When our dogs get older we often seek extra ways to help them. Osteopathy can be invaluable in adding quality to their lives, read on to find out how.
Life can be tough on the body, even for the best loved and pampered pooch, and by the time they reach their ‘Golden Years’ they can be starting to show their age in many different ways. Their metabolism slows down, often increasing weight and lowering their ability to regulate their body heat. This extra weight in itself, adds strain to already worn joints, which in turn make it harder to get your dog out for some gentle exercise to help manage the weight gain. Older dogs often also experience changes in their temperament, becoming grumpy or aggressive towards family members, especially other pets and children. This is frequently due to undiagnosed or under-treated pain, and goes hand in hand with depression, a reduced social capacity and loss of function in their normal daily activities. Pain management often becomes a big problem when the elderly dog shows the commonly seen increasing signs of side-effects and reactions to medication, and an increased reliance on them to manage simple daily tasks. I frequently hear owners feeling powerless to break this cycle – a feeling having very few satisfactory answers to helping their dog manage as their age creeps up.
Osteopathic care is a gentle approach to helping any animal function the best they can taking into account the conditions they are experiencing. Osteopaths are university trained professionals who are able to recognise where the body can function more efficiently, helping the animal move closer to ‘homeostasis’ – the body’s sense of optimal balance, ease and functioning. Osteopaths use primarily manual therapy techniques, as well as adjunctive techniques such as laser, kinesiology taping and exercise prescription.
Human studies focusing on Osteopathic Treatment in the elderly have shown improvements in respiratory function, functional ability, balance and wellbeing. There has also been noted reduction in pain levels, medication reliance and assistance with some side effects of medications such as constipation commonly seen with some pain medications. These studies, while conducted on humans, have great relevance for guiding the kind of allied care we can offer for elderly dogs, in conjunction with care provided by your Veterinarian.
Osteopathy helps to restore an animals range of motion of all joints and soft tissues of the body, creating an ability to move more comfortably through activities of daily living. In conjunction with Hydrotherapy, we can then add numerous general and specifically tailored exercises and activities for the dog and owner to complete at home to help build added strength and function. In the elderly, it always amazes me how many of the co-morbidities (additional conditions such as failing organs, sight, hearing etc) can become less bothersome when the dog is up and moving more efficiently. Movement really is the most amazing medicine for all bodies.
For more information or to discuss how I can help your Golden Oldie live their very best life, please give me a shout on 0452 472 959 or shoot me a message @centaurusosteo on facebook.
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.
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 4th 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.
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!
Yep, I’ve had requests to do so, and i’m taking a deep breath and opening up this can of worms…
Photo Credit: Courtesy Kristen Janicki
This perspective is my own, based on clinical practice observations which tend to be backed up by the findings of a very rudimentary review of recent available literature. For a really thorough literature review, have a look here. This one conducted by Ruth Taylor; BSc (Hons) Equestrian Sports Science of Hartpury College, in 2016 looks into the research available around the topic. It is very well worth a look if you’re interested in the evidence behind the current suggested limits.
I see many horses with back soreness, and unfortunately, rider weight is one factor which does come into it. More so than rider weight though, I have noticed there appears to be a strong correlation between the riders overall fitness (if I’m asking if you do other sports, or any specific fitness work besides riding, that’s why).
It’s generally accepted that riders should be somewhere between 10 and 20% of the horses bodyweight. This to me completely fails to take into account that there are heavier riders who are very forgiving of their horse – using their core correctly, keeping in balance with the horses movement and generally not hindering their horse in the goal of staying balanced throughout their work. It also fails to specify that a quite light rider who is very unbalanced, and who is on a horse with a poorly fitted saddle may be far more deleterious to the horses biomechanical wellbeing than the aforementioned heavier rider. It also fails to take into consideration the horses morphology – a stocky well boned, broad loined horse would obviously be more likely to withstand heavier weights and/or less balanced riders before soreness occurs than a fine boned, narrower horse would. Fitness also likely plays a part and a horse who has been properly and gradually conditioned with biomechanically correct work, is likely to hold up to heavier rider weights better than a poorly conditioned horse, working with the topline hollowed, who was pulled out of the paddock and asked to go out for a weekends activity.
My ultimate take therefore is that while it’s important to be mindful of your weight vs your horses weight, it is also important to consider the type of horse you ride in regards to morphology and the work you want to do. Further, if you’re suspicious that you might be slightly underhorsed or your horse is showing signs that this might be a factor I would advise that you consider improving both of your ability to control your bodies through biomechanically sound movement training.
