Physical Rehabilitation & Sports Medicine

Animal Rehabilitation & Fitness (ARF) at the Charleston Veterinary Referral Center is proud to offer state of the art care in the area of physical rehabilitation. We have the ability to provide a full range of therapeutic modalities including underwater and land based treadmills, cold laser therapy, neuromuscular and transcutaneous electrical stimulation, therapeutic ultrasound, and thermal therapy. We also have unique equipment to assist our patients with balance, coordination, and strength training, including physioballs, balance boards, wobble boards, balance discs, and cavaletti rails. Our advanced rehabilitation center functions under the guidance of staff members specially trained and certified in sports medicine and rehabilitation (DACVSMR), canine rehabilitation (CCRT/CCRP) and canine therapeutic massage (CCMT).  

Philosophy:

People undergo physical rehabilitation for a variety of disorders but mostly to restore function, increase mobility, promote balance, decrease pain, encourage healing, facilitate circulation and return to a normal lifestyle.  The same is true for your pet! 

Physical rehabilitation is a non-invasive methodology used to improve the recovery of patients with both acute and chronic conditions.  Most commonly used for patients that underwent orthopedic surgery or those with neurologic conditions, rehabilitation therapy can also be used for weight loss, conditioning of agility and sporting dogs, pain control, osteoarthritis, nonsurgical management of orthopedic conditions, and wound management.

What is an emergency/specialty hospital and how is it different than my primary veterinarian?

A specialty hospital does not offer any routine or preventative care.   Our veterinarians have advanced training in specific disciplines such as surgery, oncology, internal medicine, emergency and critical care medicine, physical rehabilitation and neurology among others.  We also have equipment that most primary veterinarians don’t have such as CT scans, MRI, endoscopic equipment, and specialized surgical tools.  We work closely with your primary veterinarian to offer these services to you.

What are some conditions that physical rehabilitation is used for? 

  • Orthopedic injuries and repair such as cruciate disease
  • Fractures
  • Spinal cord injuries such as intervertebral disc disease
  • Neurologic conditions
  • Traumatic injuries
  • Chronic pain
  • Osteoarthritis
  • Wounds such as burns
  • Obesity
  • Increasing strength and maintaining the condition of working, sporting, and agility dogs

What should I expect during my initial visit?

If you are a new client to CVRC, we encourage you to fill out our New Patient Registration Form ahead of time online, or bring the form with you. Otherwise, please arrive to your appointment approximately 10 minutes early to complete this form in our office.

Your pet will be evaluated by one of our veterinarians with advanced training in rehabilitation. They will assess muscle mass, gait, stance, pain level, mobility, and range of motion.  After initial evaluation, a customized plan for treatment is developed to address the particular challenges of your pet.  The first rehabilitation session will generally occur at the time of your initial visit.  We will discuss management options with you to determine a schedule of visits. Postoperative patients may initially be managed as inpatients, but the majority of treatments are performed on an outpatient basis.

The education of owners to perform simple strength and coordination exercises at home is an important component of therapy. The response to rehabilitation is closely monitored and your pet’s program will be adjusted accordingly.

We will communicate with your primary veterinarian during this process to ensure a collaborative treatment plan for the care of your pet. Upon discharge, you will be given a printed summary with our recommended home exercises. We will go over the exercises with you at discharge to ensure you are comfortable performing the therapy.  A full report will be sent to your family veterinarian the same day. We welcome your progress reports, questions and concerns any time and will maintain an ongoing relationship with your primary care doctor to ensure the best experience for you and the best care for your pet.

What should I bring to my initial visit?

First and most importantly, bring your pet to all visits.  Records, including recent laboratory work, can be faxed or emailed to us from your primary care veterinarian prior to the appointment. If your pet has had any x-rays taken recently, please bring those with you as well.  We can request records and digital x-rays on your behalf from your family veterinarian once you have scheduled a visit with us. If your pet has food allergies or dietary restrictions we encourage you to bring the appropriate treats or food with you so they can be rewarded during their therapy.

What should I expect during my rehabilitation sessions?

