A torn cranial cruciate ligament (CCL), the equivalent of a human ACL, is one of the most common orthopedic injuries in dogs. When this ligament ruptures, it causes instability in the knee joint, leading to pain, lameness, and long-term joint degeneration if left untreated. Tibial Plateau Leveling Osteotomy (TPLO) surgery is a widely recommended procedure for repairing CCL injuries, especially in large or active dogs. Unlike other surgical options that replace the ligament, TPLO restructures the knee by altering the tibial slope, creating stability without relying on the damaged ligament.
While TPLO surgery has a high success rate, a dog’s recovery process is just as critical as the surgery itself. Proper post-operative care, including controlled activity, rehabilitation exercises, and pain management, significantly impacts healing time, mobility, and long-term joint health. Without a structured recovery plan, dogs may develop complications like muscle atrophy, stiffness, or even reinjury.
To ensure the best possible outcome, a well-rounded rehabilitation plan is essential. While traditional veterinary care focuses on surgical recovery and physical therapy, holistic approaches such as acupressure, red light therapy, and kinesiology taping can further support healing. These complementary therapies help reduce pain, improve circulation, and restore mobility faster, allowing dogs to return to an active, pain-free life. By integrating both conventional and holistic rehabilitation strategies, pet owners can optimize their dog’s recovery and long-term joint health.
Understanding TPLO Surgery
Tibial Plateau Leveling Osteotomy (TPLO) is a specialized orthopedic procedure designed to stabilize a dog’s knee joint after a cranial cruciate ligament (CCL) tear, which is equivalent to an ACL tear in humans. Unlike some surgical techniques that aim to replace or mimic the function of the torn ligament, TPLO completely changes the biomechanics of the knee to restore stability without relying on the damaged ligament.
How TPLO Surgery Stabilizes the Knee
In a healthy knee, the CCL prevents the tibia (shin bone) from sliding forward when weight is placed on the leg. When the ligament ruptures, the knee joint becomes unstable, leading to pain, inflammation, and difficulty bearing weight.
During TPLO surgery, the surgeon makes a precise, curved cut in the top of the tibia (the tibial plateau) and rotates the bone to change its angle. This new alignment prevents the tibia from shifting forward when the dog walks, essentially eliminating the need for the damaged ligament. A metal plate and screws are then used to secure the bone in its new position, allowing it to heal over time.
This technique is different from other CCL repair surgeries, such as:
Lateral Suture (Extracapsular Repair): Uses a synthetic suture to mimic the ligament’s function. This is typically recommended for small dogs and less active pets but is less durable for large or athletic dogs.
Tibial Tuberosity Advancement (TTA): Also involves altering the tibial angle, but instead of rotating the tibial plateau, the tibial crest is moved forward. While similar to TPLO, it’s often chosen for dogs with a naturally steep tibial slope.
Why Veterinarians Recommend TPLO Surgery
TPLO is often considered the gold standard for CCL injuries in large and active dogs because it provides:
Better long-term stability compared to lateral suture repair
Faster return to activity due to improved joint mechanics
Lower risk of implant failure or breakdown over time
Veterinarians typically recommend TPLO for:
Large or giant breed dogs (e.g., Labrador Retrievers, German Shepherds)
Highly active dogs that place significant stress on their joints
Dogs with complete CCL tears, where conservative management is unlikely to restore full function
Dogs with pre-existing knee arthritis, as TPLO can help reduce further joint deterioration
While TPLO surgery is more invasive than other options, it is one of the most effective procedures for restoring mobility and reducing long-term joint damage in dogs with CCL injuries. However, proper post-surgical care and rehabilitation play a crucial role in ensuring a full recovery.
What to Expect After TPLO Surgery
TPLO surgery is a major orthopedic procedure, and proper post-operative care is essential for a successful recovery. While most dogs regain full mobility within a few months, the healing process requires patience, careful monitoring, and structured rehabilitation.
Immediate Post-Op Care (First Few Days at Home)
Pain Management
Your veterinarian will prescribe pain relievers and possibly antibiotics to prevent infection.
Ice packs can be applied to the surgical site (wrapped in a towel for short intervals) to reduce swelling in the first 48 hours.
Your dog may be groggy or reluctant to move for the first day or two—this is normal.
Incision Care & Infection Monitoring
The surgical incision should be kept clean and dry—no licking, chewing, or getting it wet.
Check the incision daily for redness, swelling, discharge, or signs of infection.
Use an Elizabethan collar (cone) or an inflatable collar if needed to prevent licking.