For you that might include an Osteopathic treatment plan, to ensure you can move symmetrically without injuring your self. Then, general fitness work (I personally love a mix of HIIT and light strength work to avoid cutting into my very small windows of available time), but also investing in some really good Pilates classes to learn how to control your core and use your limbs independently without losing that core control the moment you try to move. Remember, core control is about movement and function. If you can’t control it while moving then it’s pretty pointless. Keeping yourself balanced and light over your horses centre of gravity will hugely reduce the impact of any weight ratio imbalance that exists between you and your horse.
For your horse, I would highly recommend ensuring he is able to move symmetrically and remove any existing soreness by having him assessed by a good Animal Biomechanical Medicine practitioner (membership list here of fully qualified and insured Osteopaths, Chiropractors and Vets who’ve studied this stuff at University level). Also be sure that your tack fits. Your saddle needs to fit both of you or it will be an uphill battle to perform in a balanced manner which will reduce this ability to cope if there is an imbalance in regards your weight ratio. Very importantly – treat him like an athlete. Regardless of your chosen discipline, he not only has to go out and perform a bunch of extra movements than he would in the paddock, he has to carry you whilst doing so. Find someone who can teach you what a correct frame looks like, not just one where he is holding his neck all pretty, but one where he is using his core consistently, where he is swinging evenly through the back, where he is stepping evenly from behind and keeping his centre of gravity balanced throughout the work he is doing. Ensuring he is able to do this might involve spending time each day warming him up with correct lunge work (that is, not galloping around full pelt to get the bucks out) preferably including ground work and pole exercises. Again, your ABM professional can help to formulate a plan which incorporates specific exercises which are relevant for your horse specifically. I personally love when people incorporate groundwork into their normal routine as it also means they are getting to routinely look at their horse moving and so pick up on changes in movement which might indicate soreness well before the horse actually throws a lame step.
So there you have it… it’s not a straight forward answer at all, but it is one which we should all be contemplating when choosing our horses and/or managing the ones we already have.
I hope this has helped and if you’re keen to increase the balance and performance you and your horse have when out enjoying your chosen discipline please don’t hesitate to get in touch.
Thoracic trauma (rib fractures or costochondral dislocation) in foals is a relatively common side effect of being born quickly, with a relatively deep chest, through a relatively small, hard pelvic ring. A study done in in 1999 in Coolmore Stud in Ireland by D Jean et al discovered a rate of around 1 in 5 foals having rib fractures, and further studies have suggested this might be a conservative estimate due to the lack of sensitivity of radiographic technique in detecting these fractures/costochondral damage. Interestingly, by around 3 days of age, the majority of foals are showing no overt signs of these fractures. Dr Ian Bidstrup has spent many years digging into this problem and correlating some of the typical ongoing issues that appear to be associated with a history of birth trauma, whether actually noted at birth or not. These include:
Increased sensitivity around the girth and ribcage
Spinal pain especially around the wither and associated dysfunction in this and other regions
Pelvic/sacral dysfunction – as the foal exits the birth canal large forces are exerted in an asymmetrical manner on the sacrum and pelvis
One sidedness in work
Forefoot asymmetry – one big flat foot with low heel and one narrow foot with high heel, or possibly even clubbed foot
In practice this pattern is seen quite commonly, presenting as a typical dipped thoracic and roached lumbar posture which predisposes horses to working in a hollow frame, dropping their sternum in the thoracic sling (by contrast think of a horse in self carriage lifting through the sternum and withers between the shoulder girdle). The following picture from Dr Bidstrup’s Spinalvet website is a perfect example of this posture.
Horses will typically also begin resisting requests for a supple bend in one direction more than another by using their head and neck like a rudder for balance and by cocking or bracing the jaw. This resistance through the front end will also obviously have ramifications for the way the horse uses its back end, and if pelvic/sacral function isn’t as it should be that will compound the problems. I have also noted an anecdotal link to a propensity to gastric ulcers though of course this is often a case of chicken and egg where digestive dysfunction has a deleterious effect on thoracic and lumbar function.
So what can we do about this? Ideally all foals should be assessed and if needed treated within the first week or so of birth. By doing so, much of the asymmetry could be addressed to allow them to grow as evenly as possible with the aim of having a youngster who is as balanced as possible by the time they reach the stage of being backed and starting work. Observing foals to see how inclined they are to always graze with one particular leg forward can give a good idea of how much asymmetry they are carrying.
Photos: The Horse.com; Shutterstock.com
When we get to the stage of an established horse we’ll be dealing with more posturally and neurologically ingrained patterns as well as muscle memory and hoof asymmetry. These can take a little longer to unwind and often a few steps back in work schedule are necessary to help give the horse a chance to relearn how to use his body while the dysfunction is being worked on. It is phenomenal to see how quickly a horses patterns can change when given the chance with good Osteopathic treatment combined with some rehabilitative changes to their environment, for example introducing variable feeding positions, good farriery/hoofcare and some exercises on the ground to help translate those postural changes to work under saddle.
