animal biomechanical medicine – Sam Sherrington

The best way to avoid IVDD in your Dachshund puppy!

Aka – Things to do with every puppy to give them the best chance of a long and physically strong life. Is there anything cuter than a puppy? Yes! A Chondrodystrophic puppy! Image by congerdesign from Pixabay You’ve done your due diligence and painstakingly selected a breeder who has carefully screened their breeding dogs for … Continue reading “The best way to avoid IVDD in your Dachshund puppy!”

Aka – Things to do with every puppy to give them the best chance of a long and physically strong life.

Is there anything cuter than a puppy? Yes! A Chondrodystrophic puppy!

Image by congerdesign from Pixabay

You’ve done your due diligence and painstakingly selected a breeder who has carefully screened their breeding dogs for the common health problems in these breeds including Intervertebral Disc Disease (IVDD) and the big day arrives when you bring your new bundle of joy home.

Knowing you have a breed which is more prone to spinal and musculoskeletal problems, it is worth having a plan for prevention in place from day 1. Dachshunds are by far the most likely to be affected by IVDD, however if you have chosen any chondrodystrophic breed (Long body/Short legs) it’s well worth getting ahead of the inherent risk for back troubles from the very start.

Most breeders and breed societies have several good basic recommendations to help keep your dog healthy and injury free, including:

Prevent your dog from jumping – train your dog to wait to be lifted up and down from beds/sofas.

Avoid stair use – installing ramps and gates where needed.

Maintain a healthy body weight, especially through puppy-hood.

Avoid vigourous chasing/tugging/rumbling/tumbling games by themself or with others.

These basics are an excellent start, however there is much more you can do to help ensure your little friend has the best chance of avoiding major troubles.

Keep your dogs nails short. Long nails change the angle of the whole lower limb, and cause many of the dogs postural muscles to function in unhealthy manners. This creates increased strain both in the legs and the torso. If you can hear your dog’s nails tapping as they stroll around the house, they are too long. The best approach is to gently handle your puppy’s paws and toes as part of their daily routine, and learn to trim them regularly yourself. Whilst taking them to the vet for sedation to have them done once every few months is an option, it’s not a great one, as they’re much more likely to end up being cut too short, causing pain and bleeding and making the whole process more unbearable each time. I will do up a full post on the way I find best to trim nails without catching the blood vessel, however in the meantime you can find some quick guides on my facebook feed here, here and here.

Avoid slippery floors. If you have a house full of slipper polished floorboards or tiles, consider laying down runner mats through the main pathways your dog uses in the house. Especially don’t encourage games of fetch up and down corridors. We’ve all seen the videos on youtube of what happens when these sorts of games happen, and whilst on the surface they are amusing, the risk of serious spinal injury they pose is no laughing matter.

Next – Keep your dogs weight DOWN! Whilst yes, they can resemble sausages, little but long dogs really do need a very definite waist and palpable ribs with light coverage. A BCS of between 4 and 5 is ideal (see chart below). These little dogs generally have a low capacity for extra calories, so remember, a couple of extra snacks a day can easily add up to similar to us humans eating a couple of extra cheeseburgers a day. Keeping your dog lean will minimise the impact on both legs and spine.

Photos by Elisa Calvet B. on Unsplash, Sabrina St. from Pixabay, Own Collection – Loki Blanchard

One of the most powerful things I think you can do, is incorporate prehab (yes, like rehab, only before the problem happens!). The one basic exercise you can begin from puppyhood that I feel has the most bang for it’s buck, whilst also being super easy to incorporate into the daily routine, is changes of position.

It’s as simple as teaching your dog to do a straight sit, down and stand. Yep, that’s it. Sounds easy right? Well, yes it can be, however making sure it is properly straight is the key. Most dogs will develop a habit of slumping to one side or the other, and this often reflects a weakness in their postural muscles. This is why having them do half a dozen to a dozen repetitions of straight changes of position, once or twice a day (while they’re patiently waiting for their breakfast or dinner is a perfect time!) is so powerful. What they practice will greatly influence how they use their body for the rest of their activities.

Start by asking your dog to assume a nice straight sit position. Only pay a proper one where the dog has their weight on both rear legs, ideally with the pads touching the ground. If you’re noticing a tendency to slump onto one hip, the left one for example, you can lure their nose around to that same side so they move their front feet and this will typically bring the lazy leg back into weight bearing. If you’re noticing the pads are up off the ground and your dog is rocking back onto his hocks, ask him to stretch forwards for the reward. This will get him to push onto his pads. If he does come into a nice stand without shifting his feet that’s ok too, just try to keep those feet still.

