It is now recognised that exercise plays an important role in maintaining the integrity of muscle, tendons and ligaments. We are all familiar with the term fracture disease where we see disuse atrophy of muscles, weakening of tendons and ligaments and stagnation of joint fluid in a limb with a slowly healing fracture. Restrictions such as cage or strict rest will further exacerbate this weakening.

Wolff's law states that the structure of a bone is dependent on the forces placed upon it. This law also applies to muscles, ligaments and tendons.

In general, when talking to owners about exercise, it is important to explain that shorter more frequent walks are better than one much longer walk. Dissuade owners from over-exercising their dogs at weekends.

Most exercise programmes are tailor-made for each patient depending on the muscles and joints involved in the dog's condition. However, there are some general exercises that are applicable to most situations and are useful as a warm-up before the dog goes for a walk.

This lecture shows some simple exercises that owners can be taught to do with their dogs at home and are particularly useful for the older patient with osteoarthritis. For dogs that have a weight problem then toys or low calorie treats should be used to encourage the dog to exercise.

Stretches

To warm up, we start with some simple stretches of the spine. The first exercise is to encourage the dog to take a treat from each hip while in the standing position (Figures 1 and 2). This task flexes and extends the spine laterally. Remember to do both sides. If the dog has lost some flexibility in the spine then the treat can be taken from over the ribs. Have the owner do 10 repetitions to each side. Repeat this regime twice daily. The next stretching exercise is to have the dog take a treat from above its head and from between its front legs and in so doing it flexes and extends the spine dorsally and ventrally (Figures 3 and 4). Again have the owner do 10 repetitions twice daily. By doing these stretches twice daily owners can greatly increase the flexibility of their dog's spine. Improvements can be noted as early as just 7 days.

Figures 1 and 2. Dog taking a treat from each hip and so flexing and extending the spine laterally. All photos © David Prydie.

Figures 3 and 4. Dog taking a treat from above its head and between its front legs and so flexing and extending the spine dorsally and ventrally. All photos ©David Prydie.

Core Stability

A dog's core stability can be improved by using a technique called para-standing. An example of para-standing would be where two feet are placed on blocks approximately 5 cm high. As part of a home exercise programme, owners can use two books of the appropriate thickness. The books are placed on the floor and any combination of legs are placed on the books, e.g., left fore and left hind, left fore and right fore, right fore and left hind (Figures 5–7). Try to have the dog hold the position for 30 seconds. Swap the book standing and floor standing legs and repeat. Have the owner do two sets twice daily. Vary the combination of legs to stop the dog becoming bored and to vary the challenge.

Figures 5, 6 and 7. Examples of para-standing. All photos ©David Prydie.

Front Leg Strengthening

Ask the owner to take their dog to a lying position. Now ask the dog to come to a sit position and then have the dog return to the lie position (Figures 8 and 9). Repeat the sequence 10 times twice daily. This exercise strengthens the shoulder and triceps groups of muscles. In order to stretch the biceps muscle, teach the dog to 'give a paw'. Now encourage the dog to raise the paw higher to give a 'high five' (Figure 10). Repeat with both front legs 10 times twice daily.

Figures 8 and 9. Dog demonstrating the lie to sit exercise for front leg strengthening. All photos ©David Prydie.

Figure 10. The high five. All photos ©David Prydie.

Back Leg Strengthening

Have the owner put their dog in the sit position. Now have the dog come to the stand position and then back to the sit position (Figures 11 and 12). Repeat 10 times twice daily. This exercise is good for strengthening the gluteal, quadriceps and hamstring muscle groups.

Another exercise to encourage hind leg strengthening is tug of war. Using a tug toy above the level of the dog's head, encourage the dog to pull back (Figure 13). Allow the tugging to continue for about 30 seconds. Repeat five times twice daily. Please note that this exercise is not suitable for aggressive or possessive dogs.

Figures 11 and 12. Dog demonstrating the sit to stand exercise for back leg strengthening. All photos ©David Prydie.

Figure 13. Tug of war. All photos ©David Prydie.

Proprioceptive Retraining

For another home exercise, have the owner look out some garden tools and canes. Measure the height to the dog's shoulder as a rough guide to stride length. Place the tools parallel to each other approximately one stride length apart. (Care with the rake!) Now have the owner walk the dog up and down over the tools and canes. Repeat five passes twice daily. Another exercise using the same garden tools and canes is to arrange them haphazardly in a "pick-a-sticks" fashion. Now have the owner lead the dog through the course. The dog has to pick its way through the obstacles encouraging foot-eye coordination (Figures 14 and 15). These exercises also encourage the dog to pick the feet up higher and help reduce nail scuffing.

Figures 14 and 15. Garden tools can be used to make obstacle courses for dogs to negotiate. All photos ©David Prydie.

Summary

The above exercises are suitable for most dogs with a variety of orthopaedic conditions. They are especially of use in the older patient and can help improve mobility as part of a multimodal approach to the management of arthritis.