When and Why to Perform Range of Motion Drills for Pets
If you are going to do range of motion drills for pets, you should have an experienced practitioner demonstrate them to you, preferably on your own pet.
Passive Range of Motion (PROM) really only needs be performed on animals limbs that the animal is not able to move on their own. PROM is the passive version, and describes range of motion drills when your pet is passive and unable to move their limb.
Range of motion exercises (ROM) are exercises that we may do for others, yet those others are also capable of moving on their own. These are often recommended in veterinary medicine, and I think that this recommendation is often made when practitioners lack knowledge of better exercises to perform.
This recommendation, to do ROM, comes from the “human side”, like a lot of good information for pet recovery does, however pets work differently with respect to their damaged bodies than humans do. Making blanket recommendations to pet peeps to do ROM is not the best approach.
Some pet caretakers I have counseled have come away from surgery discharge having been told to do massage or ROM exercises. Most of the time the animal caretaker/pet owner actually does not know what this means or how to do it so that the pet is not injured.
People are often injured accidentally by their pet if they push drills to the point that the drills would actually be helpful and would make a difference. Correct range of motion drills that make a difference are likely to cause pain in a pet that already has neuromuscular function and feeling. The pet doesn’t understand and they might nip at people causing pain. If they are comfortable with joint use, they will use their joint. As pets recover, their joint use will increase naturally.
People also usually do not know when to stop and where to start with these drills. This leads to non-compliance on an exercise the clinic recommended, and usually this drill is an unnecessary expense of time if the pet is able to move their limb on their own. A referral to a strength and conditioning rehab practitioner or a neurological recovery specialist to judge protocol and beneficial movements is a great idea for pet caretakers in these cases.
Joint Stops –
I have consulted on several cases wherein people were really trying and forcing range of motion drills with no improvement in their pet’s movement. Most of them had been back to the surgeon or regular veterinarian at least once to have them check the case. In these particular cases I found that there was a “stop” in the joint that should not have been pushed. The people didn’t know that, and they trusted the veterinarian.
The “stops” I mentioned above are due to different circumstances in different cases. One cat had a pin in her knee that was part of a fracture repair, and the pin was stopping the joint from opening more fully. A surgeon needed to remove the pin. The client had been to the surgeon and to the surgeon’s rehabilitation practitioner. Both of those practitioners kept telling the client to push doing ROM on the cat. The CCRP rehab person had forced the leg towards opening during many visits. Of course, it wouldn’t open further, and any perceived gains were likely due to the pin digging into the opposing bone.
The cat was mad and in pain, as you can imagine, and was hiding under the bed when I arrived for my consult. My advice, after finally getting to gently examine the cat, was to pursue a second opinion from a different surgeon in a different practice. It’s probably obvious to you that this cat didn’t need more range of motion exercises; she needed surgical intervention to correct the pin.
Then Why Did my Veterinarian or Surgeon Recommend These Drills?
Most of the time, in my experience, the veterinarian is trying to catch up with some of the rehabilitation protocol introduced and promoted at conferences and seminars. ROM, water treadmill and balance board use are some hot topics. Also, most of the time, they don’t have extensive experience in this type of rehab. None of us has time to know everything about even our own specialties, much less all other specialties of interest. I love quantum physics. My study of quantum physics has fallen by the wayside for decades. Jus’ sayin’.
Anyway, they and many veterinary rehabilitation practitioners are doing what they have been told to do. I would guess they are really trying to do a good job. There is just so much to know that they may not have experienced these “bad” situations and then come up with other solutions to the problems.
Who knows? I don’t do everything perfectly in my practice. I have, however, had a lot of experience in a broad variety of conditions and situations, and on this website I give to you more ways to think about solving problems.
Back to ROM –
ROM drills are not usually necessary if the pet is moving on their own! Other physical activities will be a better use of rehabilitation activity time and will do a better job of encouraging overall limb and body use. Start with this foundation if you want to do some work yourself.
