Since opening our doors in 2007, Twin Cities Animal Rehabilitation & Sports Medicine Clinic has developed a successful working relationship with veterinary hospitals, doctors, and surgeons all over Minnesota and into Wisconsin, North Dakota, South Dakota and Iowa. We have built a client base composed of dedicated, motivated pet owners. During this time, we have discovered many of the clients who contact us have cited they were not made aware of rehabilitation therapies by their primary veterinarians and sought us out on their own. We often hear from clients that they wish they had known about us sooner.
There is no formal referral process but we appreciate your call, email, or notes by fax. Initial appointments with functional evaluation and owner education about the therapeutic plan take 60-90 minutes. Please have the client contact us themselves to set up an appointment time. We will send you the consultation report the day we conduct it and send you regular updates on the patient’s progress over the course of their rehabilitation program. We aim to work with you to provide the best possible care to pets and their owners.
While rehabilitation is still an emerging practice in the field of veterinary medicine, it is one that committed pet owners are requesting more and more as an option in their pets’ health. We are here to work with you in providing the best possible all-around care for your patients.
The following provides more detail into the unique services we provide:
Cold Laser Therapy – This therapeutic process is known as photobiomodulation, using red light from the spectrum that is not visible (infrared). Not all infrared lights are lasers, laser is focused and has a coherent waveform. Therapeutic lasers have a specific wavelength of light known to penetrate into tissues and to provide energy directly to the cells. The cells absorb the light energy which helps them in turn produce more of their own energy to support healing and upregulate some of their natural processes, this Cold laser helps reduce pain by altering the signals through pain nerves. It also helps reduce inflammation and improve circulation. The energy is applied directly to the affected tissues via a special probe. We use a class 3B laser, which is a low enough power laser that it cannot result in thermal injury and there is little chance for eye injury, however we still use protective eyewear.
The amount of energy needed varies depending on the depth of the target tissue, the type and size of the tissue, and the haircoat color of the patient (darker pigmented skin and fur absorbs more energy).
Effects are cumulative, so several treatments are typically recommended before we assess response.
Hydrotherapy (Underwater Treadmill): Your pet will walk in an enclosed treadmill with the water raised to a specific level dependent on the condition being treated, as different levels of water can affect the movement of specific joints.
The water’s buoyancy provides support for the patient’s body weight, thus reducing load on the joints. The drag of moving the limb through the water helps to build strength more quickly, and the hydrostatic pressure helps to improve circulation. We use underwater treadmill therapy to provide low impact strengthening, assist in gait retraining following injury, and provide exercise for patients who may otherwise be unable due to home or climate conditions.
We start with very short sessions, and gradually increase time and speed depending on your pet’s progress. To make things more challenging; depending on the patient and their condition, this may include intervals of walking faster or trotting, changes in water height (to provide less support), or walking against resistance jets.
A trained therapy technician will assist your pet in the treadmill for as many sessions as needed until your pet is comfortable walking on their own (if they are able).
In addition to the treadmill workout, patients also perform targeted land-based exercises and stretching, these vary pending their specific condition and needs, and are also progressed according to patient comfort and function.
Sessions are recommended twice weekly to start, then typically decrease in frequency as your pet progresses. It typically takes a good month of regular workouts to see progress – like you going to the gym; you can’t expect to see results if you only go once every couple of weeks!
Therapeutic Ultrasound: This modality is typically used to help with soft tissue injuries involving muscles, tendons, and ligaments. Sound waves emitted by the ultrasound machine can help to break down scar tissue, making it more pliable. These sound waves can also cause a deep tissue heating effect, which will further improve tissue extensibility. Ultrasound helps by causing a “good” inflammatory response, which improves the delivery of specific cells and factors that aid in healing of these tissues. Ultrasound therapy helps the body kick start the healing process, however following treatment the tissues still need time to continue to heal, which is then followed by appropriate strengthening.
Depending on the area and type of injury being treated treatments are typically needed twice weekly. As the soundwaves cannot effectively travel through hair, your pet will need to have the fur on the therapy sites shaved.
Shockwave: Shockwave therapy uses focused super-pulsed sound waves (not electrical) that can deliver energy deep into tissues. The energy from the high intensity shockwaves triggers the body’s own repair mechanisms, which helps speed healing.