NB – Not a recommended Exercise. Photo: Unknown – if anyone knows please let me know as I love it!
By addressing these asymmetries early on, it is possible to hugely minimise the strains on the horses body and legs and give your horse the best chance of long term soundness and performing to the peak of their ability. If you have youngsters you’d like to ensure have the best chance of a sound and successful performance career please do get in touch to see how much difference Osteopathic management can make to their future.
How Cranial Cruciate Ligament Injuries can be managed when surgery isn’t the first choice.
Ruptures and partial tears to one or both Cranial Cruciate Ligaments (CCL) is a remarkably common injury in our doggy friends. While certain breeds seem to have significantly more frequency of injury, I see it pop up in a wide variety of breeds, ages and sizes of dogs.
Traditionally, it has been believed that typically only small dogs, under about 15kg, fare just as well with conservative management as they do with surgical repair options. At significantly less cost also. This belief is based on a study which showed very positive outcomes for the small dogs and not so much resolution of lameness in the bigger dogs. Some practitioners, however, have been questioning the assumptions since.
Dr Narda Robinson DVM is one practitioner who has been quite vocal about the lack of options many pet owners are given when faced with a CCL injury. She has compiled some good evidence here to endeavour to debunk many commonly held beliefs around why surgery should be the primary go-to option for sorting out our dogs dodgy knees.
So, when an owner makes the decision to give the surgical option a miss, at least on a trial basis, what is the conservative option?
The first step is to ensure the dog is a healthy weight or slightly underweight to help reduce the loading on the stifle joint. Being overweight is one of the biggest and most manageable risk factors noted to contribute to CCL damage.
Next, keeping your dog’s activity controlled. Complete crate rest was once advised however studies have shown it to be not necessary. Rest and avoiding jumping up and down from vehicles, beds etc; minimising risk of slipping on smooth floors, and going for frequent short controlled leash walks is the ideal for 6-8 weeks.
Finally, the use of anti-inflammatory or analgesic medication as required.
From an osteopathic perspective it is possible to boost the effects of this conservative management firstly by recognising that it is, in most cases where the lameness has developed gradually and insideously, strongly likely that biomechanical restrictions in the dogs body have contributed to asymmetrical weight bearing through the hind legs and the stifle joint. This asymmetry and dysfunction can be addressed using Osteopathic techniques which are gentle and often pain free. By allowing the dog’s body, especially the lumbar and pelvic regions to function to the best of their ability, it is possible to minimise overloading of individual joints and enhance circulatory and nervous flow to the joints and tissues and hence allow the body to do it’s best healing work.
One of the big risks of CCL damage is that around 50% of dogs will present with damage to the other CCL within 6 months of surgery to repair injury to the first. This suggests two possibilities. Firstly, the obvious one that during recovery, the ‘good’ knee will be taking more than its fair share of workload, and secondly, that there is some underlying biomechanical factors that haven’t been addressed in the first instance which are continuing to throw excess loading into the joints. Whether post-surgery, or opting for the conservative option, it is therefore crucial to ensure the dog’s body is actually able to work symmetrically, as well as to then formulate a thorough rehabilitation plan to help ensure the dog begins to use themselves evenly. This rehab can begin within the first few weeks post-surgery or during the rest period if managing conservatively.
Allied therapies including dietary changes (examples here and here) and nutritional supplementation and herbs, hydrotherapy,acupuncture, laser, orthoses, stem cell therapy and cryotherapy are some of the many that may be useful within the management plan for CCL rehabilitation.
From a preventative point of view, again it is crucial to ensure dogs are able to use themselves as symmetrically as possible. This can be achieved by osteopathic preventative/maintenance visits from a young age, to thoroughly examine and uncover any dysfunctional regions of the body and remove these restrictions before they begin to significantly alter the way the dog is moving. Ensuring that dogs are given consistent, relatively controlled activity allows them to develop strong and healthy musculoskeletal systems – so avoid the weekend warrior approach of relatively little or no exercise during the week followed by manic ball chasing or frisbee catching at the weekend. Make exercise a big part of your daily routine so your dog has a good baseline level of fitness and strength to help cope with the inevitable extra fun at the weekends or on holidays. Also, make sure nails are kept trimmed regularly, both to avoid slipping risk and also to help avoid changes in limb posture which may occur if the dog is feeling discomfort during activity from overly long nails.
For further advice or consultation, please don’t hesitate to contact me to discuss how Osteopathy can be of use in helping prevent, manage or rehabilitate a CCL injury.
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.
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.)