Iliopsoas strain: the hind limb lameness you may not know about

Iliopsoas strain: the hind limb lameness you may not know about.
Posted on August 13, 2012 by Katie
20120120 High flying Steve

Steve has always been a hard-hitting, heavy-duty athletic kind of dog. When he came up lame a few years ago, my heart dropped into my stomach. I had been through two knee surgeries with Luce already, and I knew how little fun that was. Looking at Steve, I was pretty sure it wasn’t a knee problem, but in we went to the vet. He agreed it was not Steve’s knee, it was higher in the leg. I immediately panicked that he had hip dysplasia, but on xray, his hips looked lovely (and indeed, OFA rated them as “good”). He was diagnosed with a generic “soft tissue injury” and prescribed rest and Rimadyl. I rested him as best I could (good luck with that) and then tried allowing him to start being active again. He wasn’t any better. I made him an appointment with a specialist.

It took her about two seconds to diagnose him with an iliopsoas muscle strain. I had never heard of this! My regular vet had never heard of this either. But there was no question at all for someone who was familiar with the injury and looking for it. She gently pressed on his muscle; he whipped his head around and gave her the stink eye. When she extended his hind leg and rotated it inward, he squirmed and fought her. That was where he hurt. There was no question.

The iliopsoas, or hip flexor, is the major muscle that allows the dog to move his leg up toward his abdomen. In a dog with a strain, you will often see a shortened stride on that side, especially at the trot, as the dog cannot comfortably move his leg as far forward as he normally would. He also may not want to completely extend his legs behind him, because stretching like that hurts. Often, affected dogs will not bear weight equally behind while standing, putting the lion’s share of weight on the uninjured side. In some performance dogs, the first symptoms are vague- popping out of weave poles or dropping bars behind, even if the dog looks sound on the flat.

Often an agility injury resulting from dogs running, jumping, and changing directions at high speed, it is also seen in dogs who fall or splay out their hind legs on a slippery floor or ice. It can also be seen secondary to a knee injury, so an affected dog’s knee should be thoroughly examined and xrayed to make sure there is no primary problem there. Steve got hurt when he collided with a much larger dog during flyball practice and went rolling.
Angry collie.

As in human athletes, soft tissue injuries take a long time and a lot of effort to get to heal. The first order of business is strict rest. No running, no jumping, no fun. He was also prescribed regular treatments with a Cold Laser, which is a little bit controversial in some circles as they don’t believe there is enough hard evidence that it works, though they have become extremely popular among rehabilitation specialists. Cold laser helps increase circulation and reduce inflammation, reduce pain, and speed healing. It’s useful for soft tissue injuries like a groin pull like Steve has, but it is also helpful for arthritis and wound healing.

But by far, the largest and most important part of his treatment was an at-home exercise program that expanded and intensified as his treatment progressed. We began with five minute walks three times a day, passive stretches in which I manually stretched his muscles, and lots of active stretches where he did his own stretching, encouraged by a strategically-placed cookie. As he improved, we added strength-building exercises to help build his core muscles both to help him heal and help protect him against future injuries.

Unfortunately, iliopsoas injuries frequently become chronic problems. Whether it’s a small bit of scar tissue left behind, or a simple predisposition to the injury, it is not uncommon for a dog who has had this injury once to have it again in the future. It took about five months to completely rehab Steve the first time. He started rehab in June of 2010 and ran his first flyball tournament in November. He had no troubles at all until he came up lame again this past June. We are currently six weeks into a second round of rehabilitation, and while it is going much more quickly this time, it forces me to ask some serious questions about my sport dog’s future activities. It’s no fun to keep my active dog in a box, and while I refuse to keep him in a bubble, I do wonder if he should be relegated to the ranks of active pet and hiking companion rather than agility dog. I am not sure yet what the answer is.