Jump to content
BC Boards

An ACL tear and TPLO journal


Sue R
 Share

Recommended Posts

I started Foster on laser the week after surgery. It really helped limit the atrophy. Of course had sutures and not staples so we really had to keep her more quiet. That much bruising is actually quite normal. You will be amazed at how well Celt will probably get around by this weekend.

Link to comment
Share on other sites

  • Replies 329
  • Created
  • Last Reply

Top Posters In This Topic

June 21 2012 - 2nd day post-op

 

Made it through a quiet night. On Orthodogs, I seem to read about dogs that cry and fuss, fight their handling, and are just miserable, and everyone knows it. I am very grateful for Celt's stoic nature and his being a quiet dog.

 

If I had only gone to bed on time last night, when I could have and should have but didn't, I might not have been so groggy this morning that I forgot to shift his sling when he lifted his sore leg (!) to pee. That explains the load of laundry already in progress. Fortunately, a towel could be used in its place for support if needed.

 

My routine for his PT is to take him potty and then do the PT exercises as soon a we come in, with him standing if possible, because I feel like I get them done with a better perspective when he's in a standing position. So we did the PT and he was pretty relaxed about the up-and-down motions but seemed resistant (or stiff) about the bicycle, so I made those a little smaller in size and did just a few extra, very gently.

 

I'm liking chilling the area with the soaking-wet washcloth in the plastic bag. I find it makes it easy to wrap the compress around the joint and get some nice chilling on the inside, front, and outside of the stifle joint. Plus I don't think it's as bothersome as a real ice pack. It leaves the area nice and cool, and I don't mind using it a bit longer since it's not as cold as ice.

 

The incision looks great - no seepage (hooray, because the vet office says seepage is not a good sign and may mean infection).

 

My main concern is that he is three-legged but it's also time for his meds and he could be a bit more sore. He is being a trooper, and is quite hoping that the cat will come and hang around the crate so he has something to stare at - "Border Collie TV".

 

(PS - I know allowing staring and obsession is not good management on my part. This started well before I had a clue what I was doing with a dog like this. And for right now, at least it allows his mind to be on something other than his discomfort.)

Link to comment
Share on other sites

You do ROM exercises with TPLO as well. The one to be the most careful with is stretching the foot joint (the one connected to the leg - can't remember the name right now). This is very important because lack of use will cause it to lose some mobility in that joint. The stretch for it needs to be done correctly or you can cause damage to the surgical knee. You have to hold it a certain way which I can't explain in writing. My brain is tired :)

I remembered your mentioning this and went back to find it. I don't recall anyone at the vet office pointing out anything in particular with the foot. I wonder if that is part of the bicycle movement?

 

They might get tired of me calling but perhaps I'll give a call there. Or call the therapist and get her input. I wish I'd thought to ask about this yesterday but everything was a blur.

Link to comment
Share on other sites

It is way too early in Celt's rehab to do this, but for the future, you may want to take the opportunity to mentally challenge Celt to do his own rehab. What does that mean?

 

When Torque had his shoulder surgery, we eventually progressed to lifting one foot at a time so he would use his other 3 leg muscles to balance - which provides a little more work for the tripod legs. He did very well when I lifted each leg up. At the beginning, I would have to help him balance, but he quickly caught on such that I hardly had to help stabilize him. My rehab vet told me that she had a client that taught her dog to pick up each foot, and hold it up for a few seconds, on command. Well, I never taught those commands to my dog because we were almost done with rehab at the time, but I thought that it was a cool idea and appreciated that mental challenges (i.e. training)such as this were good for keeping the dog quiet and focused.

 

Your rehab exercises may not involve having Celt balance on 3 legs, but I am sure that there may be an exercise or two that could be put to command. You could do a little training once he is ready for it, and it may help give his brain a bit of work to combat the boredom he will eventually experience.

 

Good Luck,

Jovi

Link to comment
Share on other sites

Gentling exercises!

 

Something I really want to emphasize, and I don't think I can overstate it, is that it is essential that a pup (or young dog, or whatever dog you have) experiences "gentling exercises".

 

The friend whose GSD has TPLO last summer has long been the instructor for the puppy classes at our local kennel club (I know, "kennel club" is a bad word around here but this group provides a wonderful service to the community by providing classes for puppies and family dogs, among other things). She was our instructor for Celt, Bute, and Dan as pups, and for Celt, Megan, Lisa's Nellie, and Bute as young dogs.

