Veterinary Physiotherapy Treatments
Veterinary Physiotherapy is the application of manual therapies, electrotherapies and remedial exercise program prescriptions applied to help your animal heal and develop. This functional approach to healing employs highly-trained and research driven knowledge and application of modern, tried and tested protocols.
Animals show pain and discomfort in many different ways; prey animals such as horses also try and cover it up to reduce their exposure as targets to predators (historically). It is a highly-trained skill to determine:
If there is pain or discomfort affecting your horse?
Where that pain or discomfort is?
What can be done to alleviate this and aid return to full health and comfort?
What to expect from your appointment:
The investigation to determine the answer to these questions is extensive, involving assessment of your horse's previous medical history, as well as behavioural, observational and physical presentation of your horse. These assessments include the following:
Static assessment: Conformation and posture analysed when the horse is standing. This includes assessment of hoof balance and body condition scores.
Dynamic assessment: Watching your horse move in walk and trot, potentially on the lunge and under saddle depending on the nature of the complaint.
Palpation: Feeling muscles, bony landmarks and soft tissues of your horse from head-to-toe. Compensation may be hard to pin-point dynamically, but an effective manual assessment can highlight areas of pain and tension that are either directly or indirectly involved in the reason for referral.
Electrotherapies include the machines available to Physiotherapists to target healing in more focussed ways than what our hands alone are capable of. There are several different machines and ways they function that provide this therapy. the following are the examples we have available at Kirk Equine Performance.
LASER works by using light energy to increase the activity in the engine of the cell: the mitochondria. These are an "organelle" of cells (cell's version of an organ!), and are responsible for respiration; which produces the energy used all over ours and our horses’ bodies. When an injury is present, chemicals create bonds within mitochondria which build up, stopping these mitochondria from doing their job efficiently. LASER helps to break down these bonds and the toxic build-up, which provides beneficial results:
Reduction of swelling
Blood vessel growth
Improved chemical composition of that area.
LASER is a popular choice of treatment for trigger points (muscle knots), joint pain, swelling and areas of tension that are too painful to attempt other modalities. This provides a non-invasive and well-accepted method of addressing pain in your horse, making it a vital tool. When your back is stiff, the last thing you want is for it to be hammered, consider your horse in the same way… before they teach you to consider it more severely! This also means the vets may not need to prescribe as much pain relief, meaning that your horses’ livers and kidneys will also be VERY grateful!
LASER light waves are unlike a standard LED; they produce the same wavelength, do not get spread from the light chamber, and create a uniform wave pattern. This characteristic makes these machines specific, effective… and expensive! Smaller “LASERs” are available on the market for less than £200, where the “proper” conventional class 3B ones are upwards of £1500. That price difference is not purely based on the bag it comes in! If someone is treating your horse with LASER and charging as such, it may be worth having a check on what the details of the machine are.
This is a muscle stimulation machine which is incredibly useful and effective at retraining coordination and maintaining muscle function. Pain has potent abilities to alter the contraction ability of muscles. Compensations, new or old, can start to affect a lifetime of muscle function. Imagine the days you’ve twisted your ankle and you limp for a week. Your other leg hurts and your back hurts from compensating. Imagine the pain and the dysfunction you feel when that twisted ankle hurts continually for weeks on end.
Horses may go a long time before we really notice that something is not quite right for them. That means, they may have spent a long time compensating, twisting their pelvis out and clenching their back, to avoid putting full weight on the sore leg. As a result, muscles will have seized up, locked up the painful area and brace the body against using it. The muscle contraction messages could then change, and the muscle function could change as a result. Allowing altered muscle contractions to continue runs the risk of secondary problems, as the body tries to respond to altered posture and muscle because the body starts to alter and respond to the different pressures.
H-wave can effectively re-stimulate the correct muscle sequence (with correct handling of it), WITHOUT fatiguing the muscle. The H-wave mimics the natural waveform that the body uses to contract a muscle; meaning it is generally well tolerated as well as effective. The other huge benefit to this machine is that it is capable of contracting the whole muscleas the electrodes are positioned on the muscle motor point, which is where all the nerve fibres enter a muscle and therefore where any contraction starts.
The H-wave can also be used to target pain relief, but the wave frequency used for this setting is generally poorly tolerated by horses. The “Muscle pump” function with the lower frequency is well tolerated, and also has a pain-relieving effect (thanks to improving the muscle quality).
NMES – Neuromuscular Electrical Stimulation
Similar to H-wave, this is a muscle stimulator. Unlike the NMES, this has a slightly sharper wavelength to create contraction, and it DOES cause fatigue in horses. This machine does however maintain and cause increased muscle strength, stamina and treatment of muscular atrophy.
With both of the muscle stimulation machines (H wave and NMES), neurologically deficit horses could benefit. These machines are able to artificially contract muscles, maintaining their function, reducing the risk of secondary problems such as contracture. Maintaining muscle function also means that fluid movement, lymph drainage, and delivery of fresh nutrients to the tissues of the muscles and surrounds is artificially maintained. This is hugely beneficial as the toxin build up and lack of drainage can cause pain, stiffness and discomfort secondary to the actual injury that is requiring treatment. Furthermore, a horse unable to work or preparing to recommence work after injury may be able to use muscles correctly from the beginning, if the treatment plan has been committed to.
What are Electrotherapies?
H-Wave: Muscle stimulation
This manual treatment affects interstitial pressure and fluid concentrations of the muscles, physically initiating changes. Muscles in pain are likely to have a toxic environment, so massage increases blood-flow and brings fresh nutrients to the treated area. This encourages lymph drainage and pain relief, which in turn improves muscle tone, increases muscle extensibility and flexibility and manually reduces fascial restrictions and tethering.
Effleurage always starts the treatment, followed by more or deeper effleurage, or other techniques such as "Cupping", "hacking/tapping", "Compression" among others, to encourage benefits listed.
This is a vital tool as it provides us as practitioners with valuable information about your horse. We can feel the condition of the tissues being treated, as well as take note of your horse's response which will indicate their pain levels and demonstrate to us how best we should proceed. Sensitivity is key... Sometimes the massage stage of treatment does not appear to demonstrate a lot to you as the owner, but your patience and confidence in our feeling at this stage is crucial for the long-term success of our partnership and ultimately your horse's comfort.
Stretching exercises increase the strength, flexibility and extensibility of the targeted muscles. This can then allow increase in joint ROM, reduce fascial tethering, address fascial restrictions, aid and prevent fibrosis and increase muscle coordination which will encourage blood flow, improving the biochemical environment of the muscles, further improving the ability to strengthen.
The Remedial exercise program stages are often the latter stages of the program. This starts when we are sure that your horse's pain and comfort are under control and they are ready to begin muscle activation and strengthening. A huge variety of exercises are available to choose from for this part of the treatment. Often this depends on your availability as an owner - not all of us can spare hours to walk over endless poles with our horses!
Generally, the options used target:
- Joint Range of Motion
- Muscle Range of contraction and relaxation
- Muscle strengthening
- Bone conditioning - crucial following box rest
- Controlled exercise following box-rest/restricted turnout and exercise
- Ligament and tendon conditioning
- Proprioception (coordination) training and development
- Biomechanics re-education
- Gait improvement