The B’s Knees

Open 24 Hours 905.953.1933


The rehabilitation department at the 404 is supported by a unique on-site hydrotherapy centre called “Bailey’s Place”, featuring an indoor pool with resistance jets, as well as two underwater treadmills.

We feel so strongly about the evidence-based results from rehabilitation that we’ve decided to bundle 6 rehabilitation sessions into EVERY KNEE SURGERY PERFORMED at the 404.  Together with the surgical expertise of our ACVS surgeons, your dog (or cat!) will have the gold standard in post-operative care.

Veterinarians across Canada are increasingly recognizing the importance of hydrotherapy for dogs. Canine hydrotherapy involves a variety of physical therapy treatments performed in an aquatic environment. It can be an essential rehabilitation tool for treating dogs recovering from injury or surgery. Aging pets suffering from arthritis or geriatric muscle loss can also benefit a great deal from hydrotherapy. Problem areas like muscle or joint dysfunction as well as key trigger points or areas of muscle spasm can also be tended to via massage/therapeutic ultrasound and other trigger point techniques.

Underwater Treadmill

Hydrotherapy uses the principles of buoyancy to facilitate safe, early post-operative activity. Everything floats up in water, so a dog can more easily flex a knee in water because the foot tends to readily float to the surface.

Hip deep in water, a dog weighs only 39 per cent of its land-based weight. This reduced weight burden means less strain on joints, greater range of motion and enhanced comfort for the patient.

The underwater treadmill is a key tool in the rehabilitation of post-surgical orthopedic and neurosurgery patients at the 404.  Unlike free swimming,  underwater treadmill walking is ideal for strengthening the hind leg muscles in a controlled setting.  Although an animal will have less load on it’s joints in water, the muscles must work harder to advance the leg against the resistance afforded by the water. This is key as any dog having joint surgery will undergo a period of muscle wasting between 2-5 weeks post-operatively and may also have pre-existing muscle loss from a period of lameness preceding surgery.  It’s important to minimize this loss, as a leg with reduced muscle will have less stamina on walks, and may manifest as a lameness from sore “trigger points” or muscle spasms.

Many patients having had knee surgery have also developed incorrect gait movement patterns in the pre-operative period which accommodated the pain they were experiencing before surgery.  The repetitive nature of treadmill walking is often the stimulus they need to walk correctly again.

When do post-operative knee patients get to go in the treadmill?  Our patients routinely go into the underwater treadmill for their first session 24hrs after sutures or staples have been removed (at 2 weeks post-operatively).


Joint “proprioception” or position-sense awareness, is often negatively affected in patients with knee instability or knee arthritis.   Not having sharply tuned nerve endings in their joints, these patients are often prone to re-injuring their joints due to stumbles and falls.  Part of the 404’s B’s Knees program is to “re-educate” and sharpen up the proprioception in the affected joints via a variety of therapeutic exercises and balance board techniques.

What to expect in your B’s Knees Sessions:

Session time: typically around 30minutes

  1. Pre-warming the joints: Moist heat packs are placed over affected joints to pre-warm the area prior to activity
  2. Therapeutic ultrasound may be employed in the first few sessions in the event a trigger point (Muscle knot) is discovered in the quadriceps (a common finding with patients who have had a “toe pointing” lameness)
  3. A variety of proprioceptive exercises will be performed prior to going into the underwater treadmill
  4. Underwater treadmill: Times vary from 5-10min to 25min based on how far along an individual patient is in their rehab progression.
  5. Icing of the affected joint or ice massage of sore muscles, combined with low-level laser application to the joint may be employed at the end of the session if inflammation is a large component of a patient’s presentation.