The Horse

OCT 2017

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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41 October 2017 THE HORSE TheHorse.com SPORTS MEDICINE NATALIE DEFEE MENDIK, MA TheHorse.com/Sports-Medicine W hen you think of lameness, limb pain is likely the first cause to come to mind. Yet back, neck, and pelvic pain can be just as debilitating. Thankfully, therapies ranging from shock wave to acupuncture are available to help horses recover. In the first of this two-part series, we'll explore full-body rehabilitation options; in Part 2 we'll focus solely on the limbs. A Multifocal Approach Upper-body rehabilitation is rarely limited to one problem with one solution: Horses might be suffering from multiple problems, and several therapies can over- lap during the course of treatment. "I first do a full clinical exam," says Stephen Denton, DVM, owner of Abingdon Equine Veterinary Services, in Virginia, and provider of sports medicine and lameness services through Perfor- mance Equine Vets, in Aiken, South Carolina. "Many performance horses will have a lower leg component, in addition to having a back problem, which always has to be addressed for proper treatment. There's no cookbook rehab program—it depends on the horse's clinical diagnosis, history, duration of the condition, and other complicating factors." "If the horse is really painful, we'll throw the book at him," says Car- rie Schlachter, VMD, Dipl. ACVSMR, medical director at Circle Oak Equine, a lameness, sports medicine, and rehabili- tation practice in Petaluma, California. "It may be a sequential thing, such as starting with shock wave and moving to laser as the pain improves. If the horse has nonfocal pain throughout the body, we might start with chiropractic and a course of Adequan to decrease the overall body pain and then hone in with other modalities where the more specific pain is emanating from." Schlachter suggests finding a veterinar- ian within your area and budget that's experienced using more than one thera- peutic modality. Where Does it Hurt? Schlachter says the three main upper- body tissue types practitioners worry about are bone, muscle, and ligament. "The most commonly injured or painful condition in the upper body is probably bony—similar to the lower leg, arthritis in the upper body is common," she says. "With muscle issues, you may be trying to keep the muscle feeling good so the horse can work. Ligament injuries are the least common type in the upper body." Horses can develop arthritis in the cer- vical (neck), thoracic (mid-back), lumbar (loin), or sacroiliac (pelvis/croup) areas. "In performance horses in particular, arthritis can create pain, which may de- crease performance or even be significant enough to take the horse out of perfor- mance," says Schlachter. Regardless of the source of pain, she says treatment goals are to decrease inflammation and improve comfort. " Often the rehab we do for upper-body bony issues is a maintenance type of rehab, to keep the horse feeling good and in work." Further, best outcomes stem from early intervention. "I think a lot of horses are in more pain than they let on, so my general rule of thumb for my clients is if you notice consistent soreness in your horse, have him assessed," says Schlachter, add- ing that warning signs can range from discomfort during grooming to difficulty performing under saddle. Work It For both injury prevention and return to work, Denton recommends stretching and strengthening the core muscles to The Road to Recovery, Part 1 Underwater treadmills provide buoyancy that gives rehabbing horses full range of motion without concussion; this makes for safe, low-impact conditioning. PAULA DA SILVA Rehabilitation options for upper-body pain and injury

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