Common Ways Dogs Compensate for an Injured CCL
When a dog injures their cranial cruciate ligament (CCL), we spend a lot of time focusing on the affected stifle (knee). We want to reduce pain and inflammation in the joint, help strengthen the muscles around the joint, and provide the joint with some type of stability, either through surgery, bracing, the development muscular stability, or through the natural formation of scar tissue. But we would be remiss to only look at the site of the injury, as the rest of the dog’s body may tell a story of how it has been dealing with the injury.
Dogs are resilient and driven. When injured, dogs will often continue to do everything they can to get from point A to point B, but they will change the way that they move in order to compensate for the injury and avoid inducing further pain. This may result in changes to the way that they stand or walk and may include avoidance of particular activities that they have learned will create more pain and discomfort.
Typically, a dog with a CCL injury will avoid putting their full weight through the injured limb. To accomplish this, they will instead shift their weight onto the unaffected hind limb, shift their weight onto the front limbs, and/or bend their spine to avoid putting weight on the injured limb. As a result, dogs end up having to rely on the healthy limbs to bear more of the burden of the work of getting around.
A dog with an injured CCL may exhibit any of the following compensatory movement patterns:
- Changing their gait pattern to spend less time weight bearing through the injured limb
- Pushing off only the unaffected hind limb when going up stairs
- Jumping off only the unaffected hind limb when getting up onto furniture or into the car
- Kicking with only the unaffected when swimming
- Holding up the injured hind limb when transitioning from standing to sitting or sitting to standing
- Sitting with the injured leg out to the side
- Pulling through the front limbs when transitioning from down to standing, rather than pushing through both hind limbs
- Avoiding more irritating activities, like running, jumping, or playing with other dogs
It is important to identify asymmetries or compensations because these increase the risk of secondary injury or pain. For example, an alarmingly high percentage of dogs with CCL injuries in one limb will go on to tear the CCL on the opposite limb. Participation in a formal rehabilitation program can help reduce the incidence or severity of these secondary injuries!
There are several ways that we can identify areas of compensation. First, we use skilled observation as movement experts when watching a dog walk, trot, run, transition from stand to sit and down to stand, navigate stairs, or perform any other tasks relevant to their daily activities. We often employ slow motion video to highlight these differences. In dogs with subtle injuries, we may not notice any asymmetries or compensations in movement until we watch slow motion video.
Palpation, or “feeling with our hands” is a technique that helps identify muscles that are extra tense, often indicating that they are either being worked beyond their capacity or are being worked in an abnormal movement pattern. We often find that muscles in the unaffected hind limb and muscles surrounding the shoulders and neck are very tight.
We can also use a Stance Analyzer to tell us how much weight a dog is placing through each of its limbs. This is a pressure-sensitive mat with four quadrants (one for each limb) that provides a digital measurement of where the dog’s weight is distributed. A dog should normally bear 60% of its weight on its front limbs (30% on each side), and 40% on its hind limbs (20% on each side). A dog with a right hind CCL injury may bear only 5% of the weight on its right hind limb, thereby moving more weight into the front limbs and the left hind limb.
Once we identify compensations, what do we do about them? We treat them, using our full repertoire of rehab tools discussed in previous blog posts. Just like we treat the affected joint (in this case the CCL), we also must treat the dog’s WHOLE BODY to help the dog move more efficiently and reduce the risk of further injury.
If you suspect your dog may be showing signs of abnormal or compensatory movement patterns, we can help! Our goal is simple – to help all dogs move better, feel better, and live longer.
To health & mobility,
Cassie Swafford, PT, DPT