The Arthritis Pain Dilemma

Your dog looks stiff and is having issues getting around and going for regular walks.  They may have a diagnosis of osteoarthritis or degenerative joint disease, a form of arthritis that worsens overtime.  You’re advised to do less activity with them and that they may need some medication to manage the pain.

WHAT IF I TOLD YOU THAT YOU CAN DECREASE PAIN NATURALLY AND SLOW THE DISEASE PROGRESSION AND STILL ENJOY WALKING YOUR DOG?!?

LETS GO A LITTLE DEEPER INTO WHAT THIS DISEASE LOOKS LIKE IN A DOG AND WHAT IS ACTUALLY HAPPENING

WHAT ARE THE SYMPTOMS?

The symptoms look the same as they do in people.  Overtime, a dog with this type of arthritis develops chronic pain and stiffness, which leads to a decrease in activity.  A decrease in activity causes loss of strength and weight gain, which leads to more pain and stiffness.  In the end both of you are less active and unhappy.  

Sadly, a lack of activity actually creates a negative spiral that speeds up this condition.

 

WHAT IS ARTHRITIS?

Arthritis basically means inflammation (‘itis’) of one or more joints (‘arthro’) in the body. While there are several types of arthritis, one of the most common is osteoarthritis which is a “degenerative joint disease” (DJD).  The most recent stats say 1:5 to 1:4 dogs are affected by DJD.

WHAT DOES AGE HAVE TO DO WITH IT?

Age is one of the greatest risk factors for DJD however it is not the cause .  Aging often results in metabolic changes (chemical reactions in the body) and an overall decrease in activity.  The result is a decline in muscle mass (atrophy) and strength.

RISK FACTORS

Other risk factors  for DJD and associated pain include:

  • genetics
  • obesity
  • improper nutrition
  • infections
  • injuries (i.e. fractures, muscle strains, etc)
  • lack of physical activity
  • poor health / other diseases (i.e. lyme disease, diabetes, etc)

TRIGGERS

In addition to the above risk factors, research has shown that the following can cause flares of pain in arthritic joints:

  • changes in barometric pressure (i.e. rain, snow, storms)
  • cold weather
  • sudden weight gain
  • repeated movements (i.e. always jumping out of the car and making a quick turn to the right and never going left)
  • inflammatory foods (synthetic and/or starchy)
  • stress
  • intense exercise

WHY IS OA OFTEN DESCRIBED AS “WEAR AND TEAR” IN A JOINT?

Shoulder joint irritation

In a healthy joint, cartilage, a cushiony/slippery cap protects the end of bones. DJD is characterized by a breakdown of this cartilage over time.  According to Harvard Medical School, this breakdown causes inflammation and pain in the joint and often this pain radiates into the surrounding tissues (muscles and ligaments).

Everywhere in the body, tissues are always breaking down (degeneration) and being replaced by new ones (regeneration).  In joints affected by DJD, the balance between degeneration and regeneration is not maintained and there is more breakdown then building up of cartilage.  

The question is then, what can we do to maintain/re-establish the balance in the joint?

MOVEMENT IS MEDICINE

Physical activity (movement) is a critical part of arthritis management in people so why would it be any different for our furry friends? 

Cartilage needs movement to stay healthy!  

HOW DOES MOVEMENT/EXERCISE HELP MY DOG?

Movement….

  • lubricates the joint. There is also natural fluid around joints (synovial fluid) that helps keep cartilage healthy and reduces friction in the joint.   Movement helps to stimulate production. 
  • improves blood flow (circulation) providing nutrients to the joints and surrounding tissues 
  • removes cellular waste  (dying cells, etc).  
  • builds muscles strength to support the joints
  • helps stimulate new cartilage and decreases inflammation!  

Scientists are still understanding this process of how exercise stimulates anti-inflammatory reactions in the joints and the activation of genes related to rebuilding cartilage. 

An important factor on that last note, it isn’t just any exercise.  Too much exercise or stress on the joints will have an opposite effect and result in flares of pain!

SO HOW MUCH EXERCISE?

The type and amount of exercise….. depends.

The symptoms of arthritis are not linear.  Any person out there with OA knows that you have good days and bad days.  So what does that mean for your dog and activity levels?

How much and what kind of activity is going to depend on a lot on pain and stages of the disease.  From a physiotherapy perspective, we often refer to “loading” when we talk about arthritic joints.  If there is a lot of pain we want “low loads”  or less force through the joints but still encourage movement. Range of motion (AROM / PROM) is a low load activity. 

