Hydrotherapy following knee surgery (TPLO or MPL)

Hydrotherapy in an underwater treadmill post TPLO or MPL surgery aids recovery by increasing limb use, improving mobility, muscle strength, and endurance while minimising pressure on the surgical limb.

Research Authors


A hydrotherapy programme involves controlled exercises in water, leveraging buoyancy, resistance, heat, and hydrostatic pressure to aid rehabilitation. Sessions start around two weeks after surgery and typically occur 1 to 2 times per week, gradually enhancing your dog’s recovery while ensuring comfort and positive experiences through gentle introduction and hands-on assistance during therapy.

What are the benefits of hydrotherapy in the postoperative period?

The underwater treadmill works like a land based treadmill, with the added benefits of water to provide:

  • Buoyancy to reduce weight-bearing, alleviating pressure on the surgical limb and allow your dog to move more freely than they may be able to on land
  • Resistance to help rebuild muscle and strength
  • Therapeutic heat to increase blood flow and relax muscle tension
  • Hydrostatic pressure to increase blood flow and lymphatic drainage, reduce swelling and inflammation.

Within the underwater treadmill we can:

  • Encourage correct use of the surgical limb, reduce limb rotation and improve weight-bearing
  • Control speed to ensure the dog walks slowly and purposely to increase limb use
  • Stabilise the dog to walk straight, encouraging correct weight distribution
  • Increase range of motion and flexion of the knee
    Reducing compensation to other limbs
  • Perform static exercises to correct postural balance, increase limb use and build strength
  • Provide progressive adjustments throughout treatment to advance your dog’s recovery
  • Provide mental and physical stimulation while they are on exercise restrictions

How soon after surgery can my dog start hydrotherapy?

Your veterinarian will advise when your dog can begin rehabilitation.  If your dog has had surgery, they can usually start 2 weeks after surgery, once the sutures have been removed.

Your dog’s hydrotherapy programme is customised specifically for them.  As a guideline, we recommend hydrotherapy for surgery patients 1 to 2 times a week until their 8 week recheck appointment depending on how they progress.

After the session your dog may be tired or a little sore from exercising, this is quite normal and should resolve within 12 to 24 hours.

What if my dog doesn't like the water?

During the first session we will discuss your dog’s history and goals of treatment while they relax and get to know us, followed by a physical, postural and gait assessment, before introducing them to the underwater treadmill.

Underwater treadmill therapy is walking in water, not swimming.  We take things nice and slow with positive introductions to ease them into their initial session, plus we have tasty treats on hand as needed.  With proper introductions we find even those that are water shy usually enjoy and relax into their therapy.  Our hydrotherapist will always be hands-on in the underwater treadmill with your dog.