 

With each weekly class, she spent part of the time on "gentling exercises" or training activities that prepare a pup (or dog) for the eventuality of medication administration, veterinary exams, and so on. Over the six week course, the pup would become acclimated to having ears examined; mouth and teeth examined; all parts of the body handled and manipulated; liquid and solid medication (water in a syringe, and Tic-Tacs) given by mouth (without Pill Pockets or similar cover-ups).

 

When she emailed me last night, she asked if I was glad of the gentling exercises that Celt had received as a pup (and which have continued, in one form or another, over the years) and I said a resounding, "Yes!" They have stood us in very good stead over the years with all the dogs, whether there was a need to examine a cut paw and wrap it; a visit to the vet with an exam; giving of medication; or anything involving handling any part of the body.

 

The moral of the story is it is (like crate training) it is not *when you need it* that you train your dog to be handled, examined, poked and prodded, medicated, or confined - it is *before you need it" that you acclimate the dog to procedures and activities that he/she might have to experience at some time in his/her life - and which time will most likely be one that is stressful to begin with, and you don't want to add a layer of stress or resistance to an already stressful situation.

 

Off my soapbox now...and, thanks, Cindy!

Link to comment
Share on other sites

Sue - let me see if I can explain the stretch I was referring to...

 

I would have one hand at/above the knee area to hold it steady and would use the other hand to push that joint (hock) upwards. I believe it stretches the achilles tendon which can tighten up horribly if not stretched. Does that make more sense? I am not sure all rehab specialists have folks do this one because if you do it wrong you can cause problems. Our rehab specialist and ortho vet strongly suggested I do it and after showing me how to do it, figured I would do it correctly. Like I said, it is kind of hard for me to explain.

Link to comment
Share on other sites

Kim - I'm having some issues visualizing it. I don't tend to put my hand on the stifle. To do the ROM, I hold the tibia (beteen stifle and hock) and use that to move the leg about. I tried earlier just to take hold of the tibia with one hand, and use the other just to move the toes about (up, down) a bit. He resisted that a lot, and I'm wondering if they aren't already a bit stiff or if he was just being apprehensive.

 

I'm going to take him out shortly to pee and do his exercises, and I'll see how it all feels. Maybe this is a good thing to ask the therapist about if I can give her a call later.

 

Thanks for trying to describe it!

Link to comment
Share on other sites

Something that Cindy (my trainer friend, who is familiar with all our dogs, having had them in one class or another) mentioned that was a bit of a concern for me is the dynamics of our pack.

 

I've mentioned before that while Celt is, at least nominally, the pack leader (among the dogs alone), he is a weak leader. He's not confident or secure in his position. He used to be very confident, when it was him, Megan, and Bute (who always was totally submissive to Celt and deferred to him readily). He didn't need to be a strong leader because of the nature of the other dogs. Megan is inoffensive with regards to Celt (and a princess doesn't concern herself with such matters).

 

But when Dan came along, we were dealing with a whole different sort of youngster. Dan did not have Mac, a very self-assured and strong leader, to learn from (when Bute was a pup, we still had Mac as leader, which position Celt slid into when Mac passed on). Dan came along when Celt was leader but a weak leader.

 

When Dan was around 7 or 8 months old or so, he began pushing Celt - stares, posture, trying to get a reaction. Typical teenage obnoxiousness. They got into fisticuffs occasionally, which we broke up (I probably should have let Celt whip Dan's butt back then when he was able to do so). Fortunately, with management and training, Dan has backed off pushing things for the last couple of years.

 

Sure, every now and then, he does a little something that almost seems more like he is just trying to get a rise out of Celt than really to be being aggressive or make a play for position. Usually it's just a simple matter of being in his crate and knowing that Celt is being insecure and growling, and Dan will growl back as if to say, "You're being rude, I'm not doing anything wrong, but you will get a fight if you invade my crate." But 99.99% of the time, Celt can go past Dan's crate and there is no reaction - it is when Celt is already being rude that Dan responds - but with "words" only, not action.

 

But it is very typical of any herd or pack that when the leader becomes incapacitated and not able to defend his/her position, that the next in line is ready to take over - with or without aggression. Cindy pointed out to me, knowing both these dogs, their personalities, and a bit of their history, that this is a time that I need to be extremely on my guard because this is the time that Dan might may a move to replace Celt - and that could be disastrous both physically and mentally for Celt in his current condition.

