Braces for Dog Stifles (Knees)
This post is not meant to trash knee braces; no, instead it is meant to point you, the reader, toward more broad thinking. I have utilized tarsal and carpal braces very often in my practice, and soon I hope to write about the benefits and timing of using them.
I have the knee brace discussion occasionally with veterinarians and every time they ask my opinion. Most of the time, it seems that vets hear about therapy concepts at seminars or in journals, and they naturally think, “that’s a good idea!”.
There are lots of “good ideas” out there in the world. I am working to broaden the idea pool in my corner of practice with concepts I have encountered in over 35 years of athletic program design and wellness practice. Many ideas crossed over into veterinary medicine are not the greatest for our companion animal friends; however they have been a start to get a bunch of balls rolling.
Braces are a good idea for stabilizing a leg instead of surgery, especially if the person(s) designing or desiring stabilization don’t have any strength and conditioning program design experience. Most rehab practitioners and veterinarians do not have this valuable experience. Notably the veterinarians are busy with a plethora of medical issues. Strength and conditioning is its own specialty, and rehabilitation practice is often a subset of this specialty. Physical therapy in human medicine ties into this subset as well, however the designs of physical therapy work best with an intuitive practitioner that is well-versed in strength and conditioning protocol. Volumes of time and money have been spent to prove this point, and I won’t rehash it here!
In marrying several aspects of science, I believe we can practice toward a better outcome.
Stabilize the leg and joints by building the strength of the connective tissue, muscles, joints, and even bones. No, this is not exactly the same as stabilization by surgery, however I will say that not all knee surgeries “work”, and if you do opt for surgery, you STILL need to do a 12 week (optimal) progressive recovery program. As it is, all of my cases with torn knee ligaments that have followed protocol have had successful outcomes, returned to very good or great function, and more often than not, surprised the veterinarian. Most vets who see these results then embrace the protocol for their patients, however this protocol does require an owner follow the guidelines or pay me, another practitioner, or the vet to do the work! (ahhhh, the caveat…)
I do often point out that surgery is not magic, and in practical recovery using science and biology as a basis, any of us should be doing rehab after surgery or injury…
Volumes of research have been done regarding evaluation of the best gravity-based exercise methods and protocol. Since our companion animals have bones, nerves, muscles, ligaments, tendons, etc…just like we do, the research regarding strengthening is valid across species. While I haven’t had money to run research projects and individually prove the concepts I use for Great Danes, Doxies, Maine Coons, and New Zealand’s, just to name a few, I do have the knowledge to build individual and collective programs. There are and there aren’t one-size-fits-all formulas, however some basics weigh in equally across the board.
For a start on the homework for torn knee ligaments, please go to this page: http://rehabilitationandconditioningforanimals.wordpress.com/category/how-tos-for-you-to-rehab-your-pet/homework-instructions/knee-issues-homework-homework-instructions/
Problems that I have found with braces:
RehabDeb, revised August, 2014