Dogs

Hip dysplasia in dogs: how physiotherapy helps

One of the most common joint problems in dogs, and one where owners can make a real difference. The signs, what the research says about weight and exercise, and how physio helps.

By The Animal Physio Co 5 min read

A brindle dog beside the words "Hip dysplasia in dogs"

Hip dysplasia is one of the most common orthopaedic conditions in dogs, particularly in larger breeds. The diagnosis can sound daunting, but it's also a condition where owners can make a real difference. The research shows that weight and exercise matter a great deal, and veterinary guidelines recommend rehabilitation as part of managing it.

Key points

  • Hip dysplasia is common: in South Africa, 31% of screened Labradors and 22% of screened Rottweilers were graded dysplastic.1
  • Keeping your dog lean is one of the most powerful things you can do. In a lifelong study, lean Labradors developed hip arthritis about six years later than their littermates.2
  • Regular, low-impact exercise helps: dogs with hip dysplasia that exercised more each day had milder lameness.3
  • Veterinary guidelines recommend weight management, regular exercise and rehabilitation, with a formal rehab programme highly recommended as arthritis progresses.4,5

What hip dysplasia is

Hip dysplasia is a looseness of the hip joint that develops as a puppy grows. Over time the ball and socket don't fit together smoothly, which wears the cartilage and leads to arthritis.6 Genes are the biggest single risk factor, but nutrition, body weight and exercise all influence how badly a dog is affected.6,7 That's the encouraging part: the things you control at home really count.

It's common. Among dogs screened by the official South African scheme between 2007 and 2015, 31% of Labradors and 22% of Rottweilers were graded dysplastic.1

Signs to watch for

  • Limping, often worse after exercise, or stiffness after rest
  • Reluctance to get up or to jump
  • Shifting weight onto the front legs
  • Loss of muscle over the hindquarters
  • A "bunny-hopping" gait, with both back legs moving together
  • Pain around the hips6,8

In young dogs, the first sign is often lameness that gets worse with activity. In older dogs, it's more often a change in how they walk and a loss of muscle in the back legs.9 Some dogs with hip dysplasia show no obvious signs at all, and the signs don't always match what the X-rays show,6,8 so a thorough assessment of how your dog moves is the best guide.

Weight: the biggest thing you can change

The American College of Veterinary Surgeons advises that "all dogs with CHD should be kept very slim".6 The research shows why:

  • In a lifelong study of Labrador littermates, dogs fed 25% less than their siblings from puppyhood developed hip arthritis on X-rays at a median age of 12 years, compared with 6 years for their freely fed littermates.2 They also lived significantly longer.10
  • In overweight dogs with hip arthritis, losing 11–18% of body weight significantly reduced lameness.11

Canadian consensus guidelines on arthritis describe weight management as the "one common denominator in all OA stages".4

Exercise: the right kind helps

It's tempting to rest a dog with sore hips, but the guidelines are clear: "Dogs with OA require regular exercise," and severe activity restriction or rest "is generally not recommended". A lack of exercise leads to muscle loss, "further reducing joint stability and contributing to pain".4

  • In a study of 60 Labradors with hip dysplasia, dogs that exercised for longer each day had milder lameness.3
  • The 2022 AAHA pain-management guidelines state that exercise "should be encouraged as it may be protective for hip dysplasia".5

For puppies, how they're raised matters too. In a Norwegian study of 501 puppies from large breeds, those that had off-lead exercise in their first three months had a lower risk of hip dysplasia, and those that used stairs had a higher risk. The researchers recommend outdoor exercise on soft ground in moderately rough terrain for young puppies, and avoiding stairs.12 Off-lead exercise at a year old was also linked to fewer hip problems later in life.13

How physiotherapy helps

Physiotherapy for hip dysplasia aims to reduce pain, improve how freely the hips move, and build and maintain the muscle that supports them.14 It's a recognised part of managing the condition without surgery, alongside weight control, pain relief and the right exercise,15 and it's recommended after hip replacement surgery too.16

The research is encouraging:

  • In 24 dogs with hip dysplasia, adding a daily exercise programme (sit-to-stands, incline walking and similar exercises) to a joint injection kept the improvement in how much weight the dogs put through their legs going for the full six months, while dogs given the injection alone had lost it by then.17
  • A five-week therapeutic exercise programme of cavaletti poles, balance work and sit-to-stands improved hip range of motion and increased thigh muscle in dogs with arthritis.18
  • In a double-blind trial of 20 dogs with hip arthritis, laser therapy gave better pain and function scores than a three-week course of an anti-inflammatory drug, and improved hip range of motion.19
  • In overweight dogs with arthritis, an intensive physiotherapy programme alongside a diet improved weight loss and gait more than home exercises.20
  • Hip dysplasia changes how several joints in the back leg move, and each exercise has its own effect, so programmes work best when they're tailored to the individual dog.21

The guidelines agree. The international COAST guidelines recommend rehabilitation and physical therapy at every stage of arthritis,22 the Canadian consensus says a formal rehabilitation programme designed by a rehabilitation practitioner is "highly recommended" for dogs with moderate to severe arthritis,4 and the AAHA panel recommends rehabilitation as part of a comprehensive plan for dogs in chronic pain.5

What a physio programme includes

  • An assessment of your dog's gait, muscle and hip movement
  • Therapeutic exercises chosen for your dog, such as sit-to-stands, controlled incline walking, cavaletti poles and balance work
  • Hands-on manual therapy to ease muscle tension and keep joints moving
  • Laser therapy where it's likely to help
  • A home programme that fits your routine, progressed at each visit
  • Simple home changes, like rugs on slippery floors and ramps instead of steps

We work alongside your vet, who can advise on pain relief and on supplements with good evidence behind them, such as omega-3.

