Ultrasound aids injury
by Anna Armstrong*, Chartered Veterinary Physiotherapist.BSc (HONS) Physiotherapy, MSc Veterinary Physiotherapy, MCSP ACPAT
Cat Cameo is a 20 year old Welsh Section A that I was asked to see on one of my trips to Orkney in April this year. In December 2012 she got her leg caught in some wire which cut quite deeply just below her left hock. It took a long time to heal on box rest and when I saw her in April she had been back out in the field for two weeks. She is used at home as a pony for young children to ride and they were keen to be able to get back on this summer.
On observation, it was obvious that she was not using her left hind leg normally. In picture one you can see the difference in shape between the muscles over her left and right quarters. On the left the gluteals, hamstrings and quadriceps have lost strength and tone (atrophy) from disuse over the last four months. On the right these muscles were very tense and had built up extra bulk (hypertrophy) while being overused to compensate for the injury on the left.
Picture two shows again the loss of muscle in the left hind and also that Cameo was not taking her full weight on that limb (look at the position of her fetlock joint). The wound on her leg was healed but had a lot of scar tissue which was very tight, restricting extension of the limb.
Movement assessment showed that Cameo was sound at walk. At trot she was throwing her weight forwards onto her right shoulder to offload her left hind leg. Palpation supported the observations of weak muscles in the left hind and tension on the right. She did not have any tension in her back or shoulders, however this was monitored as it could potentially develop as Cameo spent more time in the field with an imbalanced movement pattern. When I assessed joint range of movement, the left hind leg had normal flexion through the joints but was stiff to stretch forwards and backwards, limited by the scar tissue.
Cameo was treated with Therapeutic Ultrasound at the site of the scar tissue. This is a sound wave which causes vibration in the tissues as they absorb the sound energy. Research has shown that when ultrasound is applied during the ‘remodelling’ phase of tissue repair it can help provide energy to the cells involved, speeding up and improving the repair process. Cameo’s owner was shown how to massage the scar tissue daily to help improve its elasticity and break down adhesions which were limiting movement in the leg. She was also shown how to stretch the leg and encourage Cameo to take weight on the leg so that her own body weight improved the stretch. Walking over poles was introduced to encourage active range of movement and more symmetrical movement behind.
After two months Cameo was sound and able to resume her duties as teacher to the children. Here is some of the feedback that I have received from the owner ‘With the treatment plan in place I noticed an improvement very quickly, and within two months she was completely sound. The scar is hardly visible now and she is able to be ridden and is enjoying life once more! I am absolutely delighted’.
To find your nearest ACPAT Physiotherapist go to the ‘find a Physio’ section at www.acpat.org Tel: 07711584314 Email: anna@ vetphysio.org Website: www. vetphysio.org
*Based in Aberdeen, covering Aberdeenshire, Orkney and Shetland.