Physiotherapy

Why veterinary physiotherapy matters

From cruciate surgery to arthritis and horses' backs: what physiotherapy does for animals, and the research and veterinary guidelines that back it.

By The Animal Physio Co 6 min read

A horse and a spaniel beside the words "Why vet physio matters"

Physiotherapy helps animals recover from injury and surgery, stay comfortable with long-term conditions such as arthritis, and keep doing the things they love. It's now part of mainstream veterinary care, recommended in veterinary guidelines and supported by a growing body of research. Here's what that research shows.

Key points

  • Veterinary pain-management guidelines recommend rehabilitation as part of care for animals in pain, and arthritis guidelines recommend it at every stage of the disease.1,2,20
  • After cruciate ligament surgery, dogs given a rehab programme rebuilt muscle and used the operated leg better. In one study, the operated leg was working as well as the healthy one by six months.3,4,5
  • In overweight dogs with arthritis, an intensive physio programme improved both gait and weight loss more than home exercises alone.6
  • In horses, targeted exercises built up the deep muscles that support the back.7

What veterinary physiotherapy does

Physiotherapy aims to get animals moving well and comfortably again. That can mean:

  • Easing pain and stiffness
  • Rebuilding muscle lost after surgery, injury or time on restricted exercise
  • Restoring range of motion in stiff or arthritic joints
  • Improving balance and coordination, especially after neurological injury
  • Keeping older animals active and independent for longer
  • Conditioning sporting and working animals, and helping them return to work after injury

A visit starts with a thorough assessment of how your animal moves. Treatment is then built around goals you agree, and usually combines therapeutic exercise, hands-on manual therapy, modalities such as laser where they'll help, and a home programme so progress continues between visits.

In South Africa, veterinary physiotherapy has been a regulated para-veterinary profession since February 2023. Physiotherapists must be registered with the South African Veterinary Council (SAVC), and they work on referral from your vet or in consultation with them, so your animal's care is joined up.8,9

Recommended by veterinary guidelines

The 2022 pain-management guidelines from the American Animal Hospital Association (AAHA) state that "rehabilitation therapy should be considered part of a comprehensive wellness plan for patients who are affected by acute or chronic pain".1 For dogs with long-term pain, the guidelines place exercise and weight management among the first-line treatments, with therapeutic exercise and rehabilitation in the next tier, and note that anti-inflammatories and therapeutic exercise can be started together.1

Guidelines for treating arthritis in dogs go further. The international COAST guidelines recommend rehabilitation and physical therapy at every stage of arthritis, a recommendation the expert panel backed unanimously.20 Canadian consensus guidelines also list physical rehabilitation as a core recommendation at every stage, from early arthritis to advanced disease, with a formal rehab programme recommended in the later stages.2

After cruciate ligament surgery

Cruciate ligament rupture is one of the most common causes of hind-leg lameness in dogs, and it's where rehab has been studied most.

  • In a study of 51 dogs after cruciate repair, dogs given a rehab programme put more force through the operated leg at six months, and their operated leg was working as well as the healthy one. Dogs on restricted exercise alone hadn't caught up.3
  • After TPLO surgery, dogs given physiotherapy had regained their thigh muscle by six weeks and had better knee movement at three and six weeks than dogs on a walking-only plan.4
  • In a randomised trial of 48 dogs after TPLO, dogs that had rehab put more weight through the leg and were more active.5
  • A 2022 systematic review of 19 studies supported therapeutic exercise after cruciate surgery.10

Arthritis

  • In a randomised trial of 29 overweight dogs with arthritis, all on a weight-loss diet, the dogs given an intensive physio programme lost more weight and walked most evenly at six months.6
  • In a placebo-controlled trial of 20 dogs with elbow arthritis, 9 of the 11 dogs given laser therapy were able to reduce their anti-inflammatory dose, compared with none of the dogs given a sham treatment.11
  • In 20 working dogs with hip arthritis, laser therapy gave better pain and function scores over the first month than an anti-inflammatory drug.12

After spinal (disc) surgery

Intervertebral disc disease (IVDD) can cause sudden weakness or paralysis, particularly in dachshunds and other short-legged breeds. Rehab helps dogs make the most of their recovery:

  • A randomised trial showed that starting rehab within days of disc surgery is safe.13
  • In one centre's study of 367 dogs given intensive neurorehabilitation after surgery, 99% of the dogs that still had pain sensation walked again, as did 59% of dogs that had lost it. Both groups did better than the centre's earlier patients.14
  • In 81 paralysed dogs that had lost deep pain sensation, 59% developed "spinal walking" with intensive rehab: a reflex walking pattern that let them get around independently. Younger and lighter dogs were more likely to achieve it.15

Every case is different. Your vet and physiotherapist will talk you through realistic goals for your dog.

