Pre-habilitation - Recovery before Your Pet Goes to Surgery!

Michelle Monk - Animal Physiotherapist

Animal Physiotherapy is now no longer a new profession. Just as in humans, it is now also widely accepted that animals benefit from physiotherapy and rehabilitation following injury, surgery and degenerative conditions. Now animals also have access to pre-surgery conditioning to speed their recovery. Welcome to the world of pre-habilitation!

Physiotherapy aims to hasten recovery and maximise function. Physiotherapy has been proven to reduce pain, swelling and inflammation, increase joint range of motion, muscle length and strength, improve balance, coordination and proprioception.

Just as in human hospitals, Animal Physiotherapists now commonly work alongside Veterinary Surgeons, each peforming their specialised roles, with the common goal of obtaining the best possible outcome for the patient.

Animal Physiotherapy research continues to be peformed by Animal Physiotherapists and published in veterinary journals, demonstrating treatment effectiveness and encouraging evidence based practice. In the small animal field, much of this research focuses on outcomes post-surgery.

There are also distinct advantages to be gained from starting physiotherapy pre-surgery where possible; termed 'pre-habilitation'. In humans who have elective surgery such as knee or hip replacements, there is now substantial evidence that physiotherapy and hydrotherapy exercises performed prior to surgery accelerate the healing process and return to function. Pre-habilitation aims to prepare the patient for surgery and improve thier outcome by maximising their strength, muscle length and range of motion; teaching them the post-operative routine of exercises so they can be commenced the day after surgery, and improveing cardiovascular fitness if necessary, to get the patient as fit as possible pre surgery. Patients who complete a pre-habilitation program are up and moving more quickly, perform their physiotherapy exercises with greater ease, and have better strength and range opf motion and faster , less painful return to function. All this of course is dependent on a good surgreon to begin with!

We have been fortunate enough to perform 'pre-habilitation' programs for several of our patients, with brilliant results. Benefits include:

- Dogs become familiar with movement of the limb, preparing them for exercises post-surgery, meaning exercises can be commenced early after surgery with much less anxiety in the patients

- Muscle atrophy is prevented and muscle mass can be built upon meaning faster return to normal muscle mass post surgery

- Owners become involved in the rehabilitation process before surgery, home exercise techniques can be perfected and progressions of treatment can be taught

- Less therapy often required post surgery

What if my dog is painful pre-surgery?

Only gentle exercises are performed. Hydrotherapy is often very beneficial and the animal can exercise with little stress through the affected limb. We can often reduce pain so that more exercises can be gradually performed.

Should I delay surgery to perform prehabilitaiton exercises?

No. Pre-habilitation may be appropriate for animals whose surgery is delayed for some reason, such as owners waiting for annual leave to have the surgey done, but having the surgery as soon as you feel is necessary is more important.

What types of patients are appropriate for pre-habilitation?

Cruciate ligament injuries are the most common patients we see, particularly those with lameness in other limbs such as elbow DJD or contralateral CCL disease. Unfortunately, while recovering from CCL surgery, some dogs will rupture the contralateral CCL early on. Surgery on the contralteral limb is not indicated until the dog has sufficiently healed on the current surgical limb. These dogs typically are unable to perform much land based exercise either. Hydrotherapy adn a home exercise program are very effective to increae msucle mass and strength in both limbs, improving the outcome after surgery when the second is finally repaired.

Individual programs are tailored to suit the particular needs of each patient. Please calll the Centre on (03) 9532 5261 and ask for physiotherapist Michelle Monk or Lisa Watson for more information on pre-habilitation services.

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