Let’s Get Physical (Therapy)

BY Elyan Shor, Ph.D.

Those of us who have experienced the dis­tinctive symptoms of getting older—perhaps a crick in the neck, an ache in the back, or finding that bending down is just not as easy as it used to be—know that try as we might, there is no escaping age or the physical changes that come with it. To address these symptoms, many turn to physical therapy, which has become a routine practice in hu­man medicine for managing discomfort and maintaining normal function. But people are far from the only beings whose bodies age—animals across taxa similarly experience the natural wear-and-tear that comes with aging. As it turns out, physical therapy is a solution for animals, too, and San Diego Zoo Wildlife Alliance is at the forefront of the emerging field of veterinary physical rehabilitation.

Physical Rehabilitation 101

The underlying objective of zoological physi­cal therapy—or physical rehabilitation, as it’s commonly called in veterinary medicine—is the same for animals as it is for people: to promote function, mobility, activity, and comfort. The un­derlying causes for needing these treatments are also the same, as illness, injury, or degenerative conditions (such as arthritis) can impair bod­ies regardless of species. Physical rehabilitation includes a variety of techniques, ranging from manual therapy and therapeutic exercise to the more high-tech photobiomodulation (therapeutic laser) and electrical stimulation; but regardless of approach, each of these techniques is gentle, noninvasive, and nonpainful.

At the San Diego Zoo, senior veterinarian Deena Brenner, DVM, DACZM, is embracing and encouraging the use of physical rehabilitation in zoological medicine. She became aware of these techniques after working with Tammy Wolfe, DPT, PT, CCRP, GCFP, a Colorado-based physi­cal therapist specializing in physical rehabilitation for animals. Dr. Brenner was inspired by the significant physical health improvements arising from the subtle movements and gentle manip­ulations that can be accomplished with manual therapy. “Almost every treatment in medicine has potential adverse effects,” explains Dr. Brenner. “But since physical rehabilitation is so gentle and noninvasive, the worst thing that could happen is that it has no effect on the patient. So, with phys­ical rehabilitation, we see improvements without risking a downside.”

Dr. Brenner has developed physical rehabilitation regimens for more than 20 patients, including Peanut the North American beaver, who regularly receives therapeutic massage.

Physical rehabilitation programs are pre­scribed in addition to—and not instead of—nec­essary medical interventions, such as analgesics for pain management. But incorporating physical therapy allows for a more complete approach to wildlife well-being: analgesics may reduce pain, but it is physical rehabilitation that will help restore and maximize function. This dynamic approach underlies San Diego Zoo Wildlife Alliance’s enduring commitment to holistic animal health.

Moving in the Right Direction

Dr. Brenner has developed physical rehabilitation regimens for more than 20 patients at the San Diego Zoo. They range in size and species from lizard to elephant, and the majority of cases have been geriatric animals (with postoperative cases accounting for the rest). She explains that although animals do often live longer in zoos than in their native habitats, “All bodies age, whether they are zoo animals, wild animals, or companion animals. No matter what or where they are, we see the same type of predictable degeneration of joints and tissues that come with normal aging.” Physical rehabilitation has proven to be such an effective treatment for geriatric animals because it relieves the limitations in mobility that occur in aging bodies. Namely, the treatment works to maximize range of motion, build strength, in­crease body awareness, and enhance coordination and balance. Together, these improvements help patients move more comfortably and functionally.

Every physical rehabilitation program begins with a thorough evaluation of the patient, includ­ing a medical exam, diagnostic imaging, and keen observations from our wildlife care specialists, whose familiarity with the animals under our care is unrivaled. Once the diagnosis is complete, Dr. Brenner and our wildlife care team create a custom physical therapy plan that specifically addresses the patient’s problems.

One of the methods that she currently employs is therapeutic exercise. This approach utilizes basic exercises to build up elements such as muscle mass and fluidity of movement. The exercises are based on the patient’s natural behav­ior, so the move­ments—such as walking, climbing, or balancing—will be familiar. These aren’t designed to be strenuous or performative; rath­er, as Dr. Brenner explains, “We’re not asking an animal to do something that is outside of its abil­ities. We’re working through focused exercises that are ultimately going to promote the most functional move­ment of their body.” Some of the exer­cises she prescribes include walking up and down ramps, weaving through cones, and stepping over and under branches.

Bola the three-banded armadillo exercises on her custom-built staircase to help strengthen her limbs and maintain fluid movements.

Another method that Dr. Brenner practices is the Wolfe Kinetic Technique, a tactile therapy technique based on gentle touch. Using only her hands, she carefully massages and manip­ulates the problem tissues and joints, avoiding motions that cause resistance while guiding correct movement patterns. As she does this, she is improving the animal’s body awareness and mobility through “neuromuscular re-education”—essentially, reprogram­ming the nerves and muscles by sending normal movement feed­back to and from the brain, which gradually overrides the abnor­mal movement patterns, and instead resets the normal patterns.

All physical rehabilitation patients learn through positive reinforcement, and they participate in their programs voluntarily; the patient always gets to decide whether to participate on any given day. But you may be wondering how the animals know what to do during their sessions. “Animals are pretty smart,” says Dr. Brenner. “They generally enjoy moving around and this is some­thing that feels good. Once they realize what to do, they partici­pate willingly, and it seems like they’re having fun!”

Slow and Steady

Wallace the Galápagos tortoise has been an active participant in his physical rehabilitation program since 2018. When our wildlife care team noticed that he was having difficulty moving around, Dr. Brenner got to work on diagnosing the problem: Wallace had developed arthritis in multiple joints—an unsurprising finding in an animal that is approximately 100 years old and is supporting about 500 pounds of body weight on his legs.

Physical rehabilitation helps manage Wallace’s arthritis and keep him moving comfortably.

Analgesic treatment alone had not resulted in significant im­provements, so Dr. Brenner began twice-weekly physical therapy sessions that included the Wolfe Kinetic Technique and therapeu­tic massage to encourage joint mobility, as well as weight-shifting exercises to prompt balance and strength (watch a session here). After only a few weeks of these sessions, Wallace’s discomfort was resolved, and he re­turned to normal movement and activity. Today, he has no active issues associated with his arthritis and does not require analgesics. To ensure his well-being, our wildlife care team still maintains a few physical rehabilitation sessions with Wallace every month, so that he can continue to move—slowly, but comfortably—for years to come.

Our work with Wallace exemplifies the efficacy of physical rehabilitation, as well as our drive to embrace innovative care and the highest standards of wildlife health. Dr. Brenner is currently completing the Certified Companion Animal Rehabilitation Ther­apist Program (College of Veterinary Medicine, North Carolina State University)—she is likely the only zoo veterinarian to under­go this type of training and certification in animal rehabilitation. Although physical therapy is not yet a common practice in the zoo community, Dr. Brenner hopes that it will one day become a routine part of wildlife medicine everywhere.

Click here to learn more about physical rehabilitation at the San Diego Zoo—and to see it in action!