Prehabilitationis a Proactive/preventive approach to manual therapy, exercise, diet and lifestyle, designed to maximise health and wellness, and minimise individual risks for injury and disease. Well-studied in human medicine, prehabilitation is found to be valuable in ‘high risk’, aged, frail or obese patients, as well as younger patients who wish to maximise their athletic performance or if injured and facing surgery, to return to their chosen sports as soon as possible. It is especially valuable when an animal is requiring surgery, and as a pre-operative approach integrates biomechanical assessment and appropriate manual therapy treatment, individualised home exercises plus diet and lifestyle advice in advance of surgery. Prehabilitation has been shown to promote lower complication rates and earlier restoration of functional activities and status during the recovery from surgery. Good quality systematic reviews show a positive impact of pre-operative exercise therapy on physical function, quality of life, postoperative complications and length of hospital stay.
Most animals have been developing compensations for minor slips, trips and falls for many months or years prior to pain or lameness becoming evident. Individualised prehabilitation helps to make sure the animal is moving well and has the best possible strength prior to undergoing surgery. This is believed to help improve the outcomes of surgery by promoting healthy circulation, minimising inflammation, reducing pain related behaviour and movement limitations, reducing strain on the healing tissues and as a bonus will often reduce the animals reliance upon medication to control inflammation and pain both before and after the surgery.
Rehabilitation takes a similar approach around the inclusion of biomechanical assessment and appropriate manual therapy treatment, individualised home exercise, diet and lifestyle advice in respect to promoting the most efficient and successful recovery after orthopaedic surgery or acute injury. Rehabilitation typically follows a pattern guided by the natural healing mechanisms within the associated tissues.
Inflammation is the main factor to manage for the first 2 – 4 weeks depending on the individual situation. This typically includes medication and rest, however these can also be complimented by gentle therapeutic options such as lymphatic drainage, laser and kinesiology taping to help the tissues clear the active inflammation and bring fresh blood supply into the healing tissues. Treatment is always considered on a case by case basis in conjunction with veterinary advice, as individual factors play a large role in the suitability of therapies during the acute stage. Gentle modalities such as laser, kinesiotaping and lymphatic drainage often appropriate immediately post surgery, and specific home exercises may be able to help maintain the nervous and muscular system function in relation to the injury.
Weeks 5-8, are crucial in ensuring the affected tissues are building their passive and active function in a symmetrical and biomechanically correct manner in order to ensure that the repairing tissue is as healthy and functional as possible. Again, passive and active techniques, more advanced exercises and modalities may be applied as appropriate to promote healthy tissue repair.
Remodelling, during weeks 9-12 is when the fun really begins. This is where, if previous stages have been completed with success, we can really start to challenge the body while still being aware there is much change still happening within the healing tissues. Monitoring the dog during this period is particularly important as they often begin to feel ‘like new’ and can easily overdo it. Rehab exercises can increase in complexity as we challenge both the musculoskeletal tissues as well as the nervous system which controls healthy movement.
Months 3 – 6 are the cherry on top as far as rehabilitation goes. While it may seem as though the dog is back to normal, it is very important to continue monitoring them for any signs that their tissues aren’t strengthening symmetrically or fully. Owners are coached on how to monitor their animals for small asymmetries or movement patterns in their own animals specific case, to help pick up early signs of trouble. This helps to reduce the likelihood of long term development of osteoarthritic changes that are common when surgical procedures have occurred. Typically at this stage home exercises should be part of normal daily life, with lifestyle changes well integrated to help the animal continue well into their older years. I always aim to make these lifestyle factors and exercises as easy to integrate into daily life as possible, which makes it significantly more likely that they will be maintained through the animals lifetime.
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.
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!
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.
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.
How to avoid and treat agility injuries for a long and fruitful agility career.
