13/02/2022
There are an extensive selection of gadgets on the market which claim to have a number of functions; helping with pain relief and promoting healing. Some products even claim to cure many common conditions and ailments…
As an owner, it can be a minefield to navigate these products and select a therapy which may benefit your horse. Some therapists will also utilise gadgets as part of their tool kit when they come to treat your horse.
Electrotherapies (or electrophysical agents) are a key component of physiotherapy practice both in the human and veterinary fields, and are essentially machines/gadgets which deliver a form of energy to tissue to promote a number of functions within the body. Common modalities include laser therapy (light energy), ultrasound therapy (sound energy) TENS and NMES (electrical energy).
Recently, I came across a section within a book, written by Mary Bromiley, which discussed the efficacy of electrotherapies in aiding physiotherapists to promote good quality healing and recovery of their patients, but also the importance of having the knowledge of how each electrotherapy works and when to use them. As not only can you have minimal to no effect with the incorrect selection of an electrotherapy, but you can also risk impinging healing and causing cell damage.
Consequently, it was suggested that these machines should be restricted to professionals who have received appropriate training in the understanding and application of these modalities, and that they are not for the lay person.
However over recent years, production companies have made their machines more widely accessible on the market and easier for an owner to purchase. Which for certain conditions, when under the direction of a professional, can lead to effective management of a number of conditions to complement a supervised treatment programme. But, in order to make these products more affordable to the owner, often this has led to a reduction in power output of the machines, and to increase the ease of application, there may be a decrease in the number of treatment settings available on the device.
This means that the scientific studies which have been undertaken over the years which support the efficacy of these therapies, are difficult to apply to some of the products on the market as the treatment parameters are so different. Consequently, this brings into question whether these devices are able to make significant difference if we have no means by which to compare them.
Each electrotherapy has a specific setting for different conditions and stages of healing, and they are also best suited to certain tissue types and regions of the body. It is down to a professional to use their clinical reasoning to determine the most appropriate modality and the correct treatment setting with regard to the condition of the tissue; its stage of healing; composition; and degree of pain.
But for many of the gadgets marketed to owners, it is very much one setting treats all. Albeit, if a massage device is bought with the intention of relaxing a horse and there is not the expectation that it will heal a tendon, then there is no problem with this - the machine will perform adequately. But it is wise to be wary of any device which claims to treat (or even cure) a large list of ailments.
Arguably, the TENS machine has only two treatment settings which we use for horses; the pain gate mechanism and the option mechanism. Both of which aim to provide pain relief. But that is the function of the TENS machine; for pain relief. We do not expect the TENS to heal a wound.
Over recent years there have been an increasing number of adverts for a number of “Massage Gun” devices which have appeared on the market. While massage is usually beneficial to horses, and may well be prescribed by a veterinary physiotherapist as owner homework, caution should be observed when applying these devices.
These devices are likely to feel nice when applied to some areas of the body; you may well discover this yourself if you apply the device to your own aches and pains. Your horse may also appear to respond to them in a similar way to a massage performed by your therapist, and look relaxed.
But, with a horse you do not get the feedback loop which you get as a person. If you hit a sore or sensitive area a person will tell you, or you will naturally avoid putting the device over that area of your body. A horse only has a limited number of ways to say “Ow”, and some horses may not be at all vocal about experiencing discomfort.
Furthermore, there are a number of circumstances when massage should not be applied to the body, such as over regions of the body where there are underlying boney prominences - as this can cause discomfort. I have seen a number of videos of owners applying the device over the wither region, which as many therapists will know can be very sore. But this depends on the condition of the muscles in this region of your horse's back, which can only be determined with experienced palpation. As you travel further back to the front of the saddle region, application of these devices can risk damaging the delicate cartilage of the scapula which lies under this region.
It is often palpation of the tissues which directs the decision of which electrotherapy will be most appropriate to use. To be effective, we must ensure that we select an electrotherapy appropriate to the tissue type, stage of healing and location of the body, and that the correct treatment setting is applied. Apart from avoiding contraindications associated with each therapy, we also risk withholding the appropriate treatment for a condition which risks delaying healing and making the problem worse.
Furthermore we must also bear in mind the incredible ability of the body to heal itself. So while it may look like a certain machine is helping to promote healing, it may just be the body undergoing the natural healing process. In the example of wound healing, if the wound is in ideal circumstances (on the body with a good blood supply and kept clean) the wound will naturally heal quicker than a leg wound which has a limited blood supply, and may be difficult to keep clean and which increases the risk of infection. Regardless of any machine applied, it is likely that a wound on the body will always heal better than a leg wound.
So while these machines can be very effective in improving healing (but not speeding up the process of healing), they must only be applied under the guidance of an individual who understands their mechanism of action and has the knowledge to apply them in a safe and effective manner.
Trust your therapist to appropriately select and apply these gadgets to your horse, to promote healing and help with your horse’s rehabilitation. Every therapist should be able to explain how each machine works and influences the body, and why they have selected this particular modality for your horse. By all means also ask them about any devices which you may have found online, or have seen advertised, before you make a purchase. They will either support the device or recommend a better device for you to use. At the end of the day it will save you from wasting your money, and most importantly potentially save your horse from discomfort or delayed healing.