Recently there has been a few clients who have done so well in their own or with their animal's rehabilitation that the importance of persistence and the amount of dedication required to the rehab process has really been highlighted!
There have been horses who were on the verge of being turned away, retired or looking at a different job altogether, dogs who had not responded to pain medication or some other conservative inerventions and physiotherapy was almost the last chance saloon!
One client in particular springs to mind who's horse had had surgery for kissing spines and a neurectomy for proximal suspensory desmitis of both hind legs. The rehabilitation process has lasted over several months with regular check ups from both myself, as the treating physiotherapist, and the veterinary surgeon, plus some real hard work from the owner in following advice and putting in some excellent rehabilitation and schooling exercise. The horse is now looking and moving great! The road has not always been smooth, with relapses and some additional diagnoses to content with, but the power of persistence has definitely paid dividends.
Similarly, a lovely canine patient with hind limb osteoarthritis and associated lameness, has improved greatly from the start of her physiotherapy and the owner has now seen her jumping obstacles in the garden, jumping into the car and changes in her behaviour at home, following regular physiotherapy sessions and a structured home exercise programme.
It is important to understand that the musculoskeletal system requires several components in order to physiologically adapt and there are certain principles that should be considered with any rehabilitation programme. Tissues need to be progressively loaded in order to develop. For example, if you only ever to 10 repetitions of an exercise at the same intensity, with the same weight, that will limit adaptation above this level. We have to progressively overload tissues to facilitate change. This should be done in a controlled manner and I always advocate quality of movement during any exercise!
It is also important to understand the importance of cross training, be that flatwork, ground work, hacking and pole/jumping sessions in the equine athlete, to fast runs, slow runs, swimming, gym, cycling, etc in the human athlete to train the body for different demands and prevent injury from repetitive overloading. As important as work days are REST days, particularly following intensive exercise to allow recovery and prevent a detrimental amount of tissue overload which could lead to failure. So, sessions of a low intensity or rest days should also be factored into any training programme.
If there are issues throughout the training/rehabilitation programme it is important to address any concerns or niggles to prevent them from escalating and to adjust the plan accordingly, so if something isn't working it is important to communicate this and tweak the plan to make it achievable, so don't be afraid to talk to your physiotherapist if something isn't working,
Most importantly, don't give up! With regular compliance and dedication to your rehabilitation programme you would usually be looking at between 6 and 12 weeks to experience progression in strength, muscle bulk and fitness, and in some cases longer depending on the pathology and individual plan. Of course these are very broad guidelines and there are occasions where physiotherapy is not successful, but sometimes this is a bumpy road which can take tenacity to see through... so please... don't underestimate the power of persistence!