Conditions that can benefit from this therapy
Orthopaedic Conditions
Osteoarthritis
A chronic, degenerative joint disease characterised by the breakdown of articular cartilage and usually affects one or two synovial joints. As the hyaline cartilage breaks down it no longer acts as a cushion to protect the bone. This causes friction in the joint, swelling in the synovial membrane, and the growth of bony spikes, resulting in painful, stiff, tender, and inflamed joints. Most affected joints are weightbearing - hips, knees, shoulders, and elbows.
One of the most common forms of arthritis in dogs, normally seen in middle aged to senior dogs, but also affect young dogs with poor breeding and malformed joints. As it progresses it worsens, pain and inflammation increases and joint mobility becomes more restricted due to bone growth and friction every time the joint moves. Overproduction of synovial fluid causes swelling, putting more pressure on the joint and ligaments, and overcompensation in other muscles. The muscles will begin to protective splint and accrue massive stresses causing myofascial pain and trigger points.
Symptoms
- Reluctance to exercise, slowing down on walks, lethargy
- Reluctant/unable to jump
- Gait changes due to stiffness i.e. bunny hopping
- Behavioural changes – aggression, irritability, depressed
- Licking Joints
- Limping, lameness on any joints, often intermittent
- Creaking or crepitus of the joints
- Reduced range of movement, motion, and stiffness, especially in the morning or after rest
- Sensitive to touch on affected joints
- Periods of acute inflammation
- Swelling/thickening or heat around the affected joint
- Difficulty posturing to urinate or defecate, or having accidents in the house
- Loss of muscle mass over the limbs and spine
How massage can help
- It is non invasive
- Alleviates pain by releasing trigger points and hypertonic muscles
- Eases compensating structures and decreases muscle splinting
- Reduces stiffness
- Improves joint mobility and reduces stiffness by warming the muscles and surrounding areas to increase suppleness.
- Reduces muscle tension and increases flexibility. Massage often combines passive range motion exercises and stretching and can reduce compressive forces on the joint.
- Improves circulation and blood flow, bringing fresh oxygen and nutrients to joints and tissues.
- Can slow down the degenerative process
- Reduces inflammation and swelling by removing toxins and cell waste
- Reduces stress, promotes relaxation, and improves emotional well-being.
- Helps break the ‘Pain Cycle’ by working with the circulatory and lymphatic systems and calming the autonomic nervous system
- Helps break the ‘Pain-tension-more pain’ cycle in affected and opposing weigh bearing limbs
Hip Dysplasia
A developmental condition that is caused by an abnormality in the formation of the hip joint. The femoral head should fit smoothly into the acetabulum, but the malformation in either the femoral head, acetabulum or both result in uneven contact in the joint surface causing instability. It can affect one or both hip joints in any dog, and affects males and females equally.
The primary cause is genetics, as it is a hereditary disease, but it is also affected by diet, growth rate, environment, exercise, and muscle mass. Managing external factors can help control the progression of the disease. It is a progressive, painful lifelong condition causing pain, swelling and inflammation. The unstable joint causes gradual bone degeneration, articular cartilage to be eroded, the capsule and ligament become stretched, and it leads to Osteoarthritis. It can also be the result of injury, and later onset of the condition can be caused by Osteoarthritis. Careful management is required and some dogs will require surgery.
Clinical signs vary, and it can go undetected for many years, but usually shows around 5-6 months, and is most diagnosed between 6-12 months. Symptoms get worse with ageing and vary depending on the severity of the disease, inflammation, looseness in the joint and how long the dog has been suffering.
Symptoms
- Difficulty sitting, lying down, getting up, climbing stairs
- Stiffness
- Decreased activity and range of motion
- Reluctance to exercise
- Intermittent/persistent lameness on one or both hind limbs
- Abnormal gait, swaying, wobbling and bunny hopping
- Sitting in ‘frog’ position (with one hip splayed outwards)
- Loss of thigh muscle, enlargement of shoulder muscles
- Pain in and around hips
- Swelling or warmth in hip area
- Reluctance to be touched
- Unexplained aggressive behaviour
How massage can help
- Decreases pain and soreness in affected area and compensating muscles
- Relieves tension and aids muscle relaxation
- Reduces stiffness, inflammation, and joint discomfort
- Addresses spasms, trigger points and pinched nerves
- Increases flexibility and mobility
- Improves stability of the joint
- Develops muscle tone and strength
- Reduces stress and improves disposition
- Helps correct balance and posture
- Helps with cycle of pain
- Brings nutrients and flushes toxins
- Improves quality of life and allows enjoyment of normal exercise
Elbow Dysplasia
The most common cause of lameness in the front legs, it relates to the abnormal development during growth of the elbow joint where the humerus, ulna and radius do not fit together perfectly. This affects articulation of the joint due to abnormal concentration of forces which affect the growth of cartilage and results in microscopic stress fractures.
