Animal Physio South West

15/08/2023

04/03/2023

If anyone, anywhere tells you to pull the horses head down (or uses leverage and gadgets to do so) they have no knowledge of healthy horse biomechanics or of correct training.
The horse's nose must always lead, with the poll highest and the gullet open. The base of the ears mustn't be lower than the withers. The jaw must be mobile. If the horse cannot chew and swallow, the hindlegs cannot operate correctly. If the hindlegs cannot operate correctly, the horse will not be able to jump, or stay off the forehand, or stay sound.
"Don’t be obsessed with the head and neck, learn to feel what the hindquarters are doing." ~ Glenys Shandley

01/02/2023

26/01/2023

I've heard numerous things over the last few months that seriously make my heart break. I have been to horses that have been in pain, and clearly being trying to convey this yet I'm being told some reputable trainers are telling the riders to 'show them whose boss' , 'they're just being naughty', and encouraging the use of bigger spurs, bigger bits, harsh gadgets and even one person suggesting to use spiked bit rings... What the actual?!
Most of my clients are amateurs, they're amazing, they seek guidance from professionals and act on it. But when that guidance is of the above nature it saddens me. Thankfully the ones I've spoken to haven't taken the advice, and instead sought help from me, but why in the 21st century is this 'advice' being dished out when we know so much about horse behaviour and it's link to pain?
Instead, why are we not saying:
'oh your horse is a little strong today, let's work on your seat and communication'
'your horse is a little unresponsive today, lets work on your leg aid'
'Your horse isn't flexing very well, let's work on suppleness exercises'
'Your horse is showing adverse behaviour/ struggling which could be a sign of pain, lets get him checked out'
A horse doesn't 'misbehave' for no reason. It's either in pain, scared or doesn't understand the question being asked, they're not vindictive.

So please, can we start listening to the horses, educating ourselves and stop looking for quick fixes.

You wouldn't tie your child up and smack it with a whip, kick it with spurs if they weren't 'listening' or didn't understand what you we're asking so why do we feel that is acceptable for our horses.

And to owners, parents, riders, if you are given this sort of advice walk away, there are plenty trainers out there who are there for the welfare of the horse, these are the people you want teaching you. If you want to read more about the horse pain ethogram follow the links below
https://youtu.be/hrZgtrqbMVI
https://beva.onlinelibrary.wiley.com/doi/epdf/10.1111/eve.13468

lastly, Thank you to the compassionate trainers out there ❤️

17/01/2023

Jean Luc wrote this in 2014, he says he would explain different now, but is accurate.
Gravity
By
Jean Luc Cornille
"The major problem that the horse has. The major problem that all terrestrial animals have. The major work that they do throughout their lives is resisting gravity. Resisting the accelerations of gravity which tend to drive them down to earth.'" (James R. Rooney, 1971)

And the pathologist explains how the fascicles of the main back muscles, the multifidus, are oriented oblique down and back, while those of the longissimus dorsi are oriented oblique down and forward. Their coordinated action creates vertical forces that cancel the attraction of gravity.


Basically and very schematically, the fascicles of the main back muscles are oriented, as illustrated in this picture with the two black arrows. The angle of the fascicles allows for the creation of horizontal forces and presses the vertebrae against each other, which results in the greater transmission of horizontal forces, i.e., "forward movement." The angle of the fascicles also permits the creation of upward forces resisting the attraction of gravity and facilitating "balance control."


Gravity is always pulling the horse's thoracolumbar spine down to earth. Richard Tucker, who in 1964 authored the first dynamic study of the equine vertebral column, explained that while one side of the body is supported by the foreleg in the stance phase (upward thrust), the other side is pulled down by the attraction of gravity, (downward thrust). "Rotary forces are always complicated by the existence of transversal forces which result in a downward thrust on any particle situated on one side of the section and an upward thrust on particles situated on the other side." Richard Tucker, Biomechanical characteristics of the Thoraco-lumbar Curvature. Vol VIII, 3: 45-72. BIALOWIEZA. 15. X. 1964"

