Back Pain. Not Just for Humans.

Back  pain  is  one  of  the  most  common  ailments  in  today’s  society. Almost  all  of  us  have suffered  from  it  at  one  time  or  another  and  in  varying  degrees. It  is  actually  rare  for  back pain  to  occur  as  a  result  of  “trauma”  (i.e.  that  one  big  strain). It  is  most  often  the result  of repetitive  strain  on  a  weak  core  (“core”  defined  as  abdominals  working  in conjunction  with the  back  muscles). Other  contributing  factors  are  poor  conditioning and/or  muscle imbalance. In  our  facility  we  work  with  a  large  number  of  performance dogs. Over  time I started  to  recognize a  similar  phenomenon. Many dogs  we see have a primary  diagnosis  of epaxial muscle strain  in  the lumbar  area  (i.e.  low back pain as  a result of tight  and/or strained muscles supporting  the lumbar  spine).   A  large  number  of  dogs have another  diagnosis  but also have  lumbar  epaxial  muscle  strain. In  this  case  the  lumbar  muscle  strain  is  either secondary to  the  primary  diagnosis  or  the lumbar  strain  caused  the primary  diagnosis. This is  such  a  common  problem  with  performance  dogs  that  I  now educate  all  of  my  clients  on how  to  identify  the  early  signs  of  lumbar  strain. I  also provide  them  with  a  number  of stretches and exercises that strengthen the dog’s core and help prevent injury. 

Which came first, the chicken or the egg?

A  presentation  commonly  seen  at  our  clinic  is  a  dog  with  a  hamstring  strain  that  also has tight  and  sore  lumbar  muscles. Did  the tight  back  muscles  cause the  hamstring  strain? Or did  the  tight  hamstrings  cause  the  back  strain? In  my  opinion,  which  came  first  is  not as important  as  making  sure we address both issues  during  the rehabilitation  process. Another example  is  an  iliopsoas  strain,  which  is  fairly  common  among  performance  dogs. The iliopsoas  muscle  is  a  hip  flexor  (brings  the  dog’s  hind  leg  forward)  that  originates  at the lumbar  vertebrae  and  attaches  to  the  dog’s  thigh  bone. These  dogs  almost  always present with  tight  and  painful lumbar  epaxial  muscles. It  would  be remiss to only treat  the iliopsoas strain  without  also  addressing  the  lumbar  muscles.    If  the  lumbar  area  is  not treated  AND strengthened,  there  is  a  high  likelihood  the  iliopsoas strain  will  re-occur and/or  the dog  will suffer another injury related to the tight back muscles.

Canine causes of low back pain:

Canine low back pain

Structural: Dogs that are long in the loin and/or long bodied typically have a weak core. I always look at a dog’s structure not with respect to the breed standard, but with respect to function. A dog that is long bodied or long in the loin has the potential for injury to their core because it is an inherent area of weakness. If the dog’s core is weak, it will compensate by bringing the hind legs forward, underneath the loin, for support.

Canine low back pain

Over time, this causes a roach and strains the low back muscles. For purposes of this article “roach” is defined as a convex curvature of the spine. In this article we are focusing on a roach in the lumbar spine.

 

 

 

Compensations:

  1. Tight hamstrings mean the dog has decreased range of motion when it brings the hind legs forward. When the dog moves the hind legs forward, it also pulls on the back muscles causing a lumbar muscle strain.
  2. Iliopsoas strains typically present with low back tightness, roaching and pain on palpation of the lumbar epaxial muscles.
  3. Injury and/or weakness in the front limbs will often cause the dog to move its hind legs closer to the center of its body to take the weight off the front legs. This causes strain on the low back muscles.
  4. I have treated dogs with good structure that have a primary diagnosis of lumbar strain. This generally occurs because the dog’s core has not been strengthened. We must remember that our dogs are athletes. They need to be stretched and conditioned. Otherwise they will fall prey to repetitive strain, just like humans.

