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| A
Bit About Lameness |
| A horse is referred to as
'lame' when anyone of
the recognised gaits is moving within an unrecognised fashion. |
| Many influences
are able to individually,
collectively, immediately and / or progressively lead to an abnormal and
unrecognised locomotary action(s). |
| Although lameness presents itself most obviously
within one or more of the limbs, the root cause of lameness can often originate
and subsequently radiate from any part of the body, causing the horse to
move in a compensatory fashion - often referred to as the 'drag
effect'. |
|
The drag effect is
usually associated with muscular stress, myofascial restriction and
/ or skeletal trauma, however, before
assessing the lame horse do not forget some of the other very real
influences that often have their place within the lame horse, either directly
or indirectly.
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|
Commonly overlooked influences
to lameness can include:-
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The neural system - creates
referred pain sensations (See
Relationship Between Massage & Lameness
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The horses tack
can create,
maintain and promote untold muscular damage, producing serious locomotary
imbalances with subsequent pain.
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The rider whom is either unbalanced, too heavy or unable to work the respective bit and /
or bridle correctly can easily create both direct and indirect muscular
stress and skeletal trauma.
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The skin that can constitute up to 20% of the horses body
weight is a classic
and accurate sign of the horses overall inner health, often revealing
signs indicative to many afflictions, such as biting insects, dermatitis
and sores, all of which can promote the horse to move in a negative
fashion.
|
| Whatever
the root cause of any lameness, it will usually be referred to as either
'mechanical lameness' or 'pain related lameness'. |
| Mechanical
Lameness |
| As
the term suggests, mechanical lameness is created and maintained from a
mechanical influence. This can include any form of abnormal mechanical
functioning of bone, tendon, ligament, muscle or fascial tissue. |
| Mechanical
lameness is not always reciprocated with pain and is most obviously presented during the horses slower and more
controlled movements, such as walk. |
| During
walk, the affected limb experiences a longer duration of
tension as it waits for its co-working limb to complete its protraction
phase. (See
Gait Analysis) |
| Pain
Related Lameness |
| Lameness
relating to pain is further segregated as a weight bearing lameness or a
non-weight bearing lameness. |
| Weight
Bearing - supporting
leg |
| Weight
bearing lameness occurs when the horse tries to alleviate its pain by
reducing the degree of weight applied to the respective limb. |
| This action is
seen as the horse displays the typical
nodding action of the head. |
| In
order to understand why the horse nods when he does; we
need to determine some primary locomotary actions and laws of compensatory
movement, a major influences of muscular stress and the drag
effect. |
| If
your horse is suffering with pain within one of his forelimbs he
will simultaneously raise his head and transfer his weight away from the
respective limb every time the limb impacts the ground. |
| If
the horse is suffering from pain within one of its hindlimbs he
will drop his head and transfer his weight away from the respective limb
every time the limb impacts the ground. |
| Take
for example a horse suffering with a lame off- side hindlimb: (OSH) |
| With
the OSH unable to support the weight of his body and execute the pull
and gravitational alignment of the movement, the horse will move with compensatory
actions. Think of someone limping. |
| The
horse will execute the following compensatory pattern of movement: |
| 1
- Transfer weight destined for the OSH over to the NSH
and over to
the NSF. |
| 2
- Head up = lame leg bearing weight then head down = NSF beating weight
the NOD. |
| As
the horse nods take note of his neck and head action - he may lean or turn