My Pet Already Moves Their Leg –
If your dog or cat or other pet is moving and flexing & extending their knee or other joint after surgery, very likely their joints are staying mobile enough for beginning recovery. They are as mobile as they are comfortable with moving.
Often better movement is dependent on better pain control. You may achieve better pain control in the short-term the most effectively with medications prescribed by your pet’s veterinarian. Supplements are usually helpful with long-term pain control. I have taken supplements for over 40 years and using the effective ones in my pet patients for over 25, if you count my own pets as patients! Unfortunately there is not a supplement at the time of this writing that will do the job that focused and thoughtfully applied pharmaceutical medications will do.
You don’t need to bug (and probably cause pain to) your pet by making them endure your “bicycling” of the hind leg. Other drills and exercises will bring about improved use and recovery of the joints, and you subsequently have less opportunity to hurt your pet (or you) if you are not trying to manipulate them. Start with this foundation if you want to do some work yourself.
Pain? Or “Just” Needs More ROM?
If your pet is able to move on their own yet is choosing to hold a limb in flexion, bent at the joint, and isn’t using the limb much, then the problem is most likely pain. Usually the issue is NOT that the pet needs to be forced to extend/unbend and flex/bend with painful drills we make them do by our own hand. Please see my posts on pain for more info.
Animals do not have the same hesitancy to use their damaged joints in the same way that humans are reluctant to do. This means that if a dog sees a cat it wants to chase, then most of those dogs will chase now and endure the consequences later!
Sidetrack to an Impulse Control Disaster –
I know of a case wherein a large dog received a hip replacement, and upon arriving home after surgery discharge, took off chasing a deer and fractured his femur. That is one reason I insist on controlled movement, a harness, and a tight leash, among other things after injury or surgery.
No, the surgeon did NOT fix the client’s mistake for free. Nor should you expect that. The dog (and the person) ruined the hip replacement. The dog had to have a FHO, another surgery. Nowadays that’s easily an average of $6000.00 or more down the drain and unnecessary pain to the dog because the client didn’t restrain the dog. At all.
Movement and Reasoning –
In fact, even though I could make an argument for animals demonstrating reasoning ability, I have seen plenty of “act now, consequences later” results! In humans we call this impulsive. Sometimes I also have impulse control issues. You probably do, too. More on that another day.
We humans are usually going to stop movement and per-determine how much pain we think the movement will cause. Our pets seem to do the same thing when they are in pain, but they don’t always restrict themselves with goodies right in front of them. Based on that conscious or subconscious evaluation of our own body, we are therefore inclined to not use the painful parts.
In those cases we need excessive coercion, like the ROM machine after knee surgery, or we just need the best basic exercise drills for our situation. My dad has shoulders that freeze up due to old injuries. He gets physical therapy once in a while and he can afterward move better. Slowly over time, he forgets to do his exercises. Then his shoulders freeze and are very painful. Then I remind him to start with the simple exercises. The pattern continues today because he forgets. He needs to continue the best drills for his situation. So does your pet, until there is remedy.
Conclusion on Forced Range of Motion –
Forced ROM is largely unnecessary for our pets unless the animal has nerve damage and cannot move their limbs; THEN you should do PROM. The only time I believe it is necessary to use range of motion exercises and drills is when the pet is not able to activate their own movement of the limb. Then you must incorporate several sessions of range of motion drills daily, especially so that the muscles don’t contract and the joints don’t freeze.
I need to edit my videos first, and then I might post about proper range of motion for a pet that cannot move its limb. There are already videos galore on the webbage that show a lot about ROM. I don’t need to duplicate those, and most of the time those vids are encouraging you to do ROM on pets that don’t need it. I’m not necessarily talking about the models for the videos not needing ROM; I can’t comment on all those vids and whether those pets need ROM. I’m talking about necessity of ROM or PROM regarding the content of this post.
(Published August 3, 2014. Updated some February 23, 2018. Might make shorter one day… 🙂 )