempt would be destabilization. Decreased movement of a
made, either consciously or subcon- joint will in time lead to associated muscle
sciously, to reduce friction in that joint by atrophy, further compounding the
reducing its movement. Extra strain will problem by reducing even further the
Common Diseases and Pathologies 177

ability of the joint to undergo its normal deterioration by increasing abnormal wear
function. This is where the canine and tear on already compromised joints.
physiotherapist can undoubtedly make a
signicant difference by keeping the joints Trauma
supple, reducing associated muscle Trauma is considered to be the
atrophy, and maintaining, as much as most common cause of OA/DJD. A
possible, normal use of a joint. traumatic incident can be severe, causing
Radiographic changes that occur with a fracture of the joint leading to healing
DJD (or with any skeletal pathology) will which will probably cause malformation
vary from patient to patient and with of that joint surface, or very minor, but
stage of disease. Radiographic signs of frequent and cumulative in the case of
DJD include the presence of periosteal chronic, repetitive wear and tear. Age has
new bone at the articular margins, also been blamed, some believing that age-
subchondral sclerosis (thickening of the related changes to the cartilage are
bone around the joints, appearing as more responsible for the arthritis observed.
whiteness), cartilage loss, joint effusion, or Certainly, it has been shown that the joint
reduction in the size of the joint space. space and the water content of the
cartilage reduce in later life. It is important
Common causes of OA/DJD to reiterate that anything that causes a
Developmental arthropathies such as joint to become unstable, thereby
elbow or hip dysplasia, as well as those affecting the way by which forces are
that are acquired, for example articular dissipated within the joint, could arguably
fractures or ligament injuries, can instigate be deemed to have an involvement in the
the degenerative process of OA. To some development of OA, no matter how
extent, causes of OA/DJD are inter- innocuous it seems at the time.
related, but for clarity will be discussed
separately below. Wear and tear
The process of wear and tear is poorly
Excessive weight and uneven exercise understood in this context. However, it is
schedules completely logical, similar to needing to
It is not difcult to see that obviously replace the tyres or brakes on a car from
overweight dogs will place undue and time to time. Two schools of thought exist:
excess strain on joints and muscles, leading one suggests that irritant chemicals are
to OA, so weight should be reduced released from the cartilage, causing
where possible. damage to surrounding tissue and
Exercise modication should also be instigating OA; the second suggests that
instigated, if appropriate, as OA may be the constant trauma to joints as a result of
caused or exacerbated by excessive being mechanically loaded and then
exercise. Unfortunately, modern life tends unloaded causes damage.
to dictate that dogs receive short walks
during the busy working week, then long Conformational abnormalities
walks at weekends as part of our Abnormal conformation of joints will
relaxation process. This may be a undoubtedly lead to abnormal use and,
contributory factor in the development of therefore, abnormal wear and tear. Any
OA, and will aggravate it if it has already joint is severely affected by alterations,
begun (see Chapter 4). Would a footballer however minor, in the forces that are
train for 5 minutes a day during the week spread across its surfaces, and any
to play for 90 on a Saturday? If DJD has abnormal destruction or deterioration in
already set in, long walks will become the cartilage of the articular surface that
unnecessarily painful and cause further results will lead to OA.
178 Chapter 7

Growth plate trauma Juvenile cancellous bone is inherently


Growth and development of the long weak and, therefore, trauma is usually
bones has been discussed in detail more destructive than in the adult.
previously. Endochondral ossication However, the properties of juvenile
occurs predominantly at the metaphyseal periosteum, which is both thick and
growth plate (see Chapter 2). Only when strong, provide a further source of growth
the growth plates cannot be detected and stability should growth plates be
radiographically can an animal be traumatized.
considered skeletally mature (see Chapter
3) (Table 19). Trauma to this region during Treatment modalities
the growing process can be devastating, The treatment of OA/DJD relies, rstly,
leading to limb deformities. These may, in on the treatment of any underlying cause,
future, predispose the animal to OA as a if possible. This must be done in order to
consequence of abnormal load bearing. prevent further deterioration of a joint; for

Table 19 Average times of closure of selected growth plates

Age at radiographic
Long bone Growth plate closure (months)
Femur Femoral head 10.5
Greater trochanter 10.5
Distal 11
Humerus Proximal 12.5
Lateral condyle 6
Radius Proximal 11
Tibia Proximal 11

Adapted from BSAVA Manual of Small Animal Fracture Repair and Management
(Coughlan and Miller, 1998).
Common Diseases and Pathologies 179

example, repair of a ruptured cruciate cartilage degeneration, as well as reducing


ligament must be done in order to prevent pain associated with synovial inam-
further joint instability and DJD. Often, it mation. Their efcacy is well documented.
is the aim of the veterinary surgeon to Any reduction in pain will allow for
manage the condition rather than to cure improved and more natural movement of
it, as, by the time of diagnosis, the degene- a joint, bone, or muscle. NSAIDS exert
ration of a joint/s is already signicant. their benecial effects by inhibition of the
Any treatment regime should not be enzymes COX 1 and COX 2 which
directed solely at the treatment of pain prevent the formation of prostaglandins,
and inammation, or at the increase of the instigators of inammation. The more
joint uid production, but aimed at the modern NSAIDs preferentially block only
reduction of severity of clinical signs, one of these enzymes, thus the benecial
attaining an improvement in animal aspects of these enzymes (the generation of
welfare, and the prevention of further protective matrices for the bladder and
deterioration of the condition. To this end, stomach walls) is preserved. This property
treatment is often multi-factorial; medical has made NSAIDs more popular than
and surgical treatments are employed corticosteroids, which were once
both separately and in combination, and widely utilized, but long-term use of corti-
also in association with physiotherapy and costeroids may cause serious side-effects,
hydrotherapy. including gastric ulceration and the
development of iatrogenic Cushings
Weight and exercise disease. The effect of such products on
These have been mentioned previously; synovial inammation is thought to be
they are very common underlying causes small; improvement in demeanour and gait
of DJD, and should be addressed as soon are probably more likely to be a result of
as possible. However, all too often, these their analgesic properties. Therefore, the
factors fail to be considered when a role of an NSAID is to prevent the
treatment protocol is designed. abnormal loading of joints by the pro-
It is believed that regular lead exercise motion of normal joint activity.
is preferable, as this will help the dog to The aim when using any such therapy
remain mobile; well-conditioned muscle is to use the lowest dose-rate possible to
and good muscular balance are important alleviate clinical signs, and, therefore, to
factors in the attenuation of the impact minimize the risks of detrimental side-
load. However, jumping, climbing, and effects. Many preparations are currently
twisting, which will undoubtedly exacer- licensed for the treatment of OA and for
bate clinical signs of OA, should be long-term use.
prevented, as these represent abnormal or As with any veterinary prescription only
excessive movements for affected joints. medicine (POM-V), they must be given in
accordance with veterinary instruction and
Medical treatment supervision, entailing regular checkups and
Anti-inammatory and pain-relieving blood tests to monitor liver and kidney
medication function. This ensures the animal is
Commercial, prescription-only (POM) and benetting from the correct dosing regime
nonprescription medications (over-the- and able to excrete the by-products safely
counter, OTC) for OA are widely available. and effectively.
Nonsteroidal anti-inammatory drugs Important note: please remember that
(NSAIDs) are arguably most commonly many human pain killers, such as aspirin,
prescribed. NSAIDs such as meloxicam paracetamol, and ibuprofen, are poisonous
and carprofen target the inammatory to dogs at human dose rates, and should
processes involved with OA, reducing never be administered.
180 Chapter 7

Pentosan polysulphate supplementing joint uid. Their use is


Another POM-V drug used in the believed, in certain circumstances, to
treatment of OA in dogs is pentosan reduce the dose of NSAIDs, or even the
polysulphate (PPS). PPS has been need for their long-term usage at all.
developed to afford chondro-protection Several preparations are available in the
rather than solely to relieve the clinical UK, with widely varying costs and
symptoms of arthritis. It is often used in therapeutic claims. Little proof of their
conjunction with NSAIDs as part of a efcacy has been established so far,
multi-drug approach to the long-term however. Human trials measuring a
treatment of OA. The efcacy of PPS has reduction in joint space as an indicator of
been demonstrated in the dog when it is OA have, however, proved positive.
administered both orally and, in a separate Investigations into the efcacy of other
study, subcutaneously. Its action is three- popular treatments, including avocado,
fold: it is believed to promote the green-lipped mussel, soya bean, and so-
synthesis of glycosaminoglycans necessary called devils claw, are ongoing.
for joint lubrication, to act as an
anticoagulant, and to down-regulate Advances in the medical treatment
detrimental enzymes stimulated by of OA
inammation and the degradation of Future treatment developments rely on
cartilage within a joint. targeting the processes involved in
arthritis more specically, for example, the
Nutraceuticals inhibition of enzymes believed to cause
The use of nutraceutical medications, cartilage destruction (so-called proteolytic
both for the prophylaxis and treatment of enzymes). Also, future advances are likely
OA has become more widespread in to be better targeted at individual
recent years. In the USA, one study inammatory mediators, for example, a
reported that 30% of pet owners had used group of enzymes called metallo-
or considered using nutraceuticals for their proteinases, found in high numbers within
animals. The belief held by many is that the chondrocytes of affected joints. These
such products can do no harm, as they enzymes are believed to promote a
largely consist of naturally occurring catabolic state within the joint, and are
substances and, therefore, such treatments potential targets for future therapy.
appear more natural. However,
regulation of such medications is limited Surgical treatment
and, therefore, one should always use In certain circumstances, surgery to repair
those from a reputable source. Examples or replace an affected joint is considered.
commonly available include chondroitin Procedures include femoral head and neck
sulphate and glucosamine. excision (see later), total hip replacement,
The intended purpose of nutraceuticals and elbow replacement, as well as
is to provide nutrition to the synovial cells procedures to correct the underlying
of the joint, to promote normal joint causes of OA, for example cruciate
structure and function, and, in some cases, rupture and hip dysplasia (see later). It
to decrease inammation. Some act as should be ensured, however, that a period
free-radical scavengers, reducing damage of strict rest and rehabilitation can and
to adjacent joint cells, and replacing or must be undertaken after such surgical
Common Diseases and Pathologies 181