From there, ask them to drop. Again, focus on rewarding them when they hold their back end straight. If they are slouching onto one hip simply ask them to come back up into a straight sit and repeat. If they can hold it for 1 second, great! Slowly over time they will become stronger and be able to hold it for longer.

Straight drops – the corgi is slumping slightly, with work he can do better and get stronger!

Coming into a stand we have a few options. To begin with, bringing them back up into a sit then asking for the stand is the easiest option. From there you can work towards bringing them straight into a stand from the drop. This is much harder and is essentially like us coming up to a stand from a deep squat. Give it a try and you’ll feel that to control the movement well, without your legs having to move to rebalance you, you need to have your core as well as your leg muscle active. This is exactly the power of this exercise for the dogs.

The final test is to help the dog learn to do a flip-back drop. This is where they start standing, then come into a drop via a bow position. This is an excellent one for whole torso control and range of motion as well as really great hind limb strengthening.

Image by Yama Zsuzsanna Márkus from Pixabay

Ultimately, the goal is to be able to have the dog assume any of the positions, from any other position, while keeping their feet still. Work on this over the course of a month or so, gradually building on the easy steps until you have the whole routine down pat!

This daily routine alone is capable of increasing the core strength, giving the spine a really thorough run through several important ranges of motion as well as building significant strength in the hind limbs, which in itself is hugely useful in breeds prone to spinal degeneration and compromise.

From there, we can move onto the even more fun stuff – Extracurricular activities!

Crawling

Wobble boards

Theraband

Swimming/UWT

I’ll get into those another day, you’ve plenty of work to do already! Hop to it!

In Defence Of The Basics

In Defence Of The Basics – 5 things every rider should be doing with their horse.

Image by Mabel Amber, still incognito… pixabay

I suspect I often sound like a broken record or that I’m actually not trying hard enough to give really interesting rehab exercises… and I promise you, I’m getting a bit tired of hearing my own voice on the topic too, but simultaneously I’m becoming more and more convinced that there’s an epidemic of foundations-phobia, a.k.a. groundwork-phobia. Either of which correlates closely with quick-fix-itis and I-can’t-understand-why-he’s-lame-again-itis.

So, in defence of the basic foundations of strong, healthy, well coordinated horses – I have decided to compile a list of some of the most important exercises I believe every, yes – EVERY, horse owner should be doing with their horse, on a regular basis. In my very humble opinion, if every horse was able to do these things correctly, with strength and good form, there would be a whole lot less soreness and brewing unsoundness in our beloved equines, and they would be immeasurably safer for us to be sitting on and entrusting to carry us around.

So, the 5 things I think every horse owner should be doing with their horse.

1 – Lunging for warm up

Yep, I said it. Lunging as part of your every day routine. When I say lunging, the last thing I mean is the old image of standing in the middle of a fixed circle, with your horse traveling at speed around you with any range of contraptions holding him into a set shape.

When I think of a good warm up lunge I’m thinking of the rider also getting a good warm up.

Use all the space you have. Get your own legs moving. Only use as much equipment as you absolutely must to ensure the horse is traveling in a relaxed and posturally beneficial manner. If a horse has been allowed to develop a habit of galloping around, full tilt, with his head in the air, I personally don’t mind simple gadgets like a bungee or chambon used sympathetically so as to show the horse a biomechanically appropriate way to travel. It’s also worthwhile to find someone who knows how they should be fitted correctly and safely to show you how to fit them, safely and correctly. Whilst doing so, it’s crucial to also build in appropriate cues and aids to reduce the reliance on the gadgets. The goal being – to be able to pop on a simple cavasson on and be able to communicate to your horse that you want him to warm up through walk, trot and canter and carry out a few transitions both between and within each pace, while maintaining an energetic, stretchy frame.

