This document provides guidelines for physical therapy technicians on stretching protocols for canine patients. It outlines the benefits of stretching, including relaxation, decreased pain, and injury prevention. Potential risks like joint contracture and adaptive muscle shortening are explained. Detailed instructions are given on proper patient positioning and techniques for stretching various muscle groups, with an emphasis on slow, gentle motions and holding for 15-60 seconds. Stretching is presented as a valuable rehabilitation tool when performed appropriately.

1. Physical Therapy
Technician Protocol:
Stretching
Level 3
Technical Skill

2. Prerequisites
Physical Therapy
Technician Knowledge
Protocols
Anatomy
Canine Biomechanics
& Gait
PROM

3. Benefits of
Stretching
Relaxation
Decreases pain
Prevents joint contracture
Prevents adaptive muscle shortening
Enhances blood & lymphatic flow
Maintains mobility of the soft tissue layers
Injury prevention

4. Joint Contracture
Permanent shortening
of a muscle,
resulting in
decreased range of
motion of a joint,
due to spasticity,
ischemia, or
prolonged
immobility.

5. Adaptive Muscle Shortening
When a muscle is
shortened for a
prolonged period of
time, it loses
sarcomeres & loses
length permanently,
resulting in joint
contracture.

6. Flexibility
The ability of the
muscles to relax &
respond to an
elongation force

7. Stretching
•Stretching can be active or passive, even in the animal
patient.
•Passive stretching techniques taught in this module are
skilled 'hands on' manual techniques.
•PROM occurs at the joint surface, ligament, & joint
capsule.
•Stretching is performed to the muscle, tendon,
ligament, joint capsule, & fascia.

8. Indications for Stretching
Immediately post-operatively.
Post-injury (following resolution of the acute,
inflammatory stage).
Geriatric patients (due to reduced flexibility).
Immobile patients, especially those prescribed crate
rest.

9. Contraindications for Stretching
Unstable or
unstabilized
fractures.
Unstable ligament or
tendon injuries.
Pain due to stretching.

10. Remember to Warm Up First!
Take the patient on a walk to warm up his body
& muscles.
Use a heating pad or hot pack (but be aware of
the potential for burns).
Massage the muscles to be stretched to
increase blood flow to the area.

11. Patient Positioning for Stretching
•Sidelying or laterally recumbent
– This is the optimal position for both you & the
patient.
– Position yourself behind the patient, if possible, for
most efficient body mechanics.
•Standing
– For fractious, nervous, or dominant dog, this may
be the only option.
– Be sure to support your patient's body when
performing standing stretching as he/she will be
balancing on three legs.

12. Stretching Procedure
Invite the patient to lie down & relax.
Give positive feedback & prepare, relax, or
distract the patient through:
–
Petting or massage.
–
Treats.
–
Toys for distraction.
Position your body & your hands
The patient should be relaxed. Be gentle.
– Your hands relay your level of stress, anxiety,
or relaxation to the patient.

13. Stretching Procedure
•Support the limbs so that the patient can relax as
much as possible.
•Consider the length of “lever arms” & adjust your
stretch based on physics.
– If the “lever” is long, be more gentle!
•Avoid handling painful areas such as wounds or
incisions.
•The motion should be slow, smooth, & steady.
•Stretch to the point of tissue resistance, not patient
discomfort.

14. Method of Stretching
Find the “end range” stretch where there is
comfortable tissue resistance.
Hold for 15-60 seconds.
Repeat 3 times.
Repeat 1-3 times daily.

15. Stretching the Cervical Spine Muscles
The pet should be
seated or standing.
Lead him to reach for a
treat by his left hip.
Gently hold back his
right shoulder blade.
Hold for 15-60
seconds.
Repeat to the right.

16. Stretching the Teres Major
The pet should be lying in
lateral recumbency.
Hold a hand behind his elbow.
Reach forwards, up, & out.
– Extension, abduction, &
external rotation.
Gently rock his shoulder blade
back with the other hand.
Hold for 15-60 seconds.

17. Stretching the Triceps
The pet should be lying in
lateral recumbency.
Hold a hand behind his elbow
& the other at the
wrist/paw.
Reach the leg forwards into
extension (towards the
head) & gently flex the
elbow.
Hold for 15-60 seconds.

18. Stretching the Biceps
The pet should be lying in
lateral recumbency.
Hold at his shoulder with the
other hand at the
carpus/paw.
Reach the leg backwards into
flexion (towards the hip) &
gently extend the elbow.
Hold for 15-60 seconds.

19. Stretching the Carpal Flexors
The pet should be lying in
lateral recumbency.
Hold at his elbow & the other
hand at the paw.
Extend/straighten the elbow &
extend/straighten the carpus.
Hold for 15-60 seconds.
THEN flex the elbow &
extend/straighten the carpus.

20. Stretching the Hamstrings
The pet should be lying in
lateral recumbency.
Hold his thigh with one
hand & the tarsus with
the other.
Flex the hip & gently
extend the stifle to
reach the paw towards
the shoulder.
Hold 15-60 seconds.

21. Stretching the Quadriceps
The pet should be lying in lateral
recumbency.
Hold his thigh with one hand &
the tarsus with the other.
Bring the hip in a 90
degree/perpendicular position
from the body, gently flex the
stifle, bringing the tarsus
towards the ischial
tuberosity/hip.
Hold 15-60 seconds.

22. Stretching the Iliopsoas
The pet should be lying
in lateral recumbency.
Hold his hip with one
hand & the stifle with
the other.
Rub his belly as you
gently extend the hip
Hold 15-60 seconds.

23. Stretching the Gastrocnemius
The pet should be lying in
lateral recumbency.
Hold his stifle in extension
with one hand & the paw
with the other.
Without flexing the stifle, flex
the tarsus. The leg will
tighten but there will be
little motion of the joints
Hold 15-60 seconds.

24. Stretching
Stretching can be a valuable therapeutic tool &
an activity taught to pet owners as well.
A rehabilitation practitioner should assess the
pet initially to determine which stretches are
appropriate & safe to perform with each pet.
Regardless, if a stretch causes pain or
discomfort, it should be discontinued until a
veterinarian or rehabilitation practitioner is
able to be consulted.