Post-Op Rehab: Your Window to Prevent a ‘New Normal’
- Ah Young Kim
- Jul 11
- 2 min read
Yes, I agree—for some of you, the concept I introduced last week might have been quite new. But veterinary sports medicine and rehabilitation is continuously evolving, and I believe it’s important for all of us to keep reading, learning, and thinking critically.
This week, I'm sharing my own clinical approach to early post-op rehabilitation—specifically after TPLO. To be clear: there’s no universally established, evidence-based protocol here. So consider this a mix of current understanding, practical logic, and my personal opinion as someone who thinks about these things probably too much. 😅
In the last post, we discussed arthrogenic muscle inhibition (AMI)—a fascinating but challenging concept. So this week, let’s walk through how this plays into the rehabilitation process after surgery.
So where do we start?
Regardless of how long ago the initial injury occurred, there’s usually residual pain or synovitis in the joint (especially the stifle). And if there’s pain, we can’t make meaningful progress.
Pain control is priority number one—especially in the immediate post-op period. Icing, cold compression, and oral analgesics are not optional. They are essential.
Whether it’s due to pain or AMI, the dog will be reluctant to use the limb. That leads to disuse, which in turn creates further problems:
Decreased range of motion
Poor joint fluid circulation
Early capsular fibrosis
Unhealthy cartilage
We know that the first 2–4 weeks post-op are key for tissue proliferation and healing. If the dog isn’t using the joint properly during this phase, the joint capsule and surrounding tissues will “heal” into a dysfunctional new normal. Not ideal.
The early rehab priorities:
Pain control – address pain immediately and thoroughly
Maintain range of motion – gentle, passive ROM within pain-free range
Encourage joint fluid circulation – helps nourish cartilage
Restore proprioceptive signaling – the joint’s sensory receptors are “confused” after surgery; help them recalibrate with low-load, gentle joint compression
Facilitate appropriate muscle activation – timing matters!
On Muscle Activation: Be Intentional
Once pain and joint care are addressed, we can focus on muscle activation. But here’s the key: don’t rush it.
If the dog refuses to extend the stifle, and you're early in the rehab process, don’t jump straight into dynamic exercises. Instead, try:
Isometric holds
Gentle perturbation during static standing
At the same time !!! Tapping or brushing to stimulate muscle response
Or low-level NMES (for tolerant patients)
If you skip this step, the dog will use surrounding muscles to compensate—and that pattern can stick. Once compensation becomes habit, it’s much harder to undo.
Yes, cavalettis can be a fantastic way to activate multiple muscle groups—but not all dogs are ready for that. Backward walking is another great option, but again, only if it’s appropriate for that individual patient.
That’s the reality of post-op rehab: if we truly want to help our patients, cookie-cutter protocols won’t work.
Even if an exercise looks good—like a nice trot over cavalettis—always ask yourself:
Which muscles are actually working right now?
Key Takeaways
✅ Pain control is your foundation
✅ Protect and maintain range of motion
✅ Promote joint health through movement
✅ Reconnect proprioceptive pathways
✅ Be intentional with muscle activation
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