It can stimulate blood vessel growth, reduce chronic inflammation and pain in the case of osteoarthritis, and stimulate collagen production which is important in tendon and ligament healing. It is also often used to stimulate bone growth in the case of poorly healing fractures. Shockwave treatments are tolerated very well by our canine patients. The intensity of the soundwaves starts out very low and is only increased to a level the patient can comfortably tolerate. We typically perform one to three treatments spaced one week apart, depending on the condition being treated.
PEMF (Pulsed Electromagnetic Field Therapy): This modality involves the use of a pulsed electromagnetic signal that affects the flow of ions in and out of tissue cells, improving the flow of cellular energy and nutrients, thus helping to upregulate natural processes within the body to help improve circulation, reduce pain, and improve healing.
There are several methods of energy delivery available:
We often use a bed that contains magnetic coils - your pet simply needs to lie on it for a 30-minute session; many pets often fall asleep while on it!
Another option is a wearable harness with PEMF patches that can be applied to target areas including hip, shoulder, and spinal joints. We also prescribe a small portable loop that can be used at home. Its size limits the area of use but is great for focal areas of pain.
There are some contraindications to using PEMF, so pets (or their owners) who have a pacemaker, heart arrhythmia, seizure history, or are pregnant should not use this product.
The following provides a library of the wide range of conditions we that we can help diagnose and manage:
Achilles tendon tears or breakdown (tendinopathy): Both dogs and cats can suffer from this condition. The issue is often a chronic, slow fraying of the tendons which results in a drop in hock (ankle) position and eventual inability to put weight-bearing pressure through the affected leg. In some dogs, the issue can affect both rear legs at once. Acute tears or lacerations are better treated surgically, then we can help in return to function after surgical repair.
Amputees: We can help with balance, strength, and reducing compensatory issues in the weight-bearing limbs and in the spine. We also offer prostheses.
Arthritis: The pain and stiffness of arthritis in one or more joints affects mobility and quality of life. With the help of an extensive rehabilitation and pain management plan for maintaining mobility, most patients with arthritis improve their ability to enjoy daily activities. (option to add, Dr Tomlinson has written and lectured extensively to veterinarians about management of arthritis and our team at tcrehab is well versed in helping pets move better and feel better )
Biceps tendinitis (tendinopathy)/shoulder tendinopathy: The biceps muscle runs from the shoulder to the elbow and the upper tendon supports the shoulder joint in movement. The supraspinatus tendon sits just next to the biceps and stabilizes the shoulder. Tendinopathies are tendon disorders that result in pain, swelling, and impaired function. This issue is common in working and sporting dogs but can happen to any pet. Diagnosis is often delayed because tendons are mostly silent structures, and the body’s alarm system to alert injury is triggered late. We can accurately diagnose the problem with ultrasound imaging (tendons cannot be seen on x-ray) and develop a targeted treatment plan; most patients successfully return to function and sport.
Back pain: The back and neck consist of vertebrae, muscles and their tendons, intervertebral discs, ligaments, blood vessels, lymphatics, and the spinal cord. The vertebral column houses the spinal cord and each nerve root exits through an intervertebral foramen, which is an opening between a vertebral pair. Back pain can come from joint disorders, and joints between vertebrae (facet joints) can become arthritic, which in people causes a dull, constant ache. Arthritis in these joints has the potential to impinge on the nerve roots, causing radiating pain. Any muscle can be strained, including the back muscles. There is a relatively large amount of musculature supporting the bones of the spine. Lameness can cause abnormal back and neck motion. The limbs should always be examined closely for sources of pain in addition to examination of the back and neck. The most widely known cause of back pain in veterinary medicine is intervertebral disc disease. These soft, pliable discs that cushion between vertebrae stiffen with age, and in some breeds (e.g. Dachshunds) they degenerate early in life. Intervertebral disc degeneration may result in splits in the disc, permitting explosive extrusion of the central gel inside, which hits the spinal cord and causes damage. More commonly, there is shrinkage of the central gel and folding and bulging of the outer fibrous coat which compresses the spine. Pain is the first symptom, but if compression worsens this results in weakness, unsteadiness, and can result in paralysis. A disc can also bulge and compress a nerve root rather than the main spinal cord, this results in radiating pain but can also result in weakness on the affected side. Extreme pain, guarding, or worsening of clinical signs are indications that urgent care is needed.
