26/04/2025
CASE STUDY OF THE MONTH
Because many people ask,
âWHAT IS OSTEOPATHY AND WHAT DOES AN OSTEOPATH DO?â,
I started a (bi-) monthly case study series to illustrate how it works and what it could do from the perspective of a WHOLE HORSE approach.
CASE STUDY #2, MOOSE
During our trip in Oregon, earlier this month, Rachel Ashworth (equine osteopath) and I saw Moose for the third time. We had worked with him twice before and had found some important puzzle pieces in understanding his situation.
The first time we saw him together was in March 2024 (Rachel had seen him before and put him on the list for a combined visit). He was a 14yr old Tennessee Walker gelding, owned by Erica for the past 2 ½ yrs. He came with the history of flipping over once in the cross ties when he was young, causing a neck injury. This led to a fused C2-C3 (2nd and 3rd neck vertebrae). Other than that, he had no known issues.
Erica purchased him for trail riding. He had a very sweet and willing demeanor, but was extremely tense under saddle. He tripped on the right front when ridden and would often blow up, trying to convince the rider to get off.
Upon checking his body and teeth, something felt very off. His innate pattern of a right dominant horse was clearly visible in his front feet, base of the neck, shoulder blades and incisors (front teeth). These areas of compensation were all matching and in line with each other, it made sense, no problem there.
But there was a different pattern as well and this one did not make sense initially. What was going on here? Why had the body created this different compensation pattern?
Looking at his face straight on, it was bend to the right, like a banana, and rotated right, with his right nostril higher than the left and his right eye socket rotated right. His right TMJ and temporal bone were not moving in any way and felt âdented inâ. His incisors (front teeth) had a slight slant, which matched his innate pattern, nothing remarkable there, but his molars were a different story. The left side of his mouth was pretty normal. But his right lower molars were enormous, twice as high as the left side. This was a mystery. What was causing these teeth to erupt so much more than the rest of the mouth? Or maybe they were not wearing down enough? We recommended x-rays of his skull, TMJâs and teeth to hopefully get some answers.
Based on the x-rays, the vet diagnosed him with arthritis in the right TMJ. An osteopath looks at x-rays as well, not to diagnose pathology (thatâs the expertise of the vet), but to look at joint positions and opening/exit spaces for nerves and circulation (blood vessels and lymph) to understand possible issues in fluid flow and nerve signaling.
Looking at the x-rays from osteopathic perspective, it showed the joint in the center of his skull (SSB) had shifted. This joint isnât fused yet in young horses and is therefore movable, for example with an impact on the skull. This made us believe it had most likely happened at the time he flipped over in the cross ties when he was young. The direction of the shift correlated with the bend in his face (the sphenoid determines the position of the upper jaw/maxilla) and the âdented inâ position of the right temporal bone and TMJ. Over time, this might have caused the TMJ arthritis which was diagnosed by the vet.
It also showed the opening space for some important cranial nerves to be almost closed, due to this shifted bone. One of the nerves running through this space is the Trigeminal nerve-the mandibular branch. This branch innervates the right lower jaw and right lower teeth. Our take on these enormous lower molars was now twofold; due to the shift in the upper jaw, top and bottom molars werenât matching anymore, causing them not to wear down. At the same time, an irritation/overactivation on the Trigeminal nerve was possibly causing these lower teeth to erupt much faster than usual.
The Trigeminal nerve also innervates the sheath around the brain and the spinal cord (dura mater). When overly activated, this sheath tightens, resulting in tension on the brain and entire spinal cord; like a jacket that is too tight and limits movement. This was most likely aggravated with a rider on his back, resulting in his behavior to try and get the person off.
All these changes and tension on the right side of his head, brain and spinal cord have an effect on his proprioception as well (knowing where your body parts are in relation to each other and space) and most likely the cause of his tripping on the right front leg.
We now had a better understanding of his body and behavior, but also realized no major changes were possible. What was created by the body as a result of the impact at a young age, needed to be respected. We worked with him from that perspective, trying to alleviate as much tension as possible.
Since then, Erica has retired him from riding. He enjoys hanging out in the herd and being ponied on the trails with his buddies.
Sometimes the best way to help, is to help find answers.
Osteopathy could be a part of the collaborative effort in figuring out the puzzle.
