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Physical Therapy After Femoral Head Ostectomy in Dogs

Physical Therapy After Femoral Head Ostectomy in Dogs

Femoral Head Ostectomy

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Owners

Step-by-step physical therapy guide for dogs after FHO surgery. Learn rehab stages, safe exercises, and recovery tips to restore mobility

By 

Sustainable Vet Group

Updated on

July 28, 2025

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Physical Therapy After Femoral Head Ostectomy in Dogs

After femoral head ostectomy (FHO) surgery, physical therapy is a key part of your dog’s recovery. While the surgery removes the damaged femoral head, it does not replace it with an artificial joint. Instead, the body forms a fibrous joint over time.

To make this new joint work well, your dog needs regular movement and controlled exercise. Without physical therapy, scar tissue may build up in the wrong way, and muscles can become weak. This can lead to long-term stiffness or limping.

Physical therapy helps in many ways:

  • Reduces post-surgery pain and swelling
  • Restores joint range of motion
  • Builds muscle strength around the hip
  • Helps your dog walk, sit, and play more naturally
  • Speeds up overall recovery and boosts confidence

With the right therapy plan, most dogs regain good use of the leg and return to an active, pain-free life.

Key Phases of FHO Recovery in Dogs

A structured rehab plan helps your dog heal safely, build strength, and return to daily life without pain.

Immediate Post-Op Care (Days 1–3)

The first few days after FHO surgery are focused on rest and pain control. Your dog should be kept in a quiet, confined space like a crate or small room to avoid sudden movements. This prevents injury to the healing tissues. Use ice packs on the surgery site for 10–15 minutes every few hours to help reduce swelling. Your vet will prescribe pain relief, which may include NSAIDs or opioids—give these exactly as directed.

It’s also important to start gentle passive range of motion (PROM) exercises with your vet’s guidance. These help prevent stiffness by slowly moving the leg through its natural range. Avoid allowing your dog to jump or walk on slippery floors. Add rugs or mats for safety and always supervise during bathroom breaks. This phase builds a safe foundation for the next stages of rehab.

  • Crate rest to limit movement
  • Ice packs 3–4 times daily
  • Pain meds given as prescribed
  • PROM to reduce stiffness

Early Rehab Phase (Week 1–2)

During the first two weeks after surgery, your dog slowly begins to move more. Start with short leash walks—just 2 to 3 minutes, 3 to 4 times a day. These walks help your dog start using the leg and prevent muscle loss. Always walk on flat, non-slippery surfaces, and go slow. Before each session, apply moist heat to the hip for 10 minutes to relax the muscles and ease pain.

Add gentle massage to the thigh and hip area to improve blood flow and reduce soreness. Continue daily passive range of motion (PROM) exercises to maintain joint flexibility. Cookie bends, where you guide your dog’s nose to each side with a treat, encourage stretching and help build core balance. All exercises must be done with care and should never cause pain.

  • Short, frequent leash walks on flat surfaces
  • Moist heat therapy before exercise
  • Light massage to loosen stiff muscles
  • Daily PROM to improve mobility
  • Cookie bends to increase body awareness and stretch

This phase sets the stage for strength building in the coming weeks.

Strengthening Phase (Week 3–6)

In this stage, your dog starts to rebuild strength and muscle control. Sit-to-stand exercises against a wall are great for engaging the rear legs. You can guide your dog into a sit and then help them stand, repeating 5–10 times per session. Controlled stair climbing is also useful—start with low steps and go slowly to avoid strain.

Walking on gentle slopes or small hills helps improve balance and weight-bearing. Cavaletti poles, placed a few inches above the ground, teach your dog to lift their legs properly. Weaving through cones or furniture improves body coordination. You can also introduce weight-shifting using a cushion or balance pad, encouraging the dog to stand on all fours and gently shift their weight side to side.

  • Sit-to-stand reps to build muscle
  • Controlled stair use (low steps only)
  • Hill walking to improve power and balance
  • Cavaletti poles for stride awareness
  • Balance pad work to improve control

Each activity should be done calmly and gradually to avoid re-injury.

