It has probably been a while since my last blog. I did have a really good idea to talk about last week but I have now forgotten what it was. Anyway patellas are always worth a few words.
I see a lot of little dogs with medially luxating patellas (the knee caps slips inwards). Most of us are familiar with the little dog that skips every so often when it is on it’s walk, think Jack Russell, Miniature Foxy, Chihuahua etc. It doesn’t seem to bother them and they get around quite well. These dogs have knee caps that slip out of their grooves while walking. The knee cap’s job is to act as a fulcrum around the knee so that when the thigh muscle in the front tighten, it pulls the knee cap up and this causes the knee to straighten. If the knee cap slips sideways out of it’s groove, the fulcrum is lost and the knee cannot straighten. In mild cases, the knee caps often slips back spontaneously and the leg is able to straighten again. Not pain, just a bit of inconvenience. However, sometimes when it is worse, there is irritation around the knee or when the knee cap doesn’t slip back into the groove, the dog can have trouble walking and appears to be in pain. Surgery to put the knee cap back is often the solution.
In some cases, I have been able to help dogs with this problem by changing the way it walks and uses it’s muscles. To reduce the chances of the patellas slipping, the body will automatically tighten up it’s front thigh muscles to hold the knee in place and to tug harder on the patella to get the knee to straighten. This results in a crouched posture and causes an arching of the back. Little dogs are often prone to back problems as well and I commonly get these dogs in with sore backs that are aggravated by patella luxations.
Sometimes by releasing the tightness in the back and thigh muscles, the knee caps are able to sit a bit lower and deeper in the knee cap groove of the leg. This reduces the severity of the problem and everyone goes home happy. At other times when doing that is not enough, we can give these dogs rehabilitation exercises to do that change the way they walk. our aim is to relax the front thigh muscles (quadriceps) and engage the hamstrings muscles instead.
Think of the process of taking a step forward. We can take a big step forward and pull our body forwards to the leg or we can take a little step forward and then take our body forwards by pushing our leg further back. The first uses the quads and the second the hamstrings. Using the hamstrings causes the body to stretch out more, the back becomes flatter and the patella is also less prone to popping out of it’s groove.
It is not a fix for all dogs and knee caps that are more severely luxating would still benefit from surgery especially if there is a dodgy back involved.
Till next time
keep healthy and happy