Anyone following our discussions knows that lateral bending of the equine thoracolumbar spine is always coupled with transversal rotation movement. Even if initiated in the thoracic vertebrae, transversal rotations involve the ribs, the sternum, and the muscular system supporting the trunk between the forelegs. The claim that muscular or myofascial release can enhance lateral bending is from la-la land where gravity is nonexistent. Whenever the horse's thoracolumbar column is bend right or left, the muscular system has to resist gravity, and gravity is not resisted releasing or even reducing muscle tone. The thoracolumbar spine bends laterally right and left in synchronization with limb movements at the walk and the trot. Lateral bending occurs mainly between T9 and T16, but there is also a small capacity of lateroflexion between L1 and L5. Transversal rotations occur mainly between T9 and T14. Lateral bending is not achieved by contracting one side and releasing the other side. This is a very naïve claim. Lateroflexion and associated rotation are the outcome of a complex orchestration of force production, and therefore muscular work dealing with many components and is created while resisting gravity.


"The reflex contractions of the spinal column muscles compensate for the bending of the spinal column. This is a characteristic behavior of the spine stabilizing system during human movement. As a result, even small compensatory difference between the right and left side causes permanent asymmetric, dynamic overloading of the soft tissue." (Ober J. K. 1974, A dynamic concept for the diagnosis of idiopathic scoliosis. In; Biomechanics IV. Proceeding of the 4th International Seminar of Biomechanics. Eds R. C. Nelson & C. A. Moorhouse, Macmillan Press Ltd, London & Basingstoke.) This is the fundamental principle of spine stability. For any muscular work bending the thoracic spine, there is a compensatory contraction stabilizing the structure.


Lateral bending is always coupled with a transversal rotation shifting the dorsal spines toward the inside of the bend. The ribs are attached to the vertebral bodies via two heads. Therefore, even if axial rotation is initiated in the thoracic vertebrae, it induces a pendular movement of the ribs and sternum, demanding work of the muscular system supporting the trunk between the forelegs. This muscular system induces a lift associated with each rotation. This is partially due to the attachment of the main pectoral muscles situated around the elbow and, therefore, higher than their insertion on the sternum. A great part of this muscular work is resisting accelerations that are produced when the effect of gravity is accelerated by other forces such as inertia. One can now understand why releasing pectoral muscles would be detrimental to the horse locomotion. A significant part of the protraction of the limbs is the elastic recoil of energy stored in the tendons and aponeurosis during the stance phase. This elastic strain energy is enhanced by the resistance of the correspondent muscles. The capacity of storing elastic strain energy in the tendons and aponeurosis is hampered when the correspondent muscles are underdeveloped or released.


The work of the muscular system is incredibly sophisticated and complex. This work is more likely disrupted by local or overall muscle release than it is enhanced. There is no question that myofascial release or other therapies are useful in case of strain, spasm, or other similar issues. What is misuse is when therapies are used to cover trainers' incompetence. An overall release of the muscle tone might minimize the horse's resistance when asked to perform lateral bending, half pass, or other movements without adequate muscular development and coordination. The cover-up serves the rider but exposes the horse to instability, dysfunction, and consequently lameness. The value of a training approach is precisely its ability to develop and efficiently coordinate the horse's physique for the athletic demand of the performance. As long as we look at muscles as moving bones through shortening or lengthening, we have a superficial perception that can be satisfied by theories that feel-good generalities with no basis in reality. Once we start to understand the complexity of the muscular work, we develop a totally different picture in our brain and, thus, a much more sophisticated perspective.