procedures. The negative effects of Canine HD inevitably leads to secondary


long periods of cage rest or exercise DJD.
restriction should be outweighed by the The processes that lead to DJD, with
amelioration or prevention of pain and resultant lameness and discernibly altered
discomfort. Temperament and age are gait, begin soon after birth. Environmental
often critical factors when making the factors, such as rapid weight gain and
decision whether to opt for surgical excessive exercise, exacerbate the
treatment. problem. At birth, hips appear
macroscopically (to the eye) unaffected,
Myotherapy /massage but, as joint looseness or laxity worsens
Pain from secondary muscle problems, with age, the joint capsule and ligaments
such as compensatory problems, can that attach the femoral head to the
sometimes be as great as the arthritis itself. acetabulum become stretched. This leads
By easing the injured or shortened muscle to subluxation (partial dislocation) of the
that may have been involved in the hip/s. From an early stage of the disease
original injury or trauma that surrounds process, load and friction forces are
the affected joint, or by lessening the applied to a weakened joint, forcing them
tension distal to the area, can have a to be dissipated in an abnormal manner.
surprisingly fast effect on the dog from The disease process then progresses
both physiological and psychological towards DJD, through various stages:
perspectives. This is one treatment area
that can lead to vast improvements within Cartilaginous destruction and
the mobility and general wellbeing of the transformation from stiff gel to brittle
dog. This is especially important to dogs noncompliant material.
that are sensitive to NSAIDs, or those that Erosion of joint margins.
will probably need protracted medical Sclerosis and bruising of subchondral
treatment. bone.
Easing the stresses on the affected area, Pain.
thereby instigating a change of muscle Bony remodelling, osteophyte
patterning and promoting a more normal production at articular margins, and
gait, can lead to a holistic change within widening of the joint surfaces to
the dog, by redistributing muscle mass increase the load-bearing surface.
(see Chapter 6). A programme of initial Scarring of the joint capsule and
treatments followed by a planned future formation of brous tissue.
treatment programme can be extremely Reduction in joint laxity.
successful, and can maintain mobility and,
therefore, stabilize the condition in the The process is, in part, the bodys
long term. attempt to heal itself by stabilizing the
joint. The intention is to reduce movement
Hip dysplasia and, therefore, to reduce pain. This leads to
Hip dysplasia (HD) is a developmental a reduction in subsequent damage to the
disease, predominantly of large and giant cartilage, synovial cells, and so on.
breeds. The aetiology of HD is
multifactorial, the major predisposing
factor being joint laxity (looseness).
182 Chapter 7

`Radiographically, the evidence is


present even in the skeletally immature
animal, but as the degenerative changes
are cumulative, they become much more
obvious with time (183, 184). The disease
appears bilateral, but one limb may be
predominantly affected, leading to
exacerbated clinical signs in that limb.
However, perhaps surprisingly, many dogs
are asymptomatic clinically, and dysplasia
is only diagnosed incidentally, prior
to breeding or during diagnostic 183 Ventrodorsal radiograph of a dog with
procedures for other diseases. minimal evidence of degenerative joint
Veterinarians and physiotherapy disease.
practitioners tend to examine dogs
suffering from HD when degeneration of
muscles surrounding the hip has already
occurred, and the ability of the dog to
compensate for the instability of the joint
is already greatly reduced. By this stage,
the arthritic process is well under way; the
disease is manifesting itself in pain and
inammation of the joints. This can occur
in animals as young as 2 years old.
Occasionally, dysplasia can be exhibited at
an even earlier stage, when the teres
ligament and joint capsule have become
lax. Here, pain is unlikely to be due to
arthritis, but is probably caused by the 184 Ventrodorsal radiograph of a dog with
abnormal way in which weight is borne. advanced HD and DJD. Note the
Classically, during the movement of the thickening of the femoral neck (arrow), the
worst cases, there is rotation of the hips, osteophyte formation (arrowhead), the
or an attempt to reduce extension of the attening of the femoral head (curved
hip joint, causing a wiggle similar to that arrow), and the reduction of the amount of
of a catwalk model. Palpation may show the femoral head within the acetabulum.
substantial development of the supporting
muscles of the hips, or, indeed, reduction
in their mass, should the disease process
be more advanced. Extension of the hip
(185) elicits pain, often manifested by
protective aggression. A reduced range of
motion is also noted.

Treatment
To date, no cure has been described, so
control is paramount. This relies upon the
identication of genetic factors, and
attempts to reduce the number and
severity of cases by careful breeding of
affected breeds. In sufferers, the 185 Hip extension technique.
Common Diseases and Pathologies 183

CASE STUDY 5

Dexter, the German Shepherd dog: from hip dysplasia to Crufts


2006 winner
When Dexter was 18 months old, his owner, Kelly Lovebury, learned that his
hip score was very high, indicating that he had bad HD. This could have
spelled a very limited existence for Dexter, but Kelly had other ideas. In
consultation with her vet, Kelly avoided giving him anti-inammatory drugs,
and hydrotherapy was chosen instead. Dexter responded well to this be-
tween the ages of 2 and 7 years, and improved sufciently to begin training
and competing in obedience trials. Unfortunately, once he reached 7 years
old, he slowly started to change: his back became stiffer, and his turns be-
came wider and much less balanced.
Kelly came to a talk given by Julia Robertson about the benets of canine
myotherapy and massage therapy, following which Kelly brought Dexter to
the Galen Therapy Centre for assessment and treatment. Upon his arrival at
the clinic, Julia noticed the unnatural roaching of his back which had
evolved slowly over time. The massage therapy he received that day re-
leased muscular spasm and eased this. Further targeted treatments facili-
tated a change within Dexters biomechanics, which resulted in altering the
way he moved and which muscles he used. Dexter was also put on a pro-
gramme of core-stability exercises, to further strengthen the deep pelvic
muscles, enabling him to be more balanced, and, therefore, to build up the
muscles supporting the badly formed joints. Within 2 months, the roaching
had disappeared, and Dexters balance had improved signicantly. He con-
tinued to attend hydrotherapy sessions to support and build up his new
muscle pattern.
Amazingly, in the spring of 2006, Dexter not only qualied for Crufts in
the Kennel Club young handler obedience elementary class, but won
against enormous competition in his class. The judge even complimented
Kellys daughter, Jessica, on his balance.

amelioration of clinical signs is important. be taken over case selection, and


Specic treatment options are available to consideration given to the long recovery
the dysplastic patient, ranging from periods. Surgical treatments include total
conservative to surgical. Conservative hip replacement, triple pelvic osteotomy,
methods employed are similar to those and femoral head and neck excision.
used for any arthritic patient: they include Despite the serious nature and early
the use of NSAIDs, nutraceuticals, onset of the disease, with the correct
physiotherapy, and hydrotherapy. Surgical treatment many dogs do have a good
options are available, but great care must quality of life, and remain pain free. The
184 Chapter 7

genetic predisposition of certain breeds a joint, and occurs as a result of a


has led to schemes aimed at eradicating disturbance of the process of endo-
the problem, breeding animals being chondral ossication, described previously
rigorously screened for the presence of (see Chapter 2). By disturbing the
congenital disease, and registration of maturation process, possibly due to the
puppies by the Kennel Club being reduction of blood supply to the area, the
declined should the parents either have cartilage of an affected joint becomes
poor hip conformation or if screening has thickened, brittle (due to poor nutrition),
not taken place. and loses both its stiff, gel-like consistency
and its ability to dissipate friction forces.
Myotherapy/massage therapy The cartilage subsequently becomes
The sooner dogs with HD can receive prone to cracking; as a result, cartilage
muscle-balancing therapy, the sooner aps form, and fragments (or joint mice),
inappropriate stresses (piezo-electric often microscopic in size, shatter off into
changes) can be prevented. Like OA, this the synovial space. Inevitably, this leads to
condition has to be managed from the day an inammatory response as the body
of diagnosis; this takes dedication, but the tries to remove these, and also because the
results can be surprisingly good. ssures form channels for inammatory
Once HD has been diagnosed, myo- mediators to reach the joint (186). The
therapy can help to rebalance the inammatory response is often considered
muscular system, easing the compensatory to be over-exaggerated. Male dogs seem to
muscle issues employed by the body to be over-represented in studies of the
stabilize the coxofemoral joint. There disease leading to the postulation that
needs to be a well-managed plan of there may be a hormonal input to the
limited exercise to ensure the slightly disease process. OCD affects medium and
exposed joint is not compromised. During large breeds from 4 to 12 months of age,
this time, a programme of pelvic postural although many are diagnosed far later,
muscle-balancing can commence, and this when DJD develops. This highlights the
is something that can successfully be need for the history and signalment to be
carried out by the handler at home (see taken into account during the diagnostic
Chapter 6). The concept is simple, but the process.
results can be outstanding, especially if Normally, affected dogs present with a
they start early after diagnosis. Once unilateral lameness, despite the fact that
stability and appropriate muscular balance the disease process invariably affects both
can be felt by the practitioner and also limbs to some degree. Clinical signs do not
observed by the handler, hydrotherapy is appear until a cartilage ap has developed.
highly benecial. To help maintain the Owners often describe their pets as being
balance, the pelvic stability exercises and slow, unwilling to exercise, or that they
hydrotherapy should be continued with have a change in their gait. In severe cases,
regular myotherapy sessions. Dexters lameness on rising or after periods of
story underlines the success of these prolonged inactivity is observed.
treatments. The precise aetiology of OCD is
unknown, but it is certain that nutrition
Osteochondritis dissecans and exercise have a signicant role to play.
Osteochondritis dissecans (OCD) is It is this knowledge that has led to advice
possibly one of the most common diseases relating to the partial restriction of
affecting young dogs, and a major causal exercise in young maturing animals, and
factor in the development of OA or DJD ensuring that overfeeding, leading to rapid
in later life. Osteochondrosis is dened as growth, does not occur. It is important to
the failure of cartilage maturation within reiterate the signicance of growth plates
Common Diseases and Pathologies 185

during bone development, and their the hip, the stie, and the hock. Often,
average times of closure (187) (see radiographic changes are particularly
Chapter 2 and Table 19). subtle and are, therefore, difcult to detect
The most common site for OCD is the by veterinary general practitioners using
shoulder, with the elbow also being a simple X-ray machines. With progression
frequently affected site (188, 189). Other of the disease process, such lesions
predilection sites are the carpus, the foot, become far more obvious radiographically,

Osteophytes/ Periosteal
Blood vessel damage new bone
periosteal new
bone formation formation
surrounding
anconeal
Joint process
cavity
OCD lesion
Sclerosis of
Joint mouse subchondral
Articular bone region
surface of coronoid
process

186 Diagram of a stie joint with lesions 188 Diagram showing common sites of
due to OCD. OCD in the elbow joint.

187 Radiograph of a skeletally immature 189 Lateral radiograph of the elbow


dog showing open growth plates showing OCD of the medial coronoid
(arrows). process (arrow).
186 Chapter 7

as does clinical suspicion based upon


clinical examination. Therefore, early Reduced
detection is crucial, in order to prevent denition of
progression of the disease. Dogs with the trabecular
correct signalment that are exhibiting pattern of
clinical signs suggestive of OCD should be Patchy bone bone
referred to larger veterinary centres, where within cavity
more sensitive imaging modalities may aid Increased
in the diagnosis of OCD. density of
medullary
canal
Treatment
Treatment of OCD is similar to that
previously described for OA and, once
again, it is aimed at reducing pain and
inammation, as well as promoting
normal movement of the joint. Arthro- 190 Diagram of a long bone affected by
scopy or surgery to repair or remove panosteitis.
damaged cartilage is widely employed.
Dietary and exercise modication appear
to be critical in the prevention of the
disease. The prognosis is usually good if
the disease is caught early enough, prior
to the development of secondary changes.