It’s a well known fact that for all the amazing benefits Agility offers dogs and their handlers and the relationship between both, it can be a hard sport physically on the dog (and the handler, but that’s another story!). Injuries can be either acute or chronic in nature, and management of the inherent risks presented by obstacles such as A-frames, jumps and seesaws is an important part of making sure your dog gets to have a long and enjoyable agility career. Factors which add to the risk of agility are the speed at which the dog is travelling, the tight lines often needed to navigate today’s courses and the athleticism required to traverse these obstacles, all of which leave the dog open to repetitive stress on various parts of their body as well as potential falls from or hitting the obstacle.
From a training perspective it is very worthwhile to aim to minimise the repetitive nature of the work the dog does, especially with young dogs whose growth plates are still very susceptible to damage from excess and repetitive pressure. Keeping the work they do varied, while practicing the skills might look like breaking the exercise down into small chunks and practicing each part at a slower more controlled pace to perfect the skill, then building those parts to perform the full obstacle. Working on many small varied parts of the greater task, at a slower pace, allows the trainer and dog to refine their skills and communication while avoiding many high speed repetitions of the full obstacle.
As mentioned above, injury to growth plates in young dogs is one worry when involved in intense competitive training, and this is largely mitigated by changing the way the dog is worked at least until physical maturity. Other risks such as sprains, strains, contusions (bruising from hitting an obstacle) and postural changes due to repetitive movements of an asymmetrical nature can be more readily managed or mitigated with the help of Osteopathy and other rehabilitation or wellness options such as swimming.
Osteopathically we look at the way the dog is moving and using their body and then palpate (feel) to identify any restrictions in the joints and any tender points, tightness or weakness in the muscles, ligaments or tendons. When identified, gentle manual techniques ranging from soft tissue work (massage like techniques) through to joint manipulation can be applied to restore healthy and full range movement throughout the body. Ensuring that the musculoskeletal system has full movement not only allows these tissues to function well, it also allows the circulatory and nervous systems which have branches running all through these tissues to function optimally. This promotes healing and gives the dog the best chance of recovering fully from any injuries, as well as helping to avoid injuries in the first place.
Agility buffs, your dogs are athletes! Their bodies are working very hard while having an absolute ball, so make sure you give them the benefit of keeping that body working to it’s best ability and you’ll give them the best chance of a long, enjoyable and injury free time leaping and bounding their way through their favourite pastime.
So what exactly are these hip flexors we’ve been speaking of, and why are they so darn important to the horse rider??
The iliopsoas is one of the very important factors in achieving a symmetrical seat. I find if the hip flexors as a group are not working well through a full normal range of motion there will be huge struggles with trying to maintain even and effective seat and leg aids. There will also be knock on effects on the upper body and aids from there also.
As you can see below, they attach to the front of the spine and the inside of the pelvis before running down through the pelvis to attach onto the inner thigh. They act to draw the knee up towards the body, and as such are a muscle group which is in a shortened position whenever we spend time sitting, either at a desk or in a car during out work days. They also play a huge role in stabilising the hip in a slightly flexed position, during many activities throughout the day. The very act of sitting on a horse puts the hip flexors into a slightly shortened position and, especially when the true core muscles aren’t doing their fair share, as soon as the horse begins to move we begin to use the hip flexors to help keep us upright and stable over the horses centre of gravity. To add to this complex system of controlling the hip and the core, we must consider the role the gluteal muscles (your butt!) play.
When tight, the hip flexors hold the hip joint in a position of slight flexion, and this is where the problems begin. In a neutral standing position this causes the pelvis to tip forwards and the lumbar spine to be pulled into extension (an increased arch in the lower back). This looks like the first mounted position we saw in the picture in Part 1.
Tightness in the hip flexors is usually also associated with other predictable muscular imbalances around the hips, pelvis and lower back, the most crucial of which is a weak abdominal core and gluteal muscles and a tight lower back and hamstrings . This pattern is often referred to as Lower Crossed Syndrome and creates for the rider a position of ‘duck butt’, lack of suppleness through the lower back, knees which grip and ride up in front of the centre of gravity and a lower leg and heel which just won’t stay where it belongs.