Brachial plexus injuries: The brachial plexus is a web of nerves to the front leg, and it sits deep in the armpit. Injury can occur due to trauma and results in signs that continue to worsen over 48 hours to days after injury. Consequently, nerves function poorly and muscles atrophy, and patients have difficulty keeping a normal posture and cannot lock their joints as they try to stand on the affected limb.
Braces and orthoses: Braces are simple devices which can help to support weak joints, but if there is significant instability a custom orthosis is required, one with special hinges that is designed from a mold made on an impression of the patient’s affected leg so that it fits the contours of the limb. These treatments are complex and need a lot of expertise. We have specific training in the prescription, fitting, and modification of orthoses and braces.
Carpal hyperextension/carpal collapse: The carpus (wrist) is supported by tendons and ligaments which act to suspend the carpus, and as these structures stretch in motion, their elastic recoil helps forward movement. Breakdown of these supporting structures can be due to acute injury or chronic repetitive overload.
Carts/wheelchairs: Carts are used for patients with paralysis or weakness but can also assist unsteady patients by providing added stability. Carts that fit improperly result in rubs, joint overload and injury. Fitted the right way and coupled with a fitness plan to progress activity, carts really improve a patient’s quality of life. We have experience fitting many styles of carts.
Chronic pain: The International Association for the Study of Pain defines this as pain without apparent biological value (does not protect you) that has persisted beyond the normal tissue healing time. We are experts at treating chronic pain, using modalities, manual therapies (some of which we prescribe for you to do at home) as well as medications and supplements. A multimodal approach provides the best chance of success.
Cruciate disease (ACL, CCL): This occurs when the cruciate ligament frays or tears, and consequently stability in the knee joint is reduced. The bony surfaces of the joint have excess movement, and this can grind down and damage the fibrous menisci which pad the joint, as well as resulting joint inflammation and pain. Muscles surrounding the joint try to add more stability but cannot replace the job of the cruciate ligament. Cruciate ligament animation: https://www.youtube.com/watch?v=CNymdzyRavs Our clinicians regularly develop rehabilitation plans to guide return to function for post-operative cases and for patients who do not undergo surgery.
Congenital abnormalities, limb deformities: Patients born with or who develop limb abnormalities as they grow can be assisted with braces, orthoses, and prostheses but also with targeted strengthening and with other assistive items such as lift harnesses, traction booties, and ramps. Our team has comprehensive knowledge to assist you in helping your pet have a long healthy active life.
Degenerative Myelopathy (DM): This is a chronic progressive disorder which results in loss of body awareness and weakness in the rear limbs, then eventually in the front limbs. Rehabilitation, including hydrotherapy, has been shown to prolong function. We are also equipped to help you and your pet maximize mobility in the home. For more information, visit this link: http://vhc.missouri.edu/small-...
Digital hyperextension: Each toe is supported by tendons and ligaments which act to suspend the bones in the soft tissues, and as these structures stretch in motion their elastic recoil helps forward movement. Breakdown of these supporting structures can be due to acute injury or chronic repetitive overload. We can help posture, comfort, and function of the digit affected in many cases.
Disabilities: We treat all disabilities with a plan to restore as much function as possible and to maximize mobility in the light of ongoing impairments.
Dizziness/falling: Balance issues can come from nervous system injuries or disorders. We treat to restore as much function as possible and maximize mobility in the light of ongoing impairments. Often, practicing simple movements along with acclimatization exercises can significantly improve function.
Elbow dysplasia: This occurs when the bones that join at the elbow do not grow at the same rate, and so the congruency or fit of the bones is uneven. The joint surface is not smooth and there is abnormal wear on the joint with overload of some areas and underload of others. Cartilage and the underlying bone is quickly damaged, resulting in pain and arthritis. There are surgical treatments for this issue in many cases. Rehabilitation maximizes comfort and joint health and function at all stages of life. Early in the disorder when patients are still growing, a rehabilitation consultation can guide feeding and joint support to help prevent worse issues.
Exercise intolerance: Our pets are athletes and need to be able to move. Whether performing a sport or simply playing, exercise intolerance is early fatigue. This can be caused by muscle issues, breathing issues, circulatory issues, lack of stamina, or other systemic disease. Our clinicians are experts at analyzing exercise tolerance and guiding you to the right help (whether with us or at a different veterinary specialty).