2 – Poles

I know I’ve already talked about poles, but they’re just so darn useful that I feel some more discussion is never a bad thing. It’s truly marvelous what can be achieved with a handful, or even less, poles and if you’re feeling adventurous a few baby potties! (insert potty.jpg)

1 pole –

It’s as simple as making sure your horse can step over it! I can feel the eye rolls from here, but it always amazes me how many people accept that their horse is “clumsy”, hence abandoning the idea of pole work, and yet haven’t taken the steps necessary to help that same horse develop the very basics of proprioception. This especially confounds me when they then expect them to jump real jumps. To me, this is a recipe for disaster, as a horse who isn’t able to muster enough control over his own feet at a walk, trot or canter to avoid stepping on or tripping over a single pole is highly unlikely to have the awareness or strength to safely and repetitively control his limbs over jumps. This also applies to trail riding – Do you really want to be on top of a horse, walking through the bush, stepping over fallen branches and through varied terrain on a horse who can’t see his way to stepping over a pole on a manicured surface without tripping??
With one pole, you can also place it parallel to a fence line and have your horse walk through, both forwards and backwards. The trick is straightness. Particularly when backing, this exercise will show up unevenness in range of motion and muscular development very quickly and so is something I find hugely beneficial both as an assessment tool and as a strength and coordination building exercise.

2 Poles –

Continue traversing the poles at all three paces. Make sure not to neglect walk. Because there is no moment of suspension and lower levels of momentum in walk, stepping over poles in walk relies entirely on muscular effort. For horses with poor coordination or proprioception, it can be surprisingly difficult to either lengthen or shorten the stride to navigate just two poles. For these horses, try to begin with the poles placed at an appropriate distance for their individual stride (see distances below), allowing them to step through easily, and then adjust as they know the task to increase the challenge.
To further increase muscular effort, control and coordination, raise the outer edge of the poles. This is where the potties come in. They make amazingly stable yet light pole holders! The outside limbs will have to lift slightly more, engaging both the core and the muscles throughout the shoulder and hip girdles, as well as taking the joints through a larger range of motion.
Place poles parallel away from a fence line and repeat walking through both forwards and backwards. Removing the physical barrier of a fence line can be quite a step up for horses with very ingrained unevenness.

3 Poles –

Continue as for two poles. Again, keep in mind that when adjusting their stride to slightly longer or shorter than their natural stride length, it will be another step in the challenge so start small. Use your judgement as to your horse’s individual needs and ability, some horses do seem to need to experience tripping over a pole now and then to give them a little reminder of what the job is, but do ensure the footing is good to avoid serious sliding or falls. We’re aiming to reduce a horse’s risk of injury, not add to it!
Beginners pick up sticks. Arrange the poles close to each other at random angles, beginning with them all flat on the ground, so they are very stable and unable to roll on each other. Lead or lunge your horse through at a walk giving him a chance to really watch where he is putting his feet. Assuming this goes well, and using your best judgement to avoid your horse tripping/putting a foot on a pole etc, progress to trot.
Beginning maze – Arrange two poles parallel to create a channel as previously and use the extra pole to sit perpendicularly at the end creating a ‘turn’. This can either be stepped over in walk or trot after navigating the channel, or used as a guide to turn in walk or trot, aiming to avoid touching the pole.

4+ poles –

Line of poles in all three paces. Each time you add a pole, make sure the distances are initially returned to a natural stride length, and once the additional pole is no issue then you can shorten or lengthen the stride. The ends can be raised, either all on one side or alternately. With 4+ poles it is easy to arrange the poles around a bend in a fan like arrangement, making adding shorter and longer strides very easily achieved by moving closer to or further away from the centre of the fan. Progress as before to raising the outer edge.
Continue pickup sticks with more poles. When the horse is really paying attention to his feet and where he is putting them, you can add planks to test his proprioception a little more. If you have flat edged poles you can cross them over each other, but be very careful doing this with round poles as they will roll.
Maze – arrange the poles into a series of channels with turns and walk and trot through, rein-back, introduce transitions at various points to add challenge. Make it a little harder by making the channels narrower.
With at least 6 poles and when you are completing these exercises under saddle you can create an S bend, allowing you to add some lateral bend control and suppleness into the exercise. This is brilliant for testing a horse’s evenness, and responsiveness to the basic bending aids.

A word on repetitions for poles – When you’re starting with a horse who is in the relearning or rehabilitating stage, it is absolutely crucial to know when to STOP. I generally advise max of around 6 repetitions over the string of poles in each direction. So that’s whether they’re at the 1 pole stage or the multiple poles stage. If your horse is springing through with ease and clearly no where near fatigue, you can begin adding a couple of extra repetitions. It is amazing how quickly a horse can go from ease to struggle though, so watch carefully and even if you’ve planned for 6 reps and you see your horse suddenly start to have more difficulty on the 4^th repetition, stop. It is always better to stop a repetition or two too soon, than to push to the point of true fatigue and have your horse make a serious mistake, step or trip on a pole and land on his head or backside. If the horse is kept at this level of working without hitting significant fatigue, you can use poles on a daily basis to improve proprioception and coordination and strength. If using poles to build muscular bulk you will need to play with some fatigue, and then give the horse rest days without poles to allow the tissues that have hit fatigue to recover and build strength.

