23/05/2024
Rehab starts too late and finishes too soon
I was intending on writing a post about kissing spine rehab but when I thought about what I wanted to say it occurred to me that the point I want to make isn’t just about rehab following surgery. it applies to any situation where we have had a change to management and we are aiming to restore normal function.
When we rehab people we get them moving really soon even with major surgery such as hip replacements. People are discharged from hospital on the same day and when they have spinal surgery they’re often walking around the day after their operation.
I understand that we have different factors to consider such as the environment, keeping the wounds clean and the behaviour of the horse but I think we all agree that keeping a horse on box rest for four weeks after having an ISLD- ligament snip operation with not being allowed to start any physiotherapy exercises is far too conservative. I personally believe this is going to limit the potential for rehab.
I am fortunate to work with vets that are really up-to-date on their understanding of recovery and the stages of rehab so I start programs following the veterinary intervention early. However, it frustrates me when I hear that this doesn’t happen around the country or around the globe.
Controlled and progressive loading, with a protocol individualised for each horse starting as soon as possible is essential. Obviously, this must take into account the experience of their owner, the injury or surgery, the environment, the pre-existing injuries, their goals, their facilities and all the other factors that influence designing a rehab plan.
But, a safe low intensity selection of exercises is going to start the progress to resuming function soon, taking advantage of the veterinary intervention and being both mentally and physically productive.
Then at the other end of the time frame, I don't actually think any rehab is ever over! Transitioning to normal work but keeping some of the useful strategies and exercises employed during rehab - scaling these up and down - is for life after injury or surgery.