Performance Veterinary Physiotherapy

08/11/2024

I have a few spaces for next week;

Tuesday 12th - Martham/Great Yarmouth FULL
Wednesday 13th - FULL
Thursday 14th - Essex (Colchester) midday and 14.30

Please text/whatsapp 07717661084

03/11/2024

IAVRPT Closing Panel - ‘Regulation of Veterinary Physiotherapy Globally’

I was looking forward to this panel, and I must say incredibly disappointed with IAVRPT for giving a very one-sided take on this topic. Every member of the panel was a human-first practitioner, and obvious bias showed.

It is clear that more regulation of the industry is required. I fully support that. However, I do not believe that the requirement for a human physiotherapy qualification has that much impact on the overall ability of a veterinary physiotherapist in practice. What we need to concentrate on as an industry is the removal of underdeveloped and inadequate courses, many of which are online-only, and standardise other body-work qualification such as equine/canine massage courses, do give them more credibility within the industry.

This seems to be a worldwide issue, and I feel so sorry for those in countries who have resolutely stuck to a human-first model. There is absolutely no way I would ever want to undertake a human physiotherapy degree, and I am not alone in that feeling. I know of people who have suffered through and scraped a pass in a human qualification purely to get onto a veterinary path… Surely this is unproductive - in the UK you can get a 2.2 with 50% pass mark on a 3 year human physiotherapy degree, which enables you to go on and study a ONE YEAR veterinary physiotherapy postgraduate course, consisting of 20 practical teaching days….

If we compare that to the TOCES course, which lasts 4 years, consisting of 13 in-person teaching blocks, approximately 52 days of hands on tuition, as well as needing to accrue 1000 practical hours over the course… and remember this is Equine specific, so that is 52 days on ONE species…. I am known for being a harsh examiner, and I do maintain a high standard of qualification. I am confident, when passing a student on their final practical exam, that they are ready to fly solo.

Can we please stop this need to promote human-first as ‘gold standard’ when in fact any OFQUAL regulated course should be considered Gold Standard. Why should people be forced to spend 3 years studying a species they have no interest in, and which has little extrapolation to the veterinary field? When talking with a vet at the symposium, he gave some very good points that there is minimal crossover between bipedal (human) and quadrupedal physiotherapy, and that doctors and vets are not interchangeable with a one year extension, so why should physiotherapy be…?

I hope that one day there will be a Veterinary Physiotherapy industry which can stand alone, without the need for prerequisites in the human world, and without the back-biting and superiority complexes I see regularly in the UK, and now worldwide.

02/11/2024

IAVRPT Symposium - Day 4

My biggest take away from the last 4 days is a realisation that I miss research. For those who do not know, I worked heavily in R&D under GRP and GLP for many years, and absolutely loved being at the cutting edge of new technologies and chemistry.

Listening to research projects being presented today, and having talked to several veterinary surgeons last night at the gala dinner about the lack of clinical studies in rehabilitation and physiotherapy has given me food for thought. Unfortunately research can be expensive, and there are few companies willing to invest funds in supporting clinical studies, which is a real shame. As TOCES is not a research facility, and receives no research grants, this means everything must be self-funded. That said, I do have some research ideas, and a renewed enthusiasm, so watch this space!

Some very interesting subjects explored today, and it has also added other items to my ‘to-do’ list, most of which will benefit students at TOCES as well as my own clients.

A very informative lecture from Dr Tom Ovendale on the signs and causes in neuro cases was the stand-out for me today. Dr Matt Brunke’s take on Librela and other OA management strategies was another lecture I took a lot away from. Having recently started giving my own dog Librela,it does astound me how many veterinary surgeons are mis-informed on this wonder drug in the UK, and how often I am seeing it administered incorrectly.

The closing panel of the symposium was entitled ‘Regulation of Vet Physio globally’, but I feel this needs its own post as there was an awful lot to digest and take away from this debate… Stay tuned for that one…

It’s been a busy few days, and I am flying home having learned a lot, met some fabulous people, and ready for a holiday…. Tomorrow I begin the epic 19hr journey home, ready to be back at TOCES lecturing on Tuesday morning!

