Cranial Cruciate Ligament (CCL) Injuries in Dogs

How Physiotherapy Supports Recovery

CCL tears are one of the most common causes of hind limb lameness in dogs, with sudden reduced mobility and pain in one or two of the hindlimbs and may bring long-term mobility challenges. Cruciate ligament ruptures may take months to a year to heal, therefore it is crucial to provide the best treatment for your dog to regain full mobility.

What is a cruciate ligament and why does it take so long to heal?

You may have heard of the ACL in humans, that crucial ligament in the knee that stabilises movement. In dogs, it’s called the CCL (cranial cruciate ligament), and it plays a very similar role in maintaining movement within safe ranges of the knee (femur bone and tibia bone). When it’s damaged or torn, the knee loses structural and mechanical stability and strength which results in abnormal movement of the knee, further strain and discomfort.

Unfortunately, the cruciate ligament has poor healing capacity and the biomechanical demands on the knee joint prolong the recovery process. Ligaments have poor blood supply therefore healing is slow. The knee is a high strain area and every step can stress the ligament healing (particularly abnormal stress). Cruciate ruptures may also be accompanied by meniscal tears (cartilage tears) and inflammation of the joint resulting in early osteoarthritis.

CCL can be treated with conservative management, but may face its challenges. With the right treatment plan, many dogs can return to a comfortable, happy life, even if they do not bounce back to pre-injury level.

What Does a CCL Injury Look Like?

You might notice:

Sudden limping and non-weight-bearing of the limb.
Toe touching while standing or walking
Difficulty rising, sitting or moving.
Swelling of the knee
Audible clicking or popping of the knee
Overtime, severe muscle loss will occur due to misuse

While these signs are common, they don’t confirm a diagnosis on their own. A full veterinary assessment (including joint testing, palpation, and possibly imaging) is essential to be sure and to rule out other conditions.

Why Do CCL Tears Happen?

Although it’s possible for a CCL tear to happen suddenly, like during a fast turn or jump, most injuries are actually caused by slow, degenerative changes in the ligament over time. Around 80% of cases are due to wear and tear, often affecting dogs between 5–7 years of age. In younger dogs, we’re more likely to see sudden, traumatic ruptures from high-energy activity.

Large and giant breeds are more prone to CCL injuries, but they can happen to dogs of any size and once it’s occurred in one knee, there’s a higher chance the other side may follow without intervention.

What Happens If It’s Left Untreated?

A torn CCL can lead to joint instability, which over time causes further damage including arthritis and meniscal tears, both of which can be painful and impact your dog’s long-term mobility.

However, with the right plan, many dogs do really well. Even if surgery is required, the recovery can be hugely improved with rehabilitation. In some cases, rehabilitation alone (without surgery) may be an appropriate and effective route particularly for partial tears or older, lower-energy dogs.

So, What’s the Right Approach for Your Dog?

That depends on a few key factors, including:

Age
Energy level and activity goals
Weight and body condition
Whether the tear is partial or full
If the meniscus is also damaged
If the other knee is already showing signs of strain

For young, very active dogs with full ruptures and additional meniscal damage, surgery followed by rehab is often recommended. But for many others, conservative management through structured physiotherapy can reduce pain, improve function, and help your dog live a full life.

Rehab Makes All the Difference

Whether surgery is needed or not, rehabilitation should always be part of the recovery plan. As qualified veterinary physiotherapists and hydrotherapists, we use evidence-based techniques tailored to your dog’s exact needs including strengthening, pain management, and safe return-to-activity plans.

Every dog is different. Our job is to work closely with you and your vet to design a recovery programme that supports your dog every step (and paw) of the way.

Want to Know More?

Begin your journey with us today. Book a free phone call to discuss how we can help tailor your dog’s needs in their recovery.

Some stories from some of our pet parents:

“I am so thankful to have been put in touch with Laura. The service she offers animals is vital to their recovery and for the maintenance of on-going health issues. Our little dog, Lilly, is recovering from TPLO surgery. The day she visits Laura has become her favourite day of the week. I was concerned she wouldn’t respond well as she does not like going to the vets, I needn’t have worried, Laura is wonderful with her. I have learned so much from her. I always have questions and everything is answered and explained, I come away feeling confident that I can help with Lilly’s recovery at home. We will be visiting Laura often in the future as Lilly was also diagnosed with hip dysplasia and arthritis. We will be working with her for pain management and hopefully the prevention of Lilly’s other conditions worsening. At the end of treatment day I have a dog that is happy, relaxed, comfortable and most importantly pain free” – Lilly’s Mum

“Minnie started coming a few months ago after injuring her cruciate ligament. When she started, she could barely put any weight on her leg. The difference in the past few months has been life changing for her. She now walks without any sign of a limp and is back to enjoying her walks along the beach. There has been so much care and attention that has been put into her recovery, ensuring that a plan is personalised for her needs and has enabled her to make excellent progress.” – Minnie’s Mum

“We have had a few visits now and Loki feels safe and enjoys our sessions. Staff are caring and always make sure he is happy. He is much improved and progressing with his rehab with the help of the physio he is receiving. This has been a long road but can now see the light at the end of the tunnel following TPLO and revision.” – Loki’s Mum

“Laura’s knowledge and understanding is immense and she gave common sense and practical advice to help Rosie. Rosie had various physiotherapy treatments during her sessions and I was given index cards with the exercises Rosie needed to do at home. Laura also loaned us physiotherapy equipment to help the rehabilitation process. I cannot recommend Laura highly enough- it’s now been a year and Rosie has only needed a cruciate ligament repair because of Laura’s treatment.
Rosie is back on the beach and pain free and I can’t thank Laura enough. Because of Rosie’s mental health, she doesn’t have many friends but Laura is one of them!” – Rosie’s Mum

“Mollie, our 6 yo black lab, has had surgery on both elbows and is awaiting cruciate surgery. She has been very unsteady when moving around. Our vet referred us to Apollo. After only a couple of mixed hydro/physio sessions, we have noticed a considerable improvement in both her mobility and in her confidence. Thank you Team Apollo.👍” – Mollie’s Dad

“Our nervous Jorkie named spud, has undergone surgery for his cruciate ligament. He also has a luxating patella and Laura has focused on strengthening muscle groups and aided with pain management. Spud is very relaxed with Laura and we are have been genuinely pleased with Spuds progress.” – Spud’s Dad

Restoring mobility, one paw at a time