A student of veterinary anatomy asked me recently: “Do you think it’s useful or necessary for a therapist or vet to have palpation skills?”
As someone who lives, breathes and teaches the fine practice of informed touch I was pretty taken aback.
“Since the rise of modern technological health care, surface palpation has been the skill most overlooked in the training of health professionals. Palpation of the musculature – assessment through touch of the muscles, tendons and fascia – is a fine and discerning art, one that is becoming lost in the morass of technologies now applied to healthcare.”
(Ref: Finando et al, 2005)
What Is Palpation:
It is the art of seeing with your fingers to assess muscle, fascia, tendons, ligaments, bone and the flow of life over the body. By assessing the tissue the discerning therapist can evaluate the needs of the patient and the modality of massage discipline necessary to manage, improve or resolve the muscular or myofascial issue which may be causing primary or secondary pain.
The therapist should have a trained understanding of the subtle nuances of tissues. Many training in the art are desperate to find an area of muscular dysfunction under their fingertips. However, the student of palpation should be aware that only when we can appreciate what is normal can we assess for the abnormal.
The canine health professional’s knowledge and skill will enable them to build a complete mental picture of the dog’s state of physicality at that time. This knowledge includes:
• Muscular origins & insertions – where a muscle begins and where it ends • Fibre direction
• Actions and responsibilities of the muscle, and
• Breed specific nuances
Why Palpate?
Quite simply because it can pinpoint the exact area of issue. And I mean exact. 
Not in a round about way. Not in a general vicinity. But right down to the bundle of muscle fibres or fascial sheath that is affected. It can reveal the source of both primary and secondary muscular pain, the latter being experienced as protective muscle splinting when an orthopaedic issue such as arthritis or hip dysplasia is present.
Commonly assessing for muscle strains, trigger points, hypertonicity and myofascial pain, the therapist should also be competent in the assessment of orthopaedic and neurological issues for which the patient would need to be referred back to their veterinary surgeon. It is important that the therapist has a distinct understanding of both when they can help and when they can’t. For instance, Canine Massage Guild members work best practice by only seeing a dog initially 3 times. In that time the dog should have shown a marked improvement. The therapist will clinically re-evaluate each case and never see a dog unnecessarily.
How Do You Palpate A Dog? 
It will typically take a student of palpation 12 months of regular defined practice to begin learning the practice of informed touch on different breeds of dog. They will experience common pathologies, muscular injury, orthopaedic conditions and different age groups as well as character and behaviour. The student of palpation also takes into account different contractive states of a muscle depending on the position a dog is in. For instance, a relaxed muscle in lateral recumbency, (i.e. when the dog is on its side), will feel completely different when the dog is standing as many of the main muscle groups will be in a strong isometric contraction to keep the dog standing. This is why certain muscle groups like the hamstrings and quadriceps cannot reliably be tested for when the dog is standing up or moving. Palpation by a skilled professional is a continually developing skill and in practice it may take anywhere from 5 – 10 years to be considered fully fledged in the art.
The 4 Ts Of Palpation 
Whilst regrettably we can’t teach you to palpate online as it needs an experienced palpation tutor at your side to teach you properly, there are some things you can look out for in your own dog.
The very basics of palpation are the assessment of typical changes in muscle tissue using the four Ts:
Tone Texture Temperature Tenderness
So as your dog’s guardian you may want to check these 4 Ts on a regular basis as this will enable you to notice any changes or problems which may need attention.
In addition to assessing the four Ts a skilled therapist will also use their skills and experience to elicit powerful responses during the palpation process as there is a constant source of biofeedback from dog to therapist – living tissue communicating with living tissue.
To Sum Up 
It is muscle and associated fascia which pulls on the bone to endow the animal kingdom with the power of movement.
Any imbalances within the musculoskeletal system inhibit normal patterns of movement. The dynamic nature of the body means that the structure is ever changing, in a constant state of self repair yet degradation. A true palpation should bring to light the areas of the dog’s body which are of primary and secondary concern so the most appropriate and effective therapy may be provided. Many dogs carry vast muscular damage but their ability to hide the associated pain by adapting their gait, posture and everyday activities never fails to amaze me. To truly assess for a dog’s muscular dysfunction the art of palpation is the foundation, the very corner stone of therapeutic practice. How can you give exercises or ‘treat’ an area if you are not confident in palpation? This often sees a worsening in a dog’s condition often resulting in ongoing and unnecessary treatment for weeks and often months.
So is palpation necessary if we want to discern the source of a patient’s pain?
I think you know my thoughts.
Now you decide.
Author: Natalie Lenton
For information please visit Natalie Lenton‘s biography
Reference: Trigger Point Therapy for Myofascial Pain, Finando et al., healing arts press; 2005