Advanced Rehab (Week 6+)

Once your dog is moving comfortably, the focus shifts to rebuilding endurance and fine motor control. Water therapy, like swimming or underwater treadmill work, is excellent for low-impact muscle building. These activities reduce joint stress while improving strength and range of motion.

Introduce tools like wobble boards or physio balls to challenge your dog’s balance. These tools force the stabilizing muscles around the hip to engage more deeply. Continue leash walking but increase the time by 5 minutes each week based on your dog’s energy and comfort level. Still include PROM and earlier strength drills to maintain gains.

Keep a close eye on any signs of limping, fatigue, or stiffness after exercise. If you notice these signs, reduce the intensity and consult your vet or rehab therapist. By this stage, most dogs are close to full function but still need consistency.

  • Underwater treadmill or swim sessions
  • Balance tools for core strength
  • Leash walks with gradual time increase
  • Ongoing PROM and earlier exercises
  • Monitor closely for soreness or limping

This phase brings your dog back to full mobility with confidence.

At-Home Therapy Tips for Dog Owners

These simple steps help you support your dog’s recovery safely and confidently at home.

Creating a Weekly Rehab Calendar

A weekly rehab calendar helps you stay organized and ensures your dog follows a consistent recovery routine. Write down all exercises, walks, and rest periods each day so nothing is missed. You can use a whiteboard, notebook, or digital app—whatever works best for your family. This schedule helps you track progress, note any signs of pain, and adjust the plan when needed.

By planning ahead, you’ll avoid skipping important sessions or repeating the same activity too often. It also helps different family members follow the same routine if more than one person is helping with care. Include reminders for medications, vet checkups, and when to add new exercises.

  • Plan rehab exercises in advance
  • Keep records of walk time, reps, and energy levels
  • Use photos or videos to track limb use
  • Adjust based on fatigue or stiffness signs

Consistency makes recovery smoother and faster.

Safe Exercise Space at Home

A safe space makes it easier for your dog to move without risk of injury. Choose a quiet area away from noise and other pets. Use non-slip rugs, yoga mats, or rubber flooring to prevent your dog from slipping, especially during exercises or walks around the house. Avoid hard surfaces like tile or hardwood.

Remove obstacles like furniture edges, cords, or toys that can cause tripping. Block access to stairs with baby gates to prevent accidental climbing. Keep the space well-lit and easy to supervise. If your dog is crate-trained, set up the crate nearby for rest after rehab.

A calm, clean setup helps reduce stress and keeps your dog focused on the exercises. It also makes transitions between rest and movement smoother.

  • Use rugs or mats for better traction
  • Block stairs and high furniture
  • Keep the area quiet and clutter-free
  • Ensure the space is easy to supervise

Safety at home supports better rehab outcomes.

How to Use Household Items for Rehab

You don’t need expensive tools for rehab—simple items at home can work well. A rolled towel can support your dog’s hip or be used to help with range of motion stretches. Place it under the belly for gentle lift support during assisted walks. Couch cushions or sofa ramps help dogs get on or off furniture safely without jumping.

Set up DIY cavaletti poles using broomsticks or PVC pipes balanced on boxes or books to train stride awareness. Use a yoga ball or pillow for gentle balance work. Even folded blankets can create soft inclines or padded surfaces for added challenge.

These simple tools keep your dog engaged and promote recovery while keeping costs low. Just ensure every item is stable and safe.

  • Rolled towels for support or stretches
  • Cushions and ramps for furniture access
  • Broomsticks for DIY walking poles
  • Blankets or pillows for balance work

Get creative while keeping safety first.

Mental Stimulation During Recovery

Mental stimulation is just as important as physical rehab, especially during periods of rest. When your dog is not allowed to move much, boredom can lead to stress or destructive behavior. Use puzzle feeders or treat-dispensing toys to keep their brain active. These slow down eating and challenge your dog to problem-solve.