Distances – (Distances are approximate and will vary depending on the size, breed and condition of your horse)

Walk and trot – 4-5 tightrope (heel to toe) steps or one large human strides (approx. 0.8 – 0.9m/ 3 foot) Canter – Three large human strides (approx. 3.66m or 12 foot)

3 – Backing up straight and around a bend

Largely covered within the poles section, this is a skill I think is often seriously neglected. When backing, either with the poles as a guide or without, the main aim is to help the horse develop straightness, an ability to take the hind leg through a larger range in the stance phase and develop strength to lift and step back in the swing phase. Rein back is particularly useful for hindquarter and core development especially in cases involving stifle dysfunction. It also promotes excellent mobility through the back and development of the back muscles.

Begin with one stride if it’s a brand new exercise and particularly if your horse is showing signs of particularly poor proprioception in general. Build slowly towards a half dozen strides. Using the fence line or poles can make developing straightness easier, while reversing up a slight incline can make it more challenging.

4 – Stepping under self on a small circle

This is a movement often seen done at speed when developing a “one rein stop” or to disengage the hindquarters for behavioral management. From the perspective of using it to build strength, coordination and a full range in the horse’s hind limb movement, it is far better done at a slower speed and on a larger diameter.

I like to begin in hand with the horse walking around the handler in a small circle of around 10 metres. By shifting your position slightly towards the horse’s hindquarters, bringing the nose in and asking him to make the circle smaller you will see him take a stride or two where his inside hind crosses over underneath his body. Progressively work on this same movement until you hit a small circle of around a metre diameter, where he is continually stepping the hind-leg under around the circle. What you want to avoid is the horse disengaging and swinging the hindquarters rapidly. You want deliberate, controlled steps with the hind legs through a full range of both adduction (moving under the body) and abduction (moving away from the body).

In a similar vein, this can be done as a small figure of 8, switching from one hind leg stepping under to the other.

Under saddle this obviously translates well to turns on the forehand, (again beginning on a larger diameter circle and bringing the front end more and more still as you progress).

5 – Moving laterally

Finally, in order to really get your horse thinking about controlling the movement of his front and back end in all directions, I really like a horse to be able to side pass in hand. To achieve this, it is easiest to make use of the fence line and face towards it. Stand facing your horse’s shoulder and ask him to move away from you. If you’ve added an “over” or “away” cue when doing the small circles, this should be a fairly natural progression with the cue aimed towards the torso rather than the back end. Start with a step or two, and aim for half a dozen steps in each direction at the most. Over time you can play with moving the shoulders a little more than the hindquarters and vice versa, as well as doing this without the fence line to restrict the forward motion.

Begin the ground work exercises daily to begin with, completing around half a dozen or so repetitions of each exercise (lunging – aim for 10 mins max for warm up). Remain watchful for signs your horse is fatiguing before the allotted 6 repetitions in each direction. That’s ok. We all start somewhere and some horses will genuinely begin to fatigue before they get through the half dozen. By challenging your horse carefully each day you will be amazed by how quickly he will change. I like to consider this a 4-6 week process at minimum of building through the complexity of each exercise. Some horses with really old patterns of faulty movement may take a lot longer. When all the exercises are easy, it is nice to make them a part of your weekly routine around 2-3 times per week. Many of these can also be adapted to be done under saddle as well, but I still like people to be doing these in hand 2-3 times a week so the horse gets an opportunity to move in all these ranges without the added weight of a rider on their back.

Ideally, before embarking on this programme, I like to make sure a horse is as balanced and restriction free as possible by giving him a full Osteopathic assessment and treatment. Failing that, if during the process your horse is finding one side particularly challenging, or not developing strength evenly, continues to trip or stumble or really just isn’t getting any particular part of the programme, then it is a wise idea to get them checked over by an Osteopath or other ABM professional.

In conclusion, if you can work your horse through this collection of basics, I truly believe you’ll have a far stronger, more coordinated, supple and less injury prone athlete to take into whichever discipline you fancy.

So there you have it, let me know how you get on if you embark on this, I love hearing the many and varied ways horses make their way to better physical health.

Horsey Pick Up Sticks – More on Proprioception

I discussed the benefits of polework in helping a horse improve their proprioception and condition previously, and have been meaning to post about another favourite when I accidentally found these notes I’d made quite some time ago, hiding in my phone :/ Enjoy!