 

Her advice is to keep them separated which, largely, we have (since Celt is confined). But more than just physically separated, visual separation is advisable. So I had realized that Dan's coming into the living room and stropping himself on the carpet rather in front of Celt's pen, and enjoyed a bone rather in front of Celt's pen, might not look like much but was sending a very stressful message to Celt.

 

And I realized that the heavy panting that Celt was doing might not have been heat (none of the other dogs were panting), or pain (he's on plenty of meds), but more likely stress due to Dan's proximity and Dan's casual-looking but probably very meaningful actions.

 

This is another good reason, I think, to avoid the use of the e-collar or Bite-Not as much as possible. I've only had it on for a while today after I observed Celt give a gentle like to the incision after I chilled it after PT. That's only the second time I've seen him touch it but Ed and I had to go out for a while and I did not want him to fuss at it when we were gone. I need to remove it now, while I can keep an eye on him.

 

So, one more layer of management for me to be aware of and implement. This is as bad as having teenage children at home...

Link to comment
Share on other sites

I finally got the xrays in a format that I could work with. Here are the two from just prior to the surgery -

 

This is the lateral view -

 

3-Celtlateralpre-surgery20120619.jpg

 

And here is the anterior view (notice that the gap between the femur and the tibia is not the same on either side of the joint, which can be an indication of an ACL tear) -

 

4-Celtanteriorpre-surgery20120619.jpg

Link to comment
Share on other sites

And here are the post-surgery views.

 

Lateral -

 

5-Celtlateralpost-surgery20120619.jpg

 

And anterior (notice the even appearance of the gap on both sides of the joint; thankfully, the meniscus was not damaged) -

 

6-Celtanteriorpost-surgery20120619.jpg

 

The staples are seen as a little railroad track (they call it his zipper). The single staple down lower on the tibia is where there was a small hole - a rod is inserted along the bone to provide support during the surgery, and that little hole is where the end of the rod comes out at the bottom (they may remove the rod through that hole after the surgery is done up above).

Link to comment
Share on other sites

I couldn't be much happier at this stage of the process - I just took Celt out and he had a nice, long pee (and I remembered to move the sling before he went so I didn't get it all soaked with urine like I did this morning). Then I let him graze a little while (all my dogs are avid grazers, and I think Celt missed his grazing as much as anything when he was gone). And then he wanted to head to the further end of the yard, like a dog on a mission - and so he was, because he pooped!

 

Now, I am often called the Queen of Poop around my family as, at times, that is what my life seems to revolve around. But I thought this was great. He went the night following his surgery, and they warned me that it could be up to four or five days before he was able to go again, as the meds (among other things) tended to slow the digestive system down. I think it's just that my dog is an over-achiever, like many Border Collies!

 

The other nice thing I saw was that he was occasionally putting his "bad" leg down, just tippy-toed, to balance when he stood and sniffed. He has been quite three-legged since he came home. Additionally, instead of hopping along only using the one hind leg, he sporadically would hobble along, using that leg for a few steps, and then back to three-legged again. Another improvement, in my eyes.

 

I think we've also mastered the two steps we must traverse to get in and out. Stairs are a no-no but the location of these stairs precludes putting in some sort of ramp. I was advised that they should not be a problem but he has (thankfully) been reluctant to do them. So I have been either lifting and placing him beyond them (which I don't like because he tends to struggle just a little bit and erratic movements like that are not good for the leg, plus that could result in a fall on landing) or (more recently) I've been getting him in position and then encouraging him to step up or down with his front end while I lift the hind end completely off the floor with the sling, and then gently place it back on the floor after the steps. That, too, has been a bit problematic but this last trip, he trusted me and it went well in both directions, nice and smoothly.

 

Our PT session was done. I've reduced the size of the bicycle movements because Cindy told me that they were more painful and harder, and it might be best to ease into them a bit more gradually. And, for the first time, I felt Celt actually relax into the cold compress and seem to enjoy it, rather than stiffening up and resisting my placing and holding it.

 

So, I know that oftentimes feeling very good about something can be followed by a set-back, or something perceived as a set-back, but I am feeling quite pleased right now. So is Celt, who enjoyed a tiny treat before and after his PT (and I am sure he was pleased that nobody else got one, especially not Dan, who was in the other room).

