🏥 What Is TPLO?

TPLO (Tibial Plateau Leveling Osteotomy) is one of the most common surgeries performed to stabilize a torn cranial cruciate ligament (CCL) in dogs. While the procedure is highly effective, it requires a structured recovery process—particularly **physical rehabilitation**—to regain strength, mobility, and long-term joint health. 🐕‍🦺

🔄 Why Rehab Matters After TPLO

Rehabilitation should begin immediately post-surgery and progress through clearly defined phases. A full rehab program enhances:

• 💪 Muscle rebuilding and joint stabilization
• ⚙️ Proper gait and limb use
• 🩻 Osteotomy healing and limb loading
• 🏃 Return to athletic function (if needed)

📆 Phase 1: Immediate Post-Op (Week 0–2)

This initial phase focuses on pain relief, inflammation control, and early limb use. 🔹

Goals:

• 🧊 Reduce swelling and pain
• 🚶 Encourage gentle limb use
• 🔄 Maintain joint range of motion

Therapies:

• 💆 Massage for edema and relaxation
• 🧊 Cold packs: 10–15 mins, several times daily
• 🦿 Passive range of motion exercises (hip + stifle)
• 🚶 Controlled leash walks: 5–10 min, 3–4x/day
• 🔦 Laser and TENS therapy to manage pain

🏋️ Phase 2: Strength & Stability (Week 2–5)

Once inflammation subsides, therapy aims to restore muscle strength and coordination. 🔸

Goals:

• 💪 Reverse disuse atrophy
• ⚙️ Improve joint mechanics
• 🧠 Enhance proprioception

Therapies:

• 💧 Underwater treadmill (UWT): slow, progressive sessions with adjusted water level and incline
• 🏋️ Balance work: sit-to-stand drills, dancing, walking backward
• 🧘 Hip and stifle stretching
• 🪡 Dry needling (trigger point therapy), laser, or manual massage for myofascial pain

Rehab sessions: 2–3x per week. Owners continue home exercises and leash walks on alternate days. 🗓️

📈 Phase 3: Core & Conditioning (Week 5–9)

This phase builds on earlier gains with added resistance and dynamic challenges. 🟠

Goals:

• 🏃 Boost muscle strength and control
• 💥 Increase cardiovascular endurance
• 🔄 Normalize gait and load bearing
• 📏 Eliminate lameness at walk and trot

Therapies:

• 💧 UWT with increased speed and incline
• 🚶 Land treadmill (introduced carefully)
• 🔧 Core work with balance discs, wobble boards, therapy peanuts, and air pillows
• 🎾 Obstacle courses for proprioception
• 🪡 Continued dry needling or trigger point therapy

Rehab continues 2–3x per week. Most dogs complete their formal rehab during or at the end of this phase.

⚡ Phase 4: Athlete Return-to-Work (Week 9–16+)

This optional phase is tailored to **canine athletes or working dogs**. Rehab sessions are more intense and tailored for full performance restoration. 🟢

Goals:

• 🏁 Prepare for sprinting, agility, or competition
• 💪 Maximize core and hind limb power
• 📉 Remove all signs of lameness at all gaits

Therapies:

• 🏊 Swimming sessions for endurance
• 💧 Extended underwater treadmill work
• 🔁 Land treadmill sprint intervals
• 🌀 Complex obstacle challenges with sequencing
• 💥 Jump drills and pivot turns

Dogs entering this phase usually have 90%+ osteotomy healing on X-ray. Phase 4 typically lasts 6–10 weeks.

📋 TPLO Rehab Summary Table

🛠️ Tools Used in Rehab

• 💧 Underwater treadmill
• 🔦 Laser therapy
• ⚡ Electrical stimulation (TENS, NMES)
• 🧘 Stretching mats and foam rollers
• 💡 Balance pads, peanut balls, therapy eggs
• 🪡 Trigger point dry needling

📲 Ask A Vet Can Help

Need help navigating TPLO recovery? Use the Ask A Vet app to connect with veterinary rehab specialists, get custom home exercise plans, and monitor healing progress. 🐶💬

🐾 Final Thoughts from Dr Duncan Houston

TPLO surgery is only half the battle. With a structured, professional rehab plan, your dog can regain full function and live a strong, active life. Whether it’s simple walks or elite agility—step-by-step therapy brings your best friend back. 💙🦿