Physical Therapy as Effective as Surgery for Torn Meniscus and Arthritis of the Knee, (Human) Study Suggests

Just One of Many Studies Published on This Topic-

My programs for conservative (no surgery) treatment are clinically and anecdotally successful. So, this means that clients and veterinarians do the work and get good results.

Physical Therapy as Effective as Surgery for Torn Meniscus and Arthritis of the Knee, (Human) Study Suggests –

“Surgery may not always be the best first course of action.

A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. To reinforce that, this study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.” Mar. 21, 2013 — A New England Journal of Medicine (NEJM) study showing that physical therapy is just as effective as surgery in patients with meniscal tears and arthritis of the knee should encourage many health care providers to reconsider their practices in the management of this common injury, according to the American Physical Therapy Association (APTA).

The study, published March 19, showed no significant differences in functional improvement after 6 months between patients who underwent surgery with postoperative physical therapy and those who received standardized physical therapy alone.

“This study demonstrates what physical therapists have long known,” explained APTA President Paul A. Rockar Jr, PT, DPT, MS. “Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. This study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.”

According to lead physical therapist for the trial and American Physical Therapy Association (APTA) member Clare Safran-Norton, PT, PhD, OCS, “our findings suggest that a course of physical therapy in this patient population may be a good first choice since there were no group differences at 6 months and 12 months in this trial.

These findings should help surgeons, physicians, physical therapists, and patients in decision-making regarding their treatment options.”

Researchers at 7 major universities and orthopedic surgery centers around the country studied 351 patients aged 45 years or older who had a meniscal tear and mild-to-moderate osteoarthritis of the knee. Patients were randomly assigned to groups who received either surgery and postoperative physical therapy or standardized physical therapy. Within 6-12 months, patients who had physical therapy alone showed similar improvement in functional status and pain as those who had undergone arthroscopic partial meniscectomy surgery. Furthermore, patients who were given standardized physical therapy — individualized treatment and a progressive home exercise program — had the option of “crossing over” to surgery if substantial improvements were not achieved. In this situation, thirty percent of patients crossed over to surgery during the first 6 months. At 12 months these patients reported similar outcomes as those who initially had surgery. Seventy percent of patients remained with standardized physical therapy.

According to an accompanying editorial in NEJM,”millions of people are being exposed to potential risks associated with a treatment [surgery] that may or may not offer specific benefit, and the costs are substantial.” Physical therapist and APTA member Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT, chief of physical therapy at Harvard University, said, “Physical therapists are experts in improving mobility and restoring motion. The individualized treatment approach is very important in the early phases of rehabilitation in order to achieve desired functional outcomes and avoid setbacks or complications.”

Story Source:

The above story is reprinted from materials provided by American Physical Therapy Association. Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:
Jeffrey N. Katz, Robert H. Brophy, Christine E. Chaisson, Leigh de Chaves, Brian J. Cole, Diane L. Dahm, Laurel A. Donnell-Fink, Ali Guermazi, Amanda K. Haas, Morgan H. Jones, Bruce A. Levy, Lisa A. Mandl, Scott D. Martin, Robert G. Marx, Anthony Miniaci, Matthew J. Matava, Joseph Palmisano, Emily K. Reinke, Brian E. Richardson, Benjamin N. Rome, Clare E. Safran-Norton, Debra J. Skoniecki, Daniel H. Solomon, Matthew V. Smith, Kurt P. Spindler, Michael J. Stuart, John Wright, Rick W. Wright, Elena Losina. Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. New England Journal of Medicine, 2013; : 130318220107009 DOI:10.1056/NEJMoa1301408

When Should I Begin Rehab on My Pet?

Rehabilitation Begins Immediately!

Begin rehabilitation immediately by taking proper care of your injured pet or your pet that has had surgery . Timing is key to the best recovery. Whenever you or your pet are injured, beginning proper movement as soon as possible is very important to recovery.

Timing of activity and recovery are especially important in the sporting pet world (dogs, horses, etc.), where workout programs and drills are designed for competition training and injury recovery.

Bella the dog playing in water with her person a year after recovering from several issues
Bella the Wonder Dog Being her Athletic Self

Learning how and when to do particular activities with your pet after injury or surgery is all part of rehabilitation. From going outside to potty (for a dog) to climbing the indoor kitty tree to running wildly and free; all in the right timing will make you and your pet’s lives easier.

The care you give when you and your pet are together and how you care for them when you are not with them is all a part of rehabilitation.

white plastic pen for small dogs
Gracie Crate for Bedroom

The information on this website will help you to begin rehabilitation and work on doing the best rehab you are able, because your pet deserves it!

Blessings-

Rehabdeb

 

Updated February 17, 2018

 

Why Do Rehabilitation for Your Pet?

Is Pet Rehabilitation Helpful or Necessary?