 

I can't believe he's only been home a little over 24 hours. I feel like we've been doing this forever right now...

Link to comment
Share on other sites

A good start to the day, a potty trip complete with peeing and pooping - again! It is always nice to know that those systems are functioning.

 

He was so eager to urinate that he stood on the repaired leg this morning. It was nice to see that it could handle his weight. He also did his hobble thing occasionally, using that leg just a bit here and there, or using it for balance when he stood.

 

The ROM exercises are still not comfortable for him so I think there is a certain level of pain or discomfort associated with them, but he is continuing to let me know by his body language that the cold compress is apparently feeling good. He is not reluctant to let me maneuver his leg to get the compress well on the inside of the leg where it is, of course, going to be more tender since that's where the incision and the plating are.

 

One valuable lesson that, fortunately, did not result in any harm - since today was a work day, I put on the Bite-Not collar because while he has not shown any real interest in licking or touching his leg, I did not want him to fuss at it while we were gone all day. When we got home, it was quite stuffy in the house - apparently, I had set the A/C to a higher temperature than I should have done. And, with the collar on and the added issue of the sore leg, he seemed to not have been able to drink during the day, and the collar may have even made panting uncomfortable.

 

So I had one hot and thirsty dog. So, if he needs a workday collar, I may have to use the dreaded cone (which he would not be able to drink with, I don't believe) or just not use a collar at all. And, since he hasn't yet worried his leg, by Monday, I assume he should be safe without a collar. Fortunately, while it was warm and stuffy inside the house, it was a cloudy day that cooled down a bit and so the house was not overly hot.

 

Each day is a learning experience. He is getting very excited about the prospect of any trip outside and wants to move about the yard at a much faster pace than I would like to see. We have to work on our "walk with me" skills. I am sure that as he feels better and better, keeping him sedate is going to get harder and harder.

 

The leg is quite red in some locations below the surgical area and there's a little puffiness by the hock. These are quite normal as swelling from the surgical area will drain down the leg and cause a jelly-like puffiness to the hock area and below. I can use a warm compress for helping to increase blood flow there to help remove the excess fluid. The redness is, I believe, due to the migration of the fluids associated with the tissue bruising above. I have seen that in myself, when severe bruising on my calf has "migrated" down to my foot so that my foot is black-and-blue even though it is not the area that was injured.

 

Two days home and three days post-surgery, and I believe things are progessing nicely. Celt thinks things are coming along way too slowly for his tastes.

Link to comment
Share on other sites

We came in from Celt's evening potty trip, after he had his PT (I've been doing that in the yard on the way back to the house, while he's standing). The beginning of his ROM exercises went easily and then he stiffened up and was very hard to move, so I just proceeded very gently and with a very reduced movement. Then, all of a sudden, he seemed to relax and became very flexible. So I finished just one or two movements on that note and brought him inside, where he walked on all four feet across the kitchen (it's pretty small) to greet Ed. Nice!

 

He really, really wants to be active when we go outside and I have to be very careful to keep him close to me and to use the sling effectively. But, I do almost wonder if the sling is impeding his progress as it may ride on his abdomen so that it "crowds" his leg.

 

Night all!

Link to comment
Share on other sites

Are you using the sling all the time? We only used it when going up and down status and on ice. Our vet encouraged him to use the leg much as he wanted to. I found the same thing about it impeeding the leg. The fist few days I took pretty much all weight but then just had tension in case he slipped. She said the stairs are actually part of the exercises she likes them to do eventually anyway to help build muscle as long as it's slow and controlled. He was very good with that.

Link to comment
Share on other sites

June 23 2012 - four days post-surgery

 

Funny you should mention that as I was paying close attention this morning on our walk (and, yes, victory in that he peed and pooped again, so I think his regular nature has him back in his normal bodily functions routine).

 

My instructions say to "use the sling at all times when walking your dog", pointing out that it is not there to lift the dog but for control of jumping and slipping. So while I give minor support with the sling, I am really just holding it to prevent unwanted movement.

 

Since he crosses several feet of linoleum twice on the way to the door, and the two steps, I use the sling until we are off the porch (concrete) and onto the grass. There I usually drop it off because he is prone to pee pretty quickly and if I don't have it off in advance, it will get soaked. He's very business-like about his business, and wastes little time. Plus, he does like to flip-flop back and forth sometimes to decide which is the perfect leg to lift (and he has stood on the leg a couple of times to pee, so it can be weight-supporting), which makes it hard with leash and sling to not get all tangled up.