Rehabilitation sessions occur after your initial rehabilitation consultation visit to CVRC.  The rehabilitation session lasts 30 minutes to 1 hour, and is centered on various exercises and therapeutic treatments that are targeted specifically to the goals of your pet’s rehabilitation plan.  Each session is fully inclusive of all the treatment modalities that we have available and are appropriate for your pet.  The rehabilitation nurse or doctor is actively tracking your pet’s progress during all rehabilitation sessions, ensuring that the exercises are appropriate and we are making progress towards our goals. At the end of the session we will go over any change to the home exercise plan and may prescribe new exercises.

May I stay with my pet and observe or participate in the rehabilitation session?

Absolutely!  We encourage you to stay when convenient and participate in your pet's rehabilitation.  This is especially useful so that we can go over the at home excercises and make sure you are comfortable performing them.  Sometimes your presence can also help keep your pet motivated during the session.

How much does it cost for a consultation with the physical rehabilitation specialist?

Our specialist consultation fee is $105.  After an assessment by our specialist, you will be provided with a detailed medical treatment plan, including all costs recommended and anticipated.  You and the specialist will review this and determine the best course of action for you and your pet.  We have several package options available to meet the needs of you and your pet.

Do I need a referral?

While referrals are recommended to see one of our specialists, they are not required.  It is always better to speak to your veterinarian about a referral so we can collaborate with your veterinarian to ensure the best care for your pet.

Will you keep my family veterinarian informed of the care my pet receives at CVRC?

We work closely with your primary veterinarian and ensure they receive copies of all medical records.  We also communicate via phone and they have the ability to access an online portal into your pet’s medical record.

Can my pet receive rehab on the day of my initial appointment?

After the initial examination with one of our rehabilitation clinicians and the presentation of a treatment plan to you, your pet may have their initial rehabilitation session.  Many times, at the initial evaluation, there is not enough time to facilitate a full rehab session but we try to start some form of treatment that same day. We want to make sure, during the initial visit, that we answer all of your questions and go over the goals for your pet’s recovery.

How many treatments will be needed?

The number of sessions required depends on many factors.  Your rehabilitation clinician will tailor a plan to meet your pet’s and your individual needs.

What treatment modalities are offered?

  • Cold Laser Therapy
  • Under Water Treadmill
  • Land Treadmill
  • Therapeutic Ultrasound
  • Electrical Stimulation (e-stim) both neuromuscular and transcutaneous
  • Hot/Cold Therapy
  • Massage
  • Therapeutic Exercises
    • Hurdles
    • Balance Boards
    • Balance Balls

What is cold laser therapy?

Laser therapy is used to increase quality and strength of tissue repair, decrease inflammation, reduce edema and give pain relief. The effects are photochemical, not thermal and happen at the cellular level. Benefits include faster wound healing, increased vascular activity, stimulated nerve function, reduction of scar formation,  decreased pain, and decreased inflammation.

What are the applications for laser therapy?

  • Wound management
  • Soft tissue injuries
  • Inflammation
  • Chronic pain
  • Arthritis
  • Acupuncture

What is underwater treadmill therapy?

Water is an excellent environment in which to exercise. The principle of buoyancy combined with that of resistance make this a unique and safe method of rehabilitation. We have an underwater treadmill that provides an opportunity to strengthen muscles with little to no pressure on the patient’s joints. The warmth of the water helps to increase flexibility and mobility of muscles, tendons, and ligaments that surround the joints as well as enhance circulation. In addition, our treadmill is also enhanced with therapeutic jets that can be used for massage, like a whirlpool, or provide increased resistance for conditioning.

It is not unusual for an animal that is not using a limb on land to use it when walking in the water. They often use it in an exaggerated motion which adds to the therapeutic benefits of hydrotherapy.

We can adjust variables of speed, duration of treatment, and water level during each treatment to maximize the therapeutic results..

What are the benefits of underwater treadmill therapy?

  • Comfortable movement
  • Earlier return to function
  • Muscle strengthening
  • Increased cardiovascular stamina
  • Neuromuscular re-education
  • Weight loss
  • Increase range of motion
  • Increase in patient’s self confidence

What are the applications for underwater treadmill therapy?