his neck into the side and direction of the lame limb. |
| When
reviewing any
suspicions of lameness, the horses actions need to be viewed from all aspects, including side
and rear view while observing any compensatory or mistimed actions
performed through the phases of
limb action. (See
Gait Analysis) |
| Non-Weight
Bearing - swinging
leg |
| Non-weight
bearing lameness occurs
when the horse is unable to create and
maintain his normal limb action as a direct result of the horses
inability to support weight upon the respective limb. |
| Examples of an
injury promoting 'non weight bearing' lameness can include: |
| Abscess
of the foot. |
| Infections
in a joint. |
| Inflamed
tendons or ligaments. |
| Skeletal malfunction. |
| Compensatory Lameness |
| Any lameness, regardless
of its cause, origin,
development and progression will create movement
of a compensatory fashion. |
| Although
compensatory movement allows the horse to move, (life saving in the
wild), it will continue to serve its purpose by feeding from muscular
tension, myofascial tension and / or skeletal malfunction however caused. |
| Finding
The Origin |
| Each cause of lameness
is an individual event. With so many
influences and patterns of cause and effect, each horse MUST be treated
individually, never leaving one suspicion uninvestigated. Not only will this help to get to the root cause of the problem,
it will also, in
most cases, go a long way in helping to prevent a future repetition of
the situation. Even with a seemingly straight forward (though disastrous)
diagnosis of lameness such as a bone fracture, try to understand
the influences that led up to this situation. These influences can
include the
horses conformation in relation to his working discipline, his rider,
his level of work in relation to his fitness and understood demands, his
age, his diet, his tack, his physical ability to perform the work that
has been asked of him, his temperament, is he tense while working, is he
happy, the questions and influences can go on and on with each one
deserving full attention. |
| Being able to
determine the origins of each lameness allows the equine massage therapist
to determine a safe, effective and targeted treatment of the respective
muscles and myofascial tissue, as well as evaluating the cranialsacral
system. Lets
look at some of the direct and subsequential influences involved in
assessing lameness. |
| Assessing
The Influences
Of Lameness |
| For
each possible influence to be determined it should undergo three primary
investigations, visual observation, palpation observation
and a manipulative observation. |
| Bones
and Joints (see
also Skeletal Bones
& Joints Back Limbs
Movement Evaluation ) |
| Different
bones of the horse mature within very different time ratios. For example,
the humerus matures far quicker than the cannon bone. |
| Different
breeds also mature within different time ratios. For example, heavier horses
such as the Shire, Suffolk Punch etc. mature later than the Thoroughbred. |
| Vulnerable
areas of the skeletal structure such as the 'lumbosacral joint' is a vulnerable
structure. Subsequently, stress created within this area can easily
create, maintain and encourage the drag effect with its self perpetuating compensatory
locomotion with its own consequences. |
| Angles
of bone attachment either to other bones or ligaments will directly affect
stress levels to the skeletal structure, especially when combined with
each horses own working discipline. |
| Visual
Observation |
| Does
the affected structure appear swollen? |
| Is
the affected structure within its correct physiological position and stance? |
| Palpation
Observation |
| Does
the swelling feel hard or soft to the touch? |
| Does
the swelling feel hot? |
| When
palpated does the swelling create a painful reaction from the horse? |
| Manipulative
Observation |
| Does
the swelling allow its respective structure to be bent
/ flex? |
| Does
the swelling allow its respective structure to be straightened? |
| Does
the swelling allow its respective structure to perform its expected range
of motion? |
| When
manipulated does the swelling create a painful reaction from the horse? |
| Muscles
(see
muscles
back neck) |
| Different
muscles and muscle types of the horse mature within very different time
