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When to Start Physical Therapy After TPLO Surgery

When to Start Physical Therapy After TPLO Surgery

TPLO

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Owners

Learn when to start physical therapy after TPLO surgery, which exercises help recovery, and how to avoid early-stage complications.

By 

Sustainable Vet Group

Updated on

October 21, 2025

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When to Start Physical Therapy After TPLO Surgery

Understanding the Role of Physical Therapy After TPLO Surgery

Physical therapy plays a critical role in helping dogs recover safely after TPLO surgery. It supports joint healing, improves muscle strength, and restores normal walking patterns without stressing the repaired tibia. A structured therapy plan, guided by your vet, ensures controlled progress and prevents complications.

  • Promotes Recovery and Strength: Gentle exercises improve circulation, prevent stiffness, and rebuild muscle mass lost during rest.
  • Restores Flexibility and Motion: Controlled movements help the stifle joint regain its natural range of motion over time.
  • Reduces Pain and Swelling: Physical therapy techniques like passive motion and hydrotherapy aid healing while minimizing inflammation.
  • Prevents Long-Term Weakness: Without therapy, muscle loss or uneven weight-bearing may delay full recovery.

Properly timed therapy ensures balanced healing, reducing risks of reinjury or joint strain.

Typical Timeline: When to Start Physical Therapy After TPLO Surgery

Starting physical therapy at the right time is crucial for a dog’s recovery after TPLO surgery. Most dogs can begin gentle rehab once the incision is healed and swelling has reduced, typically around 7–14 days post-surgery. However, every case differs depending on age, breed, and healing progress.

  • Vet-Guided Start: Physical therapy should always begin under your veterinarian’s guidance to avoid stressing the surgical site too soon.
  • Early Readiness Signs: Once the incision is dry, pain is controlled, and your dog bears limited weight on the operated leg, it’s usually safe to start mild exercises.
  • Customized Timing: Puppies and smaller breeds often heal faster than older or larger dogs, so rehab schedules should match individual recovery speeds.
  • Progress-Based Approach: Therapy intensity increases gradually—from passive motion to active exercises—based on how your dog responds to early movements.
  • Avoiding Setbacks: Starting too early or overexerting the limb can cause inflammation or jeopardize the bone plate’s stability.

Proper timing ensures muscles strengthen safely, the joint regains mobility, and your dog avoids complications during recovery.

Early Recovery Phase (Days 1–14) After TPLO Surgery

The first two weeks after TPLO surgery focus entirely on rest, incision care, and controlled movement. This period allows bone and tissue healing to begin without strain on the surgical plate or sutures.

  • Strict Rest and Confinement: Dogs should remain in a confined, quiet area with minimal movement to avoid accidental slips or jumps.
  • Short Leash Walks: Only brief walks for bathroom breaks—less than five minutes at a time—are allowed under full supervision.
  • Cold Compresses: Applying ice packs to the knee for 10–15 minutes several times a day reduces swelling and pain.
  • Incision Monitoring: Owners should check the surgical site daily for redness, discharge, or swelling before therapy begins.
  • Avoid Exercise or Play: Running, jumping, or climbing stairs can delay bone healing and increase inflammation.

During this phase, the goal is to protect the repair site while maintaining comfort. Once the incision fully heals, your vet may approve gentle range-of-motion therapy.

Intermediate Phase (Weeks 2–6): Gentle Physical Therapy Begins

Between weeks two and six, structured physical therapy typically starts. The focus shifts from passive healing to controlled movement that encourages flexibility, strength, and improved limb use.

  • Passive Range-of-Motion (PROM): Gentle joint movement helps prevent stiffness and promotes healthy cartilage recovery when done under professional supervision.
  • Assisted Standing: Supported standing exercises help dogs gradually bear weight on the surgical leg without stressing the joint.
  • Short Leash Walks: Walks of 5–10 minutes, two to three times daily, build muscle endurance safely.
  • Hydrotherapy Option: Underwater treadmill therapy, when approved by your vet, provides resistance without joint strain, improving strength faster.
  • Pain and Swelling Checks: Each session should be followed by light icing and monitoring for signs of fatigue or discomfort.

This stage is where progress becomes visible. Regular consistency ensures a steady transition from limited movement to controlled mobility without risking re-injury.

Advanced Recovery Phase (Weeks 6–12): Strength and Balance Work

By the 6–12 week mark, most dogs regain stable bone healing, allowing more advanced exercises to rebuild strength, coordination, and balance. The aim is to restore natural gait and confidence in limb use.

  • Active Strength Exercises: Sit-to-stand drills and slow, controlled walking help rebuild thigh and core muscles.
  • Balance and Coordination Work: Balance pads or gentle inclines improve proprioception and even weight distribution across all legs.
  • Stair Climbing (Controlled): Supervised, slow stair work helps develop joint stability and flexibility.
  • Hydrotherapy or Swimming: Low-impact water exercises maintain endurance without stressing healing tissues.
  • Ongoing Vet Evaluation: Regular X-rays or physical assessments confirm proper bone union before increasing intensity.

This phase focuses on steady muscle recovery and posture correction to prepare the dog for normal daily movement. Patience and consistency are key to safe progress.

Late Phase (After 12 Weeks): Return to Normal Activity

After three months, most dogs are ready to transition toward normal life. However, this final stage must be gradual to prevent relapse or strain on the healing knee.

  • Resuming Normal Walks: Begin with short, consistent outdoor walks before returning to pre-surgery activity levels.
  • Gradual Play Reintroduction: Controlled play sessions on soft ground help test endurance without risking overexertion.
  • Agility and Sports: Dogs involved in sports or agility should reintroduce jumps and running only after veterinary clearance.
  • Muscle Conditioning: Continued exercises like swimming or uphill walking maintain muscle tone and joint flexibility.
  • Final Vet Check: A full assessment ensures bone healing, muscle symmetry, and joint stability before releasing all restrictions.

