How to prevent Another Cranial Cruciate Ligament (CCL) Tear
Time to talk about Rio again. If you missed the last Learn & Go, Rio is a 10 year old Border Collie who was doing Agility and Flyball his whole life until he tore his right cranial cruciate ligament (CCL). He had surgery five months before I saw him, but hasn’t been the same since.
Rio had a typical post-cruciate “sit.” That is to say, the injured side was externally rotated, pushed forward, and there was a significant reduction in knee and hock flexion. All dogs, even Border Collies who have some external rotation in their hind limbs, should sit with their hind limbs well bent at the hock and stifle with the limbs tucked under them. Rio clearly held the affected limb abnormally.
We knew Rio was at risk of tearing his good CCL because he was overusing his good leg while he was off weighting his surgery leg. This is common after a CCL tear because the other limb ends up holding most of the weight when standing, walking, and rising from a sit or down position.
In Rio, there were already changes in his good knee that were warning signs. He had effusion, an indication of inflammation, which is the first sign of trouble. It can be reduced with supplements, possibly medications, and specific treatments, including ice, laser and Pulsed Electromagnetic Field (PEMF) therapy. But, the most important steps are to reduce the excess weight bearing on this limb and to strengthen the structures around this joint.
During his assessment, I found other complications, including back pain, elbow tenderness, and inability to stretch the biceps brachii muscle on both sides. His biceps can get excessively tight while he pulls his weight forward and over uses his front legs. As he continues to overuse his front end, we may see continued or additional areas of damage. If this happens, he will likely become less active overall as his compensations are now part of the problem. He can develop generalized atrophy and discomfort.
We were able to make him more comfortable immediately. I gave him exercises to do at home to strengthen the muscles that support the knees, hocks and elbows. We also worked on improving his range of motion at the tarsus so he can use his surgery leg appropriately, bending it underneath him, allowing for him to lift from a sit using that leg. All of these exercises will ultimately balance all 4 limbs bringing him back to a level of strength he had before the surgery.
Watch the video below all the way to the end. The last slide has great pictures of him after treatment, definitely worth watching for.
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