Panosteitis Treatment
The name suggests inammation of both Again, there is no cure for panosteitis;
cortical and medullary bone, affecting management of the pain associated with
bone marrow initially. Usually long bones the condition can, however, be helpful.
of large breed, typically male dogs are Like all lameness issues, whether chronic
affected, with new bone formation and or acute, the maintenance of muscular
remodelling particularly evident within integrity and balance with myotherapy
the diaphysis (190). An increase in and massage can signicantly reduce the
intramedullary density is noted after pain and, more importantly, can treat any
radiographic examination with indistinct secondary conditions that may be caused
margins. The radiographic changes can, through inappropriate stresses distal to the
however, be just as subtle as those of affected area.
OCD, so the comments on the diagnosis
of OCD also apply here. LeggCalvPerthes disease
It is a painful condition, possibly under- LeggCalvPerthes disease (LCPD) is a
diagnosed, usually presenting with a condition predominantly affecting small
history of a waxing and waning shifting dogs, particularly West Highland White
lameness. Elevated temperatures are noted Terriers. It is, fundamentally, a specic
on physical examination, as well as a pain form of OCD. Thankfully an uncommon
response on palpation of the long bones degenerative arthropathy, its clinical
affected, usually elicited by gently symptoms are similar to those of HD, and
squeezing the diaphysis. Often several include sudden or slow onset lameness,
bones are affected simultaneously or at stiffness or pain on manipulation of the
different stages of the disease process, hip joint and, most noticeably, a reduction
which is selimiting. in the ability to extend the hip. Often one
Common Diseases and Pathologies 187

pelvic limb may appear shorter than the Treatment


other. It is suggested that the aetiology of Conservative management, as described
the disease is the reduction in blood earlier, should be tried rst. However, if
supply to the femoral head and neck, this fails, surgical intervention is indicated:
leading to necrosis of cells through lack of a femoral head and neck excision is
nutrition and oxygen. As a consequence, performed. Here, the brosed head and
changes similar to those of OA occur, neck of the femur is removed, reducing
particularly as the necrotic cells of the the contact between the femur and the
femoral head and neck are replaced by acetabulum, thereby reducing pain and
weaker brovascular tissue, leading to further degeneration of the region (191,
weakening of the normal structure of 192). A brous joint is created as a result,
trabecular bone; as a result, this crumbles which serves the animal well. Post-
with the traumatic forces applied when surgically, the joint remains unstable, and
extending or adducting the hip. The therefore the procedure should only be
precise cause of the damage to the blood undertaken as a salvage procedure, where
supply to the epiphysis of the femur is nancial constraints mean that a total hip
unclear, but a hereditary cause is replacement is not a viable option.
suspected.

191 Ventrodorsal radiograph showing 192 Close up of fracture line (arrow).


fracture of femoral head (arrow).
188 Chapter 7

Post-surgically, this condition can be yet, no causal agent has been determined,
helped enormously by appropriate myo- but this condition initiates inammatory
therapy, massage, and scar management. pathways that inevitably lead to DJD.
The sooner these begin after surgery, the
more effective they are. The treatment is Luxation of the patella
suited to the individual, but is similar to Patellar luxation involves displacement or
that for HD. dislocation of the patella from the
trochlear groove. The patella, encap-
Septic arthritis sulated by the patellar tendon, is able to
As the name suggests, this type of arthritis move dorsally and ventrally, acting as a
is caused by (usually bacterial) infection. hinge to enable exion and extension of
The bacteria are often inoculated into a the knee. Luxation allows side-to-side
joint after trauma or the occurrence of a movement, which leads to lameness. It is
deep penetrating wound to a joint. common in small dogs, but should not be
Infection of post-surgical wounds and ignored as a cause of lameness amongst
bacterial inoculations during arthro- larger breeds. In general, the smaller
centesis are common causes; hence, breeds suffer a medial displacement, as
maximum sterility should be maintained opposed to large breeds, in which a lateral
whenever such procedures are under- luxation of the patella occurs.
taken. The patellar tendon is attached to the
Contamination of the joint with quadriceps muscle, and an underlying
bacteria leads to the inevitable malalignment of the quadriceps muscle is
inammatory response, the deposition of often blamed for this developmental
brin and white blood cells, and an condition. The displaced quadriceps
increase in the uid volume of the joint. retards the growth of the medial aspect of
In an attempt to eradicate the bacteria, the femur, further exacerbating the
enzymes released by the white blood cells condition. It is often bilateral in nature
damage the cartilage matrix and the and, therefore, can readily be mis-
synovial cells, impairing joint uid -diagnosed or go unnoticed as no gait
production and nutrition of articular abnormality or lameness is identied.
cartilage. The process is similar to that of Traumatic patellar luxation is less
any secondary joint disease. common. The most common presentation
Clinical symptoms and radiographic of a luxating patella is when it dislocates
changes noted are similar to those of OA; during exercise, causing an irregular gait,
therefore, the diagnosis can only be often described as skipping. This is noted
conrmed by arthrocentesis, followed by until the patella spontaneously relocates
bacterial culture of the joint uid. into the trochlear groove.
Bacterial arthritis may be strongly A grading system has been developed
suspected if there is a history of direct to measure the severity of patellar
trauma to a joint. luxation, ranging from I to IV. A grade I
luxation is an insignicant nding: the
Noninfectious inflammatory patella luxates rarely during normal
joint disease motion, but can be displaced by digital
Rheumatoid arthritis and other forms of pressure during a physical examination. A
immune-mediated arthritis are rare in the grade IV patellar luxation, however, is one
dog. Essentially, in these conditions the where the patella is permanently
joint surfaces are mistaken as foreign. As displaced and cannot be repositioned,
Common Diseases and Pathologies 189

leading to marked deformities of the stie


joint, and an inability to ex or extend the
joint. The higher the grade of luxation, the
shallower the trochlear groove becomes.
The articular surfaces of the patella and
trochlea become eroded, leading to an
ability to luxate more readily.
The condition inevitably leads over
time to the onset of DJD, which may
manifest itself in a crouching stance.
Prompt identication, assessment, and
treatment of the condition are very
important to reduce the effects of DJD.

Treatment 193 Post-surgical radiograph of the stie


In mild cases, physical therapy and of a dog showing K wires used to reattach
massage can create a muscular balance in the tibial crest after its transposition to
the pelvic region, especially in the smaller correct patellar luxation.
breeds. That can help to stabilize the joint,
thereby helping to prevent secondary
DJD. Treatment is not quite so
straightforward in more severe cases,
particularly in larger, heavier dogs. Here,
surgery is required to stabilize the joints.
Surgical techniques include deepening of
the trochlear groove and transposition of
the tibial crest, to which the patellar
ligament attaches (193). The aim of this
procedure is to straighten the direction of
forces applied between the quadriceps
muscle and the patella. Post-surgical
rehabilitation by a canine myotherapist is
extremely important. Unfortunately, there
are cases where the diagnosis has been
missed (see Chapter 6).

Cruciate ligament disease


The cruciate ligaments provide stability to
the stie joint, by preventing cranial and
caudal movement of the tibia in relation ness following exercise; on examination,
to the femur. As in humans, there are two the limb is seen to be rotated medially.
ligaments within the joint, the cranial and However, as with humans, partial tears, or
the caudal cruciate ligaments. Cranial chronic damage leading to sudden
cruciate disease is commonly diagnosed rupture, is also noted, which will not
within general veterinary practice. The necessarily present with such dramatic
classical history is of a sudden onset of and obvious clinical signs. Diseases of the
nonweightbearing or toe-touching lame- caudal cruciate ligaments are much rarer.
190 Chapter 7

During a physical examination, pain is necessary to undertake examination under


elicited upon the gentlest palpation of the sedation or general anaesthesia, at which
joint region, and sometimes without time conrmatory radiographs are also
exion and extension. Depending on the taken. Classical radiographic changes
duration of clinical signs, a joint swelling include joint effusion, compression of the
(or effusion) can be felt, and compen- fat pad within the joint, subchondral
satory effects, such as contracture of the sclerosis, and osteophyte formation of the
hamstrings, may be noted (194). A trochlear ridge.
technique to evaluate cruciate congruity,
known as the drawer test, is undertaken in Treatment
the conscious animal. This involves Surgical treatment is required to stabilize
manipulating the tibia forwards in relation the joint and minimize the development
to the femur, excessive movement being of secondary joint disease. There are many
described as cranial drawer (see 176, different techniques, from the placement
177). However, this is often difcult to of an extracapsular suture passing from
assess in the conscious patient, due to the the fabella through a drilled hole in the
animals natural reluctance to allow tibial crest, to a tibial plateau levelling
movement of the joint because of the pain osteotomy (TPLO). The choice depends
caused, not to mention the contracture of on the veterinary surgeons experience
the hamstring muscles: the biceps and the severity of the disease.
femoris, the semitendinosis, and the Increasing exercise post-operatively
semimembranosis. Thus, it is often over a period of time, commonly in
the region of 68 weeks, would be
encouraged. Cage rest is rarely required.
Post-surgical massage, especially the use of
passive movement (see Chapter 6) is
required as soon as the surgeon has
consented, to manage inappropriate scar
tissue and to help gain a good range of
movement back to the joint. A return to
full function of the limb occurs relatively
quickly. Physiotherapy is also usefully
employed during the recovery period, to
maintain joint exion and extension,
prevent muscle contracture, and speed up
the rehabilitation process of muscles that
will undoubtedly have become atrophied
due to lack of, or abnormal, usage.

Prevention
Possibly, there is a role for myotherapy and
massage therapy in preventative care,
leading to a more stable and balanced dog
with appropriate exercise from puppy-
194 Lateral stie radiograph, showing OA hood (see Chapter 3). Continued good
post-cruciate ligament rupture. Note the exercise management could ensure the
periosteal new bone in the region of the stie is better supported by the gluteal
trochlear ridge (black arrow), effusion or muscles and other deep pelvic supporting
swelling of the joint capsule (arrow), and muscles (see Chapter 3).
bone sclerosis (arrowheads).
Common Diseases and Pathologies 191

Disorders of muscles and Skeletal muscle injury


tendons Injuries to muscle come in two recognized
Muscular, tendinous, or ligamentous forms, the bruise (contusion) and the
injuries are commonly sustained by strain. The term bruise suggests haem-
animals, but they are often difcult to orrhage and muscle bre disruption as a
diagnose unless the traumatic incident has direct result of trauma, as opposed to a
been witnessed by the owner. An ex- strain, which is dened as stretching or
perienced practitioner may detect subtle tearing of the groups of bres, and is
differences in heat which may indicate perhaps more consistent with abnormal or
increased blood supply, possibly indicative excessive movement of a muscle beyond
of inammation due to trauma. The fact its normal range of movement. Muscular
that muscular injuries are often over- injury can cause considerable pain during
looked is perhaps due to the difculties normal locomotion. Trauma to muscles
that imaging muscular structures presents, can result in damage to individual muscle
and the perceived transient nature of the bres, disruption of the bril units of
injury. muscle, and damage to the vascular supply
of the muscle unit, leading to considerable
haemorrhage, which further disrupts its
continuity. Usually, strains tend to be a
little less severe than contusions.
Fortunately, muscle heals readily as it
has a very good blood supply. However,
this occurs only if the connective tissue
surrounding each muscle bre (the
endomysium) remains relatively intact
(195). If this is not the case, as a result of
severe trauma leading to catastrophic
haemorrhage, scar or brous tissue is laid
down, disrupting the normal architecture
of the muscle. Scar tissue does not possess
the properties of the muscle bre, i.e. its
capability to stretch and contract. Scar
tissue, therefore, retards the muscle as a
whole, reducing its ability to stretch and
contract and, therefore, affecting the
motion of the dog.
Muscular injury is invariably caused by
Individual muscle bre trauma, which may or may not be
witnessed by the owner. Unlike many
orthopaedic diseases, there is no age,
Endomysium breed, or sex predilection.