  • Orthopedic injuries and repair such as cruciate disease
  • Fractures
  • Spinal cord injuries such as intervertebral disc disease
  • Neurologic conditions
  • Traumatic injuries
  • Chronic pain
  • Osteoarthritis
  • Obesity
  • Increasing strength and maintaining the condition of working, sporting, and agility dogs

What is the difference between underwater treadmill (UWTM) therapy and swimming?

While both therapies are beneficial for cardiovascular fitness, the UWTM provides total body therapy by working both the front and rear limbs while allowing for control of the water level, treadmill speed, and water resistance. When animals swim, they typically use the front legs, but may either rudder with the back legs, keeping them tucked under their body or sporadically kick, but not in a controlled manner. For this reason, we primarily use the underwater treadmill in our rehabilitation regiment here at CVRC although swimming is available in certain circumstances.

But, my dog doesn't like water? And he doesn't know how to swim?

We begin with a slow introduction to the underwater treadmill that involves a lot of positive reinforcement. We will never rush this process and will take whatever time is necessary to be sure your pet is comfortable in the UWTM before proceeding. If your pet is one of the rare patients that does not tolerate working in the UWTM, there are a number of other activities that we can do to help your pet recover from injury or surgery.  While some dogs are able to swim in the UWTM, the majority will not. As mentioned earlier, walking in the UWTM provides a more controlled exercise environment for our patients and is often preferred over swimming while your pet is recuperating from surgery/injury.

Will my dog be wet when I pick him up?

We will do our best to get your pet as dry as possible before he goes home. We have grooming dryers to supplement towel drying after the UWTM session.

What is therapeutic ultrasound?

Therapeutic ultrasound produces both thermal and nonthermal effects. The thermal effects of a therapeutic ultrasound occur through warming of tissues and can be very beneficial in treating soft tissue injuries. It can be used to increase the flexibility of muscles while decreasing muscle spasm and scar tissue. We have also found it can increase circulation and minimize inflammation of damaged tissues. The nonthermal effects aid in tissue regeneration, soft tissue repair, bone healing along with reduction of swelling, muscle spasm, and pain.

What are the benefits for therapeutic ultrasound?

  • Soft tissue healing
  • Decrease of inflammation
  • Increases blood flow
  • Reduces swelling
  • Decreases pain
  • Increase extensibility of collagen, resulting in increased range of motion
  • Decrease scar tissue build up

What are the applications for therapeutic ultrasound?

  • Orthopedic injuries and repair such as femoral head ostectomy (FHO)
  • Fractures
  • Wound healing
  • Chronic pain
  • Osteoarthritis
  • Tendon injuries

What is electrical stimulation (e-stim)?

Electrical Stimulation (e-stim) is the application of electrical impulses to a muscle or muscle group stimulating their contraction.  Neuromuscular electrical stimulation can be used to prevent atrophy of a muscle or muscle group. Transcutaneous electrical stimulation also helps in pain management. 

What are the benefits of e-stim?

  • Increasing muscle mass and strength
  • Overcoming muscle reflex inhibition
  • Decreases pain
  • Reduces swelling/inflammation/edema

What are the applications for e-stim?

  • Muscle atrophy from disuse
  • Neurologic atrophy
  • Pain control
  • Joint effusion
  • Reduction of edema and inflammation
  • Tendon and fracture healing

What is massage therapy?

Massage is a focused, intentional, and deliberate touch using a variety of strokes. Massage is a non-invasive way to improve your pet’s health. Massage utilizes soft tissue manipulation to achieve different goals such as relaxation, stimulation, and relief of muscle problems. It allows the body to function efficiently. Massage increases circulation bringing oxygen and nutrients to the tissues. Massage provides relief from many common ailments as well as enhances performance.

What are the benefits of massage therapy?

  • Increase circulation and oxygenation to the cells of the body
  • Decrease pain, soreness and stiffness
  • Restore muscle tone
  • Improve muscle function
  • Increase flexibility and range of motion
  • Relaxation and stress reduction

What are the applications for massage therapy?

  • Postoperative healing
  • Orthopedic diseases
  • Sports injuries
  • Arthritis
  • Hindquarter weakness
  • Aging and inactivity
  • Compensatory patterns due to structural imbalances/poor conformation
  • Neurologic conditions to stimulate nerve conduction and increase superficial sensation

What are therapeutic exercises used for?