 

The other dogs are crated while we are outside and Celt has always ignored birds, rabbits, and other creatures that might frequent the yard (and we make so much noise going out that we don't run into anything), so I have been feeling more and more comfortable leaving the sling off for short distances. And, I have noticed that while he keeps his leg hitched up when the sling is on, when I have it off, he will spend part of his time using both legs as he walks about (we are usually out about five minutes so he can do his business and do a little sniffing).

 

He will use the leg when he is moving more slowly and then hitch it back up if he is moving a little more quickly. While he is out and the leg is "warmed up" a little, I will do his ROM exercises. He was not very cooperative about that this morning. As soon as we get in, I put on the cold compress.

 

If he was your normal, sausage-shaped dog, I think it would be easy to hold the sling so that it rode a bit more forward of the leg but with his high waist, it rides right there next to the leg and the incision area naturally touches it with any attempted use of the leg. So I think I will try and make sure to have at least some time each trip out without the sling, but use it in the house and on the porch (which I'm doing now) to avoid a slip or fall, and to help him up and down those two steps.

Link to comment
Share on other sites

Here are some photos showing where we are now, four days after surgery. Celt is not normally a dog to fuss at things but I noticed last evening that he was starting to lick his incision, just at the section overlying the joint itself, so he's been in the Bite-Not collar or the e-collar since, when I'm not working with him. I apologize for the lack of quality in many of my photos but I find it a bit challenging to keep the dog still (thank goodness for the "stand" command) and get a good shot while lying on the floor and holding his tail out of the way.

 

Here's an overview shot of his side, and you can see his cute little "anklet" -

 

006-1.jpg

 

And a view of the incision, showing how the section right over the joint is brighter-colored and not as flat and far along in healing as the area over more stable parts of the leg -

 

008.jpg

 

A closer view of the side of the leg, showing an area of redness below the surgical site that I think is a mild bit of rug burn, from Celt lying on that naked leg on his bedding. It's not hot, moist, or swollen so I'm not worried about it. There has been a very minor bit of fluid drainage to the area just by and below the hock, as the bruising and swelling above has broken up, but it's been almost unnoticeable -

 

010.jpg

Link to comment
Share on other sites

Out of focus, this shot does show how much the bruising on the inside of the thigh has reduced. It was pretty colorful three days ago and is now getting quite back to a normal, pink color -

 

011-1.jpg

 

A photo of Celt in the Bite-Not collar, which he thinks should be named the Happy-Not collar -

 

003.jpg

 

It's an interesting choice - the rather Victorian aspect of the Bite-Not (stiff, high, starched collar) or the Elizabethan style of the cone. Either way, he's looking at me and plotting revenge...

Link to comment
Share on other sites

I find it interesting that, in listening to recommendations/protocol outlined by the ortho vet, other people's vets (via other people's comments about what they were advised), Orthodogs, and therapists, that there is quite a range of preferred approaches to handling a dog post-surgery and implementing therapy. I am trying to take it all in, consider options, and try and see what works and what produces a good outcome in our case.

 

Primarily, I am following my vet's instructions but also realizing that those instructions are generalized for the average animal and average owner's situation. I paid him for his expertise and experience, and I would be foolish not to, but I'm also tempering some recommendations with what I see working (and not working) for Celt. But I am doing that with great care.

 

I really appreciate all the well-wishes and advice I've received from so many people over the course of this experience. Thank you!

Link to comment
Share on other sites

I realized, just a short while ago, that I usually take a good look at (and took the photos of) Celt's leg right after I do the cold compress. Looking at it without him having just been outside, without have just done the therapy, and without have done the compress (which does sweat in the humidity and leave it a little damp), I can see that the area over the joint is not quite a puffy as it appeared to be.

 

Context is a very important thing to consider...

Link to comment
Share on other sites

Just came in from some Celtie-time. First I crated the other two (who have been outside while I've spread mulch). Then I took him out and he was a bit distressed as his current favorite spots to pee have just been mulched, and lost their appeal. But he did his peeing and his pooping (so much for them not going for up to five days after surgery - my boy is regular).

