Wrist Injury

[neilnbeanie 10]

I was out with my lurcher the other evening, and as I let her off the lead, she shot off across the field in pursuit of something. She went out of sight, and was gone about 5 mins. When she came back, she was limping on her front leg,and she was covered in mud down one side, she had obviously gone over, so I took her home. Later that evening, her wrist on her front left leg had swollen up. So it was a trip to the vet. There isn't any fractures so she is now on anti inflammatory and pain killers. What I would like to know is, what is my best course of action now, as regards getting her running again, and is there anything I can do to try to prevent this happening again. How long do you think I should rest her for? Any tips? Thanks.

[riohog 5,645]

rest is the best cure , it might be a tendon injury dont rush it

[neilnbeanie 10]

Cheers mate, the vet seemed to think she may have a thorn in it, although he couldn't find any wound. I think he just wanted to sell me a course of antibiotics. Maybe I'm just a cynic lol. He didn't really want to say what it was. The swelling is going down, I was thinking about taking her out on the lead in about a week's time for a gentle walk then slowly step it up from there.

[desertdog 149]

I have had the same recently, didn't go vet, got

Some anti inflams,she's been off now for goody two month, just rest and walk .

[sandymere 8,261]

From back along.

 

Wrist injuries are one of the most common and misunderstood causes of lameness in working dogs. These often present as lameness after working with the dog seemingly mobilising well during the session itself but going lame once the work has finished, traditionally this was termed as “wristy”. The symptoms may remain for just a few days presenting as lameness after working that resolves with simple rest but alas it is often an evolving situation with increasing symptoms over time leading to early retirement. What begins as an untreated strain heals with scar tissue and gradual deterioration and arthritis or in severe cases complete breakdown.

 

The wrist itself is an extremely complex joint compressing a multitude of small bones, tendons and facia that has evolved to allow both flexibility and strength. It has three articulations with the main one being the upper, antebrachiocarpal, giving about 70% of the total movement. In the majority of dogs this joint works extremely well but it does have a telling weakness and that is that it does not have any muscular cover to help to stabilise and support the joint. When one considers that sight hound types at speed can be transferring up to five times their own body weight through the joint then occasional problems must be expected. The reality is that we have bred the sight hound types to be able to produce stress that goes beyond the evolutionary capabilities of their physical structures and a working type lifestyle often brings pressures that can push the limits of the joints capabilities to cope. Over extensions of the joint is one of the main problems, when the foot hits the floor the joint gives to absorb a degree of shock but at times it gives to much over extending itself resulting in ligaments being stretched beyond their range and even fracture to the carpal or metacarpal bones.

 

Fractures are the worst case but even with these making a diagnosis can be problematic due to the complexities of the joint with things like fractures to the Carpal bones having a mixed presentation from sudden marked lameness to gradual deterioration depending on the amount of damage done. Bearing this in mind any sign of lameness must be treated seriously until a cause is known with thorough examination of the whole limb. Even when a minor cause is found, ie a small cut the whole leg should still be examined to ensure there isn’t a more serious cause for the symptoms. With fore limbs palpation of the wrist should reveal any swelling or pain whilst gently mobilising the joint through its full range of movement should highlight any pain, instability or crepitus. The mobilisation should include all three planes of movement with internal end external rotation as well as flexion and extension but should not exceed the normal range. Any sign of fracture will need a veterinary opinion.

 

 

It is a good idea to check all joints on a weekly basis to monitor for early niggles such as minor sprains this also gets one familiar with the size, feel and normal range of movements of joints, when one knows how they should feel and move changes can be more easily identified. If unsure with an injury compare the opposite leg as a reference and have a low threshold for seeking expert advice. Minor sprains can often be picked up before they become overtly symptomatic with weekly checks allowing the opportunity to instigate restorative rehab to avert more serious problems developing. Sprains are injuries to ligaments, usually through stretching beyond their normal range and can be simple with just over stretching or more complex when there is damage such as tearing involved. Tendons have a poor blood supply so healing can be slow and problematic hence the importance of catching minor sprains before there is substantial weakening or tearing involved. Healing tendons have scar tissue which will become a weak point for the future and each incidence will build on the problem to cause further trouble. The worst case sprains lead to rupture and as with fractures any suspicion will need a veterinary opinion.

