Iliopsoas Injury – Ares Injury and Recovery

First, what is the iliopsoas?  The iliopsoas muscle is actually two muscles fused together – the Psoas Major and the Iliacus. This muscle is quite long attaching to the underside of the last 3-4 thoracic vertebrae, all the lumbar vertebrae and a part of the pelvis just below the head of the femur on the inside of the hip. 

iliopsoas-pic
Image massagetherapy.com

The Iliopsoas main function is to flex and externally rotate the hip and flex the spin.  It's used in a wide variety of high impact movements such as jumping, changing directions, climbing and lower impact movements such as laying down, standing up, and moving forward or backward.  Basically if the back half of the dog is moving, the iliopsoas is involved.    Iliopsoas strains occur as the result of excessive force.  These injuries often occur where the muscle and tendon fuse, which is the weakest part of the muscle-tendon unit.

Some common causes are:

  • training in a highly repetitive activity such as flyball, agility, etc or repetitive play such as fetch
  • other injuries which the dog overcompensates for by tightening the groin muscles
  • a dog goes "splayed-leg" during a slip or fall, especially if they were not already warmed up

 

Initial Injury and Working Towards a Diagnosis

This is a compilation of notes and facebook posts I made during the course of the injury.

October 18, 2013

Looks like Ares will be taking a little time off, I noticed last week he was moving funny, like he was in pain, so I made an appointment with the chiropractor.  He was having a hard time jump into the truck, didn't "bow" as deeply as normal when stretching, and wasn't extended as far in a trot as usual.  Tended to keep his rear legs closer together when moving.  Also noticed that on occasion he appeared kind of "bloated", like he'd recently eaten/drank a lot.  Time to make a chiropractic appointment. 

Took him to the chiro and while we were waiting I was looking down at him and realized on one side behind the rib cage he was "bloated" looking, but on the other he had a normal tuck in.  Almost like 1/2 of his body was fatter than the other. The "bloated" side is very hard and tender.  He got an adjustment, but a trip to the vet was recommended.

October 24, 2013

Took Ares to the vet today, they aren't 100% sure what's going on, originally thought it was a bad muscle tear but after taking his temp (104.5) decided he must have an infection. Like he has a foreign body in his side or something, although there is no entrance wound. The vet did say he's seen this with a cactus thorn. Ultrasound showed something but wasn't really conclusive, just that the muscles in one side don't look like the other. So he's on antibiotics, warm compresses, and twice a day temp checks to make sure it starts going down and not up. He was a champ for everything, not bad for my not always social little man, kept trying to con people at the vets office into playing tug with his leash LOL

October 28, 2013

Another trip to the vet today with Ares, another ultrasound, still no firm idea on what is going on.  The swelling has gone down, but not 100%.  Doc thinks it's an infection, the antibiotics are working and Ares temperature has returned to normal, but it's not acting like an infection. I took him to training yesterday and let him play fetch and do a little work and his side ballooned up again to the point you could see a bulge behind his ribs that stood out even more than the rib cage. Firm/hard not a soft fluid like swelling. After some ice and crate rest for the rest of the day, the swelling had reduced back to where it was first thing in the morning. Not something an infection should do. Tossing around the idea of some funky bacterial issue now, although hematoma and "facial something" (not 100% sure what Doc called it) are still on the table also.  Considering his temp went from 104.8 down to normal over the course of a few days after we started antibiotics I'd say the infection is a given, it's just the rest that has Doc stumped.

October 31, 2013

No definite diagnosis yet, still on antibiotics and crate rest.  Any time he's allowed to run around, the swelling comes back fast. 

November 1, 2013

Taking Ares to see Bev Seymour in a couple of days, a certified Electo-Acuscope/Myopulse Therapist for diagnosis/treatment. The instruments are approved by the FDA for the treatment of torn muscles, ACL's, Meniscus tears, sprains, along with relieving pain of CHD and slowing the progression of other genetic issues. The therapist is able to use the bio feed back system and pin point areas of concern. Bev has treated many torn ACL's in sport dogs along with torn Biceps and Meniscus without the dog having to go through evasive surgery.

November 3, 2013

We have a diagnosis. Ares iliopsoas muscle is torn, he'll be out for about 12 weeks doing the rest/rehab thing. So much for trialing him this fall. It's also one of those injuries that tends to be reoccurring, so after we are done with the rest and rehab we'll have to be careful to not reinjure it later. While I haven't heard of this in protection sport dogs, it's actually a pretty common injury in agility dogs with the twisting and turning they do at high speeds in tight areas.  I think he may have had an underlying infection also since he had the fever and antibiotics helped, but this is the ongoing issue he's been dealing with.  He's is still sore on that side, although the swelling is minor.  But he's on crate rest, any chance to try to run/play and the side immediately swells back up.

Treatment

November 23, 2013

Ares has been getting Electo-Acuscope/Myopulse treatments on a regular basis.  At first it was multiple treatments a week, then we went to a couple treatments a month.  This continued for approximately 4 months along with crate rest and controlled activity.  You can see his injured spot in this photo, the 'extra rib'. I didn't see it at the time this photo was taken, but noticed it when looking through photos after training.  Just doing a few retrieves that involved running about 8 feet then searching for the right object was enough for it to flare up.

December 18, 2013

Still doing crate rest and controlled exercise.  Ares is allowed to trot around the property on his own, but not run with the other dogs or play fetch.  Both which would push him to try to go "all out".

January 7, 2014

Had a great day training with my Indy Ring peeps on Sunday. I let Ares do some obedience and easy (guard of object, escort, defense of handler, etc) bite work and there was NO swelling in his side. Going to ease him back into it slowly but I think it's safe to say "He's Baaaack"

Febuary 16, 2014

Ares is back to training on a regular basis.  Still not pushing the jumps but he's doing regular bitework and obedience without issues. 

July 15, 2014

It looks like Ares has made a full recovery. I still hesitate to have him pull any weights to slow him down during training, but he's jumping, running, etc with no problems at all.

June 18, 2016

While Iliopsoas injuries can become a chronic problem, Ares has never had a repeat occurrance.  After recovering from his injury he went on to compete in French Ring and earned his FRIII.  He's also competed in other protection sports, done some herding, routinely races up and down the hills on my property, and otherwise leads a normal full tilt lifestyle including still actively training and competing.  I am careful to warm him up and cool him down, plus stretch prior to training or hard exercise.  He also receives regular chiropractic care, all which have contributed to the lack of reoccurrance. 

Resources

Dr. Maren Bell Jones DVM (certified rehab veterinarian and dog trainer) demonstrates four basic passive range of motion stretches handlers can use after warming their dogs up.  The stretch that targets the Iliopsoas area is the last one on the video.  Fawkes ( Ordre du Phenix du Dantero ) is Ares cousin.  https://www.youtube.com/watch?v=DqgTBGFwsxc

This article (click on the photo) by Karen Shaw Becker, DVM explains some basic stretching exercises for dogs.  Specifically the hip flexor stretch to help prevent Iliopsoas injuries.

 

 

 

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