RANGE OF MOTION & FLEXIBILITY

During range of motion exercises, the pet owner supports the affected limb above and below the joint and then, very gently helps the dog move the lower part of the limb.  This is like greasing a bike chain.  You put a little oil in one spot and then rock the peddles back and forth, spreading out the grease until you cover the full chain. 

Massage and gentle stretching are also good for stimulating blood flow and making moving joints, easier.  Always start with a gentle touch and gauge how your dog responds.  If they aren’t into it, it isn’t therapeutic.

Quick note on ROM exercises and dogs with paralysis.  Its very important!  A dog with paralysis can often still experience pain and since they can’t move their own limbs, it’s important you do this for them.  

It is strongly recommended that you seek out a rehab professional to assist you in learning how to safely and effectively do ROM exercises with your dog.

Stretching hind leg

STRONG & STABLE

A joint should fit together like a puzzle piece, but once the cartilage starts to break down, it no longer gets that tight fit and the joint no longer moves properly.   This is sometimes referred to as “dysplasia”.  Sometimes, when things don’t fit together properly, the ligaments around the joints loosen and the body responds by creating bone spurs to provide more stability.  This is one of the reasons strength is so important for our furry friends. Bone spurs are painful!  

Strength exercises should focus on function (i.e. standing, walking, sit to stand, etc).  Things done statically (no movement) are a good place to start, gradually increasing difficulty to more functional movements.  Strengthening exercises put more “load” through the joints. 

Types of strengthening include:

  • ISOMETRIC exercises the muscle contracts to hold the body in one position 
    • = LOW load
  • CONCENTRIC exercises the muscle contracts to move body parts
    • = MODERATE load
  • ECCENTRIC exercises the muscle contracts to slow the body down against gravity
    • = HIGH load

BALANCE & BODY AWARENESS TO HELP STAY UPRIGHT!

There is a less body awareness in arthritic joints and therefore less balance.  To ensure the safety of your dog, slippery surfaces should be avoided.  Exercises that focus on balance and body awareness are very important for dogs with DJD.  Introducing things like balance cushions during exercises can challenge balance and help with body awareness.  If you don’t have a balance cushion, try folding a yoga mat over several times.

AEROBIC EXERCISE FOR HEART HEALTH

Dogs are meant to walk, as are we!  Aerobic health keeps the body healthy, the mind happy, and helps maintain a good body weight. 

Loading comes into play with aerobic exercise too.  

The faster the movement the more force that goes through a joint.  So when joints are painful, we want our dogs to move slower.  Games of fetch can cause joint and tissue pain if a dog is already showing some soreness.  Going up and down hills also adds more force, especially down!  Uphill can be a nice strengthening activity as long as it doesn’t make your dog worse.  

Shorter and more frequent walks have been shown to be easier on the joints while still having a healthy effect.  Watch out for really hard surfaces or ones that have really complicated footing as they may worsen arthritic joints.    Swimming and walking in deep water (sandy bottom or underwater treadmill) are great for cardiovascular health and low loading through the joints!  

WHAT CAN I DO AROUND MY HOME?

Dog ramp to help dog with arthritis get onto elevated surfaces

A good tip for maintaining strength is do things in your home that encourage your dog to move independently and allow you to assist easily

These include:

  • Investing in a ramp for your vehicle instead of picking your dog up. If you hurt your own back, how can you help your dog?
  • Providing a bench or stool for them to get get onto furniture (if they usually get on furniture).
  • Using a rear harness for dogs with decreased hind end mobility so you can give them a little added support. 
  • Providing non slippery surfaces in your home, especially on stairs so you dog has more traction which aides in confidence and encouraging the right muscles to fire to move the body.  Yoga mats are a very economical option. 
  • Some dogs may also do well with orthopaedic bracing that aids in stabilizing joints, increasing comfort and allowing for more movement.
  • Introducing natural supplements such as omega 3 oils, turmeric, glucosamine (works best with MSM).  Green lip mussel is a great anti-inflammatory!
  • Talk to you vet/rehab therapist about helpful modalities and integrative treatments for pain management (i.e. acupuncture, laser therapy, cartrophen, canine rehab!, etc)
  • Maintain a healthy weight!!!!  Studies have shown a significant decrease in lameness in dogs with DJD with even modest weight loss.

FINAL THOUGHTS

While the above information is not to be used to diagnosis DJD in your dog or override your veterinary recommendations, I hope it does provide insight into how keeping your arthritic dog active is critical to, well, keeping them active and healthy!  