A strong core is crucial for a riders stability in the saddle, and may be the difference between sticking that awkward jump or unexpected stop or not. It also is crucial for allowing the rider to apply effective seat aids. The sum of these imbalances cause the body to move less freely and with less control than the ideal. Often one side is more restricted than the other and this is where many cases of short-stirrup-itis and dropping your hip or tilting one way originate from.
How does this affect your horse? From the seat alone, if one hip flexor is pulling tighter than the other, a tilt to one side is likely to occur. Looking at the shape of the pelvis in the picture above, you can see that tilting the pelvis to the side (dropping a hip/creasing at the waist) will cause one of your sit bones (ischial tuberosity) to contact the horses back more than the other. Thinking about how sensitive we hope for our horses to be to seat aids, one can instantly see the problems this might cause. The horse who always bends one way or is travelling on three tracks and just can’t seem to straighten no matter how much leg the rider applies, which incidentally feels much stronger one way than the other. The changing or disuniting canter leads. The inability to easily find or maintain the correct diagonal in trot and the horse who looks that little bit lame on one rein in trot but not the other and no clear diagnosis of true lameness can be found. These are just a handful of the problems created by unevenly tight hip flexors and the postural ramifications of such. When both are tight we typically see the proverbial “”duck butt” rider posture. The horse typically reacts by hollowing to escape the increased weight through the tree points and falls onto the forehand as the riders centre of gravity is thrown forward of the ideal. The horses back end then merrily trails out behind him, pretty much precluding any chance of hip engaging from behind and lifting the shoulder. His own core blows in the wind, while yours does the same up top.
In part 3 we will start to look at how you can test these muscle groups in yourself and where to start to unwind this pattern so you can begin to address the associated problems in yourself and your horses performance.
How tight hip flexors (ilio psoas) affect the horse and rider.
Call Sam Sherrington on 0452 472 959 if you’d like any more information on horse and rider Osteopathy.
It’s been nearly 18 months since we covered this topic (on my facebook page. Since these posts never made it to this website I’m going to review the hip flexors again, since they’re such an integral part to getting your riding position working for you and your horse, rather than against you.
Do you find you often feel crooked on your horse? Is your instructor always shouting at you to stop tipping forwards or poking your backside out? Does your horse often land on the incorrect lead or not land straight over a fence? Is one stirrup being stretched or always feel shorter? Do you often feel like you’re always tipping forwards and can’t get your leg down and around the horse to give effective aids?
(Diagram source uncertain – if anyone knows where it came from do please let me know so credit can be given where it’s due!)
One big question I’m sure you’re all wondering – Why is it that so many people have tight hip flexors and an anterior pelvic tilt?
Surely if it’s not a biomechanically sound way to operate, it wouldn’t be the ‘go to’ posture so many people find themselves in, would it?
Lets think about what things we all might do on a day to day basis that promote short, tight hip flexors.
Get up from your bed and sit down to eat breakfast.
Get straight in the car and sit for whatever period of time it takes to get to work.
Spend a decent part of your day, you guessed it, sitting. Often with your legs crossed. If you’re lucky you have a job where you get to move around a lot, but even then, because our eyes are on the front of our head and our arms reach forwards there is a strong chance you do most things in your day reaching or slightly leaning forwards.
At the end of the day, you get back in your car, head to the yard.
Jump on board your favourite four legged beast having spent not a moment thinking about warming up or stretching out your own body.
Fight with your body and if you’re lucky, have someone on the ground shout at you to Sit up! Sit up! Stop tipping forwards! Drop your right knee! Stop leaning to the right, for goodness sake!
Head home and perhaps spend a bit of time on the sofa in something approaching the foetal position, mulling over why on earth you just can’t get it together on the horse, before heading off to bed to properly assume the foetal position.
All in all, it’s a solid day of flexed hips.
