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· Understanding CCL/ACL Tear & TPLO Surgery · What Happens After Surgery · Weeks 1 - 2: Inflammation Control · Weeks 3 - 12+: Rebuilding Strength · Long-Term Joint Health · Our Approach to Rehab & Recovery · FAQ · Book a Consultation
Understanding CCL/ACL Tear & TPLO Surgery?
The CCL is the primary stabilizer of the canine stifle (knee joint). When it ruptures, whether from acute trauma or gradual degeneration, the tibia (shin bone) shifts forward under the femur (thigh bone) with every step, causing pain and instability. There are a number of surgical procedures veterinarians may choose from based on your dog's specific needs. If your veterinarian recommends TPLO surgery, the goal of this particular procedure is to correct knee instability by leveling the slope of the tibial plateau (top of the shin bone), eliminating that forward shift and restoring stability to the joint.
Please note that the information on this page focuses specifically on rehabilitation following TPLO surgery, as it is a commonly performed procedure for a torn CCL. However, this does not mean it is the only procedure performed. If your veterinarian has recommended or performed a different procedure to repair the torn CCL, please contact us directly. Our rehabilitation approach is always tailored to each dog and each specific surgical technique, and we work closely with your veterinary team regardless of which procedure was performed.
Surgical stabilization, whether by TPLO or other surgical approaches, is the essential foundation of your dog's recovery. Without a stable joint, functional rehabilitation cannot begin. Our job as rehabilitation therapists is to help your dog make the most of that surgical outcome, rebuilding the muscle, movement, and confidence that allow them to fully use their newly stable joint.
What Happens After Surgery
After TPLO surgery, your dog's body needs time and guidance to heal and recover. Surgery restores mechanical stability of the knee and physical therapy restores strength and coordination of the entire limb. After surgery, dogs naturally guard the operated leg, shift weight away from it, and move it in altered ways. This is a normal and expected part of recovery.
Physical therapy following your dog's TPLO addresses these natural post-surgical responses by:
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Retraining normal movement patterns and limb loading
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Rebuilding muscle mass that is naturally lost during recovery and confinement
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Facilitating the nervous system's control of how to use the repaired limb
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Managing soft tissue comfort as activity gradually returns to normal
The focus of rehab after knee surgery is to guide your dog's return to full, confident movement. Physical therapy provides structured support to help the body translate a stable joint into a functional one.
Weeks 1 - 2: Inflammation Control
The first two weeks following TPLO surgery are defined by one priority: protecting the repair while the soft tissue begins to heal. Your surgeon's specific discharge instructions are the governing guide during this phase, and we follow them precisely.
What We Focus On During Weeks 1-2
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Wound monitoring: Daily inspection of the incision for any changes in appearance. Early communication with your veterinary team if anything looks unusual.
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Strict confinement and controlled movement: Leash walks only, no stairs, no jumping, no off-leash activity. Duration and frequency follow your surgeon's protocol exactly.
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Gentle passive range of motion (PROM): When cleared by your surgeon, slow and controlled flexion and extension of the stifle to maintain joint mobility during confinement.
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Comfort monitoring: Behavioral observation for signs of discomfort, reported directly back to your veterinary team as needed.
Weeks 1 - 2 Recovery Checklist
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Inspect incision site daily and contact your surgeon with any concerns
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Strict leash walks o only, per your surgeon's discharge instructions
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No stairs, jumping, running, or off-leash time
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Crate or exercise pen confinement when unsupervised
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Administer all prescribed medications as directed by your veterinarian
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Attend follow-up appointment with surgeon as instructed
Weeks 3 - 12+: Rebuilding Strength
As healing progresses and your veterinarian confirms bone healing status, typically around weeks 8-10, the focus of TPLO rehab transitions from protection to active restoration. This is where evidence-based modalities and progressive therapeutic exercise make a meaningful difference in your dog's long-term outcome.
Evidence-Based Modalities We Use:
Low-Level Laser Therapy (LLLT / Photobiomodulation)
Cold laser therapy is applied to the surgical knee and surrounding soft tissue to support cellular repair, reduce inflammation, and help manage post-operative discomfort. It is a safe, non-invasive modality that complements your dog's overall recovery plan and is well-supported in veterinary rehabilitation literature.
Pulsed Electromagnetic Field Therapy (PEMF)
PEMF delivers low-frequency electromagnetic pulses to support tissue healing, reduce pain, and improve circulation. For dog's that have recently had knee surgery, PEMF is particularly useful during the mid-recovery phase when bone remodeling is active and residual soft tissue sensitivity remains.
Therapeutic Exercise: Graded and Progressive
Therapeutic exercise is the foundation of recovery for dogs after CCL/ACL surgery and is always progressed based on each dog's individual healing timeline. Our exercise programs include:
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Weight-bearing exercises: Reintroducing graded weight-bearing exercises with the use of exercise equipment and the resistance of gravity to encourage confident loading of the surgical limb.
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Proprioceptive and neuromuscular retraining: Cavaletti poles and varied surface work to retrain the nervous system's awareness of limb position and movement. This is an important component of full functional recovery.
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Land-based strength exercises: Essential for rebuilding hind limb strength (particularly the quadriceps and hamstring muscles) to protect the surgical repair and stabilize the knee joint long-term.
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Controlled leash walking progressions: Gradual, structured increases in walk duration and terrain, always paced to match your dog's stage of recovery.