ratios. |
| Vulnerable
muscles in relation to work and tack such as the Lattisimus Dorsi,
Trapezius, Longissimus Dorsi for example remain vulnerable to the negative painful
effects created by an ill-fitting saddle, even more so when the same horse
is being asked to perform dressage movements or jump heights demanding physical
freedom of movement. (student
ref: stress point cycle paper) |
| Muscular
stress and working ability will directly affect stress levels to the
tendons, ligaments and skeletal structures, especially when combined with
the respective working discipline of the horse. (See
Gait Analysis) |
| Visual
Observation |
| Does
the affected muscle or muscular area appear to of lost its normal muscle
mass? |
| Does
the affected muscle or muscular area appear to of lost its symmetry? |
| Does
the affected muscle or muscular area appear to of lost its contour? |
| Does
the affected muscle or muscular area appear to of lost its posture? |
| Palpation
Observation |
| Does
the affected muscle or muscular area feel tight and / or tense? |
| Does
the affected muscle or muscular area feel hot? |
| When
palpated does the affected muscle or muscular area create a painful
reaction from the horse? |
| Manipulative
Observation |
| Does
the affected muscle or muscular area allow its respective structure to be
bent? |
| Does
the affected muscle or muscular area allow its respective structure to be
straightened? |
| Does
the affected muscle or muscular area allow its respective structure to
perform its expected range of motion? |
| When
manipulated does the affected muscle or muscular area create a painful
reaction from the horse? |
|
Tendons and Ligaments (see
also tendons
and ligaments) |
| The
health, working ability and any negative influences experienced by any muscle
will respectively affect its attached tendon, while negative influences experienced by any
skeletal structure will respectively affect its attached ligament. (see
gait analysis - breakover) |
| Integrating
all of the above information, procedures and observations, the following
is a guideline to evaluate the horses lameness. Tailor
your investigation to the structure you
are evaluating. |
| Static
Evaluation |
| Aswell as performing the above
observational assessments, each
individual physiological area needs to have its own case
represented. |
| Head and Neck |
| The head and neck are the horses methods of balance and forehand
direction. Asymmetries or negative influences present within the neck are
guaranteed to develop their effects both directly and indirectly. (see
cranialsacral
therapy) |
| Check
the neck for its expected range of movement and motion while paying attention to the
horses reactions to every movement. |
| Back
- (see body
scoring
and cranialsacral
therapy) |
| Primary
investigations of the horses back require its evaluation of symmetry and stance. Ideally
the back should be comparatively straight displaying an equal
distribution of muscle and muscle tone. Ask yourself the following
questions: |
| Is
the muscle
proportion evenly regulated either side of the spine? If not is one
side showing muscle atrophy? |
| Is
the muscle
tone evenly developed either side of the spine? If this is not the
case then the horse may well be experiencing a drag effect of compensatory muscular
and fascia stress shown through any number of negative actions, both
physically and/ or psychologically. Do any of your findings relate to any
previous detections or suspicions? |
| Is
the muscle
proportion and tone evenly distributed through to the rump
and croup? If this is not the case then check the state of the lumbar region.
This is a very common area
for the development of lameness, sometimes only presenting itself
during 'canter' or 'jumping'? Does the horse become disunited at canter?
Has the horse suddenly started refusing jumps? (student
ref: myofascial release module III) |
| When
the horse canters, gallops and jumps he is using this lumbosacral joint to
execute the action of his hindlimbs. When the horse moves in walk and trot
he is rotating his upper limbs around the hip joint with the flexion of
the hock and stifle. (see
gait analysis) |
| Is
the pelvis
even in its placement or does it appear to of dropped on one side?
