When your dog comes home from having ACL surgery (more commonly referred to as ‘cruciate surgery’ in the dog world), it’s normal for you to feel a little overwhelmed by all the information you have been given.
There are two things that people usually remember, and this is often because they are the hardest to follow:
- Strict crate rest
- Short on-lead walks only
The article below will provide you with rehab exercises that you can complete with your dog, as they recover from ACL surgery. These exercises will help your dog recover faster, get back to normal life sooner, and tolerate the confinement that is required during the immediate post-op period. Remember if you’re ever unsure, please check with your vet before completing any of these exercises.
If you would like more information on ACL tears in dogs click here. Alternatively, our article that covers what to do in the immediate post-op period can be found here ‘Dog ACL Surgery – What to Do Next‘. These two articles work in conjunction to cover the entire post-surgical recovery.
Dog ACL Surgery Post-Op Rehab Exercises
Make sure these exercises are performed on a non-slip surface such as grass, a yoga mat, or non-slip tiles.
Use food treats where necessary. Don’t forget to take this food out of your dog’s daily food intake – it can be part, or all of dinner, split through the day.
Exercise 1 – Weight Shifting
Objectives:
- Encourage weight bearing through your dog’s post-op ACL knee.
- Improves proprioception (limb placement).
- Activate the gluteal (bum) and leg muscles.
What to do:
- Stand your dog squarely with all four feet evenly on the ground, and facing forward. It may help to put your dog’s food bowl in front of them, or have someone maintaining their forward focus (they can use treats if necessary).
- Place yourself behind your dog with one hand on each hip. For smaller dogs, you may find kneeling or sitting is more comfortable (for you, not the dog).
- Gently push your dog’s hip over to one side to encourage more weight on one leg. The overall movement is minimal. You’re not trying to push your dog over, you’re simply trying to get them to place more weight on their surgical leg.
- Hold the pressure for 2-3 seconds and then release.
- Repeat on the other side.
- IMPORTANT – The weight shift should not cause your dog’s feet to move, they stay firmly planted on the floor. If your dog is lifting their leg when you push them to that side then you need to push for a shorter period of time or gentler.
How often:
- 10 repetitions in a row (total exercise time of 30 seconds).
- 2-3 sessions per day.
- This exercise is typically only required for the first two weeks post- op, but can be performed at any point in the recovery process. The reason you would continue to use the exercise is if your dog’s weight bearing is not even through their back legs when they are standing.
- If there is any regression in their desire to weight bear on their post-op leg please talk to your vet.
Exercise 2 – Weight Bearing/ Three Point Stand
Objectives:
- Encourage weight bearing through your dog’s post-op ACL knee.
- Improves proprioception (limb placement).
- Strengthen the gluteal (bum) and leg muscles.
This exercise is more difficult than the weight shifting exercise, so remember to keep the session short. The quality of the exercise is more important than quantity in the early post-op period.
What to do:
- Stand your dog squarely with all four feet evenly on the ground, and facing forward. Their weight should be distributed evenly.
- Stand (or sit) facing your dog.
- Pick up your dog’s opposite front leg to the injured side (e.g. if your dog had ACL surgery on their left back leg, you will lift their right front leg)
- Hold for 2-3 seconds. Make sure your dog’s injured leg stays on the ground, and bearing weight firmly.
- Release their foot to the ground and repeat.
- If your dog can’t hold for 2-3 seconds then shorten this time. The quality of weight bearing is more important than doing it for longer.
How often:
- 10 repetitions in a row
- 2-3 sessions per day
- Progression throughout post-op ACL period:
- Week 1-2: hold for 2-3 seconds
- Week 3-4: hold for 5 seconds
- Week 5-6: hold for 8-10 seconds
- Week 7 -10: start lifting the opposite hind leg (instead of front leg)
- Week 10+: incorporate unstable surfaces (e.g. yoga mat/blocks, cushions, Fitpaws equipment)
Exercise 3 – Hip Flexor Stretch / Front Feet Up
Objectives:
- Increases strength in the core, gluteals (bum), and rear legs.
- Increases hip and knee joint range of motion.
- Increases positional awareness of your dog’s back limbs
What to do:
- For this exercise you will need a step approximately 10-20 cm high (exercise steps or kids stools are great if you don’t have any stairs in your house).
- Lure your dog to place their front paws on the raised step, while their back legs remain on the ground.
- Maintain this position, ideally for 10-15 seconds.
