1/16/19 Rehabilitating and Conditioning the Equine Athlete Carol Gillis DVM, PhD, DACVSMR Aiken, South Carolina equineultrasound@earthlink,net Equineultrasound.com 803-522-1700 Two different concepts In conditioning the equine athlete, we are aiming to increase speed, endurance, flexibility 2 Soft Tissue Rehab Accurate diagnosis is essential first step You don t want to spend time, effort and money unless the injury warrants it You don t want to ignore a minor injury until it becomes more serious Clinical Ultrasonographic Tendon and ligament have gotten a bad reputation for not healing; in fact they will return to normal strength range and allow the horse to fulfill his/her athletic potential without re-injury IF an appropriate rehabilitation plan is implemented. For Rehabilitation We are aiming to: 1) Control inflammation 2) Maximize healing of injured tissue back to normal strength and flexibility Clinical Palpation Observation in motion Nerve blocks if indicated 1
Diagnostic Ultrasound Provides the most detailed information about the status of tendon and ligament A relatively small degree of abnormality seen on ultrasound exam translates into a significant loss of strength Fiber damage Normal tendon and ligament are near breaking strength at the gallop, over fences etc. Much less margin of safety than bone When fibers begin to tear, strength decreases and a lower level of work can cause more damage Why? Tendon & Ligament Are similar to steel cable > fine strong strands >precisely aligned to withstand tension Why turnout is unsuccessful in a high % of injuries US results reflect a cycle of partial healing followed by repetitive injury 2
Tendon pain is several weeks Healing is 8-10 months Equine Athletes with pasture partially healed tendons Tolerate low level exercise Injury recurs when exercise difficulty increases Expensive for owner Hard on the horse Back to inflammation control Effective Anti-inflammatories A little inflammation is good; it initiates healing Too much is harmful as it can result in further tissue damage NSAIDS > Systemic >Topical Adequan Glucosamine & HA Laser TX US Hydrotherapy Massage Inflammation lasts for 3-4 weeks Anti-inflammatory agents or treatments are generally decreased or discontinued after this time frame depending on other issues with the horse (arthritis for example) Corrective Shoeing May be as simple as balancing the feet left to right and assuring an aligned hoof/pastern axis for each foot Some injuries benefit from specialized support shoeing Hind feet too! 3
Begins Day 1 Controlled Exercise Initially short walks at least 2 times per day > In hand > on exerciser Duration depends on each case Controlled exercise Means that the horse is not placed in a position to self exercise faster than a walk during rehabilitation Rehab Success Tips A slow feeder hay net kept filled and a horse in sight at all times go a long way toward decreasing stress for the rehab. horse Note and avert such behavior as door banging, kicking and pacing the stall If management tactics fail; sedation is preferable to continuous re-injury Exercise increases to: 1) Walk under saddle increasing times 2) Walk and trot under saddle 3) Walk, trot, and canter under saddle 4) Turnout if desired 5) Training to return to competition How are increases in exercise determined? Clinical and ultrasonographic exams at 6-8 week intervals We know that most cases can slowly increase exercise at these times; however, severity of injury, age and use of the horse, other horse health issues cause each rehab. plan to be slightly different When the horse is back to trot work Be sure to search for the match that started the bonfire you are currently rehabbing the horse for 4
Arthritis Arthritis RX Pain from arthritis often causes the horse to overload another region, leading to soft tissue injury NSAID Oral Glucosamine & HA > Supreme Top Form Adequan IA injections ECSW Laser Chiropractic adjustment Acupuncture The final and most important factor is quality of the rehab program at each time interval As the rehab. program progresses and the healing tissues gain strength, conditioning becomes incorporated into the exercise plan. Body Condition Factors for successful conditioning The horse should have enough muscle mass/ fat to perform well without excess weight to carry 5
Conditioning Cardiovascular fitness achieved well before musculoskeletal Methods to assess fatigue are based on cardio-respiratory response Rider must assess fatigue Most horses perform optimally when trained 4-5 days per week with alternate days off to allow for tissue response to work, repair of tissue micro-damage, and mental adaptation Increase in work load Specific Training Increasing work by 5% per week is generally optimum to gain condition with low risk of injury Give frequent short breaks during sessions Avoid overrepetition Avoid work that is harder than the horse s intended athletic use Cross Training A 6 % Grade: Hill Work Increases strain on hind suspensory ligaments Increases hip joint strain Increases incidence of bleeding from the lungs No scientific evidence that hill work improves rate or quality of conditioning 6
1/16/19 Walk Warm Up 15 minute walk warm up pre-stretches tendons & ligaments Rupture at higher forces ff. walk warm up Needs to be done every ride Walk cool down Walk Warm Up Also lubricates joints during faster exercise more effectively as joint fluid changes viscosity in response to warm up Thank you! 10 minute cool down metabolizes waste products generated during exercise that can lead to muscle tying up and other problems 7