Step 1 – Grab 4 or 5 of poles and pop them down at random angles close to each other.

Walk your horse through, allowing him full freedom of head and neck so he can view the poles and adjust his steps as required. This step will be very basic for many horses, however I consider it an important one as it will show up if the horse is severely lacking in proprioceptive skill or the strength to carry himself through, which would make the full exercise quite dangerous.

When your horse is navigating the exercise with ease shift the poles around so he has to readjust, bring some closer together and cross some over. We ideally want to avoid him stepping onto a pole and having it roll under his foot, so allow him plenty of time to pick through and if he’s the particularly clumsy sort, spend extra time working on varying distances with poles flat on the ground before crossing any over. As an aside, hexagonal/octagonal poles are a very good thing if you’re investing in new poles!

Step 2 – Once your horse is solid with step 1, increase the complexity of the pattern, adding extra poles or even adding in some narrow planks if available. The goal is to keep the horse concentrating on where he needs to place his feet with every step. Pick your way through in many different directions so the distances change.

I tend to err on the side of caution and recommend this exercise always be done in walk, though I do know some who manage well in a steady trot. Let safety always be your friend when considering if trot is an option, and set the poles back to an easier configuration before pointing your horse at them in trot for the first time.

Further, I also recommend it be done only in hand, at least until the horse is very accustomed to the point of the game, AND he has done some solid basic pole work under saddle so he has the strength to keep his posture under control whilst carrying you.

This is an excellent exercise both for condition and for rehabilitation and one which, if included regularly, can really improve your horses sure-footedness and core condition while also offering a really good lengthen and strengthen while you’re at it!

Polework

How to use easy polework exercises to build a strong foundation of soundness for your horse.

When it comes to options to help your horse develop a better, more functional posture and increased strength as well as improving their awareness of where it is they are putting their feet and how they are controlling their body (proprioception), Polework is something every horse owner would benefit from understanding.

Proprioception (/ˌproʊprioʊˈsɛpʃən, -priə-/ PROH-pree-o-SEP-shən), from Latin proprius, meaning “one’s own”, “individual”, and capio, capere, to take or grasp, is the sense of the relative position of one’s own parts of the body and strength of effort being employed in movement.

One of the biggest problems I see in horses of all ages and experiences is a lack of this proprioceptive awareness, both in the core and the peripheries, which sets them up to use their body incorrectly and to ultimately be far more likely to succumb to soreness, under-performance and injury.

As well as appropriate osteopathic techniques and treatment which will free up restrictions and help allow the horse to use his body in a more biomechanically correct fashion, the work the owner does in the period between treatments plays a huge role in determining the outcome. All the manual therapy in the world won’t change a horses soundness and fitness for its work if the work it is doing continues to be done in the way it has always been done – the way that built it up to develop soreness and unsoundness in the first place. This is where polework, both on the lunge (or free) and under saddle, can really help change things.

It often seems believed that unless you’re doing something really complicated you may as well not bother, but in reality the majority of horses would hugely benefit from the regular inclusion of the most basic polework exercises. Consider this: Would you expect to launch straight into a high level gymnastics programme without mastering the very basics of how to use your body correctly? This is exactly how we need to be thinking about most of our horses who have, at one stage or another, whether due to training deficiencies or conformational tendencies, formed a habit of using their body less than optimally.

The pictures below, from my friend Sal, which prompted me to jot down these thoughts, are an excellent example of the value of poles.

The horse, Finn, is a 4 year old. He is in the process of being backed so has not had the years of vertical forces through his back that is the hallmark of the older ridden horse. He naturally carries himself ‘proudly’, that is to say he has a tendency to lift the head, disengage the core and hollow the back. Without specific work to help him learn to carry himself with his core engaged, lengthening and lifting his lower neck/thoracic sling muscles, and intentionally placing his feet, he shows a fairly typical young horse tendency to develop his musculature incorrectly. Fortunately he has a very diligent owner who has spent time regularly working him over trot poles at varied distances.

In the first picture it is easy to see how he is engaging the core and lifting the shoulder while using his body to slow the movement as he figures out where his feet are supposed to be landing. This is all part of the proprioceptive system at work – know where your legs and body are at all times or risk falling on your face.