Treatment
Treatment, if trauma is witnessed, should
include the immediate application of a
cold compress to the area concerned. The
Perimysium cold compress can take any form, from a
Epimysium
Muscle anatomy (normal)
specially-designed ice pack to a can of
drink! However, the compress, whatever
195 Diagram of a muscle unit. it is, should always be wrapped within a
192 Chapter 7

towel or similar, to prevent skin trauma as tissue scaffold. This allows future
a result of excessive vasoconstriction. For remodelling from one side of the injury to
the same reason, a compress should only the other. During this time, exercise
be applied for short periods of time not restriction should be advised, or there may
more than 5 minutes and repeated for as be a replacement of muscle tissue by
long as the heat persists after the injury brous tissue, leading to shortening of the
(196). If the affected area is supercial, the muscle and abnormal locomotion. This is
length of time that the compress is an area where physical therapy and
applied should be reduced. massage can help enormously. If trauma is
NSAIDs are often administered during suspected, the dog should be taken as soon
the early post-injury period to reduce the as possible to the veterinary surgeon for a
inammation and the pain, although this diagnosis and quick referral to a therapist.
can often be counterproductive, as the If there is a form of intermittent or
animal automatically feels improvement, difcult to diagnose lameness, the
moves more readily, and, therefore, does likelihood is there is soft tissue involve-
not allow time for healing. ment. A good therapist will be able to
The healing process relies upon the identify the affected muscle and target the
recruitment of mesenchymal cells which exact area/s requiring treatment. The
migrate to the traumatized area and lay earlier a therapist can see any dog with
down collagen, forming the initial scar muscular trauma, however small, the

7
7

3
3
7
7
3
3

196 Cold compression of muscular trauma. These are the maximum times for cold be
applied to be repeated if heat returns. Areas of deep muscle 7 minutes, areas of
supercial bone 3 minutes; do not exceed these times.
Common Diseases and Pathologies 193

better and quicker the recovery will be, stasizing in the early stages of the disease
and fewer secondary compensatory issues process. The most common sites for this
will have time to develop. Correct particular neoplasm are the metaphyseal
massage techniques will enable scar tissue regions of the long bones, at the proximal
to be broken down and bre alignment re-
established, maintaining a balanced
muscular system (see Chapter 6).

Tendon rupture
It is not uncommon for penetrating
injuries to the supercial structures of the
limbs, poorly protected by muscle units to
result in partial or complete rupture of a
tendon. Chronic, extreme overextension
of a tendon may produce a similar
outcome. Diagnosis is relatively straight-
forward: the lacerated tendon ends can
often be observed through the skin
wound, or the diagnosis can be made
following debridement under anaesthesia.

Treatment
Treatment is invariably surgical, with
appositional and deep supporting sutures
both being used to facilitate healing (197).
The healing process is similar to that of
muscle, but slower, as the blood supply is
poorer. It is very important to coapt the
limb after surgery for up to 3 weeks, by
which time considerable atrophy of the
associated muscle groups will have
occurred. Carefully managed physical
therapy and massage can help to assist the
primary and secondary, compensatory
muscular conditions.

Neoplasia
Neoplasia, the formation of new and
abnormal growth, specically in which
cell multiplication is uncontrolled and
progressive, is a well-recognized cause of
lameness in the dog. Neoplasia can Suture used to
technically stem from any cell of the body, repair laceration
including the bones, joints, and any of to tendon
their constituent parts.
The most commonly diagnosed bone
tumour is osteosarcoma, which accounts
for 90% of long bone tumours in large and
giant breed dogs. Osteosarcoma is an 197 Surgical repair of a ruptured tendon.
aggressive neoplasm, invariably meta-
194 Chapter 7

humerus, distal radius, distal femur and Treatment


proximal tibia (198), away from the The treatment of choice in many
elbow and at the knee. It is postulated that circumstances involving vertebral trauma,
wear and tear, excessive load, and genetics intervertebral disc disease, and spinal cord
may play a part in the disease. trauma will involve surgery and a
Osteosarcoma is locally invasive, prolonged post-operative recovery period.
causing an intense periosteal reaction in It is, therefore, highly likely that a physio-
conjunction with lysis or erosion of the therapy practitioner would be involved in
cortex. This renders the bone weak, and a post-surgical rehabilitation programme
prone to pathological fracture. The of some kind during their professional
condition is known to be extremely career. Certain situations exist, however,
painful and, due to its rapid progression where surgery may be deemed inappro-
and metastasis, the prognosis is grave. priate, due to the age of the patient, or the
Diagnosis is tentatively made by palpation
and radiographs (199, 200); the disease
differs from severe OA as it does not cross
from one bone to another. It is imperative
that a physiotherapy practitioner be aware
that, should a prominent bony swelling be
palpated, at any of the aforementioned
predilection sites, immediate consultation
with a veterinary surgeon is required.

Treatment
Treatment is usually palliative;
amputation, limb sparing, bisphosphonate
medication, and chemotherapy are often
instigated in an attempt to prolong life. To
assist any secondary muscular problems,
carefully managed physiotherapy and
massage can help enormously.

Spinal disease
Several disease processes of the spine arise
in dogs. Pathologies of note include
Proximal Distal femur
discospondylitis (infection of the
humerus
intervertebral disc and the adjacent
Proximal
vertebrae), intervertebral disc disease
tibia
(displacement of the intervertebral disc,
leading to spinal cord trauma of varying
severity), chronic disc degeneration (201),
spondylosis deformans (see later), and
neoplasia. It should be emphasized that if
a dog is being treated by a physical
Distal radius
therapist and spinal disease is suspected,
physiotherapeutic treatment should be
halted and veterinary advice sought
immediately. Such cases should only be
treated under strict veterinary supervision. 198 Predilection sites for osteosarcoma.
Common Diseases and Pathologies 195

200 Lateral radiograph of the elbow


showing osteosarcoma of the proximal
ulna. Note the areas of bone lysis and
destruction of the cortex (arrow).

199 Ventrodorsal radiograph of the hip of


a dog showing osteosarcoma of the
proximal femur. Note the periosteal new
bone (arrow) and bone lysis within the
cortex of the femur (arrow head).

201 Radiograph showing calcication of


the intervertebral disc.

owners nancial constraints, e.g. in cases of the affected animal by ensuring a


of chronic disc degeneration or disc reasonable level of movement, and
disease (types 1 and 2). The physiotherapy preserving mobility for as long as possible.
practitioner may, in such circumstances, Treatment should be specically designed
be asked to provide crucial conservative for the region of the spine affected
treatment to maintain the quality of life (cervical, thoracic, lumbar).
196 Chapter 7

Spondylosis deformans to the classical sign of scuffed shortened


Spondylosis is dened as the formation of nails and knuckling of the pelvic limbs as
bony spurs on the vertebrae, often proprioceptive decits progress (see 42).
leading to fusion of an intervertebral joint, Often an increased muscular tone,
resulting in ankylosis (202, 203). It is often particularly in the quadriceps group, is
seen as an incidental nding when evident, and reexes are generally
thoracic or abdominal radiography is exaggerated, suggesting a lack of nerve
undertaken. It is a chronic condition of impulse inhibition. This narrows the
older animals and is typied by region of suspicion to the upper motor
osteogenesis and osteophyte formation at neuron system, and particularly spinal
the dorsal margins of the vertebrae. cord segments T3L3. Diagnostic imaging
Spondylosis is usually of no clinical is largely unremarkable; therefore,
importance, although, in some circum- diagnosis relies on the clinical signs and
stances, pain (thought to be similar to that the exclusion of other diseases, such as
of arthritis) is noted. Clinical signs spinal trauma and intervertebral disc
including difculty to rise, reluctance to disease.
climb or jump, and exercise intolerance.
Treatment
Treatment Treatment regimes used to date have
There is no specic treatment, but proved ineffective. Steroids or immune-
physiotherapy and massage may help in modulating drugs aimed at nullifying any
clinically affected cases. However, the immune-mediated condition have proved
effects of massage therapy are dependent ineffectual. Other treatments concentrate
on the position and the extent of the on the nutritional aetiology of the disease.
spondylytic lesion. This can be a Neither appears to halt the progression of
frustrating condition for the physio- the condition. Nevertheless, myotherapy
therapist to treat, as the response can vary and massage can assist enormously with
from excellent to exceedingly disap- the compensatory muscular results of this
pointing. However, like all lameness issues, extremely distressing condition; this is
therapists most certainly have a role in especially relevant in the lumbar region
assisting the secondary muscular and the shoulders. Because this condition
conditions. leads to large pelvic limb proprioceptive
decits, the shoulder muscles become
Degenerative myelopathy hypertonic and engorged from pulling the
Degenerative myelopathy, otherwise dog forwards; by easing the shoulders, this
known as chronic degenerative can be diminished, and mobility assisted.
radiculomyelopathy (CDRM) is a degene- The lumbar region is under huge stress to
rative disorder of the white matter of the remain stable; therefore, easing pain in the
spinal cord, involving the demyelination area can also help mobility, and, more
(stripping of the myelin sheath) of nerve importantly, quality of life.
bres, designed to accelerate nerve
impulses. The cause of CDRM remains Peripheral neurological
unclear; however, theories include an disease
immune-mediated cause, breeding, or Neurological decits causing lameness in
nutritional deciencies. The initial clinical the dog are usually due to spinal cord
signs include a seemingly innocuous disease; these have already been discussed.
weakness of the pelvic limbs, progressing However, lameness may also be due to
Common Diseases and Pathologies 197

peripheral nerve disease, which can be


caused by trauma, neoplasia, or
degeneration. The effects vary according
to the severity of the damage and the
point of injury or disease. As before, there
is no specic treatment, but symptomatic
physiotherapy and massage can be very
helpful.