Presentation of Lumbar Expaxial Strain:
Lumbar epaxial strain as a primary diagnosis: In the early stages a dog can be asymptomatic, but is at high risk for injury. Typically the dog’s low back is roached with the hind legs placed under the loin (instead of behind the loin). If back pain is more advanced, symptoms range from having difficulty sitting and/or holding stays; decreased drive and lack of hind limb extension when trotting, running and/or jumping; to hind end lameness, sometimes with short periods of non-weight bearing. It can occasionally mimic the symptoms of an ACL tear (i.e., dog comes up lame initially not putting any weight on the leg, then goes through periods of non-weightbearing alternated by partial weight bearing).

Lumbar epaxial strain as a secondary diagnosis: As mentioned earlier, I have treated dogs with hamstring strains, iliopsoas strains, and quadriceps strains that also have a low back strain. The low back strain is easily identified on palpation (muscles are hard and painful), and visual exam (low back is roached and hind legs are carried too far forward).

Identifying Tight Lumbar Epaxial Muscles: I teach my clients to look for a flat top line when their dog is standing, walking and trotting. Often dogs have been roached for so long, their owner cannot remember the dog ever having a flat top line. When conducting puppy seminars I am always surprised at the number of young dogs that are already roaching as a compensation for structural issues. Identifying this as an area of weakness in your dog is the first step in injury prevention. If you suspect your dog has tight lumbar epaxial muscles I suggest you bring them to a canine rehabilitation practitioner for a full assessment.

The good news is, it is fairly simple to stretch out your dog’s low back muscles. Once you have stretched them out completely, you must strengthen the dog’s core muscles in this new position. Otherwise the injury/compensation will re-occur.

Stretching Low Back Muscles:
If your dog will tolerate it, you can warm up the area with a heating pad for 10-15 minutes (make sure there is a towel between the heating pad and the dog’s skin). Be sure to monitor the area to prevent a burn. You can massage the lumbar epaxial muscles. I have my clients palpate the muscles of the dog’s upper back (which are typically more pliable) and compare them to the muscles of the low back. These often feel very hard. I then suggest that they massage the muscles before beginning the following stretches.

Proper Posture in Standing:
Position yourself next to the dog while he is standing. Put cookies in one hand and hold it in front of your dog’s nose. The forearm of your other hand goes in front of the dog’s hind legs, above the dog’s knees. Most importantly: you should be looking at the dog’s back muscles. Lure the dog’s head forward and up. Often dogs will push very hard with their hind legs, trying to bring them forward. Some will try to bring their legs over your arm. This is only because their back is tight, core is weak and it is difficult for them to keep their legs behind their loin while stretching. Over time, the stretch will get easier and the dogs will not push against your arm. When you see the dog’s back muscles twitch, and the dog’s top line flatten, you can “click” and reward. I have my clients name this (i.e. “stretch”, “reach”, etc.) since this will be used in a progression of exercises. Once the dogs learn to stretch on command, you usually don’t need to block the dog’s back legs.

Proper Posture in Stand:

Proper Posture in Sitting:
Have the dog sit in front of you facing sideways. Use a cookie to lure the dog’s head at a 45 degree angle to the floor. Straight line from nose to tail. You really want the dog reaching so that the low black flattens. This is sometimes difficult to see. Remember to keep your eyes on the dog’s back, not on your hand. Often the dog will stand up because they are not sure what you are asking them to do. You tell them “sit” and in their mind that’s what they are doing. Be patient, you’ll get it!

Proper Posture Sit:

Proper Posture in Sphinx Down Position:
Head parallel to the ground. Knees over toes with back flat. Put one hand on the dog’s shoulder to hold the dog down; cookie in other hand luring dog’s head forward. Dog’s paws and bottom of leg should be flat on the floor.