(See newsletter) |
| Limbs
(see swing
phase movement evaluation bones
and joints skeletal ) |
| In order
to detect which limb is either directly or indirectly being affected
assess the following questions: |
| Is
any one limb showing an unbalanced negative action? such as:- pointing the toe, resting one leg more than
another or a dropped fetlock? |
| If you see that
the
lower limb is excessively protracting or the entire limb is resting
more than expected, try a simple test. Gently guide the horse forwards 1 or 2
steps. If the horse then immediately places the limb back into the forward
position or reverts back to the resting position then suspect their is a problem within
the respective limb. |
| Feet |
| You
have heard the saying - ' no foot - no horse!' So, assess the following
questions: |
|
Is the 'wear' of the shoes or
the feet even? An uneven wearing is a strong indication of unnatural and
unbalanced movement. If you do detect this then try to see if your
findings correlate with any other detections or suspicions. Such as, if
you suspect that the horse is experiencing a problem with his off side
stifle region and you then detected excessive wear upon the outer edge of
the offside hoof and inner side of the near side hood this could
indicate the horse is shifting his weight to avoid using his off side
stifle. You can then focus in on this area and try to find a drag effect
or match up any other of your findings. (student
ref: f.c. module I) |
|
If the horse is shod, are his
shoes well fitting? Have they been left on too long? Are the toes beginning
to grow over the shoe to unbalance the horse. Again, if you detect this
then check to see any unbalanced wear upon the shoe. |
|
Is the hoof / pastern axis of a
good integration - or is it broken and tipping the horse unto an unnatural
alignment? Is it is try to establish if it matches with any of your previous
detections. |
|
Is any one hoof bigger or
smaller than an other? Once again, check to see any unbalanced wear upon
the shoe or hoof, and, try to establish if it matches with any of your previous
detections. |
| Visual
Observation |
| Does
each hoof wall appear symmetrical within its alignment? |
| Is
each hoof wall smooth or is it housing any cracks? Are the crack new, old,
short or long? |
| Is
the sole of each foot clean and clear from any obstructions or are there
any holes or puss? |
| Palpation
Observation |
| is
the coronary band of the same temperature as the hoof wall and fetlock? |
| Is
the coronary band smooth in its contours? |
| Does
the horse show any consistent negative reactions with your palpation
observations? If he does, he is experiencing discomfort to the respective
area aswell as to the pressure? Does
this correlate with any other previous detections? |
| Manipulative
Observation |
| Does
the fetlock rotate with ease? Does the horse react in any to this? |
| Does
the horse react to any tapping of the hoof wall? If he does, were there
any signs of an abscess or hole in sole of the foot? |
| Movement
Evaluation |
| When
discovering the presence of lameness, never
automatically force the horse to move more than absolutely necessary. If the lameness appears
slight and the horse shows no negative signs to moving then the standard
trot up is usually ok to perform, however, I will not advise that you do
this. Always - seek the advice of a vet. |
| If
trotting up try to get somebody who really knows what they are looking for
so the horse does not have to trot any more than necessary. Especially if
the ground is concrete. The concussive effects can sometimes promote some
causes of lameness and laminitis. |
| Always
ensure that the surface is clean, clear, level and firm. |
| Aswell
as observing the horses actions, also try to listen. This is sometimes an
easier and very obvious indication of a horse moving out of balance or
rhythm. Listen to t he beat and force of the each impact.. |
| Do
however, take into consideration the previous limb and feet assessments.
If one foot is more splayed than other than quite possibly this foot will
produce a slightly more flat sound, or, if one foot is more boxy than remember
that this foot will produce a slightly more impacted sound. Once again,
always correlate your findings with any previous observations and suspicions. |
| A
weaker limb will most often be placed down more lightly and quickly
subsequently reflecting this within its impact sound. |
| Ridden
Evaluation |
| A
ridden evaluation is once again not a method that I will willingly advise
on such a level. Working within my 'duty of care' and 'code of conduct'
I must tell you to seek out professional veterinary advice for any lameness
that you have detected or suspect. |
| This
veterinary advice can then be followed up with specialist advice from your
farrier, saddler, chiropractor, etc |
| To
Conclude |
| Remember to
correlate each new finding with previous findings and suspicions.
|
| Remember that
the horses responses are usually of a repetitive manor when he is reacting
to pain or discomfort.
|
| Remember to use
the neighbouring healthy limb for comparison if in doubt to what is
normal.
|
| Remember to take
into account any of the indicating factors that could have lead to each
horses own lameness and build a picture.
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| Relationship
Between Equine Massage Therapy and Lameness |
|
The relationship between
equine massage therapy and lameness is a vast, integrated, indicative and highly
individual scenario. For these reasons, intellectually and effective
treatment remains an individual treatment process with veterinary advice
playing an essential, major and legal integration.
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