Case one
A 13 year old gelding with a history of on going lameness and gait irregularities over a period of two years was admitted for intensive physiotherapy and rehabilitation following a bi lateral stifle arthroscopy two years previously. On arrival he presented with an intermittent gait irregularity but most striking was the significant muscle wastage over the right quarter with a right ventral rotation of the pelvis and weak top line. The horse presented with multiple areas of muscle tension, spasm and discomfort on palpation. Passive range of movement was restricted in protraction of the pelvic limbs with reduced flexibility through the spine. The horse followed a programme of 6 weeks rehabilitation using physiotherapy techniques, ground based and ridden remedial exercise and water treadmill exercise. The combination of the these methods produced a significant improvement in muscle strength, suppleness and soundness.
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The horse on arrival showing poor posture and The horse after six weeks rehabilitation
muscle weakness.
Case two
A yearling was referred for physiotherapy following a cut to the front fetlock some 6 weeks previously. It had recieved antibiotic and cortisone treatment but an area of oedema persisted around the scar tissue. The colt was treated using laser therapy and H Wave electrotherapy over the period of a week and produced an 90 % improvement of the aspect of the fetlock. Compete reduction in the oedema was achieved but some thickening remained due to scar tissue underlying the inital wound.
At commencement of treatment One week after treatment
Case three
This 12 year old pony previously used for racing and was recently purchased for an all round riding pony. The owner after a particularly long ride reported that the pony became acutely lame on the left hind but within minutes it appeared to disappear almost entirely. The photo week one shows a very asymmetric pelvis with significant muscle wastage to the left side affecting the gluteals, hamstring and quadricep groups. The photo week 6 shows a much improved muscle mass although an asymmetry clearly still exists but was attributed to a suspect previous fracture of the pelvis which may have occurred several years ago.
Week one Week six
On palpation severe muscle spasm was present in the gluteals.m of the left side in particular with adhesions and fibrosis palpable. The hamstring group showed significant tightness and muscle soreness as did the epaxial muscles of the back, particularly the left side with palpable muscle damage and adhesions in the mid thoracic region of the longissimus dorsi.m. The tuber sacrale were asymmetric with the left side significantly lower and showing a right ventral rotation of the pelvis. He was treated with intensive physiotherapy using longwave ultrasound and H Wave electrotherapy to address the presence of muscle spasm, adhesions, fibrosis and muscle weakness both in the gluteals, longissimus dorsi.m of the left back and hamstrings. Deep tissue massage, muscle release techniques and trigger point therapy combined with passive stretch exercises were used alongside a controlled and progressive remedial exercise programme.
Intensive physiotherapy followed by corrective remedial exercise was used over a period of 6 weeks followed by an on going maintenance programme of physiotherapy. The week 6 photo shows a marked improvement in muscle balance and symmetry although a certain degree of asymmetry will always exist, the pony is sound and back to work.
Case four
This horse suffered a fracture of the dorsal spinous processes (DSP) T3 to T9 due to a suspect trauma whilst stabled. X ray screening confirmed the diagnosis showing the DSP’s displaced to the left. T9 was detached and appeared to be floating. The horse was treated by NSAID for a month and underwent 3 months box rest before referral for rehabilitation. At this point the horse was referred for physiotherapy and introduction of remedial exercise. Physiotherapy was used with the aim of correcting the neuromuscular deficit addressing proprioceptive re education, disuse atrophy and muscular re education due to enforced immobility as well as supportive physiotherapy to assist healing and compensatory muscle issues that had developed. Controlled remedial exercise was introduced at week six post injury and water treadmill was used for this due to the horses unpredictable nature with in hand walking but also due to the hydrokinetics and effects on the horses musculoskeletal system as a whole.