This series of pictures illustrates beautifully the increased core activation, the lift through the thoracic sling, the lifting and lengthening of the epaxial muscles and ribcage, the engagement and intentional placing of the feet. All in all the horse is experiencing a huge increase in the amount of physical and neurological work he is doing, simply by being challenged to reach and place his feet between poles on the ground. By the 4th picture he had really figured things out, was lifting beautifully in front, measuring his stride, engaging the core and hindquarters and traveling really lightly over the poles.

Some pole work options:

Easy option 1: Stick 3-4 poles down in a straight line at a fairly normal 4-4.5 feet apart. For me this is simply 4 or so of my riding boots toe to heel or one decent step measuring from the heel of the hind foot to the toe of the forward foot. Give or take according to your horses size/length of stride so your horse can come through at its normal stride length without falling on his or her face.

Bring the poles together by a foot, and repeat. This will help your horse slow down, pick his way through more carefully and engage the core and the hocks some more.

Bring the poles apart by a foot or so. Try to keep your horse coming through with a nice steady rhythm rather than rushing full tilt and cat leaping over a pole or two in the process. This will help your horse reach, lift through the thoracic sling while also switching on the core and engaging the hocks.

Once your horse really knows to watch where he’s putting his feet, you can arrange the poles with slight variations in the distances or even in a pick-up-sticks kind of arrangement. For this I always recommend letting him walk through while he picks his way through. We’re aiming to reduce the chance of injury, not increase it 😉

Even easier option 2 (very good if you’re on board, less up and down for you):

Take your poles to a corner and set them up in an arc. Bring him through in the centre (normal stride length), then vary between closer to the centre for a shorter stride, or to the outside for a longer stride. You can even come through in a fairly straight line so you start with short strides and finish with longer stride. My most excellent illustrative capabilities show this below:

With the arc of poles, you can then progress to raising the outside of the poles to create a little more lift and activity in the outside limbs. This is especially useful if your horse has a tendency to lean or hang into one shoulder, or if you’re aiming to increase hock and glute activity.

Don’t forget to do both directions!

From these basics, you can progress to many and varied exercises which encourage both horse and rider to develop ever increasing levels of bodily strength and control, but always remember – if you can’t get these basics 100% then the chances of getting the harder ones done in such a way that both you and the horse are benefiting are slim.

And finally, when you’re doing these under saddle, do your horse a huge favour and try to stay in a light seat over the poles. But also, don’t throw your weight over his neck, forcing him onto the forehand either. Get a friend to video you, so you can really watch the way both you and your horse are doing these exercises. Ultimately you want him working with balance and engagement both front, back and core. If you’re achieving this both on the ground and under saddle then you’re good to start upping the ante and increasing the trickiness of the work, and even leaving the ground!

Finally, have a really honest and stern talk with yourself if you do find you’re struggling with your own balance, core and proprioception – Get yourself an Osteopathic treatment to unwind your own dodgy tissues, then get in touch with someone talented in helping riders develop these skills such as Rebecca Ashton at Equest Elite. You owe it to your horse!

Osteopathy And The Stressed or Anxious Horse.

How Osteopathy can help your horse’s mood.

A study published in 2017 has begun to give some credence and ask some interesting questions about chronic stress or depression in our horses. According to Jodi Pawluski and team(1) a group of horses showing signs of compromised welfare (living conditions fostering social restrictions, limited space and interactions with inexperienced riders) showed abnormally low cortisol levels.

Cortisol, aka ‘the stress hormone’ is one useful indicator of the way the horses Autonomic Nervous System (ANS) is working. The ANS is a largely unconscious mechanism which regulates bodily functions such as the heart rate, digestion, respiratory rate, pupillary response, urination, and sexual arousal. It is also involved in controlling blood sugar levels, regulating metabolism, helping to reduce inflammation, and assisting with memory function. It has two complimentary sides – the Sympathetic “flight/fight”and the Parasympathetic – “rest/digest”. When there is a balance these work nicely together to maintain homeostasis – a happy balance. Sympathetic stimulation acts to increase the blood pressure, heart rate, respiratory rate, blood sugar levels and muscular tension. All these are characteristic of the sympathetic nervous system driven “flight/fight” reaction so commonly seen both humans and animals. Elevated cortisol is one marker of Sympathetic activity. On the flip side, insufficient or suppressed levels of cortisol, as can occur when stress is chronic, reduces all these functions. One may think ‘Great! The opposite of flight/fight is rest/digest. That’s good, right?’, but unfortunately this isn’t the case. When cortisol levels become abnormally low, the body is on an almost constant ‘go slow’, with symptoms including fatigue, muscle weakness, lack of motivation or drive, an inability to cope with stress and depression. Neither state is conducive to a happy, enthusiastic individual, whether horse or human.