Proper Posture Down:

Canine back stretch

Back Stretch with Front Feet Up:
Have the dog put their front feet up on a chair, grooming table, bench, etc. Use a cookie to lure the dog’s head up and back. You want to see the dog’s low back flatten and stretch.

You can do 8-10 repetitions of each stretch, 2-3 times a day. Over time, you will notice that the dog can stretch further and more easily. You will notice the roach becoming less pronounced and the hind legs moving further back when the dog is in relaxed standing. How long it takes for the back to become fully stretched depends on how long the dog has been injured and/or compensating. The longer the dog’s back has been in this position, the longer it will take to stretch it out.

Strengthening the Core
In order to maintain a flat top line, the dog’s core needs to be strengthened in this new position. The following exercises are listed as a progression. The dog must master each step before moving on to the next.  If at any time the dog’s back becomes roached, you must back up in the series of steps. This is an indication that the dog’s core is not strong enough for this exercise.  Your dog MUST maintain a flat low back with ALL of the exercises. Otherwise you are reinforcing the compensatory pattern instead of properly strengthening the dog’s core.

Canine good posture

Good Posture with Back Feet on Box:
I generally encourage my clients to teach their dogs to put their back feet on a box (or stair, or any raised solid object) on command.  This makes it easier on the owner since they won’t have to lean down to block the dog’s legs. Otherwise you can place your dog’s back legs on the box and block their legs as you did in the standing back stretch. Use a cookie to lure the dog’s head forward and up until you see a good stretch in the dog’s lumbar area. This exercise stretches the dog’s back while at the same time strengthening the core.

Good Posture with back feet on disc:
Same as above, except this time the dog’s hind legs are on an unstable surface. This exercise marks the transition from stretching to strengthening.

Good Posture with back feet on Box and front feet on disc:
This is an advanced exercise. Make sure your dog has mastered the exercises listed above BEFORE moving on to this exercise. Start with the dog’s back feet on the box. Lure the dog’s head forward to get a good lumbar stretch. Note the position of the dog’s front feet when the back is stretched. Release the dog. Place the disc where the dog’s front feet where. Now have the dog put its back feet on the box and front feet on the disc. Make sure the dog is able to maintain a flat spine!

Each of the above exercises can be done 1-2 times a day. Start with 4-5 repetitions and work up to 10 repetitions. Remember, only progress if the dog is able to maintain a flat spine. Before you begin exercises on the peanut ball, make sure your dog is able to maintain a sit, stand and sphinx down on a stable surface (like the floor) with a flat lumbar spine. All of the exercises below must be mastered with the ball stabilized.

Sitting on Peanut Ball:
Use treats to lure the dog’s head forward and up. The dog’s back feet should be tucked up and the low back should be flat.

Canine with spinx down on peanut ball

Sphinx down on Peanut Ball:
Ask the dog to lie down in a sphinx position on the ball. Use a cookie to lure the dog’s head forward until the lumbar spine is flat and the dog’s hind legs are tucked.

Standing on Peanut ball:
As you did in the back stretch in standing, block the dog’s hind legs with one arm while luring the dog’s head forward until the low back is flat.

Once the dog has mastered all of the above positions with the ball stabilized, you can increase the difficulty by slowly rolling the ball side to side by a few inches. You can also ask the dog to transition from one position to another. For example, ask the dog to sit, then down, then sit, then down for 10 repetitions in a row. Always make sure the dog is maintaining a flat lumbar spine. If the dog is unable to maintain a flat spine, this exercise is too difficult for your dog at this time. You need to move back to an easier exercise. Working on the ball may look easy, but it is very strenuous. I generally recommend 10-15 minute sessions per day for a full body workout.

It appears that low back pain is as common in dogs as it is in humans. With working dogs, this translates to a decrease in performance and puts the dog at risk for injury. This can be prevented by stretching and strengthening the dog’s core.  Early identification of tight lumbar epaxial muscles will not only prevent injury, but will also improve performance.

chicken or the egg