Now, when you stand yourself up in between these periods of sitting and bending, your hip flexors start to complain as they’ve become quite accustomed to being shortened. So rather than happily lengthen out, they stay relatively short and instead pull your pelvis forward into a nice anterior tilt with an exaggerated lumbar lordosis. This in turn promotes short, tight lower back muscles and weak abdominal core muscles which makes your body even more likely to switch on those hip flexors to help stabilise the pelvis and lower back during unstable activities – like riding your horse 😉
So, what did you do today that would have shortened up the ol’ hip flexors?? I clipped the dog, then could barely stand upright again!
Stay tuned for Part 2, where we will look at the anatomy involved in a bit more detail and begin to consider what it is doing to you and your horse in daily work.
When bringing a horse into training for any discipline, it is important to consider an individual plan aiming to get the best improvement in muscle strength, tone and flexibility while minimising the risk of injury. Anyone who has dealt with a range of horses within various disciplines, or even within one discipline alone will know that some horses seem so much more prone to injuries during training than others. Many times this can be due to the horses past work, for example ex-racers often come into their second career with variable degrees of ligament or joint damage due to the nature of their previous training. Starting with a fresh horse with a known history can be a major headstart, however every horse has his own physique and as such care in formulating a program accordingly can minimise the chance of injury.
Human professional athletes and their coaches have long considered their physique in optimising their training programs to get the best outcome from their training regimes and similar principles may be of great value in ensuring our horses perform their best. Three types of body type are widely recognised, the Ectomorph, the Mesomorph and the Endomorph. These three represent three distinct physiques, however in reality most individuals show elements of 2 or more.
The Ectomorph – The typical lanky thoroughbred type, light of bone, lightly or poorly muscled with weak connective tissue, they are long necked and small shouldered. They have small joints and relatively long legs in relation to their body size. They often carry low body fat, and are difficult to get good condition on, even with higher than average feed consumption. They are often also quite sensitive to temperature extremes and changes. Having poor natural muscle tone and weak connective tissue, this type is most prone to overtraining, and require the most care to build their strength gradually to allow them to perform without joint or ligament damage.
The Mesomorph – The athletic, well proportioned type with mature muscle, strong connective tissue and large bones. They tend to carry themselves well naturally, gain fitness and body condition readily. They are typically quite stoic and due to their inherent strength are more physically forgiving of errors in training than the ectomorphic type.
The Endomorph – Low natural muscle tone however, unlike the ectomorph, with work will gain muscle bulk readily. They have soft bodies and gain weight readily. They typically have smaller bone structure than the mesomorph, and due to their propensity to be ‘pudgy’ often resemble the typical “Thelwell” pony, with a big round body and little legs. This type are more resilient in training than the ectomorph, however require an awareness during training of the imbalance between body weight and the relatively small bone structure carrying this large body along.
Regardless of body type, basic principles of training are common to all. Following these guidelines you can help keep your horse fit and healthy while aiming for your ultimate performance goals.
Avoid excessive fatigue. Soft tissue injuries are far more common when muscles are fatigued.
Increased training should be matched with increased rest. It is during rest that significant increases in muscle strength and power are developed.
Resistance training increases the ability of muscle to endure hard training. Combinations of poles or cavalettis and working in varied and deeper surfaces build a horses core muscles required for support during faster and more jarring activities.
Introduce new work gradually. The more time the horse is given to build strength, the less likely he is to injure himself when being pushed during training or competition.
Train on as many different surfaces as possible. Varied ground stimulates the proprioceptors in the joints and improves the horses ability to maintain good stability when moving quickly over uneven ground.
Always incorporate a good warm up and cool down period to ensure maximum elasticity and power in the ligaments and muscles respectively during work, and preventing stiffness after work.
Professional athletes make use of manual therapists to ensure their bodies are working at their best and small injuries are dealt with before they become large problems. Your horse benefits in the same way from an Osteopathic consultation allowing his joints, muscles and tendons to work most efficiently and thus minimising the strain and risk of injury during your training and competition.
Do yourself the favour of considering your own balance and its effect on your horse. The daily impact of your imbalances can greatly affect your horses balance and work.
Following these guidelines will help both you and your horse work your best and pretty soon, you’ll start seeing the results in training and competition.