Really interesting canine physiotherapy case a little while ago that i've been meaning to blog about, so thought i'd finally share some of the details. Biomechanical analysis can give some really valuable insight into a dogs musculoskeletal health, but is probably one of the most overlooked tools available to canine physiotherapists. The dog in our video below was actually being used to help us develop software for our practice in conjunction with QuinticSports, as opposed to attending for physio. Both Roberta and I noticed that he was cranially loading, albeit he was relatively symmetrical, but he had so much muscle mass over the shoulders that we struggled to locate the spine of scapula when we were placing our joint markers. Interestingly, when I performed range of motion testing on both forelimbs, I couldnt find any differences between the two. Physiotherapy for dogs relies on a multitude of different skills, from palpation to range of motion and visual assesment to create a picture of everything that is going on (it would be so much easier if the dog or horse could just tell us, but wheres the fun in that?)
Here's a video of his analysis at walk - take a look at the angle of the elbow in relation to the shoulder..
As well as having limited shoulder flexion (the joint angle getting smaller) you can see that as he protracts the forelimb (brings it forward) he also needs to raise his head and trunk. A comparison of the left and right shoulder also tells us that the right forelimb movement (in red) is restricted in relation to the left. In an ideal world the red and blue lines would lay over each other)
This is just one element of the overall picture - when we looked at all the joints both fore and hind there were other indicators of compensatory gait patterning that the owner simply wasnt aware of - and even to our trained eyes his gait at both walk and trot looked relatively symmetrical
So, to get back to the point of this post. I could easily feel hypertonicity in the shoulders and forelimbs on palpation, but what I couldnt see with just a visual gait analysis was HOW this was impacting the dog. Manual range of motion testing told me that all of the joints of the forelimbs were capable of moving through the same approximate range of motion, however during gait they do not, and because it is impossible to view the left and right sides of the dog at the same time, there is no real way to compare. This also now gives me a baseline to work to - i'm sure I am not the only therapist who worries about confirmation bias, so I can measure in real terms improvements in gait pattern over the coming months.One last real advantage of conducting a quantative gait analysis for any physio patient, whether horse or dog (not brave enough to try feline yet) is that it gives both owners and veterinarians confidence in our clinical reasoning and a better understanding of the job in hand. Whats even more powerful is when you conduct a follow up analysis 6 or 8 weeks later and can show in no uncertain terms an improvement in the underlying condition. To learn more, or to see how biomechanical analysis can assist your practice, contact us at vetruvianpb.com