During a previous discussion about the psoas, we have briefly referred to the elastic energy stored in the aponeurosis of the tensor fascia lata and how this elastic strain energy was a significant part of the mechanism swinging the hind leg forward. Since today we are on the forelegs, a brief explanation of the catapult mechanism of the biceps brachii might help us understand why simplistic theories such as touching the limbs with a whip or releasing muscles before work is feeding our fantasies but failing the horses. The fibers of the biceps brachii are short and have little scope for length change. The muscle fibers can only shorten slowly and, therefore, cannot create the rapid limb protraction demanded during the swing phase at the trot or the canter. The biceps do have a thick internal tendon that stores elastic strain energy during the stance. The energy stored in the internal tendon is then rapidly released as soon as the hoof clears the ground catapulting the front limb forward into the swing phase. The muscle fibers alone are too slow for the rapidness of the limb protraction. This ingenious mechanism is referred to as a "catapult mechanism." The contractile elements of the biceps, the muscle cells or fibers, and the internal tendon are referred to as a muscle-tendon unit (MTU). During the stance phase, the biceps' short fibers modulate the amount of energy stored in the internal tendon. "The modulation of elastic energy stored and returned by biceps is important for changes in everyday movement patterns; for example, the sum of the potential and kinetic energy required for protraction of the limb during the entire swing phase of trot is approximately only 30% of that required in gallop". (Wilson et al., 2003) The contractile elements of the biceps, the fibers, have the capacity to modulate the tension of the internal tendon to match the demands of each gait, the transitions from one gait to the other, and the variables within each gait. The nervous system changes the number and distribution of muscle fibers activated in order to create a tension of the internal tendon appropriate for the swing and, therefore, the next stride. As we ask a down transition canter to trot, the horse's brain activates the number and distribution of the muscle cells needed to create a tension of the internal tendon appropriate for the upcoming swing, which demands 30% less energy at the trot than at the canter. This is why I always teach, when you are working a transition, for example, canter to trot or trot to walk if you think about improving the walk once the horse has completed the transition, your horse's brain is ahead of yours. If you want to be effective, coordinate your body for the walk before the horse even walks.


The horse's physique is a piece of art. It deserves respect and knowledge. It is insulting for such a sophisticated biological mechanism to be treated with primitive theories such as the one rein stop, the whip on the limbs, the relaxation theories, and so on. The horse's physique is a masterpiece that deserves true masters. A true master does not live in the past. A true master is you, competitive rider, classical rider, backyard rider, or therapist who respects the horse enough to upgrade your education to actual knowledge of the equine locomotor mechanism. It is for you that we have created the IHTC.
Jean Luc
12/18/14 https://www.scienceofmotion.com/documents/gravity.html

08/01/2023

There is HOPE for horses with Shivers and Stringhalt.

In an edition of Equine Research Refresh, I found myself once again drawn to an article on movement and the forces that shape it. And, as we all know, reading research can lead us down a rabbit hole as we dive ever deeper into topics that have little to do with the original paper. This week, the rabbit hole delightfully led me to work done by Dr Stephanie Valberg on the fascinating condition known as Shivers.

Let’s explore this condition, both what is already known and what has recently come to light through the work of Dr Valberg and her team, as well as others.

🎤 What is Shivers?
Shivers is a condition affecting large breed horses, including warmbloods, thoroughbreds and draft horses. In the years when horses were used as the primary form of transportation and work, Shivers was common – ‘as common as dirt’, as a 1962 neuropathy textbook states. Geldings over 16.3hh are overrepresented in the population of horses with this condition. It typically develops in horses aged between 2 and 10 years, and most often in horses aged 5 to 7 years.

🎭 Presentation:
Shivers will initially present as hypertonic muscle contractions and protracted abduction and hyperflexion of the hind limbs when horses are asked to walk backward or lift a hind limb for a handler. In the early stages, the forward gait remains normal. Horses have no evidence of proprioceptive or vestibular deficits and can often move and compete normally for many years. In most cases, Shivers will progress slowly, eventually affecting the initiation of forward walking and turning, with intermittent hyperflexion and abduction of the hindlimb and the characteristic trembling or shivering.

We don’t have much information about how the condition progresses over time, but atrophy of the hindquarter and the topline has been reported. In some horses, the condition progresses to the point where they cannot be ridden.

Stress, excitement, transportation, prolonged standing, and changes in footing can all temporarily exacerbate muscle hypertonicity.

🥁 Two variations of Shivers
On evaluation of video footage sent in from almost 100 owners with Shivers-affected horses, Dr Valberg identified two variations of the condition:

Hyperflexion, during which the hind limb will hyperflex and abduct, with muscle trembling, then pause and return to the ground at a normal or increased speed.
Hyperextension, resulting in extreme difficulty in walking backward, with only a few backward strides possible and a noticeable shuffling gait.