Further studies are obviously needed to help drill down into the relative influence of common management practices when it comes to our horses, though without a doubt the more a horse can live like a grazing herd animal and be handled by knowledgeable and gentle handlers, the better. In reality there are many things which limit this ideal situation, and we as horse owners have a duty of care to try to mitigate the effects our environment and interactions have on our horses. For many the idea that Osteopathy can help to do this might be a new one. Many studies and much clinical evidence exists to support the idea that Osteopaths can play a significant role in helping to restore balance to the ANS function of our horses.

Recently I’ve had the pleasure of working with a thoroughbred mare who has had what can only be described as more than her fair share of stressful experiences in her life. Being used as a surrogate for several years, and being a highly sensitive mare, she has developed a strong fight response to the sensation of being confined. This likely relates to being handled within a crush and coming to associate pressure against her sides or hindquarters as a stressful and threatening thing. This, of course, makes closing her into a horse float a highly charged event. Her owner has been working patiently with her, doing regular training to help desensitise her to touch on her sides and hindquarters as well as to teach her the float is a safe environment and has got her to the stage where she self loads, however as soon as she feels the divider or ramp come up she begins double barrelling and swinging her hind end from side to side to the point of inflicting wounds on herself. This naturally only serves to reinforce her inherent stress response and belief that confinement is dangerous. In general, she was noted to be an aloof and non-affectionate mare who displayed many stress responses both in handling and in the paddock. When ridden she works and is quite relaxed and happy, however would never mouth the bit and regardless how much suppling work was done would never display a single drop of saliva at the lips.

Our initial treatment involved working through the ribcage to encourage freedom of motion at the costovertebral joints all the way to the thoracolumbar junction to effect the adrenals sympathetic ganglion as well as to encourage full function of the diaphragm during respiration. She was found to be a very shallow breather and the ribcage as a whole was quite immobile. Human studies have shown significant effects of osteopathic techniques on stress hormones, one in particular using a technique known as Rib Raising (2). This technique addresses the costovertebral joints through the length of the ribcage and is clinically well known to be a powerful way of helping balance the autonomic nervous system due to the anatomical link to the sympathetic ganglia. Further work was done to put a calming stimulus into the sacrum, which is also associated with the sympathetics. Again, the sympathetic side of the autonomic nervous system is the one which drives the fight/flight response.

The parasympathetics, drive the “rest and digest” functions. This is the calm and relaxed state of affairs. Structurally this is in part composed of cranial nerves that supply the face, cardiovascular system, respiratory system and gastrointestinal system. Parasympathetic function can be readily supported by allowing the jaw and diaphragm to function optimally. By encouraging full diaphragmatic function with simple exercises, it is possible to also give the vagus nerve a nice bit of stimulation. In the image below we are looking at numbers 3, 15 and 16, so you can see how far reaching work around the jaw and poll can be and how the diaphragm (which divides the thorax from the abdomen) may stimulate parasympathetic function via the vagus nerve.

Immediately after the first treatment the mare was noted to be far more calm than usual, quietly wandering around the small yard we were working on another horse in, picking at grass. This was noted by the owner to be quite unusual behaviour for a mare who was usually on guard around other horses and tended to pace the fence line if not in her own paddock. I left the owner with several easy exercises to do daily to help keep the autonomic nervous system more balanced. Over the next week I was pleased to receive several updates saying how relaxed the mare had become, a total change in character. The next visit we decided to push our luck a little and give her her treatment standing next to the horse float, a space she would usually become anxious and on edge. Initially obviously nervous we quietly worked through similar areas, noting a big improvement in passive range of motion and tissue tension around the ribcage as well as a greater capacity for diaphragmatic breathing. The owner was again pleased to see the mare calm and relaxed and picking grass while standing next to her least favourite piece of metal.

Our next plan is to work towards adding more stimulus by opening the tail gate and potentially eventually treating her or doing daily exercises to flick her nervous system into ‘rest and digest’ while standing on the horse float. It may take a while to retrain her nervous system that this is not a threatening situation which requires a fight response, however initial changes have been very positive and have reaffirmed how powerful Osteopathic treatment can be for modulating this crucial part of our nervous system.