Keeping Your Dog Calm & Confined
Strict rest is required during the first two weeks. Limit movement to short potty breaks only on a leash.
Use a crate, pen, or small, quiet room to restrict activity—jumping, running, and stairs must be avoided.
If your dog is anxious, talk to your vet about mild sedatives or calming supplements to encourage rest.
Recovery Timeline
Every dog heals at their own pace, and following your veterinarian’s recommendations is crucial for a smooth and successful recovery. The timeline below provides a general guideline of what to expect after TPLO surgery, but individual progress may vary. Your vet will assess your dog’s healing and may adjust activity levels or rehabilitation plans accordingly. Patience, consistency, and gradual rehabilitation are key to ensuring your dog regains full mobility while minimizing the risk of complications.
First 2 Weeks – Strict Rest & Incision Healing
Minimal activity: Only short, slow leash walks for bathroom breaks.
Continue pain management and incision care.
Swelling and bruising should gradually reduce by the end of week 2.
Veterinary check-up around 10-14 days post-surgery to remove stitches/staples and assess healing.
Weeks 3-6 – Gradual Increase in Activity
Your dog may start controlled, short leash walks (5-10 minutes at a time) to build strength.
Avoid excessive movement, no jumping, no rough play, no running.
Start gentle range-of-motion exercises (if approved by your vet) to prevent stiffness.
Swelling and discomfort should continue improving.
Weeks 7-12 – Strength Rebuilding & Rehabilitation
Increase leash walks slowly to 15-20 minutes per session.
Rehabilitation exercises like weight shifting, balance work, and hydrotherapy can begin if recommended.
Light acupressure and red light therapy can be used to reduce stiffness and sore muscles.
Your dog may start showing signs of increased mobility and comfort, but avoid high-impact activities.
3+ Months – Return to Normal Activities
Most dogs can resume normal activity around 12-16 weeks post-surgery, but caution is still needed.
Strength and muscle tone should be noticeably improved.
Controlled off-leash activity may begin, but avoid extreme exercise (like fetch or jumping) until fully cleared by the vet.
Potential Complications to Watch For
While TPLO surgery has a high success rate, complications can arise. Contact your vet if you notice:
Excessive swelling or redness around the incision site.
Limping that worsens instead of improving.
Persistent pain or unwillingness to put weight on the leg.
Signs of infection (pus, foul odor, fever, lethargy).
Clicking or popping sounds from the knee.
Lack of progress in mobility after 6-8 weeks.
By carefully managing your dog’s recovery, following vet recommendations, and incorporating supportive therapies, you can help ensure a smooth healing process and a successful return to an active, pain-free life.
Rehabilitation Strategies for Optimal Recovery
Rehabilitation after TPLO surgery is essential to restoring strength, flexibility, and mobility in your dog’s knee. A structured recovery plan not only ensures proper healing but also reduces the risk of future injuries, especially to the opposite leg, which is at higher risk of developing a CCL tear.
Physical Therapy & Strength-Building Exercises
As your dog progresses through recovery, a combination of gentle movement, targeted exercises, and gradual strengthening will help rebuild muscle and stabilize the joint.
Passive Range of Motion (PROM) Exercises
Used in the early weeks of recovery to prevent stiffness and improve circulation.
Gently bend and extend the operated leg 5-10 times, a few times per day, as long as your dog tolerates it.
Best performed when your dog is relaxed and lying on their side.
Slow, Controlled Leash Walks
Walking is essential to rebuilding strength and preventing muscle atrophy, but it must be progressed gradually.
Start with short 5-minute walks a few times a day and slowly increase duration over several weeks.
Walks should be on a leash, at a steady pace, on even surfaces—avoid stairs, slippery floors, and rough terrain.
Hydrotherapy for Low-Impact Strengthening
Water reduces joint strain while allowing your dog to build strength and mobility in a controlled way.
Underwater treadmills provide a safe, weight-supported exercise for strengthening muscles without excessive stress on the joint.
Swimming (only when cleared by the vet) can also help improve range of motion and endurance.
Cavaletti Poles & Balance Work (Later in Recovery)
Introduced around weeks 8-12 to improve coordination, proprioception, and controlled movement.
Cavaletti poles (low, spaced-out obstacles) encourage dogs to lift their legs properly and engage stabilizing muscles.
Balance pads or wobble boards (under supervision) help strengthen stabilizing muscles and improve weight distribution.
These exercises should always be guided by your vet or a rehab specialist to ensure they are performed safely and at the right time in recovery.