It normally affects both front limbs and can occur in any dog. It is an inherited condition and the cause is unclear and often affects younger dogs, and is more common in large and giant breeds. The cause may be multifactorial and affected by genetics, rapid growth in young dogs, defects in cartilage growth, trauma, overexercise, and diet. Once the elbow joint is damaged it causes osteoarthritis, inflammation, and cartilage loss, all resulting in pain and loss of function. The pressure in the joint can also lead to fractures and surgery is often recommended. Medial compartment disease has the worst prognosis as the degeneration of the articulating joint surface causes bone to be exposed and cartilage to be eroded. It causes pain and inflammation and cannot be reversed.
Often diagnosed at an early age at around 4-6 months, but in some dogs, it is later at around 4-6 years. Occasionally there are no signs.
Typical Symptoms
- Lameness in one or both forelegs, especially after exercise and doesn’t recover fully with rest
- Head bobbing – head goes up when affected leg touches the ground, and down when the good leg touches the ground
- Stiffness especially after rest
- Pain when joint is manipulated, dog may lip lick, yawn or yelp when extending or flexing
- Joint thickening or swelling over the elbow
- Reduced range of motion in the elbow
- Abnormal gait, holding the affected elbow away from the body (abduction), and paws turned inwards when walking
- Reluctance to exercise, run or play, jump into the car, go down the stairs
- Flopping to the floor without control
How massage can help
- Improves pain management
- Addresses areas of overcompensation and muscle splinting
- Relieves inflammation
- Relieves muscle tension
- Strengthens muscles around the elbow joint
- Improves range of movement, mobility, and flexibility
- Relieves trigger points and muscle spasm
- Supports articular cartilage health to help slow degeneration
- Aids recovery from surgery
Luxating Patella
A common orthopaedic disease, also known as slipping kneecap, which affects the hindlimbs. It occurs when the patella (kneecap) moves from its normal position and dislocates outside of the trochlea groove which stabilises it, enabling it to move medially (slips inward), laterally (slips outward) or in both directions. It can affect one or both legs and prevents the leg from being able to flex properly.
Female dogs are more prone to it, with medial luxation being most common in small breeds under 3 years, especially toy and miniature breeds and dogs with a ‘bow-legged’ stance. Lateral luxation is less common and is commonly diagnosed in large breeds.
There are 4 grades of luxating patella:
GRADE 1 – Patella luxates then returns to normal position
GRADE 2 – Patella luxates when stifle flexes but returns to normal when stifle is extended
GRADE 3 – Patella is luxated for majority of the time
GRADE 4 – Patella is permanently luxated
Symptoms often start to show in young puppies around 4 months old, but if caused by injury symptoms can be displayed at any age. One of the first signs is hopping/skipping when the hind leg is active with no signs of pain, the dog will limp for a few steps then return to normal.
Symptoms
- Hop hop skip when walking
- Holding hindlimb up for several minutes before continuing
- Lameness - intermittent or persistent depending on Grade
- Pain
- Momentary yelp as patella dislocates
- Stiffness in knees
- Clicking sound when patella moves
- Altered gait with knees that don’t extend properly
How massage can help
- Can re-align patella with Grade 1 and 2 cases and may prevent/postpone surgery
- Addresses muscle splinting and overcompensation, relieves muscle tension and spasms
- Lengthens and relaxes shortened muscles
- Loosens adhered tissues
- Prevents tightness in other muscles e.g. back muscles
- Reduces pain, stiffness, and soreness
- Improves mobility and activity
- Improves gait and encourage equal weight bearing on all 4 limbs
- Helps restore muscle tone and function to assist with stabilisation
- Aids post-surgery recovery and rehabilitation
- Stimulates circulatory system bringing nutrients to the stifle and articular cartilage and removes toxins
Spondylosis
A chronic, non-inflammatory, degenerative joint disease which causes abnormal bone growth on the outer edges of the spinal vertebrae. The narrowing of intervertebral discs causes growths to form and the spine to fuse together, restricting spinal mobility. It can be found in one or more locations and in dogs it is common in the thoracic (especially between the rib cage and abdomen) and lumbar vertebra and lumbosacral joint (around hips and back legs). Large breeds are more predisposed to it, and it is more common in middle aged and older dogs around 9 or 10 years old.
