Rehabilitation Modalities

What are rehabilitation modalities?

Rehabilitation therapists use many different modalities (methods) to help pets recover from an acute (sudden) injury or maintain mobility and comfort when they have a long-term condition.

The choice of modality depends on a thorough assessment of your pet’s health, including a review of diagnostic tests, surgical treatments, and orthopedic and neurologic examinations. 

There should also be reliable evidence that the modality will improve your pet’s outcome. Certain modalities can be harmful to pets with specific conditions—your pet’s rehabilitation therapist can discuss the benefits and risks with you.

What are passive range of motion exercises and stretching?

Passive exercise occurs when a therapist moves a pet’s joints through their comfortable range of motion without the pet actively using those muscles. When movement is limited, such as after an injury or surgery, joints can lose their flexibility and muscles can become shorter and atrophy (shrink), restricting movement further.

Passive range of motion (PROM) exercises and stretching improve or help maintain joint flexibility. These exercises also improve the elasticity of soft tissues (muscles, tendons, and ligaments) and help nerves and muscles interact more effectively. 

Stretching lengthens muscles and improves joint flexibility. It is best performed when the tissues are warm, such as after exercise or after warming the surface of the affected area. Slow, patient stretching can decrease pain, prevent injury, and be quite relaxing for your pet.

What is therapeutic exercise?

Therapeutic exercise is considered the most important modality used in rehabilitation. Rehabilitation therapists design exercise programs for in-clinic and home use to help pets regain the best mobility possible. These programs gradually increase in intensity and take into account each pet’s condition, stage of healing, and current abilities and limitations. 

The exercises aim to improve comfortable range of motion, muscle mass, strength, and balance. Your rehabilitation therapist regularly reassesses the program to ensure the exercises challenge your pet enough to help them improve without causing pain.

What is thermotherapy?

Thermotherapy uses heat or cold at the body’s surface to support other rehabilitation treatments. Methods can include hot or cold packs, ice massage, and cold compression units.

Superficial cooling (cryotherapy) can provide pain relief, control bleeding, and decrease inflammation and muscle spasms. It is most often used in the early stages after surgery or trauma but may be recommended at other times.

Superficial warming can help improve flexibility before activity and stretching. Heat can increase blood flow to the area, relieve pain, and relax muscle spasms.

How is electrical therapy used in rehabilitation?

The two main types of electrotherapy are transcutaneous electrical nerve stimulation (TENS) and neuromuscular electrical stimulation (NMES).

TENS uses electrodes placed on the skin to transmit small electrical pulses to nerves under the skin. The pulses are believed to block pain signals traveling from the treatment area to the brain. TENS may also stimulate the release of endorphins and other chemicals that relieve pain.

NMES stimulates muscle contractions in pets that are not using their muscles much, such as those with restricted activity or paralysis. NMES helps by reducing muscle atrophy and joint contracture (stiffening in a flexed position). It can also increase beneficial blood flow to the area and reduce edema (fluid buildup) and swelling.

What is therapeutic ultrasound?

Therapeutic ultrasound uses sound waves that people cannot hear to transfer energy, as heat, to tissues deeper than surface heating can reach. Ultrasound is often used with other modalities, such as massage and stretching to treat soft tissue injuries. It can reduce tissue tightening (contracture), scarring, and pain as the soft tissue heals. When used at the right time, ultrasound can support healing by recruiting repair cells, including fibroblasts, endothelial cells, and myofibroblasts.

How does massage therapy help my pet?

Massage is an excellent modality to use in all patients. Massage increases blood flow to muscle and fascia (connective tissue surrounding muscles). This brings more oxygen and nutrients to these tissues and helps remove waste products. 

Massage can stimulate the release of endorphins and provide pain relief. It also stimulates weak muscles and relieves tension. It can reduce swelling and pain and help build a bond between the person giving the massage and the pet. 

During massage, the therapist may also identify areas of pain or sensitivity caused by the pet compensating for the original injury or by another condition. Massage can break down adhesions (bands of tissue that stick together) beneath the skin or in the fascia, allowing tissues to move more freely.

What is joint mobilization?

Joint mobilization is a passive movement within a pet’s comfortable range of motion. Therapists use it to relieve pain and improve mobility in pets with a reduced range of motion (ROM), such as those with elbow dysplasia and osteoarthritis. It can be relaxing for many pets.

How can my pet benefit from walking on a treadmill?

Walking on a treadmill is a form of controlled exercise that can increase muscle mass, improve quality of movement, balance and coordination, and can encourage better weight-bearing after trauma or surgery. It can be useful in helping a dog learn to walk again after an injury or illness that causes paralysis.

Why is aquatic therapy useful?

Water has unique properties that make it a valuable tool for relieving pain and improving mobility in pets. Buoyancy—the support water provides—decreases the weight placed on your pet’s joints and helps them move more easily if they have weakened muscles from chronic orthopedic disease or partial paralysis. 

Water also exerts constant pressure (hydrostatic pressure) on submerged parts of the body, which can reduce swelling and pain. Water offers resistance—it is harder to walk through water than air—so moving in water strengthens muscles and improves fitness. This resistance also provides constant sensory input and can help prevent falls by giving pets more time to regain their balance if they start to fall. Warm water can also provide the benefits described in the thermotherapy section.

Underwater treadmills allow the therapist to control a pet’s movements more closely while combining the benefits of treadmill exercise and aquatic therapy. Different water levels can be used to achieve different goals, including muscle strengthening, improved joint flexibility, and pain relief.

Pool therapy takes almost the entire weight off the joints and can be especially useful for increasing fitness in overweight dogs or for dogs who have trouble maintaining their balance or standing.

What is photobiomodulation?

Photobiomodulation, also known as laser therapy, cold laser therapy, or low-level laser therapy, uses certain wavelengths of light (outside the visible spectrum) to cause beneficial changes in cells. 

Laser therapy helps reduce inflammation and edema (fluid buildup) in the treated tissues and can relieve pain. It also stimulates tissue repair by changing how cells function. Using different wavelengths, intensities, and doses can change how laser treatment works.

What is extracorporeal shockwave therapy (ESWT)?

ESWT applies high-energy sound waves through the skin and into the tissues being treated. The sound waves interact with cells, ultimately leading to reduced inflammation, improved healing, and decreased pain.

A well-trained veterinary rehabilitation team will offer specific modalities because they have proven to be effective in multiple clinical studies for certain conditions. Certain modalities may not be proven to be beneficial for your pet, or worse, could be harmful, so they will not be included in their treatment plan. There are benefits and risks to each modality that your pet’s veterinary rehabilitation team will discuss with you.