 

Then we walked in the yard but just a tiny bit, and did his PT, which he tolerated pretty well. And, since he was such a good boy, I invited him to lie down by me on the lawn and we had a leg massage/body rub time, which he thoroughly enjoyed. For a dog that does not cuddle with me, he laid right up beside me and made all sorts of eye contact (he's not big on eye contact with me unless he wants something) and silly, happy, contented faces. He even stretched his sore leg way out straight and back again. I think he liked the massaging, and the only dog time, and the petting and stroking, and the grass and the shade and the cool breezes.

 

Getting out in the good light and touching/stroking/massaging his leg all over was a good opportunity to check things out. There was still a great deal of colorful bruising further back inside his thigh (which I did not see in the house or when I took photos earlier), and I think some of that redness on his lower leg could be drainage from the bruising. It's certainly not hot or swollen or bothering him in any way.

 

When I was done with the cold compress in his x-pen, and went to get the cone to put on, I realized that he doesn't mind this one that much - he stretched out his head and neck when he saw me coming and held still for me to put it on. Of course, a couple of his current favorite treats after I do this doesn't hurt his outlook.

 

Out in the yard, he did use his sore leg sometimes when we walked very slowly. If we walk at all faster than a very slow walk, he will go back to just three legs, and he'll do that after using his sore leg for a little bit. So he alternates some, using it now, and not using it then.

 

He seemed to be quite the happy dog this afternoon - nothing like some one-on-one time with a good petting session and some massage!

 

Happy dog, happy me! Life is good!

Link to comment
Share on other sites

Perhaps I've hit on it - I did another Celtie-time this morning. No one else up yet, I took him out for his potty trip (successful, again!), did his ROM in the yard (hoping nobody I knew would drive by), and then sat in his pen with the cold compress on.

 

And then I put that aside and just did whole body rubs, and leg rubs, and watched him respond with joy at the attention, the stroking, and the love I felt for him. And I must be doing something right when I massage his leg just so because he will stretch it out full-length and hold it there, and then relax with a very comfy sort of sigh. I feel rather like stretching, holding, relaxing, and sighing myself.

 

I'm wondering how long I should be doing the cold compress. I know that after my throat surgery, cold hurt but warm felt good and relaxing, letting the muscles ease up instead of stiffening up. I need to ask about this.

 

Meanwhile, the clear e-collar that the vet gave us is not an issue for Celt - in fact, he sees it coming and holds his head and neck out for me to put in on. Ed thinks part of it is that it's clear, and he can see. He doesn't bang around with it although if he gets in a corner (like by the bed last night) and gets stuck, he just stands still and waits for me to unstick him.

 

He did not get to sleep in our room last night. He just was not settling down and wanted to sleep on the bare floor and, since that poses a slip-and-fall risk, I put him back in the pen for the night. It was a cool night and so I didn't have to worry about him being too warm. Maybe I can arrange something tonight that will allow him to sleep with us and be safe. He slept great the night before with the Bite-Not collar, although he did move off his bed and onto a non-slip throw rug next to it.

 

He is full of energy when we go out. I'm using a very short (2 1/2') leash and he is tending to pull, so there are lots of stops and starts. Once he's done his pottying, he does tend to slow down as he wants to wander and sniff a bit, or graze. When he moves slower, he uses his leg. When he moves a little more quickly, up it goes and he's Mr Bunny-Rabbit hop, hop, hopping along.

 

I only use the sling now to get him up and down the two steps so he's not using that leg too much. He seems to move much better without it and we go very slow on the two, very short, non-carpeted bits we cross.

Link to comment
Share on other sites

Sue, for the injuries I've had my docs/chiropractors/physical therapists/acupuncturists have all said cold for the first 48 hours, then alternate cold and warm in the same session, ending with warm. And that regimen makes a big difference for me.

 

I know that orthopedic surgery is a slightly different thing than sprains/dislocations, etc, but the same principle might work with Celt. You can always ask.

 

Glad to hear it's all going so well with your boy.

 

Ruth and Agent Gibbs

Link to comment
Share on other sites

Thanks, Ruth! I plan on calling today to ask.

 

Yesterday's a-ha moment was when I tried the massage prior to the ROM exercises. He was much more relaxed and I was able to more easily get a wider range of motion with the exercises.

 

He's using the leg much more for walking as well. Still very early days and I need to be very careful with him, but I am happy to see progress.

Link to comment
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

 Share

×
×
  • Create New...