Pet rehabilitation may be done by anybody who has the time to do it and will follow directions. You should see benefits from a good program within the first week if you are doing the right work for the problem!

pet rehabilitation for Wolf the Horse receiving laser therapy from me
Wolf the Horse

A proper rehabilitation program should increase function where at all possible, and it subsequently could improve quality of life on many levels.

Pet rehabilitation programs are helpful for any animals that…

  • have either had surgery or have not
  • need improved muscle tone, connective tissue strength, and overall health before going into surgery
  • are old or young and could benefit from quality-of-life improvements because they have some sort of function issues
  • need advanced conditioning for a new or changed living environment
  • are competitive and need sport training for improved conditioning and injury prevention
  • are overweight or obese and need a properly-designed exercise plan
Great Dane Miss Moneypenny Taking a Break From Rehabilitation
Great Dane Miss Moneypenny Taking a Break From Pet Rehabilitation

See this post on Goals of Therapeutic Exercise for more info.

I bet you already know why rehabilitation is a good idea, so I’m going to enable comments for this page for when you would like to tell me your “why”!

Thanks!

Rehabdeb

Updated February 17, 2018

Veterinarian Comments and Reviews

You may find more positive veterinarian comments and reviews around the web. Below are a couple I have copied from various web locations –

“We are so grateful for the expertise and compassion you provide the central/south Texas community!”
Mission Veterinary Specialists, San Antonio, TX

“Once again, thanks for engaging the veterinary industry and client owners with your work and experience. I enjoy your enthusiasm and passion for the area.”
DVM, ACVS (American College of Veterinary Surgeons), South Texas

“Thanks so much, Deborah! The book is impressive. Maybe you should leave a copy at (some shelters) since they put so many cruciate dogs on the euthanasia list…Great work and thank you!”
DVM, Austin, TX

“Read your book. Excellent job. Now at ACVS they are all for non surgical acl (rehab)…Good job!”
DVM, Austin, TX

book cover of my non-surgical recovery booklet

“Finished reading “instead of surgery” kindle booklet. Bueno! Great discussion on importance of pain control, in particular. ”
DVM, Austin, TX

“Hi Deborah! I read your book the night I got it. I really like it and have already recommended it to a client last week. I hope she bought it. I will write a review for amazon for you, too. I hope you are really successful in this. I know how hard you work!”
DVM, Kerrville, TX

“Once again, thanks for engaging the veterinary industry and client owners with your work and experience. I enjoy your enthusiasm and passion for the area.”
DVM, ACVS, South Texas

“Great plan outline! I’ve come to think that using the water treadmill is (overrated), and it’s nice to finally have a definitive plan to get clients on the road to recovery.
DVM, ACVS, Austin, TX

“Just wanted you to know I read and appreciated the CCL rehab book, I will likely keep a few in the clinic.”
DVM, Austin, TX

“Bought one of your books last week. Its great!”
Megan Kelly BVSc DIPVET CCRP Holistic Veterinary Surgeon, Cape Town, South Africa

Please see client reviews and testimonials by clicking on either ^^ word in bold color ^^ 🙂

Thanks! Rehabdeb

(Updated February 10, 2018)

Pet Injury – 3 Steps

Pepper, a medium-sized black dog doing rehabilitation walks after rupturing her calcanean or Achilles tendon
Pepper Ruptured Calcanean Tendon

 Pet Injury Follow Steps –

Short notes with instructions for you to follow after your dog has been injured. I do also work on lots of cats as well as a variety of other animals. If you want to know more about cat specifics right now (because I haven’t finished developing the cat pages), please search for cat in the search box 🙂

These recommendations also work if your pet isn’t moving as well as they used to because of arthritis or advanced age, for instance, and you would like to help them.

Please have your pet evaluated by a veterinarian if you have not already, so that we may all work to be on the right track for your pet’s recovery. It is very likely that your veterinarian does not know about this style of rehabilitation, because it is home-based, so feel free to share this site with them. I am available to discuss with your vet and provide teaching seminars for clinics, too!

For more specific info on a particular injury or diagnosis, please see the menu at the top bar or use the search box on this site. For more info on why I don’t have ever injury and recovery ever posted on my site yet, see this page or this page 🙂

1) Get the right book with a successful plan for you to use at home

Books:

Most pet (and often human) orthopedic and soft tissue injuries may be recovered without surgery when there are no broken bones, and some injuries with broken bones recover well without surgery, too! Your veterinarian should be able to help you decide if surgery is necessary for your pet’s broken bones. More on this later-

The information in this booklet my booklet with 4 weeks of foundational recovery instructions also contains a GREAT foundation-building, functional recovery base for older pets that have lost muscle mass & strength and have lost some proprioceptive abilities, lost the ability to maintain balance and know where they are physically in relation to their environment. The 4-week foundational program in the bookmy booklet with 4 weeks of foundational recovery instructions is often what is needed to help older dogs that are slipping on the floor or having trouble rising or are tripping over the doggie door threshold.