202, 203 Lateral radiograph of the lumbar


spine showing a spondylytic lesion in the
coccygeal (202) and lumbar (203)
vertebrae.
198198

Glossary of Terms
Miscellaneous denitions Ecto outer
Canine exercise Physiology (Galen Exo exterior, e.g. exoskeleton
Natural Progression): a method of End/endo/ent/ento within, inner, e.g.
assessment and maximizing move- endoscope
ment through natural exercises. Extra/extro outside, e.g. extracurricular,
Golgi tendon organ: specialized organ extrinsic
within the tendon that reports on the Hyper extra, e.g. hypertrophy,
tension or force being exerted through hyperglycaemic
the muscle to the tendon. Hypo below, decient, e.g. hypodermic
Myotherapy: a specialized therapy that (beneath the skin)
accurately assesses and treats muscle Infra behind, below, e.g. infraspinatus
pain and enhances muscle function. Inter between, e.g. intercostals
Neuromuscular junction (NMJ): the Intra within, e.g. intravenous
junction of a motor neuron axon Intro into, within, e.g. introversion,
terminal with the motor end plate on introduction
a muscle; it is where movement is Meso middle, e.g. mesoderm (middle
initiated. cell layer)
Organelle: a specialized subunit within a Meta change, e.g. metamorphosis
cell with a specic role, such as Multi many
mitochondria, which generate most of Neo new
the cells supply of adenosine Para beside, beyond, after
triphosphate (ATP), which is a source Peri around, e.g. periosteum
of energy. They are found in many cell Poly many
types, but are most numerous within Post after
muscle cells. Pre/pro before
Proprioception: the sense that indicates Re again, backwards, e.g. retract
where the various parts of the body are Retro behind
located in relation to each other. Semi half
Reciprocal inhibition: the mechanism Sub below
whereby the antagonist (muscle) Supra/super above, e.g. supraspinatus
relaxes while the agonist (muscle) Sym/syn together, with, e.g. symbiotic,
contracts, and vice versa. synapse
Trans across, through
Prexes Ultra beyond, excess
A, a without, lack of, e.g. ataxia
Ab away, e.g. abduction Sufxes
Ad towards, e.g. adduction -oma tumour, e.g. carcinoma (malignant
Ana apart, e.g. anatomy (taking apart) tumour)
Ante before, in front of, forward, e.g. -ac,-al, -ic, -oux, -tic -ous pertaining to,
anteex (bend forward) relating to, e.g. thoracic, tarsal
Anti against, opposing, e.g. antibrachii -algia, -dynia pain, e.g. neuralgia
Auto self, e.g. autoimmune, automatic -ectomy, removal, e.g. appendectomy
Bi two -aemia blood, e.g. leukaemia, anaemia
Circum around -ent, -er, -ist, -or person or agent, e.g.
Dia between, through, apart, across, e.g. anatomist
diameter, diaphragm -esis, -ia, -iasis, -ism, -ity, -osis, -sis, -tion,
Dis apart from, free from, e.g. dissect -y state or condition, e.g. lordosis
Glossary of Terms 199

-form resembling, shaped like, e.g. Derivation of muscle names


fusiform Action, e.g. extensor carpi radialis,
-itis inammation, e.g. arthritis, neuritis, adductor
dermatitis Direction of bres, e.g. orbicular or
-logy study of obliques
-penia/paenia deciency, lack of Location, e.g. external obliques
-stomy surgical opening e.g. colostomy Number of sections or heads, e.g. triceps
Origin, insertion, e.g. sternomandibulus
Skeletal terminology Shape, e.g. rhomboideus
Crest a ridge of bone, e.g. the occipital
crest Movement denitions
Condyle a rounded projection of bone Abduct move away from the midline of
at a joint, e.g. the femoral condyles the body
Epicondyle a separate prominence close Adduct move towards the midline of
to the condyle the body
Foramen a natural opening in a bone, Circumduct move circularly or conically
through which nerves, blood vessels, e.g. a function of the coxofemoral (hip)
and so on pass, e.g. the obturator joint
foramen of the pelvis Depress draw downwards
Fossa a hollow or depression, e.g. the Elevate draw upwards
olecranon fossa of the elbow Extend increasing the inner angle of the
Head a rounded articular surface, e.g. joint, arch the back dorsally
the head of the femur (Hyperextension is when a joint
Tuberocity a protuberance of a bone, e.g. extends beyond 180.)
the tibial tuberocity Flex decrease the inner angle of the
Trochanter a large rough process of the joint, arch the back upwards
femur Laterally ex bend sideways, e.g. turning
Trochlea a depression in the bone where head and neck
major tendons lie, e.g. the trochlear Laterally rotate rotate outwards
groove of the knee joint Medially rotate rotate inwards
Tubercle a rounded process where a Pronate rotate the lateral aspect of the
muscle inserts, e.g. the greater tubercle paw medially
of the femur Protract draw forward
Retract draw backwards
Muscle names Supinate rotate the lateral aspect of the
Externus outer paw laterally (the normal position of
Gracilis slender the paw is supine)
Latissimus wide
Longissimus long Anatomical positioning of
Quadratus square muscles
Rectus straight Extrinsic muscles are those that attach the
Rhomboideus kite, diamond-shaped appendicular skeleton (limbs) to the
Scalenus unequal, irregular triangle axial skeleton (torso).
Serratus saw-tooth Intrinsic muscles are those that attach to
Teres round or cylindrical the appendicular skeleton but not to
Transversus across the axial, or those that attach to the
Vastus great axial skeleton and not to the
appendicular skeleton.
Axial muscles are divided into two groups:
200 Glossary of Terms

Epaxial muscles that lie dorsal to the Planes of motion


transverse processes and are involved A plane, here, is an imaginary at area
with extension of the vertebral column. bisecting the dogs body (56):
Hypaxial all muscles that lie ventral to
the transverse processes of the Frontal plane divides the body
vertebrae, including the abdominal and horizontally into upper and lower
thoracic walls. halves.
Sagittal plane divides the body
Muscle roles vertically into left and right halves.
Agonist or prime mover muscle whose Transverse plane divides the body
contraction causes a specic vertically into cranial and caudal
movement. halves.
Antagonist muscle which contracts in
opposition to the agonist. Regions of the body
Fixator muscles which stabilize an area Caudal part that is nearest to the tail.
for the action of the agonist, e.g. the Cranial part that is nearest to the head.
xator muscles of the scapula (e.g. m. Distal part that is furthest away from the
supraspinatus) and form a rm body or organ.
foundation for movement within the Dorsal the upper surface of the body or
distal thoracic limb. the front surface of the carpus and
Reciprocal inhibition neural inhibition tarsus.
response causing relaxation of the Palmar bottom surface of the thoracic
antagonist when the agonist contracts, limb paw.
thus allowing easy movement without Plantar bottom surface of the pelvic
any opposing tension. limb paw.
Synergist these tend to be the smaller, Proximal part that is nearest to the body
deeper muscles that work with the or organ.
agonist to provide isolation and stability Rostral in the head, the part that is
to a joint. closest to the nose.
Ventral lower surface of the body. This
Types of muscle movements is not used in the limbs, where the
Concentric contraction contraction of terms palmar (front legs) or plantar
muscle bres in which they are (back legs) are used.
shortened; this is used in protraction,
retraction, adduction, and abduction. Regions of the limbs
Eccentric contraction lengthening of the Antebrachium part of the thoracic limb
muscle bres under tension, when between the elbow and the carpus.
forces cause the muscle to extend even Brachium part of the thoracic limb
though the muscle bres themselves between the shoulder and the elbow.
are shortening. Therefore, the muscle Crus part of the pelvic limb between the
develops tension while lengthening, e.g. stifle and the tarsus.
when landing after a jump, the Manus distal part of the thoracic limb
antagonist contracts, thereby stabilizing (includes the carpus, the metacarpus,
the movement. and the digits).
Isometric contraction muscle bres Pes distal part of the pelvic limb
contracting against a xed resistance in (includes the tarsus, the metatarsus,
order to provide stability, e.g. when the and digits).
dog is standing still on a moving
platform.
201

Further Reading
Coughlan AR, Miller A (eds) (1998). Robertson J, Pope E (2012). From
BSAVA Manual of Small Animal Fracture Tongue to Tail: the Integrated Movement
Repair and Management. British Small of the Dog (DVD). Parkes Publication.
Animal Veterinary Association.
ISBN 978-0905214375. Whalen-Shaw PW (2000). Canine
Massage The Workbook. Bookmasters
De Domenico G (2007). Beards Inc.
Massage Principles and Practice of Soft ISBN 978-1930511026.
Tissue Manipulation. WB
Saunders/Elsevier, 5th edn. Wyche S (2002). The Horses Muscles in
ISBN 978-0721603506. Motion. Crowood Press.
ISBN 978-1861264565.
Fischer MS, Lilje KE (2011). Dogs in
Motion. VDH Service GmbH und
Franckh-Kosmos Verlags-GmbH & Co.
ISBN 978-3981433906.

Hodges PW, Richardson CA (1996).


Inefficient muscular stabilization of the
lumbar spine associated with low back
pain. Spine 21: 264050.

Myers TW (2008). Anatomy Trains.


Myofascial Meridians for Manual and
Movement Therapists, 2nd edn. Churchill
Livingstone.
ISBN 978-0443102837.

Robertson J (2010). The Complete Dog


Massage Manual. Veloce Publishing Ltd.
ISBN 978-1845843229.

Robertson J, Pope E (2011). Exercising


Your Puppy: a Natural and Gentle
Approach. Veloce Publishing Ltd.
ISBN 978-1845843229.
202

Appendix
The muscles of the dog their placement and actions

Extrinsic muscles of the thoracic limb


Muscle Origin Insertion Innervation Action

Trapezius Dorsal median Cervical part Dorsal branch of Cervical part


(Protractor and raphe (seam) of dorsal two-thirds accessory nerve draws scapula
retractor of the neck and the of the scapula (XI) craniodorsally
scapula) supraspinous spine Thoracic part
(204, 210) ligament from Thoracic part draws scapula
the level of the dorsal third of caudodorsally
3rd cervical the scapula Cervical &
vertebrae to the spine thoracic parts
level of the acting together
spinous draw scapula
processes of the dorsally
9th/10th
vertebrae

Omo- Acromion of Wing of atlas Ventral branch Draws scapula


transversarius scapula (cranially) of 4th cervical and thoracic
(Lateral flexor (caudally) nerve limb forwards
of neck, aids Flexes neck
protraction of laterally
thoracic limb)
(204, 207)

Rhomboideus Rhomboideus Capitis cranial Ventral branches Elevates and


(Thoracic limb capitis nuchal dorsal border of of cervical and retracts thoracic
stabilizer and crest of the scapula thoracic spinal limb
elevator of occipital bone Cervicis caudal nn. Draws scapula
scapula) Rhomboideus (base) of . against trunk
(205, 208, 219) cervicis dorsal scapula, When neck is
median raphe of medially and lowered,
the neck from laterally elevates neck
the 2nd cervical Thoracis
to 1st thoracic caudal (base) of
vertebra scapula,
Rhomboideus medially and
thoracis laterally
spinous
processes of the
first seven
thoracic
vertebrae

(continues)
Appendix

Extrinsic muscles of the thoracic limb (continued)


Muscle Origin Insertion Innervation Action

Serratus Serratus cervicis Dorsomedial Ventral rami of Most important


Ventralis transverse third of the cervical spinal muscle
(Supports trunk processes of the serrated surface nn. and long supporting the
and last five cervical of scapula thoracic nerve trunk
thoracic limb) vertebrae Carries trunk
(209, 219) Serratus thoracis and shoulder
first seven or forward and
eight ribs ventral back
to their midline Depresses
scapula

