TPLO Post-Operative Physical Therapy Regimen

Studies show that structured physical therapy after Tibial Plateau Leveling Osteotomy (TPLO) surgery can significantly reduce recovery time and improve joint function. However, both insufficient and excessive therapy can lead to complications. If you are interested in professional rehabilitation, please consult our team.

Key Guidelines:

1. Too little therapy may delay recovery and cause muscle atrophy.

2. Too much therapy too soon may cause implant failure or surgical complications.

3. Always follow your veterinarian’s instructions and progress gradually.

Weeks 1-2: Initial Recovery Phase (Strict Rest & Pain Management)

• First 24-48 Hours:

  • Expect some pain, grogginess, or whining due to surgery and medications.

  • No free movement—keep your pet confined to a crate or a small, carpeted space.

  • Use a short leash & belly sling for bathroom breaks only.

  • No stairs, jumping, or off-leash activity.

• Pain & Swelling Management:

  • Days 1-7 – Apply ice packs (wrapped in cloth) for 10-20 minutes, 2-3 times daily to reduce swelling.

  • Days 5-7 – Begin heat therapy for 10-20 minutes before Range of Motion (ROM) exercises.

  • Pain medications – Administer as prescribed. If pain seems uncontrolled, contact us.

• Range of Motion (ROM) Exercise:

  • Position-- Pet should lie on the non-surgical side in a calm environment.

  • Movement:

    • Gently flex & extend the knee 10 times, once daily.

    • Do not push past your pet’s comfort level.

    • Apply ice packs after therapy to prevent inflammation.

    • NO additional exercises during this phase.

Weeks 3-4: Introduction to Controlled Movement

• Pain Management--Continue pain medication if needed.

• ROM & Strength-Building Exercises:

  • Continue daily ROM exercises as described in Weeks 1-2.

  • Lift the front of your dog’s body for 5-second intervals (5-7 times before walks) to improve weight-bearing on the surgical leg.

• Leash Walking:

  • Start short, controlled leash walks indoors (on non-slip flooring) or in the yard.

  • Walk slowly to ensure even weight-bearing.

  • If your dog limps, stop and have them back up a few steps to encourage proper movement.

  • Gradually increase walks by 5 minutes per week, reaching 20 minutes, twice daily by Week 4.

  • Avoid uncontrolled environments (e.g., parks, dog encounters, or slippery surfaces).

• Passive Stretching (3 sets, 15-30 sec, 2-3 times daily)- Added after short walks, stretching the hip and knee joints.

• Moist Heat Therapy (Before ROM Exercises):

  • Use a warm compress for 5 minutes before ROM exercises.

  • Do NOT use a heating pad (risk of burns).

Weeks 5-6: Increased Endurance & Strengthening

• Walking:

  • 15-20 minutes, twice daily (Do not exceed 20 minutes).

  • Hydrotherapy (if available) – Water-based therapy reduces joint stress while improving range of motion.

• New Strength Exercises:

  • Sit-to-Stand Exercise – Encourage 10 reps, twice daily.

  • Massage Therapy – Perform 10-15 min of superficial and deep muscle massage, focusing on the thigh & shin muscles.

🚫 Still no running or jumping.

Weeks 7-8: Follow-Up & Gradual Return to Normal Activity

• Veterinary Follow-Up X-Ray Required!

  • Ensure proper healing before increasing activity.

  • If cleared, slowly transition to normal daily exercise.

• Expanded Physical Therapy:

  • Gradually increase leash walks to 30 minutes.

  • Introduce stairs & mild inclines.

  • Sling support no longer needed but bring it for long walks in case of fatigue.

🚫 No off-leash play or uncontrolled activities yet!

Weeks 9-10: Building Strength & Controlled Off-Leash Activity

• Supervised Off-Leash Time Indoors

  • Allow free movement inside the house but no jumping or running.

  • Continue controlled leash walks, including hills & stairs.

• Strength-Building Exercises:

  • Walking tight circles, figure 8s, and serpentines.

  • Jogging exercise (short leash, intermittent jog-walks for 10 minutes, twice daily

  • "Dancing" Exercise – Gently lift front limbs and walk forward/backward with support.

Weeks 12-14: Advanced Recovery & Functional Strength Training

• Physical Therapy Exercises:

  • Sit-to-Stand repetitions.

  • Walking on inclines/stairs.

  • Hopping on surgical leg (with assistance).

  • Light jogging (10 min, twice daily, increasing gradually).

  • Supervised light play (on long leash, no uncontrolled running/jumping).

  • Monitor for pain and adjust accordingly.

Weeks 15-16: Mild Off-Leash Activity & Full Recovery

• Controlled Off-Leash Activity (No Rough Play)

  • Gradually reintroduce normal exercise—still no jumping or high-impact activities.

  • Continue short-leash support for long walks.

• Final Veterinary Check-Up (5 Months Post-Surgery)

  • Update your veterinary Technician on your dog’s progress.

  • If cleared, return to full pre-injury activity levels.

  • Congratulations! Your pet is on the path to full recovery!

Long-Term Joint Health & Prevention

• Maintain a healthy weight – Obesity significantly increases the risk of CCL injuries in the other knee (40% chance of second injury).

• Joint Supplements (Glucosamine/Chondroitin/MSM/Omega-3s) – May support cartilage health and reduce arthritis progression.

• Monitor for signs of meniscal damage – Some dogs may require a second surgery if cartilage wear occurs.