More strengthening and drills should be added after this program. A full 12-week, progressively difficult, program designed by me or a practitioner with a lot of experience and training in exercise physiology program design and functional recovery is what I’m about! For most people and pets, even a little bit of improvement makes everyone happy and makes a big difference in quality of life.

You have to start with a specific foundationmy booklet with 4 weeks of foundational recovery instructions, though, at the beginning, to make sure your pet has a solid foundation to help offset additional injury.

Please also pay attention to the discharge instructions your veterinarian has given you if your pet just had surgery or you have received instruction regarding your pet’s injury.  Please pay special attention to the part about no running, jumping, or playing. If you follow my booklet instructions, you and your pet will be doing work appropriate to recovery and should not be causing any harm. Still, no running or jumping or playing! You may, however, incorporate the directions I give to you for allowable activity. Otherwise, your injured pet should be restricted!

Right now I only have one book published with information about helping your pet build a foundational base through four progressive weeks of work after injury. This is the book, then, to get you started and the one to order if your pet has lost any degree of function, especially in their hind end.

This book is specifically addressing torn knee ligaments, yet until I am able to publish the books I am working on that deal with hip issues, other knee issues, elbows, old age/arthritis, and spinal issues, the book below will be helpful to you for those situations, too. This book contains the restrictions and advice I would give to get you started after almost any orthopedic injury or diminished functional condition.

Note that your pet’s veterinarian really needs to evaluate most injuries sooner than later, even if you think you know exactly what the problem is. Unless you have a full range of personal experience with diagnostic knowledge and an x-ray machine, you might miss something very important! And even veterinarians can run into orthopedic or neurological problems they aren’t sure how to treat, so joining with a specialist like me builds your pet’s recovery team!

Please do not involve additional work until you have passed the 4-week foundation with gold stars! Please follow all the instructions for the best outcome 🙂 Please do not (again, I say it, because you’d be surprised at how many people think adding other work to this intro recovery system is a great idea) don’t add swimming (no swimming yet), stairs (no stairs yet), hill repeats (no hill repeats yet), poles (no poles yet), cavalettis (no cavalettis yet), or other dynamic activity.

Your pet may seem to be doing great and may seem to you like she/he is healed, especially if they have good pain medication, but I can assure you that biologically the minimum amount of time for soft tissue recovery is on average 8-12 weeks. Some situations take up to a year to heal well (nerve damage, torn muscles, etc…), so please don’t be fooled by appearances or by programs that don’t understand biological recovery science. Best way I know to say it ^^ and I’ve seen complications from hundreds of cases where a proper foundation wasn’t followed 🙂

Being able to walk a mile or around the block a day doesn’t matter if your pet has function problems elsewhere in their life, so get this info, follow it, and establish a solid base. If your pet can walk a mile but can’t get up off the floor, this plan is for them. The book explains more about this approach.

After the base is built, then always there are additional strengthening and proprioceptive drills to be done in order to return your pet to a better quality of movement and lifestyle!

Conservative treatment after torn knee ligament, instead of surgery:

my booklet with 4 week base-building recovery plan
Amazon for USA, CA, DE, ES, FR, IT, & UKlinks to buy the booklet in different countries, including the USA
Amazon in other countries
Books are also available on Barnes and Noble and you should be able to order from any bookseller (available on Kindle and in paperback).

Also, if the injury you are concerned about is a torn knee ligament in your dog, then please click here to read more info (then return to the instructions on this page!).

2) In addition to thoroughly reading any of that ^^ info, please watch > this video twice, and begin to do this massage daily for a month.

Please watch the video to see my recommendations on method of use for massager unit AND so you will hopefully have success introducing the buzzy massager.

There are also written instructions under the video on the linked page.

Here is what the massager looks like, and if you click on the picture, you may buy it on Amazon if you choose:

there is additional information about where you might purchase this particular massager in the written instructions under the video. I am often asked if this massager or that massager will work, and the answer is, “no, not as well”. There are “we love science” reasons for my choice.

3) If your pet is still limping 5-7 days or more after surgery, please read this > pain post < all the way through!

There is more on the topic of pain within the books-

Check out other resources under the “Rehab Resources & Tools” link in the menu under the website title at the top or by clicking here.

If you would like advanced or personalized exercises, then contact me for a consult. There is a contact form at the bottom of this page <<Click on link . Use this form if you would like to schedule a paid phone or in-person consult with me for rehabilitation for your pet.

Blessings-
Rehabdeb

 

(Updated January 25, 2018. First posted on this site April, 2015)