tarsal hyperextension

[Guest guest]

I am posting for my colleage who has a 2 year old golden retriever

that he performed bilateral TPOs on when 5 months old. Over the last

1 1/2 years, the dog has had progression of hock hyperextension - was

unilateral and now bilateral. No collateral ligament injury palpable

and no pain upon full ROM. Discomfort only while placing load on the

joint. Anyone have any experience with strenthening or other

modalities to lessen the dog's persistance in breaking over in the

hock while gaiting?

D. , DVM, DACVS

[Guest guest]

How are the rest of the hind limb joints? Any range of motion restrictions, arthritis, etc at the stifle and/or hips? Any lumbar spine/L-S pain? When in the gait cycle does the dog hyperextend--throughout stance phase, or just at end-stance/toe-off? And how are the hocks when the dog is just standing static?

Krista Niebaum, MPT, CCRT

Scout's House

tarsal hyperextension

I am posting for my colleage who has a 2 year old golden retriever

that he performed bilateral TPOs on when 5 months old. Over the last

1 1/2 years, the dog has had progression of hock hyperextension - was

unilateral and now bilateral. No collateral ligament injury palpable

and no pain upon full ROM. Discomfort only while placing load on the

joint. Anyone have any experience with strenthening or other

modalities to lessen the dog's persistance in breaking over in the

hock while gaiting?

D. , DVM, DACVS

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[Guest guest]

Hi.I've seen this in a majority of the dogs that I've treated post-TPO.  Non-painful that I can tell but obvious instability medial-lateral and hyperextension during gait/function/postures.  I have one patient now that had a TPO on one side and no surgery on the other.  The TPO side is more obviously "involved" than the non-operated.  I assume that this deviation is due to the change in biomechanics due to the TPO but also to the dog's conformational faults.Amie   Amie Lamoreaux Hesbach, MSPT, CCRPPresident, Animal Physical Therapy Special Interest Group, Orthopaedic Section, American Physical Therapy Associationwww.orthopt.orgInstructor, The Canine Rehabilitation InstituteWellington, Florida USAwww.caninerehabinstitute.comCEO, For Paws Rehabilitation, LLCPort Republic, land USAwww.forpawsrehabilitation.comManager, Physical Rehabilitation, The Mid-Atlantic Animal Specialty Hospital, LLCHuntingtown, land USAwww.vetmash.com How are the rest of the hind limb joints? Any range of motion restrictions, arthritis, etc at the stifle and/or hips? Any lumbar spine/L-S pain? When in the gait cycle does the dog hyperextend--throughout stance phase, or just at end-stance/toe-off? And how are the hocks when the dog is just standing static? Krista Niebaum, MPT, CCRTScout's House   tarsal hyperextensionI am posting for my colleage who has a 2 year old golden retriever that he performed bilateral TPOs on when 5 months old. Over the last 1 1/2 years, the dog has had progression of hock hyperextension - was unilateral and now bilateral. No collateral ligament injury palpable and no pain upon full ROM. Discomfort only while placing load on the joint. Anyone have any experience with strenthening or other modalities to lessen the dog's persistance in breaking over in the hock while gaiting? D. , DVM, DACVSAOL now offers free email to everyone. Find out more about what's free from AOL atAOL.com.

[Guest guest]

Dear Cheryl,

Does the dog have any bite or skull conformation abnormalities? This may influence the speed of the recovery. I would be suspicious as the dog has been so severely affected as a young dog.

This is a classic case of postural problems causing pathology. This condition is caused by an exaggerated "pitch" to the rear resulting in an extreme engagement of the postural extensors. The hip problems were a function of this misorientation also. I would recommend some very sophisticated upper cervical adjusting and postural reprogramming to reset the "autopilot" upper cervical righting mechanisms and the major postural reflexes, and you will see a major improvement in function and stance. The tightness of his hamstrings will lessen immediately, and the hocks will be carried further back. If the hocks are now hypermobile in hyperextension then prolotherapy to tighten the ligaments in their new orientation may help immensely. Without the postural change it is very hard to stay ahead of the abnormal wear and tear.

Also feeding on a chute on the steps with " slow feed" bowl and front feet up high enough up the stairs to extend the hips is great, easy to do, twice a day therapy.