Snuffle mats are great for scent games. You can also hide treats around the room and let your dog search for them, encouraging light movement and focus. Training short commands like “sit,” “stay,” or “touch” helps maintain obedience and builds confidence.

Keep sessions short—just 5 to 10 minutes, 2–3 times per day. Rotate toys and games so your dog doesn’t get bored. This helps with healing and keeps your dog happy.

  • Puzzle toys to challenge the brain
  • Snuffle mats for scent work
  • Hide-and-seek treat games
  • Gentle command training for focus

Mental exercise supports full recovery inside and out.

Common Mistakes to Avoid in Rehab

Even with the best intentions, some common mistakes can slow down your dog’s recovery. One of the biggest issues is overdoing exercise too soon. Skipping rest or adding activities without your vet’s guidance can cause setbacks. Always warm up with gentle walks and cool down with light stretching or massage.

Letting your dog walk or play off-leash before they’re ready is risky, even in the yard. They might run, jump, or twist the leg, undoing the progress made. Not attending follow-up vet visits also leads to missed signs of delayed healing or complications.

Stick to the plan your vet or rehab expert provides. If your dog seems sore, stiff, or tired, scale back and adjust. Patience and proper pacing are key to success.

  • Do not skip rest phases
  • Never let the dog roam freely too early
  • Warm-up and cool-down are essential
  • Follow all progress checks with your vet

Avoiding these mistakes keeps your dog’s recovery on track.

Long-Term Care and Mobility Maintenance

After your dog has completed the main stages of rehab, long-term care becomes essential for keeping their hip strong and pain-free. Even though the joint forms a functional fibrous connection, it still needs regular use to stay flexible. Low-impact activities like swimming or walking on an underwater treadmill are ideal. These support muscle tone without adding pressure on the joint.

  • Weekly swimming or treadmill sessions for gentle exercise
  • Keep your dog at a healthy weight to reduce joint strain
  • Use joint supplements like glucosamine if advised by your vet
  • Watch for signs of limping or stiffness that return later

Over time, you should gradually build your dog’s strength with moderate exercise. Long walks, gentle fetch, and uphill strolls are fine—as long as your dog stays comfortable. Lifelong care helps your dog enjoy an active, happy life after FHO.

When to Call the Vet During Rehab

It's important to know when something is not right during recovery. Some soreness is normal, but certain signs mean you should call your vet immediately. Increased limping, swelling around the hip, or signs of infection should never be ignored. If your dog seems quieter than usual, refuses food, or has a wound that reopens, get help.

  • Limping that worsens or returns after exercise
  • Swelling, redness, or heat near the surgery site
  • Wound that opens or leaks fluid
  • Mood change, tiredness, or poor appetite

Quick action can prevent setbacks and protect your dog from further pain. Always follow your vet’s advice if you're unsure what’s normal during recovery.

FAQs About Physical Therapy After FHO Surgery

How soon should I start physical therapy after FHO surgery?

Most dogs begin basic rehab like passive range of motion within 1 to 3 days after surgery, depending on the vet’s recommendation. Active exercises like leash walks or sit-to-stands usually start in week 1 or 2, once pain is managed and healing begins.

Can my dog fully recover without physical therapy?

It’s possible, but less likely. Without physical therapy, the leg may stay weak or stiff, and scar tissue can limit movement. Rehab helps your dog regain full use of the leg faster and more completely.

What if my dog doesn’t want to use the leg?

It’s common early on, but avoid forcing it. Use short, slow leash walks and supportive exercises like towel slings or underwater therapy. If the limp lasts beyond a few weeks, consult your vet or a rehab specialist.

Are joint supplements necessary after FHO?

Joint supplements like glucosamine or omega-3s can support long-term comfort and joint health. While not required for all dogs, they’re especially helpful for older pets or those with arthritis in other joints.

Is swimming good for dogs after FHO surgery?

Yes, swimming or underwater treadmill is highly recommended after week 6. These exercises build muscle without stressing the joint and can become part of your dog’s regular fitness routine post-recovery.

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