Ageing, injury (especially spinal trauma), genetic predisposition, repeated pressure from activity, or other conditions which de-stabilise the spinal column, such as Intervertebral disc disease, cause the vertebral bones and joints to degenerate and become unstable. It is also common in neutered female dogs with excessive scarring as this weakens the core muscles. To re-establish stability and reinforce weakened joints, bony spurs, called osteophytes, form at the endplates.
It is a progressive condition and cannot be cured. As the disease progresses the bony spurs may bridge from one vertebra to another, attach or insert themselves into neck bones, and touch nerves in the spinal region resulting in increased pain, and reduced range of motion and flexibility.
Symptoms
Most dogs are asymptomatic, but as it progresses and spinal fusion occurs, symptoms become more noticeable:
- Stiffness and rigidity
- Reduced range of motion and loss of flexibility
- Altered gait
- Lameness
- Back and neck pain
- Reluctance for back or spinal column to be touched
- Muscle loss, weakness, or numbness in limbs
- Loss of co-ordination and balance
- Reluctance to sit, or difficulty in rising from lying position
- Change in behaviour or character
How massage can help
- Reduces stiffness and improves joint flexibility and movement
- Natural pain reliever which helps with referred pain, myofascial pain and trigger points
- Relieves and reduces areas of overcompensation and muscle splinting
- Improves posture and Gait
- Relieves stress, helping to calm and relax the dog and the muscles
Osteochondritis Dissecans (OCD)
A painful inflammatory condition that occurs in joints when cartilage is damaged or grows abnormally and becomes partially detached or separates completely from underlying bone. This causes fluid build-up in the joint and it becomes inflamed, swollen and nerves become irritated. It is a developmental disease occurring during growth, when the process of endochondral ossification is taking place, and is a result of an abnormality in the cartilage to bone transformation. The cartilage is abnormally thick making it less resistant to mechanical stress and results in lesions ranging in severity.
There are four grades:
Grade 1 – is an intact lesion with no signs of separation
Grade 2 – shows early signs of separation from articular cartilage and underlying bone
Grade 3 – is a partially attached lesion
Grade 4 – is a lesion with a crater and a loose body floating in the joint (called a Joint mouse)
It can affect any joint and may be bilateral or affect several joints. It is more common in the shoulder, elbow, hock and stifle, but rarely seen in the spine or wrist.
Clinical signs can vary depending on the size of the cartilage defect, which joint is affected, and severity of the lesion, and in some cases are asymptomatic. Symptoms are usually evident before 1 year old, around 4-7 months, but occasionally (especially with Shoulder OCD) they may present when the dog is older.
Typical Symptoms
- Lameness which becomes worse after heavy exercise and prolonged rest, may be intermittent and initially mild
- Mild pain/constant pain depending on severity
- Crying when affected joint is manipulated/pressure applied
- Swelling and heat in the joint
- Reduced range of motion and mobility
- Reluctance to flex or extend affected joint resulting in scraping nails
- Advanced cases may cause joint instability and locking
- Abnormal gait, holding leg in different position to reduce weight bearing
- Uneven weight bearing through limbs
- Muscle wastage around affected joint
- Reluctance to exercise
- Stress and Depression
How massage can help
- Reduces pain and tension
- Relieves muscle spasms
- Relieves areas of overcompensation
- Increases range of motion, and mobility
- Encourages equal weight bearing on all 4 legs
- Improves muscle tone and strength
- Reduces muscle wastage
- Improves circulation
- Reduces risk of oedema and flushes toxins and brings nutrients to the joint
- Aids pre surgical conditioning
- Reduces recovery time post surgery
Soft Tissue Conditions
How massage can help
Speeds up recovery from injury
Helps stretch and realign scar tissue
Eases pain and discomfort
Prevents injury and weakness by toning the muscles, making them stronger and more pliable
Sprains
A sprain is a soft tissue injury caused by the overstretching or tearing of ligaments around a joint. It occurs when the joint twists or wrenches in an unnatural position causing attachments to become stressed beyond their normal capacity and results in joint or muscle pain, swelling and bruising around the area and reduced joint mobility. It is a common injury and the most affected areas in dogs are the stifle, hock, toes and wrist (carpus). Due to limited blood supply the healing process is slow and results in the formation of inferior scar tissue, this can weaken the joint and result in repeat injury. It is important to protect the area whilst the tissue heals but also keep it moving to increase circulation as this promotes healing. There are various grades of sprain, and these affect the rehabilitation process.
