Why does my dog lick to the point of bleeding?

dog licking paw - english bulldog licking paw isolated on white

A common problem dog owners find themselves facing is when their beloved dog develops a habit of excessively licking a paw or leg, or sometimes even a body part to the point a sore develops. Often this is put down to anxiety, however it is often also triggered by a pain sensation which either becomes chronic, thus the dog continues giving it attention, or becomes a comforting habit. In the case of a chronic irritation, this can be as a result of localised pain, referred pain or pain in another area which causes the dog to seek comfort and the feel-good endorphin release provided by the licking behaviour. Similar to the way we humans rub a sore muscle or joint, our dogs find the best way they can to manage the discomfort.

Obviously if open sores are present we will want the owner to be consulting a vet for investigation for underlying factors such as parasites, allergies and arthritic joints amongst other sources as well as for topical management strategies, whether that be antibiotics, antifungals, antihistamines etc to help settle the local tissue response. An Elizabethan collar may also be an appropriate strategy to help break the licking habit and protect the skin while the underlying problem is addressed. From an Osteopathic perspective there is much we can do to help alleviate this discomfort.

One of the most common sources of lick sores when no definitive underlying problem has been identified is referred pain or nerve pain from a more central restriction or dysfunction in the body. In these cases, we search for tissues and joints around the spine, limb and associated areas which can alter the function of the nerves, blood vessels and pain sensitive structures all the way to the tip of the toes. If you’ve ever sat on your leg or slept on your arm and then moved to find your limb initially ‘dead’, closely followed by a strong pins and needles sensation or many other odd sensations associated with nerve and blood flow restriction, you’re sure to be able to picture the sensations your dog is trying to ease.  By finding these kinds of restrictions in the tissues it is often possible to create take enough pressure off these sensitive structures which may allow the dog to return his attention to the more fun things in life.

Furry-friends-welcome-Bob-the-dog-enjoying-the-view-from-Llanbedrog-headland-Abersoch-Daydreams-300x200

 

 

Hip Flexor for the rider – Part 2

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.

HIp flexor 2Lower cross

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.

Hip flexor 1

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.

duck-butt-2(Above picture from this very humorous look at one riders battle with “duck butt”- https://barnbrat7732.wordpress.com/2015/07/15/a-swiftly-tilting-pelvis/).

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.

 

 

Hip Flexors for the rider – Part 1

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?

Hip flexor on horse

(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?

 

hip flexors seated

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.

 

 

Pain and lameness in ridden horses

Lameness

Call Sam Sherrington on 0452 472 959 for more information on Human and Animal Osteopathy.

It is established that more than 47% of the sports horse population in normal work may be lame, without having been identified as such by their regular owner or trainer. A new study by the industrious and ever driven Sue Dyson and team has made huge headway by testing the validity of a list of easily observed behavioural features that may indicate lameness in the ridden horse. The ethogram allows owners and riders to be more attuned to the signs that their horse may be in pain and thus could help to reduce the incidence of undiagnosed lameness in performance horses. The study compared the frequency and reliability of a group of 114 behaviours and reduced the list down to 24 reliable signs that occur significantly more frequently in lame horses than non-lame horses under saddle in trot and canter, when working large, on 20m and on 10m circles.

Many of the behaviours discovered to be significantly more common or exclusively seen in the lame group of horses are commonly viewed as purely behavioural and thus often addressed by stronger tack/equipment or punitive training methods. This study therefore provides some very compulsive evidence for always giving the horse the benefit of the doubt when a new or unusual behaviour crops up during work.

In my practice I’ve long seen many of these features as signs of pain in one part of the body or another, so it is fantastic to have some solid evidence to affirm the link and to help owners become more adept at recognising that these behaviours are in fact a cause for action. As the study concluded –

If ≥ 8 of the 24 identified behaviours linked to pain are observed within a fixed period of 3-5 minutes, it may be advisable to seek out a specialist for assessment of pain (lameness) in the horse.

So, keep this list of prime signs in mind if, while working with your horses, they begin to show undesirable behavioural changes. Young or green horses may be expected to show some of these signs as they are physically and mentally establishing their work, however if the behaviour continues then it is also well worth considering as a possible sign of pain.

  • Ears back
  • Mouth repeatedly opening and closing
  • Tongue exposed or tongue repeatedly moving in and out of the mouth
  • Working on 3 tracks in a straight line.
  • Increased frequency or changes in frequency of steps within a gait, especially if when going from large to small diameter circles.
  • Incorrect canter (Changing behind/in front)
  • Unwillingness to move forwards and resistances.
  • Spontanously breaking from one gait to another
  • Stumbling and toe dragging

The full list of 24 signs is below for those really keen to keep on top of this aspect of horse management.

