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Veterinary Physiotherapy
What is veterinary physiotherapy?
Equine physiotherapy involves the assessment and treatment of musculoskeletal conditions in horses. It combines movement analysis with knowledge of the anatomy of the musculo-skeletal system in order to identify potential problems.
Chartered Physiotherapists are highly trained in the skilled use of their hands to detect, assess and treat soft tissue injuries that may cause lameness or poor performance. They are also extensively trained in rehabilitation techniques and are able to offer guidance on the best way to successfully rehabilitate your horse.
A variety of soft tissue techniques, joint mobilisation techniques and electrotherapy treatments are incorporated into veterinary physiotherapy treatments as appropriate. This helps your horse to be in the best physical condition, enabling him to perform to the level that you require.
Soft tissue injuries involving muscle, tendon, joint capsule or ligament can be treated successfully with physiotherapy if used correctly and at the right time. Physiotherapy can also aid in the rehabilitation process following orthopaedic surgery. Both spinal and peripheral conditions respond well to physiotherapy.
Physiotherapy is not an alternative but often an essential adjunct to conventional veterinary medicine. Treatment in the early stages of injury is most beneficial and therefore prompt referral to the physiotherapist from the veterinary surgeon is recommended. Many veterinarians do not ask for physiotherapy intervention until all else has failed and the owner is pestering for 'something to be done'. Treatment at this stage is often less effective and this means that 'physiotherapy' is looked upon as a waste of time and money. Physiotherapy should not be thought of as a last resort, it is very effective when used at the appropriate time.
The horse is an athlete whether he is used for light hacking or top level competition. Routine maintenance of the horse's neuromuscular and muscular-skeletal systems will help to ensure he remains in peak condition.
In accordance with the Veterinary Act 1966, it is a requirement that the Physiotherapist has veterinary consent prior to treat your horse. We aim to work as a team alongside your vet, farrier, saddler and trainer to offer your horse the best possible care.
Why does my horse need physio?
Animals can't tell us where their pain is or if they have injured themselves, and they are often clever at hiding their discomfort.
Schooling problems, behavioural problems or reduced performance can all be caused by pain, muscle weakness or joint stiffness. Equally your horse may have suffered a direct injury ad may need rehabilitation to get back to its previous level of workload.
Horses of today are asked to do far more than evolution could have expected, with greater pressure to perform at high standards. It is not surprising that injuries occur. Pain or discomfort in any degree is inhibiting and detracts from the performance ability of the horse. Physiotherapy aims to restore flexibility and normal range of movement in the musculoskeletal system there where movement is restricted and painful. The balance needs to be restored and can be treated successfully with physiotherapy if used correctly and at the right time. The aim is to restore and maintain health, soundness and performance by decreasing pain and by improving movement. Physiotherapy can also aid in the rehabilitation process following orthopaedic surgery.
What causes the problem?
Trauma is often the most obvious cause: e.g. falls, accidents, being cast etc. Other causes include:
- Direct injury or trauma
- Following lameness
- Underlying pathology
- Badly fitting tack
- Poor rider technique
- Lack of fitness
- Foot balance
- Dental problems
- Lack of natural mobility or athletic ability – not all horses are natural gymnasts and
- Some may need help to improve suppleness to reach a higher level of performance
In an event of trauma the muscles compensate. Muscle spasm and tension is the body's way of protecting itself against further injury, but also causes asymmetry along the spine. With time, this affects the balance and performance of the horse.
When to seek help?
- Muscle imbalance/atrophy
- Sore back
- Stiffness and resistance
- Napping, rearing, bucking
- Hollowing and lack of engagement
- Incorrect lead or disunited in canter
- Deterioration in performance
- Difficulty maintaining an outline
- Difficulty in engaging hindquarters
- Reluctant to go forward
- Poor balance during lateral work
- Poor transitions
- Loss of jumping capacity
- Uneven shoe wear
- Poor performance
- Abnormal behaviour
- After an injury
- Post surgery
- Ill fitting saddle
- Lameness
- Pre-post competition
Physiotherapy is not an alternative but often an essential adjunct to conventional veterinary medicine. Treatment in the early stages of injury is most beneficial and therefore prompt referral to the physiotherapist from the veterinary surgeon is recommended.
The consultation: what happens?
A physiotherapy assessment will take up to one hour and a half. A full history is taken followed by a physical examination. This will involve observation of standing posture and symmetry, seeing the horse move in straight lines, on the lunge and often ridden as well. Movement abnormalities are noted. Range of movement of neck, back, fore and hind limbs are assessed and a palpatory examination will reveal areas of tension, tenderness and lack of mobility. Following the assessment process where problems are identified, a treatment and rehabilitation plan is formulated.
The treatment involves soft tissue techniques and the use of electrotherapy to stretch out adhesions in muscles, reduce spasm and mobilise deeper structures. Once the musculature is released, the joints are manipulated to regain full range of movement.
An aftercare programme is formulated with exercise tailored to the horse's need.
