Physical therapy exercises after cruciate ligament surgery

After a dog undergoes cruciate ligament surgery, whether it's TPLO, lateral suture, or another surgical technique, physical therapy becomes one of the most important factors in ensuring a successful recovery.

While the surgery corrects the mechanical instability in the joint, it is physical rehabilitation that helps restore mobility, rebuild muscle mass, and minimize long-term complications like joint stiffness or muscle atrophy. Many dog owners are surprised by how much their pet's recovery depends on what happens after the surgery, not just the operation itself.

The first few days following the procedure are typically focused on rest and pain management. But very soon—usually within the first week—gentle, controlled exercises are introduced under veterinary guidance.

These exercises are not just about movement; they're carefully designed to stimulate blood flow, reduce inflammation, and promote proper healing of the tissues around the knee joint. A common initial activity is passive range of motion, where the dog's limb is gently moved to mimic walking without bearing weight. This helps prevent joint contractures and keeps the tissues flexible while healing occurs.

As the weeks progress, the dog is gradually encouraged to bear more weight and start walking slowly on a leash for short periods, always on even, non-slippery surfaces. The progression is based on the dog’s individual healing, age, weight, and any complications that may arise.

Under the supervision of a veterinarian or canine rehabilitation therapist, additional techniques like hydrotherapy may be introduced. Swimming or walking on an underwater treadmill allows the dog to move without putting full weight on the limb, offering the benefits of exercise while minimizing stress on the healing joint.

Later stages of recovery involve exercises that rebuild strength, coordination, and balance—such as sit-to-stand transitions, cavaletti poles, and controlled inclines. These activities help retrain the neuromuscular system and prepare the limb for a return to normal function. The ultimate goal is to restore not just movement, but confidence in the limb, so the dog can return to an active, pain-free life.

However, it's important to avoid overexertion, especially during the critical healing window of the first 8–12 weeks post-surgery. Re-injury is possible if the rehabilitation plan is rushed or if the dog resumes full activity too soon.

Owners play a vital role in this process.

Adhering to the rehab schedule, following instructions closely, and providing a safe environment at home can make a tremendous difference. Ramps, non-slip flooring, and confined resting areas help prevent slips and falls.

And perhaps most importantly, owners should be patient and observant, reporting any signs of discomfort, swelling, or limping to the veterinarian immediately. With commitment, guidance, and a structured approach, most dogs regain excellent function and quality of life following cruciate ligament surgery.

References:

Millis DL, Levine D. Canine Rehabilitation and Physical Therapy. 2nd ed. Elsevier; 2014.

Zink MC, Van Dyke JB. Canine Sports Medicine and Rehabilitation. 2nd ed. Wiley-Blackwell; 2018.

About the autor

Felipe Garofallo is a veterinarian in Brazil, specialized in orthopedic and neurosurgical care for dogs and cats.

He is also the founder of Ortho for Pets – Veterinary Orthopedics and Specialties.