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Pawsitive Strides
Physical Rehabilitation & Conditioning for Dogs

Hydrotherapy

The principle effects of water include buoyancy, resistance (viscosity), hydrostatic pressure and surface tension. Understanding these basic principles helps us utilize them to their fullest potential on individual cases.

Bouyancy and resistance are the most commonly known principles of water. Bouyancy is the upward thrust placed on a body when submerged. The reduced weight bearing load placed on the op allows many post operative patients to exercise more safely and with less pain. In the underwater treadmill the reduction of weight bearing is 62% when the water level is near/at the level of the greater trochanter (hip). When it is at elbow height the weight load is reduced by about 15% and when it is at the hock it is reduced by 9% (depending on breed and body condition score). For instance, a dog weighing 100lb with the water to the greater trochanter is carrying only 38lb, at the elbow 85 lb and at the hock 91lb.

Hydrotherapy Benefits:

  • Increases Strength
  • Increases Stamina
  • Improves Comfort
  • Improves Joint Range of Motion
  • Improves Flexibility
  • Improves Balance
  • Improves Neurologic Function
  • Improves Confidence in Geriatric Dogs

Resistance increases the demand placed on the muscles as they propel the limbs through the water which makes it effective for building strength and increasing range of motion. Additionally, the viscosity of the water is thought to increase sensation awareness of the skin (tactile sensation) and proprioception (limb awareness). Balance is improved when the height of the water is sufficient enough to act as a stabilizing force. Weak or ataxic patients are allowed more time for correction of balance since movements are slowed by the resistance/viscosity of the water.

Surface tension is created when water molecules adhere more closely to one another at the surface of the water. This is important for underwater treadmill work because of the ability to increase or decrease demand placed on a specific part of the body by raising or lowering the water level to a certain height.

Hydrostatic pressure is the pressure exerted on all surfaces of the body when submerged in fluid. It is proportional to depth and fluid density. The deeper the body is submerged the more pressure is exerted on it. This is commonly used in horses to help alleviate inflammation and swelling in the lower limbs.

Therapeutic effects of water can be altered by increasing or decreasing the temperature. Warm water can alleviate joint and muscle stiffness by increasing circulation and flexibility of soft tissues while cold water is used to decrease pain by reducing or limiting inflammation and slowing nerve conduction.

Forms of hydrotherapy in small animal physical rehabilitation most commonly include swimming and underwater treadmill work. While the benefits of swimming and underwater treadmill work seem similar they do have their differences. Little (if any) scientific research has been done to determine when one is more beneficial than the other and both use all of the principles of water to help alleviate pain, strengthen muscles, improve range of motion and increase stamina.

Swimming Basics

Swimming alleviates any and all weight bearing forces exerted through the limbs. When patients are properly assisted swimming can be very therapeutic for dogs that are in the earliest stages of post operative orthopedic or neurologic physical rehabilitation. It can also be used for general fitness conditioning in dogs that suffer from chronic, severe osteoarthritis.

While swimming is certainly therapeutic for many cases it does come with some challenges and idiosyncrasies. Lack of consistent control over patient ability and confidence in water, speed, intensity and appropriate limb use should be considered when selecting swim therapy as a physical rehabilitation modality. The swim “stride” has a “foot-fall” sequence that is opposite that of a walk stride and may be contraindicated if the patient is neurologically affected or is working on correcting foot-fall sequencing while ambulating on land. When dogs swim they first use a front foot (right front), then the ipsilateral (right)rear, then the diagonal (left) front followed lastly by the other (left) rear limb. At a walk, they strike off with a rear limb first, followed by the ipsilateral front limb, then the diagonal rear limb and finally the other front limb.

Dogs that are confident swimmers will be relaxed, the head will be carried just above the surface of the water, the back at the top or just below the water. Generally speaking they will use their front end more than the rear to propel themselves but this does vary from one dog to the next. Dogs that are frantic swimmers are not good candidates for swimming due to increased muscle tension and frantic swim stride. The shoulders and elbows will be more extended causing quite a lot of splashing. The head will be elevated out of the water, nose point toward the sky and the rear limbs forced downward into extension – sometimes hyper-extension - as they search for bottom.

Underwater Treadmill Basics

Underwater treadmill work, like swimming, can be used for general conditioning, rehabilitating dogs recovering from injury or surgery, dogs with mild to severe osteoarthritis and dogs that have neurologic deficits. Unlike swimming, UWTM work does not eliminate weight bearing and works with the dogs’ own gait patterns at a walk and trot. Because speed and water depth can be controlled (resistance and buoyancy) UWTM work allows for a wide range of variables with which to manipulate stride length, intensity and speed of stride, range of motion, weight bearing, balance and proprioception. Physical manipulation of limbs and assisted foot placement is easily done in the UWTM.

While not all dogs are “natural” swimmers I have met only one during the past 18 months that I did not feel was a good candidate for underwater treadmill therapy. The underwater treadmill seems to level the playing field for many of my patients and I have not witnessed a large discrepancy in ease of use when it comes to being a water dog versus a lap dog. The simple fact of the matter is that being locked in a box with water filling around you and then having your feet moved out from underneath you is, in fact, a scary thing the first few times and even experienced water dogs show concern. Typically by the third visit (unless unable to support their own body weight due to neurologic condition) most dogs do well without having {moral} support inside the tank.

Hydrotherapy is not the “be all end all” in physical rehabilitation, but over the years has become an increasingly popular and successful modality. When coupled with standard medical or holistic protocols, swimming and underwater treadmill work can help many dogs with acute or chronic pain return to a more comfortable and functional lifestyle.