We do these all the time; often, if caught early enough, the hip surgeries can be avoided.Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com

To: VetRehab From: CTANO@...Date: Mon, 19 May 2008 02:32:49 +0000Subject: Tarsal hyperextension

Hello,I have a 1 year old Austrialian Shephard that had bilateral FHO's in Feb 08. We have been working with her for hip extension, strength and improvement of kyphosis which are all tremendously improved but she also has bilateral tarsal hyperextension. I have been doing e-stim on her gastroc muscles to strengthen them for the eccentric work they do maintaining the hock and I recently started dong e-stim on the cranial tibial muscles. I was going to try therabands at a walk to promote hip extension and possibly put the bands low to work the hock. Does anyone have any thoughts or suggestions on how to improve this condition?Thank you,Cheryl Tano DVM, DVSc, DACVS CCRT candidateAffiliated Veterinary Specialist Maitland, Fl Change the world with e-mail. Join the i’m Initiative from Microsoft.

[Guest guest]

Dear Dr. Shoemaker,

No Maggie does not have any bite or skull confomation

abnormallities. She appears to be an appropriately sized Australian

Shepard. She is a BCS of 5/9.

Thank you for the information however, it sounds as if I would need

a certified canine chiropracter. Does anybody know of any in

Orlando, Florida area? I would not be comfortable performing these

techniques myself.

We have been working hip extension for many weeks and we are

improving but she still needs work. My most recent addition is to

walk her with therabands at the thigh to provide resistance and

lengthen her stride. That seemed to help a bit after her first

session. We will continue that. We do cookie stretches up with her

feet now on about a 12 inch elevation in clinic and the owners feed

on a step. We are doing other stretches etc working her hip and

spine extensors.

From what I read in the rehab archives it sounds like the general

feel is the tarsal hyperextension is secondary to not wanting to

extend the hips. Do you agree? If so I will continue to work her

hips and hope to ultimately reap the benefits to the tarsi.

Thank you again and I appreciate any information you or anyone can

share.

Cheryl Tano DVM, DVSc, DACVS, CCRT candidate

>

> Dear Cheryl,

>

> Does the dog have any bite or skull conformation abnormalities?

This may influence the speed of the recovery. I would be suspicious

as the dog has been so severely affected as a young dog.

>

> This is a classic case of postural problems causing pathology.

This condition is caused by an exaggerated " pitch " to the rear

resulting in an extreme engagement of the postural extensors. The

hip problems were a function of this misorientation also. I would

recommend some very sophisticated upper cervical adjusting and

postural reprogramming to reset the " autopilot " upper cervical

righting mechanisms and the major postural reflexes, and you will

see a major improvement in function and stance. The tightness of

his hamstrings will lessen immediately, and the hocks will be

carried further back. If the hocks are now hypermobile in

hyperextension then prolotherapy to tighten the ligaments in their

new orientation may help immensely. Without the postural change it

is very hard to stay ahead of the abnormal wear and tear.

>

> Also feeding on a chute on the steps with " slow feed " bowl and

front feet up high enough up the stairs to extend the hips is great,

easy to do, twice a day therapy.

>

> We do these all the time; often, if caught early enough, the hip

surgeries can be avoided.Judith M. Shoemaker, DVMAlways Helpful

Veterinary Services305 Nottingham RoadNottingham, PA 19362ph 717-529-

0526 fax info@... www.judithshoemaker.com

>

>

> To: VetRehab@...: CTANO@...: Mon, 19 May 2008 02:32:49

+0000Subject: Tarsal hyperextension

>

>

>

>

> Hello,I have a 1 year old Austrialian Shephard that had bilateral

FHO's in Feb 08. We have been working with her for hip extension,

strength and improvement of kyphosis which are all tremendously

improved but she also has bilateral tarsal hyperextension. I have

been doing e-stim on her gastroc muscles to strengthen them for the

eccentric work they do maintaining the hock and I recently started

dong e-stim on the cranial tibial muscles. I was going to try

therabands at a walk to promote hip extension and possibly put the

bands low to work the hock. Does anyone have any thoughts or

suggestions on how to improve this condition?Thank you,Cheryl Tano

DVM, DVSc, DACVS CCRT candidateAffiliated Veterinary Specialist

Maitland, Fl

>

>

>

>

>

>

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