Horses

  • Three months of dynamic mobilisation exercises (baited stretches, where the horse follows a treat into flexion and bending) increased the size of the multifidus, a deep muscle that stabilises the spine, at every level measured from the mid-back to the loins, and made the two sides more even.7
  • A second study found the same muscle growth, and that adding gymnastic exercises lengthened the horses' stride at walk.16
  • Trotting over poles more than doubled how high horses lifted their front hooves, by bending every joint of the leg more,17 which is why polework is a staple of equine rehab and conditioning.
  • In 61 competition horses with back pain, laser therapy, alone or combined with chiropractic care, reduced pain and stiffness.18

Cats

Cats benefit too. In a study of 36 cats with severe spinal cord injury, those given physical rehabilitation were more likely to walk again.19 With cats we keep sessions short and gentle, use play and food to motivate, and adapt the home so they can keep reaching their favourite spots.

How we use the evidence

We build every programme around the treatments with the strongest support, with therapeutic exercise at the centre. We measure progress at each visit, work closely with your vet, and adjust the plan as your animal improves.

When to consider physiotherapy

  • After orthopaedic or spinal surgery, once your vet is happy for rehab to start
  • If your animal has arthritis, is stiff, or is slowing down
  • For lameness your vet has diagnosed
  • For neurological conditions such as IVDD
  • For sporting and working dogs and horses, to condition and help prevent injury
  • Alongside a weight-loss plan
  • To keep older animals moving comfortably

If any of these sound familiar, book an assessment. We're mobile, so we come to you across the Overberg, Somerset West and Stellenbosch.

References

  1. 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.
  2. 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.
  3. Marsolais GS, Dvorak G, Conzemius MG. Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs. Journal of the American Veterinary Medical Association. 2002;220(9):1325–1330.
  4. Monk ML, Preston CA, McGowan CM. Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament. American Journal of Veterinary Research. 2006;67(3):529–536.
  5. Baltzer WI, Smith-Ostrin S, Warnock JJ, et al. Evaluation of the clinical effects of diet and physical rehabilitation in dogs following tibial plateau leveling osteotomy. Journal of the American Veterinary Medical Association. 2018;252(6):686–700.
  6. 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.
  7. Stubbs NC, Kaiser LJ, Hauptman J, Clayton HM. Dynamic mobilisation exercises increase cross sectional area of musculus multifidus. Equine Veterinary Journal. 2011;43(5):522–529.
  8. South African Veterinary Council. Rules relating to the practising of the para-veterinary profession of veterinary physiotherapist. Government Gazette No. 48104, 24 February 2023.
  9. South African Veterinary Council. Veterinary physiotherapist.
  10. Alvarez LX, Repac JA, Kirkby Shaw K, Compton N. Systematic review of postoperative rehabilitation interventions after cranial cruciate ligament surgery in dogs. Veterinary Surgery. 2022;51(2):233–243.
  11. Looney AL, Huntingford JL, Blaeser LL, et al. A randomized blind placebo-controlled trial investigating the effects of photobiomodulation therapy (PBMT) on canine elbow osteoarthritis. Canadian Veterinary Journal. 2018;59(9):959–966.
  12. Alves JC, Santos A, Jorge P, et al. A randomized double-blinded controlled trial on the effects of photobiomodulation therapy in dogs with osteoarthritis. American Journal of Veterinary Research. 2022;83(8).
  13. Zidan N, Sims C, Fenn J, et al. A randomized, blinded, prospective clinical trial of postoperative rehabilitation in dogs after surgical decompression of acute thoracolumbar intervertebral disc herniation. Journal of Veterinary Internal Medicine. 2018;32(3):1133–1144.
  14. Martins Â, Gouveia D, Cardoso A, et al. A controlled clinical study of intensive neurorehabilitation in post-surgical dogs with severe acute intervertebral disc extrusion. Animals. 2021;11(11):3034.
  15. Gallucci A, Dragone L, Menchetti M, et al. Acquisition of involuntary spinal locomotion (spinal walking) in dogs with irreversible thoracolumbar spinal cord lesion: 81 dogs. Journal of Veterinary Internal Medicine. 2017;31(2):492–497.
  16. de Oliveira K, Soutello RVG, da Fonseca R, et al. Gymnastic training and dynamic mobilization exercises improve stride quality and increase epaxial muscle size in therapy horses. Journal of Equine Veterinary Science. 2015;35(11–12):888–893.
  17. Brown S, Stubbs NC, Kaiser LJ, et al. Swing phase kinematics of horses trotting over poles. Equine Veterinary Journal. 2015;47(1):107–112.
  18. Haussler KK, Manchon PT, Donnell JR, et al. Effects of low-level laser therapy and chiropractic care on back pain in Quarter Horses. Journal of Equine Veterinary Science. 2020;86:102891.
  19. Gallucci A, Dragone L, Al Kafaji T, et al. Outcome in cats with acute onset of severe thoracolumbar spinal cord injury following physical rehabilitation. Veterinary Sciences. 2021;8(2):22.
  20. 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.