For those interested in more reading about how Osteopathic treatment can help us (and presumably our horses) towards a less stressed and more healthy state, I have attached are some extra references for studies (2, 3 & 4) which also have shown preliminary findings of positive effects of various Osteopathic technniques on the autonomic nervous system in both relaxed and stressed humans, measuring indicators for sympathovagal function at heart level, cortisol levels and immune function.

It is a fascinating aspect of Osteopathic practice which I always enjoy seeing results from. As with all natural approaches, results will vary and een after 15 years of practice i’m still often surprised by how much change can be achieved, and in ways I wasn’t necessarily anticipating. The main principle of Osteopathy is that if the tissues in the body are moving and functioning to the best of their ability then that body will head towards homeostasis (a happy healthy balance), and the path that takes is sometimes a little unpredictable but with time and patience it’s a rare case where we can’t help the horse achieve that balance in their system.

Update – After posting this, I received a call from the mare in questions owner. She was thrilled to report she had spent an afternoon during the week playing with the mare around the whole travelling in the float issue. She began with groundwork exercises to calm the mares nervous system as prescribed. Then as she was going so well progressed to loading her, letting her stand, bringing the divider across, again waiting, bringing up the tail gate and the final test a slow drive around the block. The mare maintained her composure the entire time besides one small kick out when actually moving. Upon return she stood calmly for another 5 minutes with the tail gate down and waited for the cue to back off. Naturally the owner is absolutely thrilled to be approaching the stage she can again contemplate taking her lovely horse out again! I’m also thrilled to see the changes 2 treatments have brought to this lovely mare’s general day to day anxiety levels. Stay tuned and I’ll add more updates as they come to hand.

References/Further Reading:

1 – Pawluski, J., Jego, P., Henry, S., Bruchet, A., Palme, R., Coste, C., Hausberger. M. Low plasma cortisol and fecal cortisol metabolite measures as indicators of compromised welfare in domestic horses (Equus caballus). PLOS ONE, 2017; 12 (9): e0182257 DOI: 10.1371/journal.pone.0182257

2 – Henderson, A.T., OMS III; Fisher, J.F., OMS III; Blair, J., OMS I; Shea, C., OMS III; Li, T.S., DO; Grove Bridges, K., PhD. Effects of Rib Raising on the Autonomic Nervous System: A Pilot Study Using Noninvasive Biomarkers. The Journal of the American Osteopathic Association, June 2010, Vol. 110, 324-330.

(Twenty-three participants were recruited, of whom 14 completed the study (7 in each group). Subjects who received rib raising had a statistically significant decrease in α-amylase activity both immediately after (P=.014) and 10 minutes after (P=.008) the procedure. A statistically significant change in α-amylase activity was not seen in the placebo group at either time point. Changes in salivary cortisol levels and flow rate were not statistically significant in either group.
Conclusions: The results of the present pilot study suggest that SNS activity may decrease immediately after rib raising, but the hypothalamic-pituitary-adrenal axis and parasympathetic activity are not altered by this technique. Salivary α-amylase may be a useful biomarker for investigating manipulative treatments targeting the SNS. Additional studies with a greater number of subjects are needed to expand on these results.)

3 – Fornari, M. DO (Italy); Carnevali, L. PhD; Sgoifo, A. PhD. Single Osteopathic Manipulative Therapy Session Dampens Acute Autonomic and Neuroendocrine Responses to Mental Stress in Healthy Male Participants. The Journal of the American Osteopathic Association, September 2017, Vol. 117, 559-567. doi:10.7556/jaoa.2017.110

(Conclusion: The application of a single OMTh session to healthy participants induced a faster recovery of heart rate and sympathovagal balance after an acute mental stressor by substantially dampening parasympathetic withdrawal and sympathetic prevalence. The OMTh session also prevented the typical increase in cortisol levels observed immediately after a brief mental challenge.)

4 – Saggio, G., DO; Docimo, S., DO; Pilc, J., DO; Norton, J., DO, RN; Gilliar, W., DO. Impact of Osteopathic Manipulative Treatment on Secretory Immunoglobulin A Levels in a Stressed Population. The Journal of the American Osteopathic Association, March 2011, Vol. 111, 143-147.

(Conclusion: High levels of human secretory immunoglobulin A (sIgA) have been shown to decrease the incidence of acquiring upper respiratory tract infections. This study demonstrates the positive effect of OMT on sIgA levels in persons experiencing high stress. Results suggest that OMT may then have therapeutic preventive and protective effects on both healthy and hospitalized patients, especially those experiencing high levels of emotional or physiological stress and those at higher risk of acquiring upper respiratory tract infections.)