Femoral Head Ostectomy (FHO): We provide rehabilitation after surgery to remove an arthritic or diseased femoral head at the hip, or to treat a dislocated hip. Rehabilitation is important because many patients initially do not want to use their leg after the surgery and need to build up muscular support around the hip area as the new ‘joint’ forms with scar tissue.
Flexor carpi ulnaris strains: This tendon is part of the ‘bow string’ that supports the carpal joint, and if it is injured the joint support can break down. We provide support while we stimulate tendon healing.
Foot deformities: Patients born with or who develop toe and foot deformities from injury can be assisted with boots, tape support, spacers, etc. but also with targeted strengthening and other assistive items. Our team has comprehensive knowledge to assist you in helping your pet have a long healthy active life.
Fractures: After surgical fracture repair or splinting, we work to manage mobility in both the early and late stages of healing. Bone strengthens and heals in response to controlled guided loading and our clinicians are experts at maximizing healing response in partnership with your pet’s orthopedic surgeon.
Geriatric patients: While old age is not a disease, there are a myriad of issues that commonly arise in older patients. Mobility is affected by age related muscle loss, arthritis, loss of fine motor control and balance, and disease in organ systems. We are experts in multimodal therapy to help your pet age well and get back to having some fun with you.
GOLPP (geriatric onset laryngeal paralysis polyneuropathy): This progressive disease affects the nerves that open the airway but also causes weakness in the rear limbs by affecting the long nerves that supply the rear legs. A comprehensive rehabilitation plan aims to maximize strength and stability to maintain function and mobility as long as possible.
Gracilis contracture: This is a disorder of the gracilis muscle, which is an inner thigh muscle. The muscle becomes replaced with fibrous, scar-like tissue and loses the ability to stretch and stabilize the leg as the knee and ankle moves. There is a characteristic gait in the late stages of the disorder with a short stride and a rapid internal rotation of the foot during limb advancement. We use modalities as well as therapeutic exercises to restore or improve function. This condition is best treated early.
Healthy aging: see geriatric patients
Hip dysplasia: This occurs when the bones that join at the hip do not fit together well. The joint surface is not smooth and there is abnormal wear on the joint with overload of some areas and underload of others. Cartilage and the underlying bone is quickly damaged, and pain and arthritis develops. There are surgical treatments for this issue early in development and in the late stages in many cases. Rehabilitation maximizes comfort, muscular support of the joint, joint health and function. Rehabilitation maximizes comfort, joint health and function at all stages of life. Early in the disorder when patients are still growing, a rehabilitation consultation can guide feeding and joint support to help prevent more severe issues.
Hip replacement post-surgical rehabilitation: After this surgery we will expertly guide return to function, as the muscles heal they need to strengthen. The patient needs to relearn how to use the leg well with balance and fine motor control.
Joint sprains, instability, injuries: A sprain is a traumatic injury to the joint which can result in damage to the supporting ligaments and the fibrous joint capsule, resulting in joint inflammation which can also lead to arthritis. We treat the inflammation, pain and stability issues.
Masticatory myositis: This inflammatory syndrome causing jaw pain and reduced ability to open the mouth is caused by the body attacking the muscles of the jaw. We work to reduce inflammation and improve jaw function.
Medial shoulder syndrome – This condition occurs when the soft tissues around the joint become damaged and cannot provide support for high-impact activities, such as jumping. This lack of support results in joint pain and inflammation. We provide bracing and modalities to stimulate healing. These modalities are guided by diagnostics.
Mobility issues: We treat to restore as much function as possible and maximize mobility in the light of ongoing impairments.
Muscle injuries (strains, tears): Any muscle can be strained; overstretching leaves the muscle vulnerable to injury with even small loads. Overload can tear muscle fibers, whether it is repetitive loading without adequate recovery time or an absolute one-time overload. Most pets are athletic; acute injuries usually occur during sudden unplanned movements (squirrel went up a tree and the patient tried to jump up to follow) rather than movements that are practiced and expected such as jumping into the lake to retrieve a ball. Muscle shortens in response to injury (muscle spasm)--this is a protective mechanism but can cause wide-ranging problems. When a muscle is in spasm and not functioning correctly in motion, the neighboring muscles are overloaded which can further contribute to pain.
Myopathies: These are diseases of muscle in which the muscle fibers do not function properly. Diagnosis is usually by biopsy under the guidance of a neurologist or internal medicine specialist. Our rehabilitation team provides mobility assistance through careful, focused strengthening and pain management as well as assistive devices.