There are 4 degrees of sprain:
- 1st Degree – mild sprain when there is a minor tear or stretch. There may be some pain and swelling but the ligament is still functional and the joint will be stable. There may be mild lameness.
- 2nd Degree– moderate sprain where the ligament is partially torn or significantly stretched, and the ligament does not have the strength to function normally. Swelling and pain occur, and the joint cannot be used fully presenting sudden lameness.
- 3rd Degree – severe sprain where the ligament is completely ruptured and no longer connects the bones together resulting in excessive movement and flexibility of the joint. The joint will not be able to bear weight and will need to be stabilised.
- 4th Degree – called an avulsion fracture, the ligament remains intact but the bony attachments breaks away from the main part of the bone taking a small piece of bone with it causing severe pain. Immobilisation will be necessary and in severe cases, surgery will be necessary.
Symptoms
These can vary depending on the severity of the sprain and can go from hardly noticeable to crippling.
- Lameness, limping or reluctance to bear weight
- Pain and swelling and the joint may be hot and tender
- Stiffness and struggling to get up from sitting or going up stairs
- Loss of appetite
- Change in behaviour, may whine or hide due to pain
- Excessive licking or chewing of the affected joint
Strains
Muscle strain, sometimes referred to as a pulled muscle or torn muscle, describes a partial or complete tear in the muscle and can occur in any part of the muscle structure including tendons and blood vessels. Damage occurs to the muscle fibres, and/or it’s tendon, when the muscle is overstretched, twisted, or contracted too quickly. This causes tension on the muscle whilst it is contracting, such as a sudden jerk or twist or when there is excessive loading on the muscle. Acute strains happen fast, often during activities that require explosive movements, such as jumping, sudden changes in direction or speed, or falling awkwardly. Chronic strains occur due to overuse, often during activities which have repetitive or prolonged movements, such as walking on slippery laminate flooring.
There are 3 categories of strain depending on the severity of the rupture and how many muscle fibres are affected, and these gradings can provide an idea of how long recovery may take.
- Grade 1 – is a mild strain. Damage to the fibres is less than 5%. There will be some pain and tenderness, but this is often delayed until the next day. Swelling may not be obvious and there will be minimal loss of strength and full range of motion. There will be minimal scar tissue.
- Grade 2 – is a moderate strain. Approximately half of the muscle fibres will be torn, but the muscle is not completely ruptured. There will be significant pain and swelling and muscle strength and range of motion will be reduced. A massage therapist may be able to feel the damage when palpating. There will be moderate scar tissue.
- Grade 3 – is a severe strain. The muscle is completely ruptured with either the muscle belly being torn in two, or the tendon being torn from the muscle, and the defect is palpable (but swelling can make this difficult). There will be severe swelling and tenderness and loss of strength, range of motion and function. Surgery may be required to reattach the damaged muscle and tendon. There will be significant scar tissue.
