22/12/2025
When we look at this illustration, it becomes clear how dramatically a forelimb amputee must reorganise their body through each moment of the gait cycle just to move forward.
This is not a small adaptation - it is a full-body strategy.
As the dog attempts to “walk,” the head drops and the centre of mass shifts forward and down, placing an enormous load onto the remaining thoracic limb. The thoracic sling collapses, the sternum travels toward the ground. At the same time, the hindquarters elevate to counterbalance the loss of stability in the front.
To lift the forelimb, the dog throws the head up and back, barely generating enough lift for the forepaw to clear the ground and to protract.
Across these two frames, we see a loss of spinal alignment. This dog is unable to maintain a neutral horizontal balance.
The neck, thoracic spine, shoulder, elbow, and carpus take the brunt of this compensation, and over time, this repetitive overload commonly progresses into carpal hyperextension, thoracic sling fatigue, and secondary musculoskeletal pain.
This illustration highlights a key point: These compensatory patterns are not occasional - they occur with every step.
Why this matters for hydrotherapy
This pronounced forward collapse and head-dip strategy is precisely why the underwater treadmill is often inappropriate for forelimb amputees.
To move on a treadmill, the dog must continue to:
👉 Overload the remaining forelimb
👉 Drop the forequarter to stabilise
👉 Rock back and forth to generate forward motion
👉 Reinforce the same dysfunctional pattern we are trying to correct
Because the UWT still requires weight bearing, it forces the amputee to rely on the very compensations that are causing harm. In many cases, it will worsen the asymmetry and accelerate overload injuries.
For these patients, we need an environment where we can:
👉 Fully remove weight bearing
👉 Allow the spine to lengthen into neutral alignment
👉 Encourage true thoracic sling engagement
👉 Support controlled, pain-free joint motion through full ROM
👉 Build strength without reinforcing pathological movement
This is why swimming becomes the most appropriate hydrotherapy choice for many amputees: buoyancy enables us to retrain movement rather than perpetuate compensation.
❓ What gait compensations do you see most commonly in your forelimb amputee patients when they attempt to walk forward?
Onlinepethealth Hydro members can now watch our full webinar “Hydrotherapy for Amputee Patients: Goals, Ethics, and Practical Approaches” with Angela Griffiths in the members library.
Not a member yet? Comment HYD and we’ll send you the registration info.
To learn more, explore our blogs: The Three Strands of Rehabilitation in the Canine Amputee Why Your Amputee Needs a Hydrotherapist. Comment AMPUTEE and we will send you those links :-)