Sternohyoideus Manubrium of Basihyoideum Ventral branch Draws the


sternum of first cervical tongue caudally
nerve (when
hypertonic
could have
negative
influence on
balance)

Brachiocephalicus Cleidobrachialis Cleidobrachialis Accessory nerve Cleidobrachialis


(Prime shoulder ventral aspect distal third, and ventral extends
extensor) of clavicular cranial surface of branches of shoulder joint
(204, 206) intersection humerus cervical spinal and advances
Cleidocephalicus Cleidocephalicus nn. thoracic limb
dorsal aspect cervical part Cleidocephalicus
of clavicular cranial half, mid draws head to
intersection dorsal fibrous the side and
raphe and extends neck
occasionally to
nuchal crest of
occipital bone
Cleidomastoideus
mastoid part
of temporal
bone

Latissimus dorsi Thoracolumbar Teres major Thoracodorsal Prime flexor of


(Prime shoulder fascia from tuberosity of nerve shoulder joint
flexor) spinous humerus and When limb is
(204, 215, 219) processes of teres major fixed draws
most caudal tendon the trunk
seven or eight cranially
thoracic When limb is
vertebrae and free draws
lumbar the limb
vertebrae; most caudally
caudal to or four
ribs

(continues)
204 Appendix

Extrinsic muscles of the thoracic limb (continued)


Muscle Origin Insertion Innervation Action

Superficial Transverse All but the most Cranial pectoral Adducts limb
pectoral portion the distal part of the nerve when non
(Thoracic limb first two or crest of the weightbearing
adductor) three sternabrae greater tubercle Prevents limb
(218) Descending of the humerus from abducting
portion - when
manubrium weightbearing

Deep pectoral Manubrium of Major portion Caudal pectoral Adducts the


(Thoracic limb sternum and the partly muscular, nerve limb when limb
adductor and fibrous raphe partly tendinous advanced and
retractor) between fellow on the lesser fixed pulls
(218) muscles tubercle of the trunk cranially
The deep humerus and to extend
abdominal Also via an the shoulder
fascia in the aponeurosis to joint
region of the the greater When limb non
xiphoid cartilage tubercle and its weight bearing
(the caudal end crest draws limb
of the sternum) Lesser portion caudally and
medial brachial flexes shoulder
fascia joint
Appendix 205

Intrinsic muscles of thoracic limb


Muscle Origin Insertion Innervation Action

Deltoideus Spinous head Deltoid Axillary nerve Spinous head


(Shoulder scapular spine, tuberosity of the flexes shoulder
abduction blending humerus Acromial head
Aids thoracic with the abducts
limb flexion) infraspinatus shoulder
(204, 217)

Supraspinatus Acromial head Cranially on the Suprascapular Extends shoulder


(Shoulder acromion greater tubercle nerve Stabilizes and
extensor and Supraspinous of the humerus prevents
stabilizer) fossa of scapula by means of a dislocation
(216, 219, 221) thick tendon of shoulder

Infraspinatus Infraspinous Lateral side of Suprascapular Flexes shoulder


(Shoulder fossa and spine greater tubercle nerve Abducts
flexor) of scapula of humerus shoulder
(216, 219, 221) Stabilizes
shoulder

Coracobrachialis Coracoid Caudomedial Musculo- Extends shoulder


(Shoulder extensor process of area of proximal cutaneous nerve Adducts
and adductor) scapula humerus shoulder
(216, 219) Stabilizes
shoulder joint

Triceps brachii Long head Olecranon Radial nerve Extends elbow


(Shoulder flexor caudal border of process joint
and elbow scapula Helps tense
extensor) Lateral head antebrachial
(204, 214, 219) tricipital line of fascia
humerus Long head
Accessory flexes shoulder
head caudal joint
neck of humerus
Medial head
crest of lesser
tubercle near
the teres major
tuberosity of
humerus

Biceps brachii Supraglenoid Radial Musculo- Flexes elbow


(Shoulder tubercle of tuberosity, cutaneous nerve Extends
extensor and scapula proximomedial shoulder
elbow flexor) ulna Some passive
(212, 219) stability when
weightbearing,
preventing
shoulder flexion

Brachialis Proximal third, Ulnar and radial Musculo- Flexes elbow


(Elbow flexor) lateral surface of tuberosities cutaneous nerve
(211, 212) humerus

(continues)
206 Appendix

Intrinsic muscles of thoracic limb (continued)


EPAXIAL MUSCLES (220, 221)
This group of dorsal vertebral and costal muscles are divided into three individual muscle
groups lying in parallel, each overlapping. It is almost impossible to give exact insertions
and origins, due to the many overlapping fascicles
Extensors of the vertebral column dorsally, and, when unilaterally contracted, laterally
Deep and medial:
Transversospinalis system: spinalis, semispinalis, multifidus, rotators, interspinalis, and
interansversarius (complex that joins vertebrae both those adjacent and slightly distal)
Intermediate portion:
Longissimus capitis origin T13; insertion: mastoid part of temporal bone (passing over
atlas)
Longissimus cervicis lying in an overlapping style in the angle of the cervical and thoracic
vertebrae and inserting on the transverse processes of C47
Longissimus thoracis and longissimus lumborum originate from crest of ilium via
aponeurosis to spinous processes of lumbar and thoracic vertebrae
The most ventrally situated of the group:
Iliocostalis thoracis origin transverse process of C7C12
Iliocostalis lumborum origin wing of ilium and then on the transverse processes of lumbar
vertebrae and the last four to five costals

Muscles of the head and neck

Muscle Origin Insertion Innervation Action

Masseter Zygomatic arch Masseteric fossa Mandibular Raises the


(204) of mandible nerve (branch of mandible
the trigeminal (closes the jaw)
nerve)

Sternocephalicus Manubrium Mastoid part of Accessory nerve Draws head


(204) temporal bone and ventral and neck to the
and nuchal crest branches of side
of occipital bone cervical spinal
nerve

Splenius Cranial border Nuchal crest and Dorsal branch of Extension and
(206, 220, 221) of mastoid part of cervical and lateral flexion of
thoracolumbar temporal bone thoracic nerve. head and neck
fascia Spines of
first three
thoracic
vertebrae
Entire median
raphe of neck
Appendix 207

Muscles of the pelvic limb: caudal thigh muscles (hamstrings)


Muscle Origin Insertion Innervation Action

Biceps femoris Sacrotuberous Patellar Sciatic nerve Extends hip,


(Hip, stifle and ligament and ligament and Cranial part stifle, and tarsus
tarsus extensor ischiatic cranial border of receives Caudal part of
Stifle flexor tuberosity tibia via fascia additional muscle flexes
Pelvic limb lata and crural stimulation from the stifle
retractor) fascia the caudal Retracts pelvic
(222) Tibial body via gluteal nerve limb
crural fascia
Calcaneal
tuberosity

Semi- Ischiatic Distal medial lip Sciatic nerve Extends hip


membranosus tuberosity of caudal rough Femoral
(Hip extensor surface of femur attachment
and stifle flexor) Proximal medial extends stifle
(222, 227, 228) surface of tibia Tibial
(medial tibial attachment
condyle) flexes or
extends
stifle depending
on position of
limb

Semi- Ischiatic Distocranial Sciatic nerve Extends hip


tendinosus tuberosity border of tibia Flexes stifle
(Hip and hock Medial surface, Extends hock
extensor body of tibia
Stifle flexor) The tuber
(222, 227229) calcanei by
means of the
crural fascia
208 Appendix

Medial thigh muscles


Muscle Origin Insertion Innervation Action

Sartorius Cranial part Cranial part Femoral nerve Flexes the hip
(Hip flexor) iliac crest and patella Cranial part
(226, 227, 229) thoracolumbar Caudal part extends stifle
fascia cranial border Caudal part
Caudal part of tibia flexes stifle
cranioventral
iliac spine and
adjacent ventral
border of ilium

Gracilis Pelvic symphysis Cranial border Obturator nerve Adducts pelvic


(Limb adductor) by means of of tibia (and with limb
(226, 229) symphysial the Flexes stifle
tendon semitendinosis), Extends hip
the tuber and hock
calcanei

Pectineus Iliopubic Medial lip, Obturator nerve Adducts pelvic


(Limb adductor eminence caudal rough limb
and hip flexor) surface (facies Flexes hip
(226, 228, 229) aspera) of femur

Adductor Entire pelvic Entire lateral lip Obturator nerve Adducts pelvic
(Limb adductor symphysis of caudal facies limb
and hip by means of the aspera (rough Extends hip
extensor) symphysial face of femur)
(228, 229) tendon, the
adjacent part of
the ischiatic
arch, and
ventral surface
of the pubis and
ischium
Appendix 209

Lateral thigh muscles


Muscle Origin Insertion Innervation Action

Tensor fascia Tuber coxae and Cranial Cranial gluteal Flexes hip
latae adjacent part of superficial part nerve Extends stifle
(Hip flexor and ilium patella and tibial Tensor of the
stifle extensor) Aponeurosis of tuberosity by fascia lata
(222) middle gluteal means of the Draws limb
muscle fascia lata and forward in
patella ligament cranial
Caudal deeper movement of
part lateral lip the stride
of facies aspera
of the femur

Superficial Lateral border of Third trochanter Caudal gluteal Extends hip


gluteal sacrum and first of femur nerve Abducts pelvic
(Hip extensor caudal vertebra, limb
and limb ab- partly by means
ductor) of the
(222, 224) sacrotuberous
ligament
Cranial dorsal
iliac spine by
way of gluteal
fascia

Middle gluteal Crest and Greater Cranial gluteal Extends and


(Hip extensor gluteal surface trochanter of nerve abduct hip
and abductor) of ilium femur Rotates pelvic
(222, 224) limb medially
Aids
stabilization
within
coxofemoral
joint

Deep gluteal Body of ilium Cranial aspect Cranial gluteal Extends and
(Hind limb ex- and sciatic spine of greater nerve abducts pelvic
tensor and ab- trochanter limb
ductor) Rotates pelvic
(224) limb medially
210 Appendix

Sublumbar muscles
Muscle Origin Insertion Innervation Action

Iliopsoas Psoas major Psoas major Ventral branches Flexes hip


(Hip flexor) transverse lesser of lumbar Flexes vertebral
(223, 225) processes of trochanter, with spinal nn. column
lumbar iliacus Extends lumbar
vertebrae Iliacus lesser spine
Iliacus ventral trochanter with When pelvic
surface of ilium iliacus limb is
extended,
draws limb
forward
Supinates hip
When limb
fixed, stabilizes
vertebral
column
Flexes hip

Quadratus Last three Transverse Ventral branches Lateral flexion


lumborum thoracic and processes of the of the lumbar and fixation of
(Lateral flexor lumbar cranial lumbar spinal nn. the lumbar
of the transverse vertebrae and vertebral
vertebrae) processes auricular surface column
of the pelvis