Symptoms
- Immediate pain at the time of the strain
- Pain that worsens when contracting the muscle
- Localised swelling, inflammation and bruising
- Loss of strength and range of motion
- Unable to bear weight evenly
- Stiffness
- Inflamed in the injured area
- Vocalising pain – yelping/screaming
- Hesitant or unable to jump or go up and down stairs
- Struggling to do usual daily activities
- Reluctance to eat
- Avoiding being touched
- Intolerant of other dogs
Trigger Points
Trigger points cause the most common muscular issues for dogs and are often referred to as ‘knots’. They are found in the muscle tissue or fascia and are hyper irritable points in taut bands of skeletal muscle. When muscle fibres become dysfunctional and stay in a contracted state, the muscle cannot relax and a tight band forms in the muscle. Supply of blood and oxygen is restricted, and waste products accumulate. It is the point where the waste accumulates, that is called the trigger point. They cause the muscle to be weaker, decrease contractile range and create tension where the muscle attaches to bones and other tissues. They are also commonly found alongside injuries such as sprains, strains and orthopaedic conditions.
The main causes are:
- Muscle overuse and insufficient recovery time at strenuous exercise
- Muscle overload
- Muscle fatigue
- Soft tissue injuries such as strains and sprains
- High impact or trauma e.g. body slamming by other dogs
- Daily living e.g. using stairs, jumping off furniture
- Repetitive action or strenuous exercise e.g. chasing a ball, flyball, agility
- Ageing
- Poor posture
- Excessive stretching
- Stress
- Weak joints such as arthritic or dysplastic joints
- Sleeping in one position for extended periods/ in restricted space i.e. curved beds/small crates
Trigger points can vary in shape and size and are extremely tender, causing pain when compressed. The pain can cause discomfort and extreme or debilitating chronic pain which can be localised or cause predictable patterns of referred pain elsewhere in the body. As dogs are good at hiding pain, and the pain often mimics other conditions, including arthritis, the dog can suffer for a long time and trigger points are often missed as being the source of pain.
Typical Symptoms
- Reduced stamina and muscle weakness
- Increased stiffness or lameness, lack of extension in the fore or rear legs
- Lack of co-ordination
- Decreased range of motion and mobility
- Unwilling to be touched or groomed in the area
- Hot spots felt through the skin and fur
- Twitching/Flinching of the skin
- Chronic ongoing pain
- ‘Tickly’ spot in the middle of the back – the pain makes the dog grimace
- A ‘Jump sign’ which is in response to intense pain and startles the dog so that they may jump, yelp, cry or show signs of aggression
- Hair flicking up where it didn’t before
- Premature aging
- Lack of enthusiasm for walks/play/food
- Fatigues quickly on walks
- Depressed, non-typical behaviour/mood
- Knots or lumps in the muscle
- Nerve irritation
- Referred pain – pain is felt in a different location to the trigger point
- Ischemia – trigger points prevent metabolic by products from being removed, thereby causing further restriction, tissue dysfunction and nerve irritation.
There are different types of trigger point that have different qualities, and which are classified based on symptoms and location:
- Active Trigger Points – painful when at rest or when movement occurs. Tender when compressed and can cause localised or referred pain. Usually located in the muscle belly.
- Latent Trigger Points – only produces pain when palpated. The muscle will feel knotty and may be weaker with reduced range of motion. More common than active trigger points. Can remain latent for years but can revert to being active.
- Primary trigger Point – directly activated by mechanical strain or overload in the muscle and is the main cause of pain.
- Secondary Trigger Points – activated in overworked synergist or antagonist muscles
- Satellite – found in muscles that lie within the referral pattern of primary trigger points. Often form in a cluster resulting in muscles being unable to fully extend and feel weaker than they are. They cause referred pain,
- Key Trigger Points - have pain referral along a nerve pathway so they weaken the muscle and cause surrounding muscles to work harder which forms more knots which then activate satellite points or latent trigger points.
Massage which includes deep tissue work, trigger point therapy and myofascial release can reduce pain and discomfort, resulting in a significant improvement of flexibility and movement. Some trigger points will be completely resolved, however, if it has been in the body for a long time, permanent damage to the tissue will have occurred, which means that the dog will only get a temporary release and ongoing treatment will be needed to reduce reactivity.
