01/28/2023
What exactly is "East West"? Does your dog have it? And which conditioning exercises can help?
In dogs, East West is an umbrella term that refers to any external rotation of the thoracic limb that results in the toes facing outward. Nebulous… My favorite🙄🤦♀️. Given that there are several distinct postural deviations that cause the toes to face outward, I wanted to cover each, and discuss…
1. Where in the canine anatomy the East West / lateral rotation is stemming from.
2. Help you identify which one your pup might have.
3. Discuss what might be done to improve this postural deviation.
⭐️(Link to the full post, including more descriptive images, and links to exercise tutorials at the bottom go the post)⭐️
1️⃣TYPE 1: TRUE East West / External Shoulder Rotation
In dogs, this East West deviation is sometimes referred to as ‘elbows turned in’ or ‘loose elbows’. But this postural deviation is not technically related to the elbow at all. The elbow is a hinge joint. It does not rotate. Instead, this East West deviation comes from a lateral or outward rotation of the humerus at the level of the shoulder joint. As the proximal humerus rotates laterally, the distal humerus and antebrachium rotate medially. As a result, this postural deviation can be easily identified by a narrowness between the elbows and antebrachium.
2️⃣TYPE 2: Carpal Valgus
Carpal valgus is a lateral deviation of the paw, from the line of the radius / ulna at the level of the wrist (carpal abduction). Dogs with carpal valgus do not display the external shoulder rotation and resulting narrowness as described above, or the dwarf mutation / angular limb deformity covered below. Instead this East West deviation is localized to the level of the dog’s carpus or wrist joint. There are several progressive degrees of this deviation ranging from mild to severe.
3️⃣TYPE 3: Angular Limb Deformity
All chondrodystrophic or dwarf breeds are all affected by some degree of angular limb deformity. This is the result of intentionally breeding the genetic mutation that produces short limbs… which create the breeds’ unique look and function. These genetics cause a premature closure of the distal ulnar growth plate, and a length discrepancy between the radius and ulna, resulting in the East West appearance through the forelimbs of dwarf breeds. As with any genetic trait, this postural deviation can be seen with more mild or more severe characteristics.
❓So what can we do to help dogs with East West Deviation?
The first step is identifying which specific deviation your pup is displaying, and getting checked out by a rehab professional or sports medicine vet to ensure the postural deviation is not the result of a past or current injury. True East West / External Shoulder Rotation and Carpal Valgus deviations are likely to be improved by targeted strengthening exercises.
💪Exercises for East West: External Shoulder Rotation
The following exercises help to address the strength and mobility discrepancy between the muscles in the rotator cuff. In all of these exercises, we are looking for the upper and lower forelimb to demonstrate less external rotation over time. These exercises may have prerequisites, all of which are listed at the bottom of each video tutorial.
📌Fold Back Down
📌Ipsilateral Foot Target
📌Manual Leg Lift
📌Bow
🤌Exercises for East West: Carpal Valgus
The following exercises help to strengthen the musculature on the medial aspect of the carpus. These exercises may have prerequisites, all of which are listed at the bottom of each video tutorial.
📌The Dig Dig exercise activates the caudal thoracic chain which runs along the back portion of the thoracic limb. These muscles have a primary action of carpal flexion, but also support the medial aspect of the carpus and assist in carpal adduction.
In the following exercise, we will leverage the shape of the PawPod to create a carpal bias, which re-aligns the paw, allowing the medial carpal stabilizers to work and strengthen.
📌PawPod Carpal Bias
📌Manual leg lift on Paw Pods
🛑Running in sand or gravel, or feeding from an elevated feeder are often suggested activities to help ‘fix” carpal valgus. And while there may be some mild positive changes attributed to these methods, this is not the best approach. We know from human physical therapy and fitness modalities, that implementing targeted exercise that produces neuromuscular re-education is far superior, faster and more effective long term. Teaching the dog to properly engage the deep and superficial digital flexors is the actual solution to the problem, and carries much less risk than running a dog repeatedly on gravel. For more on this topic, check out my blog post on neuromuscular re-education.
‼️Exercises for East West: Angular Limb Deformity
Dogs with Angular Limb Deformity will also benefit from targeted conditioning exercises, but require a more customized approach, and will see best results