🔬 Pathophysiology
In 2015, Valberg et al. published a paper investigating and identifying the aetiology of Shivers. They were able to establish that Shivers is an end-terminal neuroaxonal degeneration of the deep cerebellar nuclei, resulting in context-specific hypermetria and myoclonus.

They undertook an extensive histopathologic, immunohistochemical and electron microscopic study of the entire central nervous system, the hind limb peripheral nerves and the hind limb musculature of five Shivers-affected horses. Within the cerebellar nuclei of the Shivers horses, there was axonal degeneration of the Purkinje cells. Additionally, the end terminals of the Purkinje cells within the nucleus lateralis appeared to be reduced in the Shivers horses.

Axons of Purkinje cells are the sole efferent output from the cerebellum, and their pattern of connections in the cerebellar nuclei roughly maintains the temporal and spatial features of the cerebellum itself. The dorsal portion of the lateral cerebellar nucleus projects into the primary motor and premotor areas of the cerebral cortex, which play a key role in modulating voluntary movement of the extremities. Focal axonal degeneration within the lateral cerebellar nuclei in Shivers horses could explain the specificity of the gait disorder, affecting slow and learned movements.

Shivers horses have an increased type 2A to 2B muscle fibre ratio, a finding also seen in horses undergoing training. This can be as a result of constant muscle fibre recruitment induced by myoclonus.

💪 Muscle recruitment
In 2017 the research continued, with Dr Valberg and colleagues investigating the muscle recruitment patterns in Shivers horses through surface EMG. For the first time, the researchers were able to determine that Shivers horses had a severely affected muscle recruitment pattern in the hindlimbs. This pattern was characterised by sustained, elevated levels of activation, a loss of temporal modulation and loss of the precise firing patterns that are normal in a coordinated and controlled gait.

Unlike the control horses, Shivers horses showed large variations in temporal activity, making it difficult to identify precise firing patterns in individual muscles. These abnormal muscle recruitment patterns occurred throughout the stride cycle during backward walking. Temporal modulation was either completely absent, or masked by uncontrolled co-contraction of flexor and extensor muscles, resulting in disordered bursts of muscle activation or continuous tonic muscle activity throughout the stride. This finding correlates well with the fixed hyper flexed or hyper extended hindlimb posture we see during backward walking of these horses.

In addition to the findings regarding backward movement, abnormalities in the muscle firing patterns were also found in forward walking. This indicates that although clinical signs might not appear to be present, there are indeed abnormalities in motor unit recruitment patterns in the forward gaits.

🎠 Where does that leave us?
We now have some really great, super-valuable information, even though the research is still in its infancy and has involved only a small number of horses. There is obviously a great deal more to learn about the condition before we can move on to treating or slowing the progression of Shivers in our equine patients, but naturally the treatment of this condition interests me as a Vetrehabber.

I have all sorts of questions: What are the main treatment goals for this condition? How would we target these patients? And if we could improve the muscle firing patterns in the hindlimbs – if we could improve the fine motor and learned behaviours – would we slow the degeneration of the Purkinje cells?

I’d love to hear from you. How much experience do you have in treating horses with Shivers? What are your goals and how do you effectively and safely achieve them with these rather interesting horses?

📚 Resources:
I am very grateful to Dr Stephanie Valberg and others for her research. Since she has made it all open access, look them up! They’re well worth a read!

Abnormal locomotor muscle recruitment activity is present in horses with shivering and Purkinje cell distal axonopathy, Aman et al 2018

Stringhalt, Shivers, and Other Hard-to-Classify Movement Disorders, MacKay, et al.

The Equine Movement Disorder ‘‘Shivers’’ Is Associated With Selective Cerebellar Purkinje Cell Axonal Degeneration, Valberg et al, 2015.

Three-Dimensional Kinematic Motion Analysis of Shivers in Horses: A Pilot Study, Seino et al, 2019

Shivers and Movement Disorders, Stephanie J Valberg DVM PhD Diplomate CVIM, ACVSMR

07/01/2023

Your horse's tail is an extension of his spine.

Using tail exercises not only affects the tail itself but also the spine all the way forward, including the back.