Red Light Therapy for Healing & Pain Relief
Red light therapy is a powerful tool for reducing inflammation, accelerating tissue repair, and minimizing pain after TPLO surgery. It provides non-invasive, drug-free support to help speed up recovery and improve mobility.
How Red Light Therapy Supports Healing
Reduces inflammation by increasing circulation and lymphatic drainage.
Enhances cellular repair by stimulating mitochondria to produce ATP (energy for healing).
Alleviates pain naturally by blocking pain receptors and reducing swelling.
Improves joint flexibility and minimizes post-surgical stiffness.
When & How to Use Red Light Therapy
Can be introduced as early as a few days post-surgery to reduce swelling and discomfort.
Apply red light therapy 2-3 times a day for 20 minutes per session over the surgical site and surrounding muscles.
Continue applying throughout the entire recovery process, adjusting frequency as healing progresses.
Benefits for Reducing Scar Tissue & Improving Mobility
Helps prevent excessive scar tissue buildup, which can restrict movement.
Supports muscle recovery by reducing tension and promoting flexibility.
Can be used alongside physical therapy exercises to enhance results and keep your dog comfortable.
By combining structured rehab exercises and red light therapy, you can significantly improve your dog’s comfort, mobility, and overall recovery outcome after TPLO surgery.
Acupressure for Post-Surgical Support
Acupressure is a gentle yet effective therapy that can support pain management, circulation, and muscle recovery after TPLO surgery. By stimulating specific acupressure points, pet owners can help their dogs heal faster, reduce discomfort, and stay calm during the recovery process.
How Acupressure Aids Pain Management & Speeds Up Healing
Stimulates the release of endorphins, the body’s natural pain relievers.
Enhances circulation to the surgical site, promoting oxygen and nutrient delivery for faster tissue repair.
Reduces inflammation and swelling by improving lymphatic drainage.
Supports muscle relaxation, helping prevent compensatory tension in the opposite leg.
Key Acupressure Points for TPLO Recovery
GB 34 (Gallbladder 34) – "Influential Point for Tendons & Ligaments"
Location: On the outside of the hind leg, just below the knee.
Benefits: Helps relieve stiffness, supports ligament healing, and enhances flexibility.
BL 60 (Bladder 60) – "Aspirin Point"
Location: Just above the ankle on the outer side of the hind leg.
Benefits: Provides pain relief and reduces swelling.
Calming Points to Reduce Anxiety & Stress During Confinement
PC 6 (Pericardium 6) – "Anti-Nausea & Relaxation Point"
Location: On the inside of the foreleg, just above the wrist.
Benefits: Eases post-surgical nausea (from medications) and promotes relaxation.
HT 7 (Heart 7) – "Shen Men, The Spirit Gate"
Location: On the front leg, just above the wrist on the outside.
Benefits: Encourages emotional balance, reduces anxiety, and promotes restful sleep.
How to Apply Acupressure
Use gentle, steady pressure on each point for 30-60 seconds, a few times per day.
Make sure your dog is relaxed and comfortable before starting.
Observe your dog’s response—if they seem sensitive, adjust the pressure.
Want to Learn More About Acupressure?
If you're interested in learning how to find acupressure points correctly and apply techniques with confidence, check out our online course on acupressure for dogs. This course covers point locations, their benefits, and how to incorporate acupressure into your dog’s wellness routine—perfect for pet owners who want to support their dog's recovery naturally!
Kinesiology Taping for Joint Support
Kinesiology taping is a non-invasive way to support the knee, reduce swelling, and improve proprioception (body awareness). It can be introduced in the later stages of recovery to assist with movement and stability.
How Taping Reduces Swelling & Improves Proprioception
Lifts the skin slightly, allowing better circulation and lymphatic drainage.
Supports weak muscles and ligaments, reducing strain on the recovering leg.
Enhances proprioception, helping the dog regain confidence in using the affected limb.
Safe Application Techniques for TPLO Recovery
Important: Always work with a trained practitioner or consult your veterinarian before applying kinesiology tape to ensure correct placement and avoid irritation.
Use a mild stretch when applying the tape to allow gentle support without restricting movement.
Avoid placing tape directly over the incision site—it should be used on muscles surrounding the knee for support.
Apply in a fan or wave pattern to encourage lymphatic drainage and reduce swelling.
Use a stabilizing strip along the back of the leg to support muscle engagement and prevent overuse of the opposite limb.
When to Introduce Taping into Rehab
Weeks 3-6: Can be used to reduce swelling and encourage circulation as activity increases.
Weeks 7-12: Helps improve stability and muscle engagement as rehab exercises progress.