Your saddle will be assessed on good fit. Joëlle has followed a saddle fitting course and is currently doing more training in saddle fitting with the society of Master Saddlers.
How often will my horse need treatment?
Any horse from ageing pets to elite athletes in competition can benefit from appropriate physiotherapy treatment, which is tailored to the animal's needs.
Horses receive great benefit from preventative treatment. As an athlete, fine tuning helps them perform at their best.
For the majority of the cases two or three treatments are sufficient to resolve the problem, particularly if the injury is acute i.e. from a slip in the field, over exerting over a fence or muscle fatigue after strenuous exercise. We aim to carry out a minimum number of treatments. If a horse is not significantly improved at the second treatment we would refer the horse back to the vet. This is in order to check there are no underlying problems causing the soft tissue symptoms.
Generally a horse is reassessed 10 to 14 days after the 1st appointment with a final check up 14 to 21 days later, with 1 to 2 days rest required after a treatment.
Our aim is to treat your horse with the minimum possible disruption to his work program. By ‘freeing off’ areas of muscle spasm, regaining full range of movement in joints and removing pain we allow the horse to return to work. By correct work after treatment the horse and rider will carry out their own physiotherapy to continue building muscle strength and joint stability.
Many owners choose to include routine check-ups in their yearly budget. Any horse will benefit from being assessed twice a year. We generally recommend toward the end of the summer and then again at the end of the winter.
We advise that horses competing regularly in riding club activities are assessed four times a year. For those competing at a higher level we normally devise a maintenance program in conjunction with the rider around their competition and training schedule, taking into account the horses weaknesses, level of training etc.
We would not expect to need to treat the horse on every occasion but owners find the input useful. Whether it is monitoring correct muscular development in a young horse, or suggesting suppling exercises for the more mature hack.
Conditions treated:
Performance horses:
- Screening for potential problems
- Pre-and post competition to maximise performance
- Following injury
Compensatory Problems:
- Back pain secondary to underlying pathology such as: OCD, DJD, Kissing Spine, pelvic asymmetry etc.
- Adaptive compensatory gait due to primary lameness
- Back pain due to ill fitting saddle or poor rider technique
Soft Tissue Injury:
- Muscle injury
- Open wound
- Haematoma
- Tendon/ligament injury
Post Surgery:
- Improve range of movement of joints and soft tissue during and after immobilisation
- Pain management
- Maintain muscle tonus, improve muscle strength
- Rehabilitation to a normal gait pattern
- Controlled exercise programme to regain full performance
Treatments available
Physiotherapy is a science based healthcare profession and can be defined as the use of physical techniques for the treatment and prevention of injuries and conditions affecting movement. General aims of physiotherapy include: reduction of pain, restoring normal movement pattern, increasing and maintaining strength and flexibility. Treatment in the early stages after injury or loss of performance is essential for quick and full recovery.
- Manual and osteopathic techniques
- Soft tissue manipulations: Reflex Inhibition Technique
- Joint mobilisation
- Myofascial Release
- Trigger Point Therapy
- Soft Tissue Mobilisation
- Acupressure
- Deep friction massage
- Massage/bodywork
- Neuromuscular techniques
- Core stability training
- Proprioceptive taping
- Rehabilitation programmes
- Electrotherapy : Neuromuscular Stimulation, TENS, Ultrasound, Laser, Pulsed Magnetic Field
- Advice on saddle fit
First appointment guidelines
Please read the following notes for guidance on your first assessment with Joëlle.
Without Veterinary approval we are unable to treat any horse – please ensure that you have contacted your Veterinary Surgeon to give them time to discuss your animal's symptoms prior to our contact.
Approximate duration of appointment is 1 hour minimum.
It may be necessary for us to confirm the time of your appointment nearer the scheduled date. Please note all times given are approximate. Whenever possible we will try to contact you should our Physiotherapist be delayed due to unforeseen circumstances.
The horse must be held by his owner or a competent handler/adult nominated by the owner.
Make sure that your horse is dry and clean. Presenting a well groomed animal isn't merely a cosmetic exercise.
Your first appointment will require you to give us full details of the horse history etc. Please give this some thought in advance, checking on any relevant dates, etc. Please leave written details if you are unable to be present at the appointment.
Please have all tack immediately to hand.
Provide the right facilities for the best service. You may be surprised to know that quite a large proportion of horse owners, including some who ride at a very high level, have little understanding of the facilities the physiotherapist will need on the day of the treatment. It isn't unknown for the physio to arrive at the client's premises to discover the 'facilities' consist entirely of an extremely muddy field … a paddock that is totally dried out and rutted… or a wonderful ménage that is already occupied because the client omitted to pre-book!
We are likely to need to see your horse trotted up and lunged. Ridden if necessary.
So we need a flat, hard surface where the horse can be stood up and run up in hand.
Make sure there is a stable or some form of shelter with a flat dry surface where the horse can be treated. A muddy field is not an adequate environment to perform a safe and effective treatment.
A minimum of 2 days off will be required after treatment – please check your diaries!