01/11/2024

IAVRPT Symposium - Day 3

Asymmetry. Laterality. Lameness. These were very much the buzzwords of the day.

Within the industry, we are often discussing what the differentiation between these things are. It seems that there is no definitive answer, and the debate is ongoing and fluid. Some researcher’s tolerance for ‘threshold’ is greater than others, and it is clear that many factors should be taken into account rather than just how a horse trots on a straight line or a circle.

There are many tools available now to help vets and therapists to understand gait and asymmetry. Within the UK, the Veterinary Surgeons Act prevents anyone other than a vet from making a lameness diagnosis, but does this mean that therapists should not be able to monitor or comment on asymmetry and lameness when they see it? Especially if validated software is being utilised to objectively make that assessment. It is within scope of a therapist to say there is a lameness, and refer on to a vet, in my opinion. However, no therapists should be offering their assessment of WHY a horse might be lame - that is for a veterinary surgeon to work out, using the vast array of tools at their disposal.

With the increase of technology available, should we be making better use of it in our day to day practice? If so, who bears the brunt of this cost?

How can therapists make significant investment in their business, when there are few clients willing to pay extra for this additional investment?

It is becoming more apparent that rehabilitation is being taken more seriously, but veterinary professionals and owners alike. Unfortunately we are still unable to offer much in the way of objective measurement to guide rehabilitation plans.

A lot of food for thought today, and a lot of technology that had me wanting to reach for my credit card. However, with my own practice at full capacity, I cannot see a way to add any more investment without passing the cost on to clients, and I am not sure this would be viable in the current economic climate in the UK…

I do think I need to have a re-think about my business, and I have some exciting plans for the future…

01/11/2024

IAVRPT Symposium - Day 2

Unity and cohesion within the industry.

I am almost relieved to see this is a worldwide issue, and not just limited to the UK. It is obvious that there are many problems across the industry as a whole, especially when it comes to professionals working together in their intra and interdisciplinary capacities.

What can we do about it?

I loved the analogy today that all Equine Health Professionals act like a group of fisherman trying to fish in the same puddle - all competing for the same fish (clients). Currently there is too much competing and rivalry, and not enough collaboration.

If you work alone, you limit your ability to learn. If you work as a team, you can gain so much perspective and knowledge it benefits everyone around you.

Unfortunately people will always disagree. We will always have preferred modes of working, and people who will clash over certain aspects.

There is a huge lack of research conducted in the veterinary field with regard to physiotherapy and rehabilitation. This is a real shame, but it is often the cost that prohibits extensive research capable of validation from being undertaken. How can we change this? Who can we approach to fund efficacy studies which give credibility to the industry as a whole?

How can vets be better educated about the need for physiotherapy and rehabilitation? Should they be studying it at university? Should there be CPD geared up to give them a better overall picture? Would regulation of Veterinary Physiotherapists by the RCVS help? Currently, many vets are told only to recommend human-first practitioners, but with the wealth of intensive degree and postgraduate level courses now available in the UK, is this shortsighted? Many direct-route practitioners have actually studied for more years than their human-first counterparts (I include myself in this bracket, having completed approximately 8 years of graduate and postgraduate training from a university).

One thing I am sure of now, is that the industry must change. It cannot go on being so divided and hostile. But how do we promote cohesion and unity?

01/11/2024

IAVRPT Symposium Day 1

I travelled to Cape Town with the hope of enhancing my knowledge and skills, as well as making connections with physiotherapists and vets from all over the globe.

Today was spent undertaking a ‘wet lab’ session, entitled ‘Equine Functional Gait Analysis - focusing on identifying the individual ‘fingerprint pattern’ of a horse’s asymmetry over time and explore the relation to function and rider perceived performance’

One thing I often say to students is that when we stand and watch dynamic assessments, everyone sees something slightly different. Today we had 30 people, including some of the best orthopaedic and biomechanical vets in the world, as well as a wealth of physiotherapists and researchers, and I can guarantee that we all saw different things emerging in the horses before us. We must not forget that dynamic assessments are largely SUBJECTIVE .

However, we also used AI led software to map the movement patterns in these horses, as well as evaluating the pros and cons of this method. There was some very interesting debate, and a lot of food for thought.