Myofascial Pain
Myofascial Pain is a common condition which can be defined as having the presence of multiple sensitive trigger points in the fascia or surrounding muscle which are caused by inflammation or irritation, and which cause chronic pain in the musculoskeletal system. There are various causes including:
- Muscle injury or trauma including sprains, strains, and contusions
- Repetitive overload or overuse of the muscles
- Poor posture or biomechanics
- Nerve root compression
- Stress or emotional trauma
- Old age
- Hormone imbalances such as hypothyroidism and endocrinopathies
- Nutritional imbalances such as deficiency of iron or folic acid
- Dehydration from the dog not drinking enough/other reasons such as diabetes
- Secondary condition to osteoarthritis
Myofascial pain relates to pain in the muscles which is caused by the fascia that is surrounding it. The pain comes from trigger points which are sensitive areas in the muscles caused my taut bands of highly irritable muscles fibres which feel like small bumps, nodules or knots. They occur due to an excess of acetylcholine and calcium which leads to a lack of oxygen, causing blood flow to stop and the muscle tissue becoming hypercontracted, which results in an accumulation of waste materials. Muscles require oxygen to relax, but as there is a lack of it due to tightness and restricted blood flow, it can't reach the muscle, so it can't relax and heal, and it becomes a self perpetuating problem. This causes the trigger points to become irritated and sends pain signals to the brain to stop using the muscle, which means that surrounding muscles have to work harder to compensate. As fascia is continuous, a restriction in one part can affect another which can lead to many muscles being affected at the same time. Diagnosis of myofascial pain is often difficult because the pain is diffused and not easy to localise. It also mimics other conditions such as Arthritis and Fibromyalgia and symptoms can vary from dog to dog depending on severity and tenderness. In addition it is not possible to use MRI scans or X-rays as fascia does not show up in them.
Dogs with Myofascial Pain may exhibit one or more of the following symptoms:
- Local Twitch response or flinching when palpated caused by contraction of the taut band. The twitch occurs because nerve and pain sensitivity is increased by the tightening of the fascia on the skin. This is not essential for diagnosis but if it is present is very significant. It can sometimes be difficult to observe depending on the thickness of dog’s hair and location of the muscle affected
- Jump response – defined by Franks in 1999 and includes the dog turning their head, attempting to bite, yelping or growling and attempting to withdraw when the affected area is touched
- Sore stiff limbs, especially the back legs
- Tenderness to touch and reluctance to be handled or groomed
- Restricted range of motion, shorter strides, or lameness
- Alterations in gait function due to primary muscle fatigue and muscle weakness
- Postural changes including an arched or hunched back and preferring a lowered head
- Excessively rolling on their back
- Tight skin that cannot be lifted away from underlying muscles
- Change in behaviour becoming more anxious/depressed/nervous
- Hair flicking up that wasn’t there before
- A 'tickly spot' in the middle of their back which causes them to grimace
Myofascial Pain can cause unrelenting pain and discomfort and can gradually worsen if it is not treated. Massage therapy can address trigger points and help increase blood flow to the hypercontracted muscle tissue, supplying it with fresh oxygen which helps muscles to relax and stop contracting and help to end the Pain Cycle.
Hypertonicity
A hypertonic muscle is a muscle that has too much resting tone that causes extreme tightness. Golgi tendon organs are responsible for sensing muscle tension and switching muscle activity on or off. When the muscle is tight, they become overstimulated, and the signals sent through the nervous system become disturbed causing the muscle to be contracted even though there is no movement.
There are various reasons for hypertonicity occurring:
- Muscle Injury
- Myofascial pain and trigger points
- Stress on muscles
- Curved beds or crates that are too small
- Activities of Daily Living e.g. jumping on/off furniture, ball chasing
- Lack of recovery time for sporting, working dogs
- Other orthopaedic conditions e.g. Arthritis/Spondylosis/Elbow and Hip Dysplasia
As the muscle cannot relax, it cannot recuperate and becomes fatigued. They also become hard and inflexible and may bulge which further impedes its ability to contract. The fascia also begins to tighten adding to further restriction and making the muscle prone to trigger points. These factors cause the muscle to become locked in a pain cycle, so the muscle will be tender, have dull aching pain and nerve irritation. As the muscle is rigid, there is loss of function and normal movement becomes more difficult, walking may be stiff, jerky and uncoordinated. The dog may also experience cramps and is more susceptible to tearing or straining the muscle. As the contracted muscle may be long or short, posture is also affected
How massage can help
- Reducing tension and over contraction of the muscle
- Freeing adhesions that restrict fascia
- Softening and loosening tissue
- Reducing pain
- Strengthening the muscle to avoid re occurrence
- Increasing flexibility
- Increased mobility
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