A canine rehab therapist can also assist you in tailoring a home exercise plan for your dog. 

Overall,  moderate activity levels based on your dogs symptoms and occasional flare ups, have a healthy diet, manage weight, and most of all enjoy being active with your dog!

Thanks for reading and stay active! ~ Sarah and the pups.

Sarah MacKeigan with Reg and Sam

References

American Academy of Orthopedic Surgeons

American College of Veterinary Surgeons

Arthritis Foundation

Physio Can Help

Definitely Not the Long-Term Death Sentence You May Think It Is

Defining acute flares in knee osteoarthritis: a systematic review

Exercise helps prevent cartilage damage caused by arthritis

Exercise: Rx for overcoming osteoarthritis

Johns Hopkins Arthritis Centre

Mechanical loading inhibits cartilage inflammatory signalling via an HDAC6 and IFT-dependent mechanism regulating primary cilia elongation

Role of Exercise in Arthritis Management

Risk Factors for Osteoarthritis and Contributing Factors to Current Arthritic Pain in South Korean Older Adults

The effect of weight loss on lameness in obese dogs with osteoarthritis

The impact of aging on osteoarthritis

Quick tip for putting on PAWZ balloon bootties

Easy application of PAWZ boots to protect your dog’s feet in the winter!

Trying to protect your pups feet from the winter cold and harsh salt? This is an easy application of ballon booties made by PAWZ.

Walking your dog is important for their overall mental and physical health. Protecting their feet from salt can help maintain mobility. If you have ever used PAWZ waterproof boots, you know they are great protection but can be a pain to put on. Well here is a awesome tip that was shared with me by a friend.

TIP: Stretch the balloon boot over a cup and then slide your dog’s paw into the boot/cup and like magic, the boot is on ??

For more tips, tricks and to learn how canine rehab can help keep your dog active and happy, follow me @UpwardDogRehab

#dogwalk #caninerehab #dogphysio #physiohelps #healthydog#tuesdaytip

When rest and medications aren’t helping…. What next?

Have you ever had the experience with your dog where he/she pulls up slightly ‘off’ after certain activities, nothing shows on x-rays so you follow the usual regime of rest and anti-inflammatory drugs, and your dog doesn’t improve? You gradually get back to the activity and he/she seems to get better and then a few weeks/months later it happens again?


Frustrating! 😡🥵

SOFT TISSUE INJURIES & TRADITIONAL THERAPY…

Soft tissue injuries affecting the muscles and tendons are very common, especially in active dogs. These injuries can be acute (traumatic event occurred) but more often are repetitive use injuries that have been micro injuries building over time, causing the tissue to slowly breakdown. In a healthy tendon, all those little tissue fibres are aligned providing the best strength and performance. With small repeated injuries, followed by inactivity, the tissues become weaker and less flexible. This creates a downward spiral as the dog starts to come up lame more often.

‘TENDINOPATHY’ – IT’S NOT INFLAMED SO ANTI-INFLAMMATORY MEDICATION DOESN’T USUALLY HELP!

A ‘tendinopathy’ is a general term used to describe injury/dysfunction of a tendon. In overuse injuries of tendons, there is little to no inflammation present. The technical term for this breakdown of the tissues is ‘tendonosis’. This lack of inflammation is one of the reasons anti-inflammatory medications don’t have much effect. More to that point, a recent people study by Bittermann et al., 2018 found that anti-inflammatories may even slow down the normal healing process! (See references listed below).

Please note, I am not saying pain management isn’t important. It’s very important! This is an explanation as to why anti-inflammatories may not be giving your the effect you are looking for with your dog.

And what what about strict rest???


Tendons don’t have great blood supply. What improves blood supply? Movement! Circulation helps bring in nutrient rich blood to promote healing while removing waste products from injury sites. Yes, the body produces ‘waste’ products. Cells die and new ones grow. Circulation helps get rid of the bad renew the good. 🐾

But wait, there is even more benefit to movement…

Are you familiar with the phrase: “use it or lose it”? It’s a real thing! Regardless of species, the body responds to the activity/force put through it. Controlled and gradual increases in activity help to realign and strengthen those muscle and tendon fibres! 💪 On the other hand, lack of controlled and gradual activity/force results in weaker tissues. Basically, they get weak and can’t do their job very well which then leads to more problems. ☹️

At this point you may be thinking “so what now???” Don’t worry, we are about to talk about what has been show help with those stubborn ‘tendinopathies’!

DISCLAIMER ALERT!