Tail exercises can :-
🐎 Stretch the muscles, fascia, tendons, ligaments and connective tissues within the spine
🐎 Help influence the horse's balance and centre of mass, stimulating recruitment of core postural muscles
🐎 Encourage relaxation within the spine
🐎 Help with realignment of the spine
🐎 Influence nervous system connections

For tips and exercises to do with your own horse watch the FREE Tail Exercises tutorial video available in the HIO Academy* - visit www.horsesinsideout.com/academy
*you do need to be a member of the HIO Academy to view this video (it's FREE to sign up)

16/08/2022

Boots and bandages - are we harming our horses as we try to protect them?

Bandaging and booting our horses is becoming more and more popular, especially with the popularity of matchy matchy sets. But are we doing more harm than good? Most people will have come across the articles in magazines and comments from vets saying they are, and yet still they become more and more popular. Why is that? Why do riders still cover their horses in thick fleece bandages or fluffy boots despite the dangers? Tradition I suppose. Wanting to fit in. Or just habit, some will feel like they haven’t finished tacking up if they haven’t put the boots on.

I know this isn’t about dentistry (for which I apologise) but I am a vet first and foremost, and as a dressage rider I am asked why I don’t use bandages all the time. I’ve written about this several times now and no one pays attention, so rather than stating facts and quoting research, I’d like to take you through my journey of discovery, please bear with me. Facts and papers are at the end.

Rewind 12 years and I was in my final year at vet school. Prior to and during vet school I had a horse and we did dressage. I had planned to ODE but this horse pulled every tendon and ligament known to vet kind. He spent more time out of work than in. Each time I would up my game with the latest boots/bandages on the market. From fluffy boots to wraps to sports fetlock boots, fleece bandages to gamgee and cotton to the half fleece/half elastic bandages. I learnt new techniques for better support, figure of 8 bandaging to cradle the fetlock etc etc. I’d been there and done it. My collection was extensive.

Right at the end of vet school I had my rotations. I chose Equine lameness as one of my options. During in this I very vividly remember a wet lab with Dr Renate Weller where she had a skinned horses leg (showing all of the tendons and ligaments) in a machine that mimicked the pressures a horse applies to their limbs. She took us through walk, trot, canter and gallop, loading this leg so we could see the inside workings of the horses leg without the skin. It was fascinating I can tell you, and I very clearly remember thinking about my horse and wondering how on earth we are suppose to support this limb when it undergoes these incredible forces! Half a ton of animal pushing down a tiny spindle of a leg held by tendons barely thicker than my thumb. Craziness!

Fast forward just a few short months and I was a fully qualified vet in the big wide world. I attended my first BEVA Congress and during the break I wandered around the stalls looking at the latest inventions and technologies companies bring to these gatherings. Here I came across a company with the Equestride Boot which caught my eye. Now if you haven’t seen this boot, it’s wonderful and I’ve since used it a few times in rehabbing very severe tendon and ligament injuries with great success. The boot is a carbon fibre boot that stops the fetlock dropping, which stops the tendons and ligaments being fully loaded while they heal. This boot is super strong. You couldn’t ride a horse in it as it is limiting the range of motion so much, but they can move about easily enough at the lower settings to rehab etc. The guy on the stand (I’m afraid I can’t remember his name) showed me their research and in the straight talking Irish way explained the stupidity of expecting a thin piece of material to support a horse. And of course it can’t! Literally no bandage or boot (short of this very expensive carbon fibre rehab boot) is capable of reducing the amount the fetlock drops. Thinking back to Dr Weller’s demonstration, I could very clearly see how ridiculous I had been to ever believe a scrap of material could do anything to reduce or support that pressure.