First port of call for all overt lameness cases is your vet, and once veterinary sources of pain are eliminated Sam Sherrington – Equine Osteopath if in the Hills and  Hawkesbury regions of NSW, Australia or another Osteopath or Chiropractor (or Veterinarian trained in biomechanical treatment of horses) who has university level training to assess and treat musculoskeletal causes of lameness and pain.

Dyson, S., Berger, J., Ellis, A.D., Mullard, J., 2018. Development of an ethogram for a pain scoring system in ridden horses and its application to determine the presence of musculoskeletal pain. J. Vet. Behav. 23, 47-57. http://www.journalvetbehavior.com/article/S1558-7878(17)30172-7/fulltext

 

The Essential Jaw

Following on from our contemplations on the principles of Osteopathy, it seems natural to begin to consider some of the specific problems and syndromes that are commonly encountered in the performance horse. While focusing largely on the performance horse, the mechanical stresses in sporting dogs are often similar and principles of evaluation and treatment remain the same and may therefore be extrapolated in many cases.

I frequently have the privilege of helping horses who are showing signs of dysfunction in the TMJ – the Temporomandibular Joint. This is a fancy name for one of the most important joints in the performance horses body; the Jaw.

Symptoms that might suggest your horse is suffering from TMJ dysfunction might include localised pain or tenderness, leaning on the bit, resistance to one direction, poll flexion or one-sidedness, dropping a lot of feed or passing whole grains in his manure, ear or poll shyness, head-shaking, unexplained mild to moderate lameness especially “bridle lameness”, or generally being out of character.
Common management factors such as reduced grazing time and increased grain consumption, feeding from a raised feed trough, routine dental work, the use of various kinds of bits and nosebands can initiate or exacerbate dysfunction in this region. Injuries to the poll, pulling back or hitting the head in the stable or horse box are also common events leading to TMJ dysfunction. Conversely, dysfunction in associated regions can result in compensatory TMJ dysfunction as the horse attempts to work around discomfort in these areas.
The TMJ is an amazing joint, functionally it is involved in the simple act of chewing, the horses sense of balance, as well as being structurally linked to the rest of the body, from the upper neck to potentially as far as the pelvis. Because the function of the lower jaw requires so much movement for day to day survival, structurally it has come to be a complex joint allowing side to side movement, lengthways towards and away from the front teeth (retraction and protraction) as well as opening and closing. The structure of the joint itself is enhanced by strong connective tissue, musculature and nerve supply which supports the joint and enables the movement required. This tissue directly links the jaw to the base of the skull, the upper and lower neck and the structures through the upper respiratory and digestive system. Through the base of the skull run important cranial nerves which are responsible for many higher level functions in the head and the respiratory and digestive systems. The musculature from the upper neck functionally links the TMJ to the shoulder through both gross motor muscles and small deep postural muscles. The connective tissue of the TMJ also has slips to the connective tissue surrounding the spinal cord which ultimately ends at the level of the sacrum in the pelvis, functionally linking the jaw and the pelvis. Due to all these anatomical and functional links, the balance between the two sides of the jaw is integral to the correct functioning of all these systems. As such, when there is a loss of free range of movement and balance in the TMJ, the horse can suffer significant amounts of discomfort and ultimately loss of performance.
Osteopathically, the jaw is a satisfying structure to work with. Bringing balance to the TMJ typically triggers a cascade of improvements in many systems. Certainly, as with any other structure in the body, it is not a cure-all, however its effect locally as well as in functionally associated regions is powerful. Following release of the jaw horses will often yawn or shake their head, their expression often changes to a more relaxed and ‘happy’ demeanor. It is not infrequent to see a total relaxation of the whole horse due to the intimate links between the connective tissue of the jaw and the base of the skull and its cranial nerves. Upon walking the horse out, an increased freedom and length of gait is generally noted, due to the relationship of the jaw to the shoulder as well as the pelvic region through the spinal cord connective tissues.
If your horse is showing any of these signs it is well worth having him assessed for possible TMJ and surrounding dysfunction. As discussed, treatment can result in some huge improvements in performance and attitude. If you have experienced the days you wake up sore or with a headache and yet still have to go out and do your days work, you know how grumpy this can make you. Give your horse the benefit of being free of this kind of discomfort and you might find yourself and your horse coming ahead in leaps and bounds.