Femoral muscles

Quadriceps Rectus femoris All four bellies Femoral nerve Extends stifle
femoris ilium of the Flexes hip
(Major stifle Vasti muscles: quadriceps (rectus femoris
extensor) Vastus lateralis femoris form only)
(227, 228, 229) lateral side one common
and proximal tendon of
end of femur insertion which
Vastus extends distally
intermedius to invest the
lateral side and patella and
proximal end of insert on the
femur tibial tuberosity
Vastus medialis
medial side,
proximal end,
and cranial
surface of
femur
Appendix 211

Deep muscles of the coxofemoral joint


Muscle Origin Insertion Innervation Action

Internal Symphysis of the Trochanteric Sciatic nerve Rotates the


obturator pelvis and dorsal fossa of the pelvic limb
surface of the femur laterally at
ischium and coxofemoral
pubis joint

Gemelli Lateral surface Trochanteric Sciatic nerve Rotates the


of the ischium fossa pelvic limb
caudal to the laterally at
acetabulum coxofemoral
joint

Quadratus Ventral surface Trochanteric Sciatic nerve Rotates the


femoris of the caudal fossa pelvic limb and
part of the extends the hip
ischium

External Ventral surface Trochanteric Obturator nerve Rotates hip


obturator of the pubis and fossa laterally
ischium

Articularis Lunate surface Proximal and Flexes the hip


coxae of acetabulum medial to the
line of vastus
lateralis
212 Appendix

Masseter

cleidocephalicus

Trapezius

Sternocephalicus

Omo-transversarius

Cleidobrachialis

Deltoideus

Triceps brachii
Latissimus dorsi

204 Muscles of the thoracic limb.

Rhomboideus

Cleidobrachialis

205 Rhomboideus. 206 Cleidobrachialis.


Appendix 213

Capitis

Omo-transversarius

Cervicis

Thoracis

207 Omo-transversarius. 208 Rhomboideus.

Serratus
ventralis
cervicis

Cervical

Origin

Thoracic
Serratus ventralis
thoracis

209 Serratus ventralis. 210 Trapezius.


214 Appendix

Coracobrachialis

Brachialis Biceps
(sharing brachii
same
insertion
Brachialis as biceps
brachii

211 Trapezius 212 Biceps brachii (sharing 213 Coracobrachialis


same insertion as biceps brachii

Long head

Accessory
Lateral head
head
Medial
head

214 Triceps brachii

Latissimus dorsi
(insertion)

215 Latissimus dorsi (insertion).


Appendix 215

Supraspinatus

Spinous head
Infraspinatus

Acromial head

216 Supraspinatus, Infraspinatus. 217 Deltoideus.

Descending
portion
Insertion

Transverse
portion

Deep pectoral
Origin muscle

218 Pectoral group.

Rhomboideus Serratus ventralis


Supraspinatus
Carocobrachialis

Infraspinatus Serratus Latissimus Supraspinatus


ventralis dorsi

Triceps
Brachialis brachii
Biceps Triceps
brachii brachii
Biceps brachii Biceps brachii

Lateral Medial

219 Muscles of the thoracic limb.


216 Appendix

Splenius

Spinal and
semispinal Longissmus
muscles thoracis et
Longissmus lumborum
capitis
Longissmus
cervis

Thoracic iliocostal Lumbar iliocostal

220 Epaxial muscles.

Multidus Short rotator


Semispinalis
Long rotator Spinalis Interspinalis
T6 7
8 9 13 L1 2 3 4
10 11 12 5 6 7

Ilium

Iliocostalis thoracis Intertransversarius Longissimus lumborum


Longissimus lumborum
Iliocostalis lumborum
Transversospinalis system
Longissimus system
Iliocostalis system

221 Epaxial muscles.


Appendix 217

Midde gluteal

Superficial Psoas major


gluteal
Cut edge Semimembranosus
of gluteal
fascia Semitendinosus

Tensor Biceps
fascia femoris
latae

Sartorius

Illiacus

222 Muscles of the pelvic limb. 223 Sublumber muscles.

Middle
gluteal

Deep
gluteal

Superficial
gluteal
Iliopsoas

224 Gluteal muscles. 225 Iliopsoas.

Deep gluteal
Pectineus

Cranial
part of Sartorius Rectus
sartorius femoris

Vastus Adductor
Cranial lateralis
part of Semitendinosus
sartorius Gracilis

Semimembranosus

226 Medial thigh muscles. 227 Femoral muscles.


218 Appendix

Rectus femoris
Pectineus
Adductor

Semimembranosus

Semitendinosus

228 Muscles of the pelvic limb.

Pectineus
Rectus femoris

Adductor Vastus medialis

Gracilis Sartorius (cranial part)


Sartorius (caudal part)

Semimembranosus

Semitendinosus

229 Muscles of the pelvic limb.


219

Index
Note: Page references in italic refer to tables blood vessels 512
or boxes bone 16
bone 1218
abdominal line 62, 63 biomechanics 1820
abduction cellular structure 14
pelvic limb 74, 74 compact (cortical) 13
thoracic limb 745 constituents 1213
acetylcholine (ACh) 26, 42 construction 16
achondroplastic dogs 56, 153, 154, 155 development 1516, 367
actin 22, 23 trabecular 14
action potential 25 bones, classification 1617
acupressure 12832 bony landmarks 20, 21
acupressure points 129 Bowen technique 128
adduction brachial plexus 44
pelvic limb 74, 74 brachialis 205
thoracic limb 75, 75 brachiocephalicus 203
adductor muscles 31, 65, 208 brain 423
adductor stretch (handler) 11011 lesions and effects 49
adenosine diphosphate (ADP) 28 brainstem 43, 49
adenosine triphosphate (ATP) 28 break-over point 69
adhesions 131, 132 breathing, deep lateral 52
adrenaline 42 breed/type 154
age of dog 154 Bull, Tania 104, 105
agility dog 81, 914, 105
anatomical trains 356 calcaneous 57
appendicular skeleton 567 calcium homeostasis 14
Arrian 7 calcium ions 256
arteries 51, 52 Canicross 1001
arthritis capillaries 51
immune-mediated 188 car, jumping in/out of 102
septic 188 cardiovascular system 514
see also osteoarthritis (OA) carpal joints
arthrocentesis 174 anatomy 17, 567
arthroscopy 173 hyperextension 70, 923, 95
articularis coxae 61, 211 cartilage 20, 175
assessment of dog 32, 126, 15360 loss/damage 175, 184
condition 154 case studies 34, 35, 38, 62, 63, 183
gait 155 central nervous system (CNS) 25, 3940, 424
observation and visual 126, 153 cerebellum 42, 48
skin 51 lesions 49
weight bearing 15960 cerebrum 42
autonomic nervous system (ANS) 41 Chartered Society of Physiotherapy 8
axial skeleton 57 Chi 128
axon 41 Chinese medicine, see traditional Chinese
Ayurvedic medicine 8 medicine (TCM)
chondro-protection 180
balance 155 chondroitin sulphate 180
assessment 159, 160 chronic degenerative radiculomyelopathy
muscular 812, 967 (CDRM) 196
balance cushion 1212 clavicle 56, 72
ball play 103 claws
banana shape 157, 159, 1623 dew 745
Beards Massage. Principles and Practice of Soft length 69
Tissue Manipulation 125 cleidobrachialis 69, 72, 203, 212
behaviour, observation 126 cleidocephalicus 72, 203
biceps brachii 67, 69, 205, 214 cleidomastoideus 72, 203
biceps femoris 31, 207, 217 coat condition 126, 154
220 Index

cold compress 1912 endurance 81


collagen 12, 16 environment, for massage 133
companion dogs 1013, 154 epaxial muscles 723, 206, 216
comparative anatomy 547 epidermis 49
compensation 9, 38, 83, 181 epiphyses 15
compression technique 140, 151 erythrocytes 51
computed tomography (CT) 172 exercise
concussion 945 excessive 177
condition of dog 126, 154 in osteoarthritis 179
conditioning, muscle 27, 801 puppy 76, 83
conformational abnormalities 177 rehabilitation 11418
connective tissue 12 extension leads 115
connective tissue massage (Rolfing) 128 extensors 29
contraindications to massage 164, 1657 extrinsic muscles 25
coracobrachialis 67, 205, 214 eye, look in 160, 161
core muscles 81
core stability fascia 329, 128
challenges 835 anatomy 324
development 813 and muscle 356
corticosteroids 179 and posture 37
costals 57 fascial trains 31, 356
counter stress techniques 11314 fatigue 28
coxofemoral joint, see hip joint feeding, before massage 167
cranial drawer test 171, 190 feet, stress 98
cranial nerves 44 femoral muscles 210, 21718
creatine phosphate 28 femur 19, 57
cross-fibre working 142, 150 osteosarcoma 195
cruciate ligament disease 18990 palpable points 21
cupping 143 fibre spread 142
current practice 89 fibrous tissue 127, 1302
cutaneous reflex 51 fight or flight 72
Cyriax, James 134 finger glide/stripping 140, 151
cytokines 175 flexors 29, 31
floors 103
deep pain response 49 flyball 945
degenerative joint disease (DJD) 17481 footfall 155
deltoideus 69, 205, 215 foramen 20
dendrites 41 forebrain lesions 49
dermis 49 fossa 20
dew claw 745 Fox, Dr Michael 125
diagonal hold 15960 friction techniques 132, 13942, 150
digitigrade stance 55 frontal bone 17
discomfort, signs of 91, 121, 170 frontal plane 64
drawer test 171, 190 furniture, jumping on/off 102, 103
dressage (horses) 95 fusiform (spindle-shaped) muscles 24
dry nose 119
gait, assessment 155
Eastern cultures 8 Galen Therapy Centre 106
effleurage technique 134, 1367 Galenus, Claudius 8
deep 137, 1478 gallop, pelvic limb action 66, 67
key points 137 gastrocnemius 65
superficial 147 gastrocnemius stretch (handler) 1089
elbow joint gemelli 60, 61, 211
anatomy 19 glucosamine 180
OCD 185 gluteal muscles 31, 60, 61, 66, 85, 209, 217
osteosarcoma 195 development 62, 63
Elliott, Rachel Page 68, 153 gluteal stretch (handler) 11011
endochondral ossification 15, 178, 184 glycogen 28
endocrine system 51, 52, 132 glycolysis 28
endomysium 22, 191 glycosaminoglycans 20, 180
Index 221