One small disclaimer before we continue. All this information and suggestions are just that, information and suggestions. If your dog is coming up lame, please get him/her checked out by your canine health professional right away. Having the right diagnosis enables recovery. Then, if you are dealing with something that comes and goes, and sounds like what has been described here so far, consider the recommendations below.

MOVEMENT IS MEDICINE…

Recommendations for chronic overuse injuries:

✅Avoid rough and uncontrolled activity such as rough play with other dogs in the beginning.
✅Initially, discontinue the activity that you think may have brought this on (this isn’t forever, just initially).
✅Adequately warm up and cool down your dog. Warmups can be about 5-10 minutes of light activity similar to the activity you are about to do, but very easy going. Cool downs may look the same and include some light stretches as well as using the necessary tools to help regulate body temperature (blankets in the winter, cooling beds/water in the summer, etc).
✅Continue light to moderate activity that incorporates strengthening exercises for the affected area. Gradually increase activity over several weeks.
✅Incorporate body awareness exercises.
✅Massage and gentle stretching after activity may help to improve blood flow and aid in tissue healing. Static stretching is NOT recommended as part of warmups!

BE ‘ECCENTRIC’…

Research has found that ‘eccentric’ exercises are a one of the best ways of helping strengthen tendons. This technical term is a type of muscle contraction where the muscle works against gravity to help slow down the body. For example, going down stairs is an eccentric movement for the muscles in the front of a dogs shoulders and thighs.

FINAL THOUGHTS…

What activity and how much should you do with your dog? It depends…. Sorry but this isn’t an easy answer. It requires proper assessment and guidance of a professional trained in canine rehabilitation. Consider the above guidelines. If you do suspect a tendon issue, I do really encourage you to seek out a canine rehab therapist that can guide you through a progressive exercise routine to get your dog back to top notch condition!

Did you know we have a video on Facebook that goes into lots of detail on this??? Check it out by clicking the icon below

LInk to Facebook live on soft tissue injuries

Thanks for reading and happy training!

REFERENCES
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312643/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/
https://clinmedjournals.org/articles/jmdt/journal-of-musculoskeletal-disorders-and-treatment-jmdt-4-049.php?jid=jmdt
https://www.ncbi.nlm.nih.gov/pubmed/15634833.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2770552/

Overload vs Overtraining: The difference between fitness & injury

Sleeping dog after big fetch session. Canine conditioning/canine rehabilitation and Overload vs Overtraining

If you are anything like myself and the millions of pet parents out there, your dogs are active family members.  We take them hiking, swimming, running, and to the beach. Maybe you have an athlete or working dog in which case the expectations of activity and performance are even higher.  So let’s talk about how to help them stay active family members.

Continue reading “Overload vs Overtraining: The difference between fitness & injury”

Posture & Pain:

“Since dogs can’t talk, how do you know when they have mild pain or discomfort?

Sometimes the signs of something brewing are much more subtle and knowing what to look for is part of keeping them living long, active, and healthy lives. Even your dog’s stance reveals potential problem areas and discomfort.  How they carry their head, the placement of their feet under their body and the position of the tail all give signs of their physical wellbeing.  

Continue reading “Posture & Pain:”

Does a dog have a collarbone?

Dog anatomy fact, canine rehabilitation

A dogs shoulder consists of 25 muscles responsible for movement and stability! 😲⁣

In people, the collarbone (clavicle) 🦴connects the arms to the trunk (torso). This helps us push, lift and swing the arms. Dogs don’t push and lift with their front limbs. Their body is designed for running, jumping, and turning – locomotion. Dogs lack a fully developed collarbone and instead have a small cartilaginous structure (softer than bone). This design allows for enhanced speed and agility. Continue reading “Does a dog have a collarbone?”

Daily “Physiotherapy” Increases Life Span of Dogs with Degenerative Myelopathy

Degenerative Myelopathy
Canine Degenerative Myelopathy, DM, Physiotherapy, Canine Rehabilitation

A diagnosis of degenerative myelopathy (DM) can be devastating to a pet parent. I can say that as a pet parent who has lived through it. To find out that your dog has a progressive neurological condition that will eventually lead to paralysis, may leave you feeling raw, lost, angry…. And it’s often hard to grasp the disease progression because your dog is usually doing very well when symptoms are first noticed. If you have gone through this experience, you may have experienced an onslaught of questions running through your mind. Is it going to hurt, how long does my dog have, can I do anything to slow it down….? And the list goes on. Continue reading “Daily “Physiotherapy” Increases Life Span of Dogs with Degenerative Myelopathy”