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Thursday, 9 July, 2020

Horse Well-Being And Health After A Long Period Of Inactivity: Lockdown And Discomfort, How Does A Chain Of Injury Set In?

With the osteopathy development in the equestrian field for about twenty years now, a concept spread itself to become very trendy between riders and osteopaths: “physical compensation”. A term that has become familiar to explain, as a rider, what seems logical (or not…) on the horse’s movement deficiency. This term is rightly used to explain the dynamic and/or postural consequences of a chain of lesions which manifests itself by the mobility restrictions at different levels and can lead to so-called secondary lesions, that are often muscle or joint fixations, more or less linked to the primary lesion.

The primary lesion may be of traumatic, osteoarticular, tendino-muscular, fascial, visceral, or even systemic (nervous or endocrine for example) origin. The role of the expert is not to neglect any aspect in his diagnostic; understanding the chain of injury can be a complex exercise that requires the integration of multifactorial anatomic, biodynamic, and physiologic data. It is about considering the horse as a whole and as a set of systems that interact, balance, and COMPENSATE each other permanently to maintain this unstable and so fragile state that we call homeostasis.

Puccini’s story allows us to follow a classic and frequent chain of injury which illustrates this point without too much complexity.

1. Introduction: consultations’ process

The following article has been written by the veterinary doctor Eva Jonville. To understand it better, she explains her consultations’ process in the next paragraph:

Acupuncture is part of my work approach and is central during my consultations, built over a Traditional Chinese Medicine method. Then, I use osteopathy or Natural Medicine, in a complementary way, to evict musculoskeletal-type structural focuses when necessary.

Finally, depending on the problem, after a session using acupuncture needles, I realize a Chinese pharmacopeia treatment, that allows the acupuncture needles’ effects to last in time, avoiding too many consultations.

 

Ma Niu I Fang, 1399

The diagnosis is therefore done and refined according to 3 methods:

  • Veterinary,
  • Traditional Chinese,
  • Osteopathic (structural, fascial, neuro-vascular, craniosacral...)

The mutual use of these technics allows to have maximum results, the goal is to give horses an Integrative Medicine for a complete follow-up, that is also complementary and coherent.

This being said, there is not only one type of consultation: each horse guides me towards his needs, which are also my limits not to break the dynamic that is settled between the horse and me. It is about being precise in the choice of information given to the technic used.

Therefore, the method of treatment that is chosen depends on a precise and individual diagnostic, deep knowledge about therapeutic technics, and a continuously enriched experience.”

2. A reason for consultation: a horse who lost his forequarters strongness

Puccini is a 9-year-old Selle Français, chestnut with three nice white socks, two on the forelegs, and one on the hind legs. He was regularly trained until the beginning of the lockdown – he is an eventing horse, then he went through 6 weeks in his field and with lunge sessions in a sand arena. His owner could not visit him from the 16th of March to the 1st of May. When they could finally be back exercising, Puccini was not lame or unsteady, but it looked like his shoulders’ movement was less relaxed, mostly on the right shoulder. Jumping, he uses his wither less.  Palpation reveals withers with limited mobility, and tension zones in the brachial triceps, on both sides.

Chestnut horse

By observing his feet, we can see that there are impacts on the hoof’ walls, right above the horseshoes, and that the feet are trimmed quite short; but not abnormal sensibility or heat at the hooves’ level, no digitized pulse of engorgement. Nevertheless, his white feet are more sensitive at the toe test than the pigmented feet. The owner confirms that Puccini hesitates more on stony grounds and that he wears horseshoes with plates during show season. Palpation reading in acupuncture reveals approximately symmetrical blockages on the three lateral meridians of the forelimb (Large Intestine, Triple Heater Meridian, especially on the right, and Small Intestine on each side). The diagnosis in osteopathy is a fixation on the 4th and 5th thoracic vertebrae (withers) and the right shoulder.

3. Where does this shoulders and withers’ mobility reduction come from?

From the feet.

Puccini, like all the horses in the stable, was taken his horseshoes off to go to his field at the beginning of the lockdown, then they were put on again at the end of April in order to restart his activity. During his barefoot weeks, the ground was dry, his fragile and brittle white feet did not leave the farrier much horn for the last shoeing.

Puccini may have suffered from his bare feet for several weeks and perhaps from a slightly tight-fitting for the first few days. When his owner returned at the beginning of May, Puccini's feet were no longer sore; but the discomfort in his feet generated enough muscle tension to immobilize a couple of thoracic vertebrae and a shoulder.

Hooves

4. What solutions?

Acupuncture needles and osteopathic manipulation have restored Puccini's normal locomotion, the owner is now careful to regularly stretch his horse's shoulders while waiting for the next shoeing with plates. To perform this shoulder stretching, you have to stand facing the front leg that is going to be mobilized, looking towards the back of the horse, then take the hoof and stretch the leg in extension while remaining parallel to the longitudinal axis of the horse without too much detachment of the hoof from the ground, so that the shoulder is lowered in a cranial movement. This movement can be done before work for more flexibility - it also allows the scapula to be released from the saddle and to put the saddle "at the right place" behind the withers, and after work to release the tension in the brachial triceps.

Shoulder stretching
The shoulder's stretching

A horse that experiences permanent or intermittent but regular discomfort in one or two forelegs will eventually, through the use of analgesic postures and gait, have high muscular tensions which will themselves lead, as in Puccini's case, to osteopathic fixations requiring external intervention.

Seaver technology, in this case, can help the rider to objectively measure a reduction in the mobility of the horse's shoulders, on the same type of work, and in the same ground conditions. A horse who lost in forequarters movement will have more difficulty deploying its forelegs and mounting its withers, thus reducing its bounce and the amplitude of its vertical movement. The tool developed by Seaver proposes a comparison of the elevation over the sessions as well as the measure of the trot symmetry which can reveal if it is not optimal and evolutionary, a lack of mobility of the horse. This being said, it should be kept in mind that the elevation can vary according to the type of work (in a round and low attitude, the elevation values will be different from those of a collected work) and according to the terrain (a deep ground leads to a weak elevation when a soft or hard ground leads to a stronger elevation). This objectification of a locomotion defect, carried out by comparing Seaver data over several sessions under the same conditions, will allow you to anticipate the breaking point, i.e. to avoid the moment when the over-stressed tissue decompensates and passes into the clinical phase, revealed by lameness.