If your dog has hip dysplasia, or is stiff, slow to get up or losing muscle in the back legs, book an assessment. We come to you across the Overberg, Somerset West and Stellenbosch.

References

  1. Kirberger RM. Phenotypic hip and elbow dysplasia trends in Rottweilers and Labrador retrievers in South Africa (2007–2015): are we making progress? Journal of the South African Veterinary Association. 2017;88:e1–e10.
  2. Smith GK, Paster ER, Powers MY, et al. Lifelong diet restriction and radiographic evidence of osteoarthritis of the hip joint in dogs. Journal of the American Veterinary Medical Association. 2006;229(5):690–693.
  3. Greene LM, Marcellin-Little DJ, Lascelles BD. Associations among exercise duration, lameness severity, and hip joint range of motion in Labrador Retrievers with hip dysplasia. Journal of the American Veterinary Medical Association. 2013;242(11):1528–1533.
  4. Mosley C, Edwards T, Romano L, et al. Proposed Canadian consensus guidelines on osteoarthritis treatment based on OA-COAST stages 1–4. Frontiers in Veterinary Science. 2022;9:830098.
  5. Gruen ME, Lascelles BDX, Colleran E, et al. 2022 AAHA pain management guidelines for dogs and cats. Journal of the American Animal Hospital Association. 2022;58(2):55–76.
  6. American College of Veterinary Surgeons. Canine hip dysplasia.
  7. King MD. Etiopathogenesis of canine hip dysplasia, prevalence, and genetics. Veterinary Clinics of North America: Small Animal Practice. 2017;47(4):753–767.
  8. Merck Veterinary Manual. Hip dysplasia in dogs.
  9. Schachner ER, Lopez MJ. Diagnosis, prevention, and management of canine hip dysplasia: a review. Veterinary Medicine: Research and Reports. 2015;6:181–192.
  10. Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-related changes in dogs. Journal of the American Veterinary Medical Association. 2002;220(9):1315–1320.
  11. Impellizeri JA, Tetrick MA, Muir P. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis. Journal of the American Veterinary Medical Association. 2000;216(7):1089–1091.
  12. Krontveit RI, Nødtvedt A, Sævik BK, et al. Housing- and exercise-related risk factors associated with the development of hip dysplasia as determined by radiographic evaluation in a prospective cohort of Newfoundlands, Labrador Retrievers, Leonbergers, and Irish Wolfhounds in Norway. American Journal of Veterinary Research. 2012;73(6):838–846.
  13. Krontveit RI, Trangerud C, Sævik BK, et al. Risk factors for hip-related clinical signs in a prospective cohort study of four large dog breeds in Norway. Preventive Veterinary Medicine. 2012;103(2–3):219–227.
  14. Dycus DL, Levine D, Marcellin-Little DJ. Physical rehabilitation for the management of canine hip dysplasia. Veterinary Clinics of North America: Small Animal Practice. 2017;47(4):823–850.
  15. Harper TAM. Conservative management of hip dysplasia. Veterinary Clinics of North America: Small Animal Practice. 2017;47(4):807–821.
  16. Marcellin-Little DJ, Doyle ND, Pyke JF. Physical rehabilitation after total joint arthroplasty in companion animals. Veterinary Clinics of North America: Small Animal Practice. 2015;45(1):145–165.
  17. Cuervo B, Rubio M, Chicharro D, et al. Objective comparison between platelet rich plasma alone and in combination with physical therapy in dogs with osteoarthritis caused by hip dysplasia. Animals. 2020;10(2):175.
  18. Török M, Dvoranová M, Lipták T, et al. Structured therapeutic exercise program effect on PROM and muscle mass in dogs with osteoarthritis: a prospective clinical study. Frontiers in Veterinary Science. 2026;13:1836746.
  19. Alves JC, Santos A, Jorge P, Carreira LM. A randomized double-blinded controlled trial on the effects of photobiomodulation therapy in dogs with osteoarthritis. American Journal of Veterinary Research. 2022;83(8).
  20. Mlacnik E, Bockstahler BA, Müller M, et al. Effects of caloric restriction and a moderate or intense physiotherapy program for treatment of lameness in overweight dogs with osteoarthritis. Journal of the American Veterinary Medical Association. 2006;229(11):1756–1760.
  21. Bockstahler BA, Prickler B, Lewy E, et al. Hind limb kinematics during therapeutic exercises in dogs with osteoarthritis of the hip joints. American Journal of Veterinary Research. 2012;73(9):1371–1376.
  22. Cachon T, Frykman O, Innes JF, et al. COAST Development Group's international consensus guidelines for the treatment of canine osteoarthritis. Frontiers in Veterinary Science. 2023;10:1137888.

This article is general information, not veterinary advice. Speak to your vet before starting any supplement or treatment, and ask a qualified animal physiotherapist to assess your animal individually.