3+ months: Can be applied as needed to prevent fatigue and provide ongoing support during high-activity periods.
By incorporating acupressure and kinesiology taping into your dog’s rehabilitation plan, you can enhance pain relief, speed up healing, and support long-term joint health, ensuring a smooth and successful recovery from TPLO surgery.
Long-Term Care and Prevention of Future Injuries
Even after your dog has fully recovered from TPLO surgery, ongoing care is essential to maintain joint health and prevent future injuries. Many dogs who experience a CCL tear in one leg are at an increased risk of injuring the opposite leg due to changes in weight distribution and muscle imbalances. A thoughtful long-term plan that includes gradual reintroduction to activity, weight management, and strength training can help ensure a pain-free, active future for your dog.
How to Safely Return to Normal Activities Without Reinjury
Once your veterinarian has cleared your dog for normal activity, it’s important to ease back into exercise gradually rather than immediately resuming high-impact activities.
Increase intensity slowly – Start with controlled leash walks on even terrain before introducing running or off-leash play.
Avoid sudden stops, sharp turns, and jumping – These movements put excessive strain on the knee joint and could lead to reinjury.
Incorporate structured exercise – Swimming, slow hikes, and balance work are great ways to maintain strength without excessive joint stress.
Monitor for signs of discomfort – If your dog shows stiffness, limping, or hesitation to bear weight, reduce activity and consult your vet.
The Importance of Maintaining a Healthy Weight
Excess weight places significant strain on the joints, increasing the risk of arthritis and re-injury. Keeping your dog at an ideal body weight is one of the most effective ways to protect joint health long-term.
Monitor calorie intake – Adjust feeding portions to maintain a lean body condition.
Feed a joint-supportive diet – High-quality protein, anti-inflammatory foods (like omega-3 fatty acids), and joint supplements (glucosamine, chondroitin, MSM) can help maintain cartilage health.
Encourage regular, low-impact activity – Consistent exercise prevents muscle loss while avoiding excessive joint stress.
Tip: You should be able to feel your dog’s ribs without excess fat covering them, and they should have a visible waistline when viewed from above.
Strength Training to Prevent Future ACL Injuries in the Opposite Leg
Since dogs naturally shift weight onto their uninjured leg during recovery, the opposite CCL is at increased risk for injury. Strength training helps rebalance muscle development, improving stability and reducing stress on the joints.
Controlled leash walking on inclines – Strengthens hind-leg muscles evenly.
Weight shifting exercises – Encourages the injured leg to bear weight properly.
Balance work (Cavaletti poles, wobble boards, or standing on uneven surfaces) – Improves proprioception and knee stability.
Hydrotherapy – Provides resistance training without impact, ideal for long-term joint health.
Consistently working on balanced muscle engagement and proper movement patterns can greatly reduce the risk of future injuries.
Monitoring for Arthritis or Long-Term Joint Issues After Surgery
Even with a successful TPLO surgery, some dogs may develop arthritis or chronic joint stiffness over time. Early detection and proactive joint care can help keep your dog comfortable and mobile for years to come.
Watch for signs of arthritis: such as stiffness after resting, reluctance to jump, or decreased activity levels.
Maintain joint mobility with acupressure, red light therapy, and gentle stretching.
Use joint-supporting supplements to protect cartilage and reduce inflammation.
Schedule regular veterinary check-ups to assess long-term knee health.
By staying proactive with weight management, strength training, and joint care, you can help your dog enjoy a healthy, active life while minimizing the risk of further injury.
Conclusion: A Holistic Approach to TPLO Recovery
Recovering from TPLO surgery is a journey that requires patience, commitment, and a well-structured rehabilitation plan. While the surgery itself provides stability to the knee joint, proper post-operative care and gradual rehabilitation are what truly determine a dog’s long-term success.
By following your veterinarian’s recommendations and incorporating a balanced approach—including physical therapy, red light therapy, acupressure, and kinesiology taping—you can help your dog heal more comfortably and regain strength safely. Preventative care, such as maintaining a healthy weight, strength training, and ongoing joint support, will further reduce the risk of re-injury and promote long-term mobility.
Whether your goal is to help your dog return to their favorite activities or simply ensure a pain-free, active future, a comprehensive recovery plan will make all the difference. If you’re interested in learning more about acupressure techniques to support your dog’s recovery, check out my online course, where you can gain hands-on knowledge about key acupressure points and holistic care strategies.
With the right care and dedication, your dog can make a full recovery and continue to enjoy life with strong, healthy joints.