We evaluate each patient and design a set of exercises that are most effective in that patient’s rehabilitation. These are designed to achieve the goals for that patient’s recovery. Exercises may be directed at helping the patient with strengthening specific muscles or stretching to increase flexibility or learning how to regain the feeling and use of a foot or limb. We demonstrate each activity and teach our pet owners to perform these at home on a prescribed schedule. We try to incorporate the special needs and skills of patients and their families.

What is hot/cold therapy and when is it used?

Appropriately timed in the rehabilitation process, cold and heat can be very beneficial in decreasing pain and inflammation.

Initially, in the first 72 hours, we use cold therapy to decrease the pain and inflammation associated with surgery or trauma. This occurs by decreasing pain perception, decreasing blood flow and decreasing inflammation.

Heat therapy is used later in the healing process to increase blood flow, increase muscle flexibility decrease pain and increase healing.

My pet is overweight or out of shape.  What can I do?

Unfortunately, many pets are overweight or have poor conditioning.  This makes it more likely for them to develop a variety of health conditions, such as arthritis, diabetes, ligament injuries, and dysfunction of body systems such as the circulatory, digestive and excretory systems.  Conditioning, fitness, and weight loss are goals that can be obtained with a comprehensive plan from our physical rehabilitation department.

My dog doesn't have an injury. Can he still benefit from rehab?

Definitely! Just like people, pets can benefit from a regular exercise program. If you are interested in setting up a conditioning program for your pet, please contact us to schedule an initial consult. This will allow us to evaluate your pet and make sure there are no contraindications to your pet beginning our conditioning program.

Can my pet receive rehabilitation while hospitalized?

Depending on your pet’s condition, rehabilitation is often begun during the initial hospital stay after surgery or injury.  Our rehabilitation team will collaborate with your primary doctor at CVRC to discuss and offer rehabilitation if it is appropriate for your pet’s condition.

Can I leave my pet for the day?

We are happy to offer day boarding for our rehabilitation patients.  Please let us know when scheduling that you will be leaving your pet with us.  Also, please bring any medications that will need to be administered while your pet is at CVRC.

Will I need to do exercises at home?

Results of therapy are much better when a home exercise plan (HEP) is followed.  We evaluate each patient and design a set of exercises that are most effective in that patient’s rehabilitation. These are designed to achieve the goals for that patient’s recovery. Exercises may be directed at helping the patient with strengthening specific muscles or stretching to increase flexibility or learning how to regain the feeling and use of a foot or limb. We demonstrate each activity and teach our pet owners to perform these at home on a prescribed schedule. We try to incorporate the special needs and skills of patients and their families.

What if I don't have time to work with my pet at home?

The home exercise program (HEP) is meant to complement your pet's rehabilitation sessions performed here at CVRC. We recognize that your lifestyle and time constraints may not be conducive to performing all the additional exercises at home. We will work with you to develop a program that will fit your schedule while still benefitting your pet. Please let us know what you feel you can perform and our rehabilitation team will work with you to make this a positive part of your pet's rehabilitation experience.

I cannot come to CVRC for routine rehabilitation appointments, is it beneficial to come for an appointment for a home rehabilitation plan?

Absolutley!  After assessing your pet, we can form a rehabilitation plan that works logistically for you and your pet.  This can be a plan where most of the activity is done at home, with only an occasional visit to CVRC for reevaluation.

Is it normal for my pet to be sore or tired after therapy?

It is very common for your pet to be tired after rehabilitation, especially early on in the treatment plan.  This should improve over time as your pet’s physical condition improves.  If your pet seems sore or uncomfortable, please let us know so that we can adjust the rehabilitation plan, or prescribe medications if needed.

Should my pet have physical rehabilitation after an injury or surgery?

Consultation with your pet’s surgeon, or family veterinarian, review of history, full physical examination, and discussion with you will dictate the necessity of physical rehabilitation.  Many patients respond very well to physical rehabilitation and have a faster return to function after injury or surgery.  We have several certified rehabilitation specialists who collaborate with our surgical team to ensure the best outcome for your pet.