But the boots/bandages don’t actually cause any harm do they? Surely it’s ok to use them on the off chance they might help and if we look good in the meantime, great! Well, not long after this, research started appearing that got me very worried about my bandage collection. Heat. Anyone that uses bandages and boots will not be surprised to see sweat marks under their bandages/boots after they’ve been removed. They trap a lot of heat. The horses body and legs generate a lot of heat when working. The tendons/ligaments in the leg, along with an increased blood flow generate ALOT of heat. Fleece bandages/boots in particular, hold this heat in the horses leg. Very few boots and virtually no bandages (especially if you use a pad under) allow the legs to breath adequately. This heat is easily enough to kill tendon/ligament cells. Each tendon/ligament is made of thousands and thousands of cells all lined up end on end and side by side in long thin spindles. They stretch and return to their original shape and size like an elastic band, absorbing and redistributing the pressures applied from further up the leg and from the ground impact below. All of these cells must work together as one to do this effectively.

Just a little side step here to explain how tendons/ligaments heal. A tendon/ligament cell can not be replaced like for like. They always heal with scar tissue. This is why reinjury is so much more likely if a tendon/ligament is blown. The fibrous scar tissue doesn’t stretch, it isn’t capable of stretching or absorbing the impact of a horses movement. It will always be a weak spot. In a full blown sprain/strain the whole (or most) of the tendon has been damaged. But this heat injury might just kill a few cells at a time. Those few cells are replaced by fibrous scar tissue, then next time a few more etc etc. Like a rubber band degrading over time the tendon/ligament loses its elasticity and eventually goes snap. Then you’ve fully blown a tendon/ligament. The injury didn’t start to happen at that moment, but that was the final straw. The damage adds up over time, each time thermal necrosis (vet word for cell death) occurs.

So if using boots/bandages can not offer any sort of support, and using them generates heat that slowly damages the tendons/ligaments until they give way. Why use them? Protection. This is the only reason to use boots. To stop the horse brushing, injuring themselves catching a pole or over cross country. But for goodness sake make sure your boots are breathable! If the horse is sweaty under the boot but not above or below, the boot is not breathable enough. And don’t use fleece bandages just because you like the colour. These fleece bandages are the worst at holding heat in the leg, way above the threshold for thermal necrosis to the cells of the tendons and ligaments. If your horse doesn’t need protection, don’t use boots. I haven’t for the last 12 years and *touch wood* I haven’t had a single tendon/ligament injury in any of my horses. I will never go back to boots or especially bandages now. I don’t use them for schooling, lunging, jumping, travelling, turnout, stable, in fact I don’t use them at all. Ever. But I don’t hunt or XC.

I hope you have found my story useful and can make informed decisions on boots and bandaging going forward.

For more information on the Equestride boot and their research into support offered by boots and bandages, visit http://www.equestride.com/ and https://www.equinetendon.com/services/equestride/

The horses leg under the compression machine at the Irish Equine rehabilitation and fitness centre https://fb.watch/cmVMt6-iOJ/ (I highly recommend you watch this incredible video. It clearly shows the amount of force the leg goes through and demonstrates the real purpose of boots)

Other relevant papers-
https://equimanagement.com/.amp/articles/horse-skin-temperature-under-boots-after-exercise
https://pdfs.semanticscholar.org/8f15/0ea480edca142260d01f419f80d2e7e7fb29.pdf
http://www.asbweb.org/conferences/1990s/1998/59/index.html

Edit 1 - I am getting asked about stable wraps very frequently. This post is about riding, the tendons and blood flow create heat which is trapped by bandages/boots during exercise. This doesn’t occur in the stable stood still. If the horse has a strain/sprain resulting in inflammation, then there is an increase in blood flow and there is heat being created. In this situation you should not be bandaging. But if it’s cold and an old horse needs stable wraps to keep the joints warm and improve sluggish blood flow (filled legs) you can use the heat trapping to your advantage. But you need to be careful in summer.

Edit 2 - the other thing I’m being asked about is compression. Compression DOES NOT control inflammation. The inflammation still occurs, but the swelling can not escape the bandages and the increase in internal pressure reduces blood flow, causing ischemic damage. Like laminitis within the hoof. The hoof capsule prevents swelling so the inflammation expands inwards and cuts off the blood supply. This is why laminitis is so painful and difficult to treat. Compression is only useful in the case of leaky vessels, for example reduced blood pressure, reduced movement so the blood isn’t being pumped backup the legs, or osmotic imbalances eg low protein with diarrhoea. In these situations, compression of the legs can encourage blood to return to the vessels and continue circulating.