Weeks 3-12 Recovery Checklist:
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Perform prescribed home exercise program on non-clinic days
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Continue leash-only activity until cleared by your surgeon
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Attend follow-up radiograph appointment (typically 8-10 weeks post-op)
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Monitor for limb disuse, excessive licking of the incision site, or gait changes
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Communicate any changes in comfort or movement to your veterinary team promptly
Long-Term Joint Health
Full recovery from TPLO surgery is a gradual process, and long-term outcomes are shaped by the care that happens both in the clinic and at home. Several factors beyond the physical therapy sessions themselves play an important role a smooth recovery.
Weight Management
Body condition has a meaningful impact on joint health and recovery. Maintaining a healthy weight reduces load on the recovering limb and supports overall mobility. Your veterinarian can help you manage your dog's weight and recommend a nutrition plan if needed.
Environmental Safety
Non-slip surfaces, such as yoga mats, rubber-backed rugs, and non-slip booties, reduce the risk of slipping during the recovery period while balance and limb confidence are still being restored. Minimizing high-impact movements on slippery surfaces is a simple, effective way to support your dog at home. Pro-Tip: Focus on modifying 'high-traffic' areas like the path to the food bowl or the entryway to ensure your dog feels secure during every transition.
Supporting the Whole Dog, Including the Opposite Limb
Dogs who have experienced a CCL injury in one hind limb do have a higher likelihood of experiencing a similar injury in the opposite hind limb. This is simply a reflection of the fact that both limbs share the same anatomy, body weight, and movement patterns. It is not a cause for alarm, but it is a good reason to be proactive. Rehab and physical therapy is one of the best things you can do to support that opposite limb. By restoring balanced muscle strength, retraining symmetrical movement, and keeping your dog moving normally and at a healthy weight, we are actively supporting both limbs, not just the one that had surgery. Rehab is an investment in your dog's whole body, and that includes protecting the leg that has been working overtime during recovery.
A Gradual Return to Full Activity
The final phase of your dog's TPLO recovery involves a structured, step-by-step return to the activities your dog loves, including play, hiking, swimming, and sport. We work closely with your veterinary team to ensure that activity progressions align with healing milestones, and we never rush that process. Our goal is a dog who returns to full activity confidently and sustainably.
Our Approach to Rehab & Recovery
Our goal is to work closely with your veterinarian to ensure a seamless transition from the operating room to the rehab floor.
This means:
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We collaborate with your veterinarian to ensure treatment and exercise progression is appropriate for each stage of your dog's recovery
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We follow your veterinarian's post-operative guidelines at each stage of recovery
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We send monthly progress notes to your veterinarian updating them on your dog's improvements in physical therapy
If you are a pet parent whose dog just underwent TPLO surgery, we welcome the opportunity to work alongside you and your veterinarian to help your dog recover their mobility.
We offer two treatment paths so you can choose what works best for your family:
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Therapist-led: We perform all treatment in our clinic, typically twice per week. You bring your dog in and we handle the rehabilitation.
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Pet parent-led: We teach you how to perform therapeutic exercises at home. We start with weekly visits, demonstrate every exercise, have you practice it with us, and provide video instructions. Visit frequency is gradually reduced as your dog return to full function.
Frequently Asked Questions
When should we start canine rehabilitation after TPLO surgery?
Once cleared by your veterinarian, we recommend an initial evaluation within the first few days after surgery to establish a baseline and begin gentle passive modalities, including medical massage, cold laser, and PEMF. Formal therapeutic exercise is introduced gradually as your dog progresses through the healing process. We never move faster than the healing allows.
Do I need a referral from my veterinarian for physical therapy?
Yes, we ask for a veterinary referral before beginning treatment. This allows us to coordinate with your veterinary team and ensures we have the clinical information we need to build a safe, appropriate program for your dog's specific situation. We believe in the continuum of care model, where the surgeon, primary vet, and rehabilitation therapist function as a coordinated team around your dog's recovery.
Does my dog need physical therapy after TPLO, or will rest alone be enough?
Rest is essential because it protects the repair. Post-operative canine rehabilitation builds on that protected rest to restore the strength, movement, and confidence your dog needs to fully use their repaired joint. We think of our role as helping your dog get the most out of the investment your veterinary surgeon made.
How long does TPLO recovery take?
Bone healing is typically confirmed by your veterinarian at 8-10 weeks. Full functional recovery, including return to more demanding activity, generally takes 4-6 months with a structured post-surgical CCL rehab program. Your surgeon and veterinary team will guide the overall timeline.
Do you treat dogs in both Omaha and Lincoln?
Yes. Macke Institute of Canine Therapy provides canine rehabilitation in Omaha and Lincoln, NE. Contact us to find out which location works best for your family.
Begin Your Dog's Recovery Journey
Your veterinarian stabilized your dog's joint. We help your dog use it fully and confidently.
If your dog has recently undergone TPLO surgery, or if you are preparing for an upcoming procedure, contact Macke Institute of Canine Therapy to schedule your dog's TPLO physical therapy evaluation. We serve dogs, their families, and veterinarians across the Omaha and Lincoln metro, as well as the surrounding Nebraska communities.
[i] “Canine Cruciate Ligament Injury.” James L. Voss Veterinary Teaching Hospital, Colorado State University, 2022, https://vetmedbiosci.colostate.edu/vth/services/orthopedic-medicine/canine-cruciate-ligament-injury/.