By this stage, your dog should move comfortably and confidently. Continued low-impact exercise helps preserve joint health and prevent future ligament strain.

Signs You May Need to Delay Physical Therapy After TPLO Surgery

Starting physical therapy too soon after TPLO can cause more harm than good. The body needs time for bone healing and incision recovery before introducing movement. Recognizing warning signs early helps prevent complications and ensures your dog’s safety during rehabilitation.

  • Redness or Swelling Around the Incision: Any inflammation, heat, or discharge from the surgical site means healing isn’t complete. Physical activity could reopen the wound or cause infection.
  • Pain During or After Mild Activity: Whimpering, licking the surgical area, or avoiding movement signals discomfort and may indicate tissue irritation or joint inflammation.
  • Limping or Sudden Lameness: If your dog starts limping after short walks, it’s a sign the leg isn’t ready for increased activity yet.
  • Fluid or Seroma Formation: Swelling under the incision may suggest fluid buildup, which requires veterinary attention before resuming exercises.
  • Reluctance to Bear Weight: Dogs that hesitate to use the operated leg may still be in the early recovery phase and need more rest.

Pausing therapy until your vet confirms readiness helps protect bone healing, avoid reinjury, and ensure long-term recovery success.

Benefits of Starting Physical Therapy at the Right Time After TPLO Surgery

Starting physical therapy at the correct stage makes all the difference in how quickly and effectively your dog regains normal function. Proper timing promotes muscle recovery, strengthens the joint, and enhances overall mobility without risking surgical damage.

  • Accelerated Muscle Recovery: Gentle, timely exercises prevent muscle atrophy and help rebuild strength lost during the rest phase.
  • Better Joint Stability: Controlled movements restore balance between supporting muscles, protecting the stifle joint from future strain or instability.
  • Reduced Risk of Complications: Appropriate rehab timing prevents swelling, incision reopening, and plate stress while improving blood circulation to healing tissues.
  • Improved Range of Motion: Gradual stretching and weight-bearing help regain flexibility and prevent long-term stiffness or gait imbalance.
  • Enhanced Long-Term Mobility: Well-timed therapy strengthens both legs, minimizing compensation-related injuries and supporting lifelong mobility.

Physical therapy started under veterinary guidance not only speeds recovery but also ensures your dog regains strength, comfort, and confidence safely.

Working With a Certified Canine Rehabilitation Specialist After TPLO Surgery

Professional canine rehabilitation offers a safer, structured, and evidence-based approach to TPLO recovery compared to unsupervised home exercises. A certified specialist customizes therapy to match your dog’s condition, age, and progress.

  • Customized Recovery Plans: Specialists assess your dog’s muscle tone, joint movement, and surgical healing to create personalized exercises for safe progression.
  • Advanced Equipment and Techniques: Clinics may use underwater treadmills, laser therapy, or balance tools that provide resistance training without joint stress.
  • Supervised Progress Tracking: Each session is monitored for pain response, mobility improvement, and healing consistency to prevent overexertion.
  • Education for Owners: Rehabilitation professionals teach correct exercise techniques so owners can safely continue therapy at home between visits.
  • Comprehensive Evaluation: Regular assessments help modify the plan based on progress, ensuring efficient recovery and reduced reinjury risk.

Working with a certified canine rehab specialist ensures your dog receives expert-guided therapy, improving outcomes, safety, and confidence during every phase of recovery.

Conclusion

Physical therapy is essential for restoring your dog’s strength, balance, and confidence after TPLO surgery. When started at the right time, it prevents stiffness, builds muscle, and protects the joint from future injury.

  • Ideal Timeline: Begin light exercises around 7–14 days post-surgery once the incision heals and your vet confirms readiness.
  • Gradual Progression: Each rehab phase—passive motion, gentle walking, and strength building—should progress slowly to avoid setbacks.
  • Professional Guidance: Always consult your veterinarian or a certified rehab specialist before changing activity levels or adding new exercises.
  • Long-Term Benefit: Consistent, structured physical therapy not only speeds recovery but also ensures lifelong joint health and improved mobility.

A patient, guided approach to physical therapy ensures your dog heals stronger, moves better, and enjoys a full, active life after TPLO surgery.

FAQs

When should I start exercises after TPLO surgery?

Most dogs begin gentle physical therapy 7–14 days after TPLO surgery, once the incision is fully healed and swelling has subsided. Your vet will assess bone stability before clearing you to start. Beginning too early can strain the surgical plate or cause inflammation, so always follow veterinary advice.

What type of therapy helps my dog recover faster?

Hydrotherapy, passive range-of-motion exercises, and short, controlled leash walks are most effective during early rehab. As recovery progresses, balance training, strengthening drills, and swimming improve muscle tone and stability without stressing the joint.

Can I do therapy at home or should I visit a rehab center?

Simple exercises like gentle walking and passive stretching can be done at home under veterinary guidance. However, a certified canine rehabilitation specialist offers professional monitoring, hydrotherapy access, and advanced modalities for faster, safer progress.

How long does TPLO physical therapy last?

Most dogs complete a structured therapy plan within 8–12 weeks, but recovery time varies with age, size, and healing rate. Some high-energy or large breeds may need continued conditioning for up to four months before returning to full activity.

What signs show my dog is ready for more activity?

Improved weight-bearing, smoother walking, and equal use of both hind legs indicate readiness for advanced exercises. Your vet may also perform stability checks or follow-up X-rays before approving increased activity or off-leash play.

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