 

 

 

 

With possible fracture your vet will likely need to x-ray the joint from a number of directions but even with x-rays diagnosis can be problematic due to the afore mentioned complexities of the structures involved. Then of course tendons are not very amenable to being seen on X-ray but that does not mean they are without value in soft tissue injuries because the effects of this type of injury can lead to misplacement of the bony structures through there loss of support, dislocations etc. Whatever the final diagnosis treatment will depend on the particular injury with fracture likely needing a cast as will many of the more serious sprains, with less severe tendon damage there may still be the need for support with bandages, splints etc. As tendons need time to heal these appliances can be in place for some time. If the joint is mobilised improperly or too early it can lead to permanent damage such as elongation and excessive scar tissue formation. That not to say that mobilisation is bad just that there should be a proper planned approach to rehab that is tailored to the individual injury. Without this long term problems can result in weakened tendons leading to an unstable joint and the likelihood of future problems.

 

 

 

 

Personally I take lameness seriously until I know it’s not anything to worry about, at the first signs I check the dog over and act according to what I find. A simple thorn will be removed and work continued as will a knock that resolves with a bit of a check and rub down but any sign of joint swelling or if I cannot find a cause I will cool the limb in the nearest water before heading home to make a proper evaluation and management plan. Anti-inflammatory pain killers, under the supervision of the vet, are a good stand by and a short course of treatment along with a bit of rest can work wonders in many cases but there needs to be the initial recognition of the problem then proper evaluation of the treatment needed. Health is all about early intervention, sort the problem straight away and it is less likely to develop into a major issue, ignore the early signs and sometimes things will settle on their own but sooner or later they will progress into a serious injury that can end a season or even career.

[skycat 6,172]

If the ligaments are over stretched, as happens with a bad sprain, it can takes months to heal. If you've ever seriously sprained an ankle, you'll know that the joint may never feel quite the same again. I'd allow a good 2 months on the lead before even thinking of letting the dog off. Unfortunately, x-rays can't tell what sort of soft tissue injury there is, so it is better to err on the side of caution, which is why I always follow my local 'man's advice to the letter. If he says keep the dog on the lead for 2 or 3 months, then I do, no exceptions. Very often a prolonged lack of fast work will see this type of injury heal very well, but most people don't give it long enough, and the dog pays the price when the injury blows up all over again.

[neilnbeanie 10]

Thank you all for your advice, it's more information than I got from my vet. I will keep her on her lead now for a couple of months, although she is staring longingly at fields now, when we are out in the car. Is there any kind of support I can use for when I first start running her again? I just want to do it gradually, and I would be gutted if we went back to square 1 again. Thanks again for your help. Neil

[sandymere 8,261]

Exactly where is it swollen?

[neilnbeanie 10]

It's the joint just above her front paw. It's pretty much all the way round. It had started to go right down, but then she decided to come down the stairs this morning and jump the stair gate at the bottom of the stairs. She was then standing in the hallway holding it up and crying for a couple of seconds. It has now swollen up a bit again, but she is walking ok on it now. She just lifts it carefully if she changes direction in the house and sort of skips on her other front leg, if that makes sense. Neil.

[sandymere 8,261]

Do you mean below the wrist more towards the foot, if so suspect Sesamoid fracture.

[neilnbeanie 10]

No I would say it's right on her wrist, or if anything a fraction above it. Looking at her from a front view, the main swelling is on the outside of her leg.

Edited January 14, 2015 by neilnbeanie

[sandymere 8,261]

If they are sure it’s not a fracture then it’s likely to be damage to the tendons/facia of the wrist/distal foreleg. Something like an injury to the facia around the wrist, Extensor reticulum, or one of the ligaments/muscle attachments from the foreleg, Ulnaris Lateralis/Lateral Digital Extensor. Time is key, keep it moving ie lead walking but it will takes weeks rather than days to heal.

[neilnbeanie 10]

Thanks mate.

[terryd 8,110]

Mine has a similar injury to the rear leg and I am heading for 3 months in and still months to go I reckon. His been lead only and it vital I keep a a tight rein on him and any mad rushing about or jumping knocks him back. I think I am slowly getting the better of it but its not easy on him being a young dog and missing out on every thing he just wants to run the poor bugger.

Fingers crossed yours is not serious and makes a good recovery but rest and more rest seems to be the key

[slip lead 862]

Give this a try,it does what it says on the tin.