Water Treadmill

Water Treadmill

…is not necessary in over 90% of cases in small animal veterinary medicine in my experience and estimation. The 10% I allow for usually applies to large paralyzed animals. Large pets that have had multiple orthopedic surgeries all at once and that are in pain are difficult for many people to manage at home. I have seen many of those cases, and that’s a topic for another post. See my Q & A section for some answers I’ve given people about this topic. I also have a longer post on water treadmill if you want to read that.

What do I and you use instead of water treadmill?

The majority of cases may be recovered well with very good pain medications and solid, gravity-and-land-based exercise programs that are progressive. See my pain post and use the search box on this site for more info on pain.

These programs ^ should be written by a strength and conditioning professional or a specialist with a lot of experience in functional recovery. The rehabilitation specialist programs in veterinary medicine do not teach those foundations.

Changing Veterinary Rehabilitation

I hope to change the structure of veterinary rehabilitation by pushing for rehab professionals to train in sports medicine and exercise physiology. I believe recovery medicine works best with a foundation and experience in the sciences that study and produce physiological improvements. More foundational science and less tricks and toys might be one way to look at it.

Early in my independent practice a veterinarian friend asked me about hip problem recovery without surgery for dogs. When I explained my basic and also advanced protocol, including a certain method for doing hill repeats after building a proper foundation of stability and strength, she quizzically said, “But it’s a dog…?”.

I looked at her, perplexed, and stated, “But it has muscle, connective tissue, nerve, and bone that all respond to exercise physiology”. She agreed that my approach made good sense. She wasn’t taught information like my background in veterinary medicine studies, and she graduated at the top of her class. That’s ok…I’m a specialist in the things I have been doing for many decades, and she is a specialist in her strengths.

People have expectations that one practitioner should know *everything*, but logically we know this is impossible. That’s a topic for a post I hope to write sometime soon. Keep calm and carry on…and look for solid source information.

Originally posted January 25, 2016. Updated February 20, 2018.

Successful Rehab Without Water Treadmill

Water Treadmill is Not Necessary for Your Pet’s Rehabilitation

Compared to the number of dogs in the world, then compared to the number of ruptured cruciate ligaments on aforementioned dogs, then compared to the number of these dogs with ruptured ligaments that are treated by a veterinarian, then compared to the number of those dogs who are taken to surgery after initial veterinarian assessment for surgical repair after the torn ligament, there are relatively very few rehab clinics in the world and fewer still with water treadmills…as compared to the number of these dogs with ligament tears, etc…

Dogs of the world do relatively “ok” in all areas of the rehabilitation treatment spectrum after torn knee ligament and/or meniscus and definitely do not need to be “put down” due to ruptured cruciate ligament (torn ACL, CCL). I have encountered clients in my practice who were told unless they had surgery performed on their dog, regardless of the size of dog (even), the dog would have to be euthanized. Just wanted to clear up that bit of misinformation (much to your delight, I hope).

That being said, and along with explaining the title of this blog, of foremost importance I will note that I came into veterinary functional rehabilitation in 2004 with approximately 25 years experience in human sport science, functional program design, and nutrition. I decided to call my practice “functional rehab”, not having seen that designation applied much but having presumably heard the term somewhere. I decided to use it when I began an independent, mobile rehab practice in 2007, two years after starting and running a rehab clinic for a veterinary specialty hospital.

I became more aware of the water treadmill via my work at the hospital, and I found that the use of it was/is widely promoted within small animal veterinary medicine and the canine rehab model, which draws heavily from structured, academic-oriented, human physical therapy concepts. I think the overall concept is decent, yet the wtm is one very, very small tool in the vast array of protocol and modalities that exist in order to better the health of your pet.

I also believe the introduction and overuse of the water treadmill in small animal medicine is due to a misunderstanding of the science that exists regarding functional physical recovery and a misapplication of “human” based machines and protocol from physical therapy models. Also, the use of the wtm was brought over into small animal veterinary rehab I presume because it has been such a great tool in equine medicine and has been for decades.

Quite simply put, horses and other very heavy animals often struggle with pain after injury/surgery, and the pain control medicines and protocol that exist for (especially) horses do not often alleviate pain as much as we’d like to see. That, coupled with the sheer weight of these large animals, can really do additional damage to a healing body. The water treadmill for an animal that weighs a ton or so is a godsend, I’d think. In those cases the water displaces just enough weight so as to encourage appropriate exercise protocol while building recovery and assisting with pain control (because all the weight isn’t on the damaged limbs).

Water treadmill for horses or other very heavy animals is extremely helpful for recovery. Water treadmill for smaller animals is not necessary, often a trauma to the pet, often an unnecessary additional cost to the pet caretaker, and definitely overused. After a week of easy recovery post-surgery the pet should have enough analgesic available (and dosed) and should definitely have ability to walk on dry land and should be pursuing a controlled plan daily in the home environment.

Unfortunately, I found that what is not taught within this same model of small animal veterinary rehab is a good basis and understanding of program design, writing training programs, and the development of dynamic activities/protocol designed to encourage healing and increase muscle and bone mass. These are principles I began learning over 30 years ago as an athlete, as a self-coached athlete, and then as a coach and trainer to others, even world-class athletes.

What does this mean to you and your pet (primarily dogs…)?

The chief complaint I hear from people who contact me is that they were referred to a veterinary rehab clinic or three (no, not all clinics are the same) for post-surgical rehab, and after many weeks of walking in the treadmill, moving around on balls, and doing a variety of other cookie-cutter things, the pet is not much better or is not to a place where the owner feels comfortable with letting them be loose and rambunctious.

Their pet isn’t where the owner thought they would be after surgery.

When I was in a clinic setting and working on utilizing the wtm we had and I helped design, I did structure the workouts to be progressively difficult, using a 3x workout adjustment protocol, meaning that if three workouts went well, then I changed the protocol, making the workout more dynamic. This could be done by increasing time or lowering water in the tank. Since I do not believe that much benefit is realized by walking in a wtm more than 20 min., and some data is published to recommend that animals not be worked beyond that time anyway, I find more benefit realised by lowering the water height, thus increasing the force on the joint/leg/muscle/bone.

Overall, over time, and according to decades of research, however, the most benefit is realized by work on dry land, where possible, using gravity to strengthen bones, connective tissue, and muscle. I began developing protocol for just that for small animal rehab since I did not find any published when I arrived on the scene in 2004.

Your pet will use their leg to some extent and will use it increasingly after surgery if he/she is not in pain. That has been my finding after working with hundreds and hundreds of cases, some having had surgery and some going the conservative route. With that in mind, a structured workout program is entirely necessary and may vary from any standardized protocol depending on the nature of the pet and the owner.

If your pet is not using the leg within 2-3 days after surgery, then my findings are always that they are in pain, and that they are in pain due to

1) not enough post-op analgesic, which I believe should be a combo of at least two analgesics for potentially several weeks while we pursue the best activity and homework for healing (in this area we commonly use an nsaid and Tramadol, however I find more benefit and big-picture-science backing the combo use of Gabapentin and Tramadol);

2) infection, the pain of which will only be finally remedied by antibiotics (and subsequently the infection remedied as well); or

3) structural abnormality, i.e. some sort of failure related to the surgery, yet not necessarily the surgeons/your/your dogs *fault*.

The homework protocol I generically recommend is found here. If you are within range of my services, I recommend you contact me for an evaluation appointment and we establish a base for your dog and then you perform the exercises which will bring solid healing while helping to also protect the opposing limb.

Thank you!

Jicky E-Collar