Post-surgical rehabilitation plays a vital role in helping animals return to function, reduce pain, and strengthen musculoskeletal integrity. Among the tools employed, manual therapy - ranging from passive range-of-motion to massage and joint mobilisation - holds promise. Yet, as with any intervention, its use must be grounded in evidence, guided by physiology, and tailored to individual patient needs to avoid harm.
The Physiological Framework
Healing after surgery follows a predictable sequence: inflammation, proliferation, and remodeling. Manual therapy can support recovery, for instance, through gentle joint mobilisation to restore range of motion or massage to mitigate edema and pain, but only when the tissue is past the fragile inflammatory phase (1, 2). As the Veterinary Surgery consensus notes, therapists should reassess frequently and progress treatment based on the individual’s tissue healing and functional status (1).
Benefits of Manual Techniques
- Passive range-of-motion (PROM) enhances joint mobility and reduces stiffness, supported by studies in Labradors with osteoarthritis (3).
- Soft-tissue massage can ease pain, boost lymphatic flow, and promote relaxation: core goals in post-op care (4).
- Hydrotherapy combined with manual support, such as underwater treadmills, is evidenced to accelerate strength and functional recovery after procedures like cruciate ligament repair (2).
Potential Risks and Contraindications
Manual therapy isn’t universally safe post-surgery. Techniques involving thrusts or excessive force can worsen injuries or delay healing, particularly risky in the presence of fractures, implants, or weakened tissues (5). Massage or mobilisation directly over surgical sites during the early inflammatory stage may exacerbate swelling or disrupt tissue repair (6).
Finding the Safe Zone
Timing matters: Initiate manual techniques after the inflammatory phase has subsided, typically days to weeks post-operatively, based on tissue type and healing phase (1)(4).
Client-specific plans: Rehab programs must be individualised, adjusting as healing progresses, aligned with Veterinary Surgery principles (1).
Scope of practice: Veterinarians and Certified Canine Rehabilitation Therapists (CCRTs) or physiotherapists should decide which techniques are appropriate, ensuring they complement diagnostics and overall care (2).
Integrate modalities: Combining manual therapy with therapeutic exercises and modalities like laser or TENS enhances outcomes more than single techniques (7).
When Manual Therapy Crosses the Line
Applying joint manipulation or aggressive soft-tissue work too early.
Treating surgical sites without vet input on healing progress.
Using high-force techniques where gentle methods suffice or where tissue remains vulnerable.
Practicing without ongoing reassessment of risks as healing evolves.
The Role of Osteopathy in Post-Surgical Recovery
Osteopathy, with its emphasis on tissue tension, circulation, and the body’s self-regulating mechanisms, can play a valuable role in post-surgical rehabilitation when applied judiciously. Rather than focusing on symptom relief alone, osteopathic practitioners assess the broader mechanical and physiological context, recognising how surgical trauma may alter fascial dynamics, joint loading, and visceral motion.
Techniques such as gentle myofascial release, balanced ligamentous tension, or craniosacral work may support recovery by improving local circulation, reducing compensatory strain, and enhancing neuromuscular coordination. However, as with any manual approach, timing, pressure, and patient selection are critical. Osteopathy should never be seen as a replacement for veterinary oversight, but as a complementary modality that can help restore functional harmony during and after rehabilitation
Final Thoughts
Manual therapy holds a valuable, evidence-based role in post-surgical reha, but only when applied with clinical acumen. The key lies in respecting physiological timelines, customising care to patient recovery, collaborating across disciplines, and avoiding premature or forceful applications. In that balance, manual therapy transitions from helpful adjunct to a potential hazard.
Resources for Further Reading
Kirkby Shaw et al., 2019 – Fundamental Principles of Rehabilitation and Musculoskeletal Tissue Healing, Veterinary Surgery. Review of tissue-healing phases and rehab guidelines. Full text available via PubMed Central: https://pubmed.ncbi.nlm.nih.gov/31271225/ animalphysionz.com+4PubMed+4ResearchGate+4
Monk ML, Preston CA, McGowan CM, 2006 – Effects of Early Intensive Postoperative Physiotherapy on Limb Function after TPLO, Am J Vet Res. Demonstrated that early physiotherapy improves thigh circumference and joint ROM after surgery. PDF available: https://dogrehabworks.com/ResearchArticles/POCruciateAmJVetRes2006.pdf avmajournals.avma.org+4dogrehabworks.com+4arccarticles.s3.amazonaws.com+4
Pedersen A et al., 2023 – Effect of TENS on Gait Parameters in Dogs, Acta Veterinaria Scandinavica. Showed improved weight-bearing in arthritic dogs after TENS therapy. Full paper: https://www.mdpi.com/2076-2615/14/11/1626
Michael C. Petty, DVM, 2025 – Rehab Therapy in the Post‑op Patient, Veterinary Practice News (Jan 24, 2025). A clear overview of multimodal post-op rehabilitation including laser, massage, and exercise: https://www.veterinarypracticenews.com/post-operative-rehabilitation/
[1]: https://pmc.ncbi.nlm.nih.gov/articles/PMC6973127 "Fundamental principles of rehabilitation and musculoskeletal tissue ..."
[2]: https://www.aescparker.com/blog/physical-rehabilitation-to-improve-surgical-recovery "Physical Rehabilitation to Improve Surgical Recovery - Parker (AESC)"
[4]: https://www.advancesinsmallanimalcare.com/article/S2666-450X(21)00012-2/abstract "[PDF] Manual Therapy in Small Animal Rehabilitation"
[5]: https://www.merckvetmanual.com/therapeutics/integrative-complementary-and-alternative-veterinary-medicine/manual-therapy-in-veterinary-patients "Manual Therapy in Veterinary Patients - Therapeutics"
[6]: https://pmc.ncbi.nlm.nih.gov/articles/PMC9303706/ "Systematic review of postoperative rehabilitation interventions after ..."
[7]: https://www.veterinarypracticenews.com/post-operative-rehabilitation/ "Rehab therapy in the post-op patient - Veterinary Practice News"
.png)
.png)