All appointments cancelled, giving less than 48 hours notice are chargeable.
It is the role of your Insurance Company to reimburse you for fees that you have already paid and not to reimburse us direct. Regardless of any insurance cover, you as owner remain responsible for prompt and full settlement of our fees at the time of treatment.
The travel or call out fee can only be shared between clients treated on the same yard.
Aftercare guidelines
Please leave your horse in his stable for 3 hours following treatment, thereafter he can be turned out.
Ensure that your horse remains as calm and sedate as possible.
Do not groom the body or back area for 1 day following treatment. Do not ride 2 days following treatment.
Please walk your horse around in hand before mounting for a few minutes the first time after treatment and exercise on straight lines for the first few days. ALWAYS use a mounting block to mount your horse!!
Exercise mainly on stretching your horse in straight lines when ridding the first few days post treatment.
If your horse shows any adverse symptoms post treatment such as a cold back, stiffness or lameness which sometimes may happen, please let me know.
Please do not have your horses teeth rasped or feet shod for at least 3 days following treatment.
At all times encourage to feed from lower surfaces. Do not feed from hay racks or nets.
If your horse has a habit of pulling back, please avoid this at all costs.
If your horse becomes cast or falls in the field in the next couple of weeks, please inform me sooner rather than later as the effects of treatment may have been disturbed.
Choosing a physiotherapist
Unlike the title 'Veterinary Surgeon', the title 'Animal or Veterinary Physiotherapist' is not protected by law, which means that anyone can in theory call themselves an animal or veterinary physiotherapist regardless of their qualifications.
However, the title 'Chartered Physiotherapist' is protected by law and can only be used by physiotherapists who have achieved a high level of academic and practical training in all aspects of physiotherapy. The word 'Chartered' can only be used by physiotherapists who have undertaken a four year course at University, leading to a Degree in Human Physiotherapy. Chartered Physiotherapists who wish to specialise in Animal Therapy must then complete two years general practice within the human field before undergoing further training with animals. This initial human training is invaluable as it is here that skills in biomechanical assessment and treatment techniques are developed.
Working with "humans" first, allows physiotherapists to sensitise their hands and to refine their treatment techniques. They also develop a keen eye for seeing subtle movement abnormalities. This experience is invaluable and allows Animal Physiotherapists to be very sensitive to the identification and treatment of problems in animals.
Valuable feedback gained from human patients is essential to adapt treatment techniques for use on animals. They are often far more sensitive than humans (just think of how quickly a horse can sense and twitch a fly from its skin), therefore an experienced, gentle and re-assuring touch is needed to treat animals.
CPD is required to remain member of the association of ACPAT. Seminars and courses are organised every year by ACPAT and the Royal Veterinary College in association with Veterinary Surgeons.
The Association of Chartered Physiotherapists in Animal Therapy (ACPAT) is recognized by the Chartered Society of Physiotherapy (CSP) as the Clinical Interest Group representing the interests of Chartered Physiotherapists in Animal Therapy. ACPAT members are fully qualified Chartered Physiotherapists (MSCP's) who have also trained in physiotherapy and rehabilitation for animals (www.acpat.org).
Although there are various 'physiotherapy' courses that someone can attend, members of the Association of Chartered Animal Physiotherapists (ACPAT) will either have completed the MSc/Postgraduate Diploma in Veterinary Physiotherapy run by the Royal Veterinary College or completed the ACPAT Core Knowledge and Skills course.
When choosing a physiotherapist for your animal (or yourself!) it is advisable to only choose one who has the initials MCSP (Member of Chartered Society Physiotherapists).
Ask your therapist or "back man" the following questions:
What are your qualifications?
An apprenticeship from dad or somebody famous, watching others at work, or simply coming from a long traditional line of 'horse people' is not a qualification. Do ask your therapist what his qualifications are and what they mean. The argument that qualifications really do not mean much compared to experience does not really wash, because qualifications matter a great deal. The horsey world seems filled to the brim with many exceedingly experienced people who have little knowledge of basic equine needs.
Do you work with veterinary approval?
It is very useful for the therapist to get medical history from the vet. Many owners forget relevant details of their horse's medical history or do not understand what some medical terms mean. Owners and vets also have a different point of view, both of which should be considered. The vet will usually appreciate a report following the consultation. You may find that the practitioner who does work in conjunction with the vet, keeps up with the required paperwork and charges similar amounts to the therapist hoe does not.
Are you covered by any insurance?
In other words: if he/she makes a real mess of your horse, can you take legal action?
Are you a member of any relevant association?
Using a therapist who is not qualified is a risk in itself because he can seriously damage your horse. If your therapist is not insured, even if you can sue for damages, they may have no money to pay. If your therapist is not a member of a reputable professional body, you will not be able to report him to anyone. As an example by contrast, chartered physiotherapists are required to follow strict guidelines and can be disciplined or struck off by the CSP (Chartered Society of Physiotherapy). In other words, we have a great deal to lose. The unregulated or poorly regulated therapist can do (or not do) as he pleases.