- Let them down and repeat after 30 seconds rest.
How often:
- 5 repetitions in a row.
- 2-3 sessions per day.
- Progression throughout post-op ACL period:
- Week 1-2: your dog is not yet ready for this exercise.
- Week 3-4: hold for 10-15 seconds.
- Week 5-6: hold for 20-30 seconds. At this stage you can also start luring you dog forwards and backwards while their feet remain in position (shifting weight without actually moving their feet)
- Week 7 -10: hold for 30 -60 seconds.
- Week 10+: incorporate unstable surfaces (e.g. yoga blocks, cushions, Fitpaws equipment).
For more information or problem-solving the hip flexor (front feet up) stretch, click here.
Exercise 4 – Sit to Stand/ Dog Squats
Objectives:
- Increases functional joint range of motion.
- Builds strength and positional awareness of your dog’s back limbs.
What to do:
- Stand your dog squarely with all four feet evenly on the ground, and facing forward. Their weight should be distributed evenly.
- Stand facing your dog.
- Ask your dog to sit. You may need to lure your dog backwards into a sitting position, reward.
- F on the sitting position, lure them forward into a stand position. The back paws need to stay firmly planted on the floor, with your dog leading their movement by stepping their front paws forward.
- IMPORTANT – When sitting, your dog needs to tuck both of their legs in tight, sitting squarely. Lazy sits (legs pointing outwards) should not be encouraged and are considered poor technique. If your dog starts to go into a sit and gets half way down before their feet turn out, position them next to a wall (with the lazy leg) so that as they sit the wall stops the leg from rotating outwards. If they sit lazy through both legs you can perform the exercise in a corner or between two objects.
- Repeat.
How often:
- 10 repetitions in a row.
- 2-3 sessions per day.
- Progression throughout post-op ACL period:
- Week 1-4: your dog is not yet ready for this exercise.
- Week 5-10: perform this exercise on a solid, stable surface.
- Week 10+: incorporate unstable surfaces (e.g. yoga blocks, cushions, Fitpaws equipment).
Exercise 5 – Cavalletti (Trot Poles)
Objectives:
- Increases range of motion in the knee joint and ensures your dog doesn’t develop stiffness following surgery.
- Increases limb awareness and aids in muscle strengthening. This will increase your dogs confidence and teaches them to pick up their feet.
Before starting the exercise, you will need:
- Four to six poles about one meter in length. These can be purchased from a hardware store, or you can use pool noodles or tomato stakes.
- Something to elevate the poles off the ground slightly (~ wrist height). A set of small cones or squashed tin cans / bottles work (if your dog is not scared by their sound if they move).
- Measure your dog from the top of their shoulder to the floor. This will be a guide for the distance between the poles. As a guide – large dogs will be about 30-40 cm, medium dogs 20-30 cm and small dogs 15-20 cm apart.
What to do:
- To start with, you need to place 4-6 poles a little closer than shoulder height apart.
- The poles need to be elevated off the ground to wrist height (~10-15 cm). Be careful working with the poles on the ground. If your dog accidentally steps on a pole it may roll away causing an injury.
- Your dog should be leashed for this exercise.
- Once set up, slowly guide your dog from one end of the poles to the other. Make sure one leg goes in each section at a time. You want this to be a slow but continuous movement.
- You can modify the distance between the poles if your dog is not single-stepping the spaces. You can also modify the height if your dog is knocking bars. The height should never exceed elbow height.
- At the end, ensure you take a wide turning circle and pivot on your dog’s non-injured leg. Then return in the other direction.
How often:
- 10 repetitions in a row.
- 2 sessions per day.
- Progression throughout post-op ACL period:
- Week 1-4: your dog is not yet ready for this exercise.
- Week 5-8: go slow, your dog should only be walking.
- Week 9 -12: stretch out the distance between the poles, and do the first 4 passes at a trot instead of a walk. Slow down and do the rest at a walk.
- Week 12+: can be entirely at a trot and can now be completed off lead if desired.
For more information on cavaletti read our article ‘Cavaletti For Dogs’.
Conclusion
The above rehab exercises are intended to help your dog progressively return to normal activities after ACL surgery. Do not start, or progress, any of the exercises before the suggested time frames. These exercises never replace the advice of your vet or canine rehab professional. While time frames have been given as a guide, some dogs may take longer to recover.
For a comprehensive guide to ACL injuries, treatment, and rehabilitation check out our e-book ‘The Complete Guide to ACL Injuries‘.