Golgi tendon organs 28, 29, 47, 144 signs of 91


gracilis 74, 163, 208, 21718 skeletal muscle 1913
growth plates 15 injury cycle 84
closure 178 internal oblique muscle 81, 83
trauma 178 interneuron 45
gundogs 978, 105 interstitial fluid 130
intervertebral disc disease 1945
hacking 143 intrinsic muscles 25
half-moon body shape 156, 158, 162
hamstring muscles 31, 65, 207 joint capsule 20
fascial bands 33 joint cavity 19
shortening 162 joint fluid 19, 20, 144, 174, 175
handler 9 joint mouse 184, 185
connection with dog 107 joints 18
exercises 10811 conformational abnormalities 177
harness 11415 mechanoreceptors 48
Canicross 100 movements 1819
Husky sledding 98, 99 passive movement 1446
Haversian system 16 range 801
head structure 1920, 176
muscles and actions 702, 206 trauma 177
passive movement 11921 jumping 8792
head position, obedience dog 967 stresses of 38, 39, 102, 103
heart disorders 166
heel work 967, 116 kneading
hills, lateral walking 11516 deep 139, 149
hinge joints 19 superficial 1389
hip (coxofemoral) joint kyphosis 156, 158
anatomy 60, 61
muscles 211 lactic acid 28
hip dysplasia 1814 lacuna 14
hip extension technique 182 lameness
hip flexor stretch (handler) 109 assessment 153, 154
Hippocrates 8 diagnostic techniques 1704
history of massage 8 examination 170
homeostasis 9 history 16970
hormones 51, 52, 132 post-exercise 29, 132
horses, training 85, 95 landmarks, bony 20, 21
human anatomy 36, 547 lateral hill walking 11516
human drugs 179 lateral movement 77, 117
humerus 56 latissimus dorsi 69, 70, 162, 203, 212, 214
Husky sledding 989 fascial tear 34, 35
hydrotherapy 1223 lead exercise 179
hydroxyapatite 13, 16 puppy 76
hypertonia 30, 31, 160 rehabilitation 114
hypertonic muscle 30, 31 LeggCalvPerthes disease 1868
hypotonia 31, 48 Ling, Per Henrik 8
LMN, see lower motor neuron system
iliacus 65, 162, 217 long bones 16, 17
iliocostalis lumborum 73, 206, 216 longissimus capitis 73, 206, 216
iliocostalis thoracis 73, 206, 216 longissimus cervicus 73, 206, 216
iliopsoas 65, 210, 217 longissimus lumborum 65, 73
illness, contraindications for massage 165 longissimus thoracis 73, 206, 216
imaging techniques 1713 look in the eye 160, 161
infection 54, 165 Lovebury, Kelly 183
infraspinatus 67, 205, 215 lower motor neuron system (LMN) 40, 41
injury damage 489
contraindications for massage 165 lumbar problems 31, 83, 155
nervous system 489 lymphatic system 524, 77, 130
repetitive 9 lymphoedema 54
222 Index

magnetic resonance imaging (MRI) 172 neurons


massage communication 42
definitions 125, 1267 structure 41
direct benefits 77, 114, 126 neurotransmitters 26, 42
massage application nonsteroidal anti-inflammatory drugs
number 134 (NSAIDs) 179, 192
pressure 134, 135 noradrenaline 42
rhythm 134 nose, dry 119
massage techniques, purposes and nuchal ligament 701, 116
effects 14752 nutraceuticals 180
masseter muscle 206, 212
medical treatments, OA/DJA 17980 obedience dogs 959, 105
Meissners corpuscles 47 observation 126
Merkels discs 47, 50 obturator internus/externus 60, 61, 211
metalloproteinases 180 OCD, see osteochondritis dissecans
microtrauma 289, 97, 132 omotransversarius 69, 202, 213
misfit 157, 159, 164 ossification
mobility, restricted 32, 54, 62, 63, 118 endochondral 15, 178, 184
motor (efferent) nerves 40 intramembranous 16
movement, initiation 623 osteoarthritis (OA) 17481
multifidus 81, 83, 206, 216 osteoblasts 14, 37
muscle, smooth (visceral) 22 osteochondritis dissecans (OCD) 1846
muscle (skeletal) osteochondrosis 184
anatomy 223, 478, 191 osteoclasts 14, 37
coordination 2930 osteocytes 14, 175
hypertonia 30, 31, 160 osteone 16
hypotonia/atrophy 31, 48 osteosarcoma 1934, 195
injury 1913 overweight dogs 177
microtrauma 289, 97, 132
physiology 259 pace
shape and function 245 length 801
muscle conditioning 27, 801 speed of 97
muscle fibres 22, 23 Pacinian corpuscles 47
fast twitch 27 pain, signs of 91, 121, 170
intrafusal 47 pain-relieving medication 17980
slow twitch 267 palpation 32, 1345
muscle leverage 81 panniculus adiposus 49
muscle memory 28 panosteitis 186
muscle spindles 478 parasympathetic nervous system 41, 132
muscle tone 302 Pare, Ambroise 8
muscular balance 812, 967 passive movements 11821, 1446
myelopathy, degenerative 196 head and neck 11921
Myers, Tom 35 pelvic limb 119, 146
myofascial stress 367 purpose and effects 144, 152
myofilament 22, 23 thoracic limb 118, 119, 145
myosin 22, 23 passive touch 146
patella, luxation 188
nails, see claws patellar tendon 188
neck paw, thoracic limb 69
hypertonia 160 pectineus 74, 208, 21718
muscle placement and actions 702, 206 pectoral muscles 67, 69, 70, 72, 204, 215
passive movement 11921 pelvic limb
problems 98, 116, 119 abduction 74, 74
neoplasia 166, 1934 adduction 74, 74
nervous system 3949, 132 muscle placement and action 606, 207
damage 489 11, 21718
neural reprogramming 144 passive movement 119, 146
neuroglial cells 42 protraction 645
neuromuscular junction (NMJ) 25 retraction 667
neuromuscular technique (trigger point pelvic slide 157, 159, 1624
massage) 127
Index 223

pelvis sacroiliac joint 31, 60, 61


anatomy 19, 57 safety 133
dorsal tilt 31 sagittal plane 64
pennate muscles 24, 25 sarcoplasmic reticulum 26
pentosan polysulphate 180 sartorius 65, 208, 21718
percussion (tapotment) 143, 152 scapula 56
perimysium 191 movement 68
periosteum 16 muscles and attachments 66, 67, 68, 2023
peripheral nervous system (PNS) 39, 44 scar tissue 127, 1302, 191
peripheral neurological disease 1967 scenting exercises 116
petrissage 1379, 149 sebum 49
picking up 140, 141, 149 sedation 1701
pinch test 131 semilunar valves 54
piriformis 74 semimembranosus 31, 65, 207, 21718
planes of motion 64 semitendinosus 31, 65, 207, 21718
plantigrade stance 545 sensory (afferent) nerves 40
plucking 138, 151 sensory receptors 458, 130
pole walking 85, 11617 septic arthritis 188
pool 1223 serratus ventralis 67, 69, 70, 203, 213
post-operative rehabilitation 114 sesamoid bones 17, 18
postural muscles 24, 81 shape of dog 1569
hip 60 shock 165
scapula 68 shoulder joint, OCD 185
posture, role of fascia 37 shoulders
potassium ions 25 angulation 56, 68
power 81 protraction 689
pressure 134, 135 retraction 701
proprioception 45, 46, 767 rotation 93
deficits 11617 see also scapula
proteoglycans 175 show dogs 1001
proteolytic enzymes 180 skeleton 1213
psoas major 65, 162, 217 appendicular 12
puppy 767, 83 axial 12
exercise 76, 83 terminology 20
growth plate closure 178 visceral 12
massage 77 skin 4951
spatial awareness 767 feel of 51
pyruvic acid 28 sensory receptors 457, 130
structure 50
quadratus femoris 60, 61, 211 skin disorders 166
quadratus lumborum 210 skin rolling 38, 138, 151
quadriceps muscles 31, 65, 188, 210 skull 17
smell, use in assessment 126
radiography 172, 173 Society of Trained Masseurs 8
hip dysplasia 182 sodium ions 25
ramp 102 soreness, post-exercise 29, 132
rectus abdominis 62, 66 spatial awareness 767, 85
rectus femoris 210, 21718 spinal column, see vertebral column
recumbent dogs 114, 118 spinal cord 434
reflex arcs 45 damage 489
reflex response 29, 456 segment 44
reflexive techniques 1323 spinal disease 1946
rehabilitation 11314 spinal plexus 44
rheumatoid arthritis 188 splenius 206, 216
rhomboideus 67, 69, 70, 202, 212, 213 spondylosis deformans 196, 197
roached back 156, 158 stairs, climbing 103
road work exercise 98 sternocephalicus 72, 206, 212
Rolf, Ida 128 sternohyoideus 203
Rolfing 128 stifle joint
Ruffini endings 47, 48 anatomy 21, 57
arthrocentesis 174
224 Index

OCD 185 treatment room 133


osteoarthritis 176 triceps brachii 23, 67, 70, 205, 212, 214
passive movement 146 trigeminal nerve 44
patella luxation 188 trigger point massage 127
weakness 60, 155 trochanter 20
strength 81 trochlea 20
stress point massage 127 TTouch 128
stretching tubercle 20
observation of 126 tuberosity 20
remedial exercises 118 tunnels 75, 92, 93
stride length 155
sublumbar muscles 65, 210, 217 ulna 56, 57
subscapularis 67, 69 ultrasonography 1723
supraspinatus 67, 205, 215 UMN, see upper motor neuron system
supraspinous ligament 71, 116 upper motor neuron system (UMN) 40, 41
surfaces, ground 84, 115 damage 489
surgery
osteoarthritis 1801 vagus nerve (cranial nerve X) 41, 44
patellar luxation 189 vasti muscles 210, 21718
sweat 49 veins 51
Swedish massage 8, 130, 136 venous return 512, 130
swimming 1223 vertebrae 17
sympathetic nervous system 41, 132 disc disease 1945
synapse 42 spondylosis 196, 197
synovial fluid 19, 20, 144, 174, 175 vertebral column 43, 723
synovial joints 1920, 176 comparative anatomy 57
synovial membrane 19, 20 divisions 43
veterinary surgeon 87, 165, 165
tail, observation 155 visual evaluation 153
tapotment 143, 152
tarsus 57 walking exercise 11516
TCM, see traditional Chinese medicine (TCM) walks, weekend 101, 154, 177
team, canine 867 warm-down
Tellington-Jones, Linda 128 dog 80, 1067, 114
tendon release 143, 152 handler 10811
tendons, rupture 193 warm-up
tensor fascia latae 65, 209 dog 80, 1046, 114
teres minor 67 handler 10811
therapist, positioning 133 weaving poles 74, 92, 94
thermoregulation 49, 50 weight 177, 179
thoracic limb weight bearing, assessment 15960
abduction 745 Whalen-Shaw, Patricia 8
adduction 75, 75 whiplash-type injury 100
muscle placement and actions 6670, 71, wounds, open 165
2026, 21216 Wyche, Sara 9
passive movement 118, 119, 145
thumb glide 1402, 151
tibial crest, transposition 189
tibial plateau levelling osteotomy (TPLO) 190
torpedo body shape 156, 158, 1601
torque effect 103
touch, passive 146
touch therapy 9, 126, 128
TPLO, see tibial plateau levelling osteotomy
traditional Chinese medicine (TCM) 8, 128
transverse abdominal muscles 81, 83
transverse plane 64
trapezius 67, 69, 92, 202, 21314
trapezius stretch (handler) 11011
Travel, Dr Janet 127