Neck pain: see back pain.
Neuropathies/polyneuropathies: These are disease or dysfunction of the peripheral nerves, usually progressive. Our rehabilitation team provides mobility assistance through careful, focused strengthening and pain management as well as modalities to maximize nerve function, along with the use of assistive devices when appropriate.
Neurologic diseases and disorders: Our rehabilitation team provides mobility assistance through targeted strengthening and balance practice, along with the use of modalities to maximize nerve function, along with the use of assistive devices when appropriate.
Poor performance: Athletes that are having trouble performing at their previous or expected level benefit from a sports medicine consultation so that we can develop a diagnosis of issues contributing to the problem and provide a treatment plan.
Post-surgery: Neurologic/back surgery: our team provides focused strengthening and balance practice, along with the use of modalities to maximize nerve function. Assistive devices are utilized when appropriate.
Post-surgery: Orthopedic surgery: Our team provides therapy aimed at maximizing tissue healing and comfort--we then move on to strengthening, balance, and fine coordination exercises, and finally return to function (or sport) training.
Prosthetic needs: A custom prosthesis is specifically molded on an impression of the patient’s affected leg. We have specific training in the prescription, fitting, and modification of prostheses. Amputees or patients born with partial limbs can be helped with a prosthesis, but these devices cannot be fit to every leg.
Soft tissue injuries: Our clinicians are experts at diagnosing soft tissue injuries. Information of the exact structure injured (for example which muscle or tendon) guides our treatment plan so that therapeutic modalities can be applied to best effect.
Sports injuries: Athletes are prone to injury of joints, bones, and soft tissues. Our expert clinicians work with many athletes (40-50% of our caseload), getting them back safely to their sport.
Sports conditioning: Athletes need to be fit. Their joints, bones, muscles, tendons, ligaments, heart, lungs and nervous system (including the brain’s coordination of complex motions) need to be trained to absorb the workload of the sport and to recover without tissue damage. Training is not just used to learn the sport, it also reduces the incidence of injury. Our clinicians are experts at assessment of your sporting dog and guiding you in keeping them fit and healthy.
Tail injuries, limber tail, weakness: The tail is really another limb! It provides balance as well as body language. Tail injuries can be very painful. Our team works to manage pain and maximize healing in addition to preventing re-injury.
Toe injuries: The joints of the toes can be injured or develop arthritis just as commonly as the other joints. Because these joints hit the ground with every step, we have to think outside the box in diagnosis and in treatment approach and have had good success with our patients.
Traumatic injuries: We diagnose and treat injury to joints, bones, and soft tissues. Our expert clinicians work with you to get your pet safely back to full activity.
Vestibular syndrome: This is a disorder of the body’s balance system. It occurs most commonly in older dogs, but there is a wide range of causes identified by neurologists. Definitive diagnosis of cause is not always identified. We work to improve balance and mobility and stimulate adaptive responses in the nervous system. We also provide assistive devices to help with any residual balance and mobility deficits.
Weakness: Our team are experts at improving strength in our patients through a combination of at-home and in-clinic therapies.
Wobbliness: Unsteadiness is usually caused by disorders of the central nervous system, brain, and spinal cord. Balance and stability exercises can help recovery and or adaptation to an unsteady gait. Stronger muscles help a pet to rescue themselves from falling if they do wobble. Our team can also provide guidance on making your home easier to navigate for your pet.
Wobblers syndrome: This is a disease of the neck that affects large and giant breeds of dogs (and horses). The fit of the vertebral bones, discs, and soft tissues around the spinal cord is abnormal which results in compression of the nerves in the neck. Compression causes nerves to function poorly, affecting balance and coordination. This condition can worsen as a dog gets older but can also affect the young. We work to maximize mobility and reduce any inflammation in order to minimize secondary compression of nerves. See above under wobbliness for more details about therapy.
Weight loss/obesity: Being overweight is likely to shorten the lifespan of a pet, and it increases the risk of arthritis and cancer. Each extra pound of body weight is quadrupled in shear force on the joints, meaning a dog who is 5 pounds overweight is in effect carrying a 20-poound backpack when they move. Weight loss is difficult; we are all pet owners and we understand the struggle. Our team uses dietary planning as well as exercise--this combination is most effective at mediating weight loss. Our clinicians will work with your primary care vet to help rule out any underlying issues hindering progress.