One thing that stood out today was the overriding agreement that there is a huge difference between asymmetry/functional asymmetry and lameness. The rider’s influence over the horse must also not be underestimated. In addition, compensatory pathways develop over time, and can be cemented by poor neural relays being ingrained.

This has really given me some motivation to finally develop biomechanics clinics for 2025; helping riders to manage their horse’s asymmetry on a day to day basis, rather than just calling for help when it really gets too bad.

Looking forwards to Day 2….

29/10/2024

Fabulous news from The Open College of Equine Studies - a lot of work from the team to get the course OFQUAL approved, making it one of the best courses available in the UK and Internationally 🎉

🆕 In a very exciting development for the equine therapy industry, we are delighted to announce that TOCES is now an accredited centre working with the Ofqual regulated awarding body Open Awards 🆕

Details of our Ofqual regulated Equine Massage and Physiotherapy qualifications will be released soon!

🆕 Watch this space! 🆕

28/10/2024

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My WhatsApp has stopped working. I cannot open or see any messages. If anyone is trying to get in contact, please send me a normal text message. I will be back in the UK on 4th November and hopefully will sort it and catch up with messages then.

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30/09/2024

Diagnosis

Be aware - no one can diagnose your horse’s issues other than a qualified and registered veterinary surgeon.

A body worker cannot tell you that your horse ‘definitely has kissing spine’.

An instructor cannot tell you that your horse ‘definitely has ulcers’

A Thermographer cannot tell you that your horse ‘definitely has arthritis’.

These three things happened to my clients last week!

Whilst we can suggest you seek veterinary diagnosis, it is very unprofessional for anyone other than a vet to start labelling issues, especially without veterinary diagnostic imaging.

Thermography is not a reliable diagnostic modality, and has many flaws in application. Performing it on a yard, with drafts, with dirty/dusty horses, with horses that have only just finished a workout - these are just some of the variables that can affect the outcome.

When the ‘operator’ has no knowledge of anatomy and physiology, uses inferior equipment and then puts the fear of god into you by saying your horse has arthritic changes, these people need reporting to RCVS, not paying!

03/09/2024

Any of these sound familiar?

It takes a lot of courage to stick you head above the parapet and go against the flow.

When you do, you are often gaslighted like the above examples.

Ok, so sometimes it can be jealousy, ignorance and hypocrisy, but a lot of what I see is genuine concern for a sport which is rapidly declining in ethics and morality.

Just because I have never competed at the Olympics, does not mean I am not allowed an opinion on the lame horse passing a vet check, or the discomfort expressed on the face of the horses competing.

Just because I do not like the now normal practices of neurectomies and repeated injections to keep horses climbing the levels (very different to those having treatment to rehab I hasten to add) someone bites back with “you’re too fat to ride” in response… How does bringing up my issue address the primary point?

Just because I can see a horse looking unhappy and a rider oblivious to their horse’s discomfort “### is so happy today” as it jogs away in pain… doesn’t mean I am jealous of your horse/lifestyle….

We need to be allowed to voice concerns in an adult and structured manner without these tit for tat excuses and aggression. Unfortunately this sort of response just leads to the behaviour becoming acceptable and people turning a blind eye.

02/09/2024

I’ve been passionate about dressage for many years - since my teens (so yes, many, many years!!)

Unfortunately I, like many, have witnessed a decline in ethical behaviour in favour of results and popularity. I can no longer stand to watch most international competitors (there are still some good ones out there I hasten to add).

I decided earlier this year to give up my BD membership after over 20 years of support. I no longer feel the organisation has the horse’s best interests at heart sadly. Instead, I have decided to support local, unaffiliated dressage competitions.

Forest Edge has provided a safe and welcoming venue for me over the years since my accident. When I struggled with my confidence, anxiety and all my neurodivergent tendencies, they have always been supportive and friendly. They constantly strive to improve their facilities, whilst ensuring competitions remain affordable and enjoyable for all levels.

I am really looking forward to supporting their winter league, and excited at the AMAZING prizes we will have up for grabs at the championships! My motto is if you’re going to do something, do it right - so expect rugs, sashes, mounted prizegiving and more!!

28/08/2024