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The Horse

What to Expect

The 3 T's

Feet 1

Feet 2

Examination

Physiology

 
Does this sound familiar?
You, the rider, have noticed a problem - your horse seems unlevel, perhaps mildly lame, or more on the forehand. Maybe he's stopped jumping or approaches the jump differently, rushes, jumps flat, bucks on landing. He might have become stiffer on one rein, is more difficult to bend one way to the other, or is no longer straight. He might have started to behave in an uncharacteristic way - jogging, biting, rearing, unhappy. He's hard work, needs pushing and has lost his lightness. Whatever the cause, he's different.

You might have consulted your vet who has seen and examined your horse but there is little to find on the trot up or on the lunge, and flexion testing doesn't clarify the situation. There's apparently nothing significantly wrong, but you're still not happy - something is going on and you can't quite put your finger on it.
Horse with back pain
The stance of a horse with back
stiffness and pain, likened to a
goat standing on a rock
Old horse with back pain
This much older horse exhibits the same
features. He's also hopping from foot
to foot to relieve discomfort

Physiology versus pathology

When there's something obvious like a warm joint, pus in the foot or a tendon injury, it's easy to understand why your horse isn't right.
Much more commonly however minor stresses and strains build up, generated from a variety of sources like poor foot balance, ill-fitting tack, a conformation problem, or an unbalanced rider.
Your horse will compensate, but the tightness that develops in the musculo-skeletal system (MSS) as a result of these stresses will eventually cause pain and poor performance.
It's a bit like a repetitive strain injury that you might suffer. Tennis elbow is a good example. It's caused by minor, repeated strain and gives you a painful joint with restricted capacity, but there is little external evidence to account for your suffering!
So you have a physiological problem (muscle stiffness, joint ligament pain) but there is no pathological abnormality (the joint is not swollen; an X-ray would be normal)
Doctors, and vets, are trained to diagnose and treat pathology, which means we find something that is wrong (an inflamed tendon, joint injury or arthritis, infection, trauma) and use various techniques to put it right (drug treatment, surgery). The investigations we use depend on there being an abnormality that will show up - in a blood test or an X ray for example. If there is no pathology we are generally reassured there is nothing serious wrong.

X ray pastern joint

Enter the "Therapist"

Therapists such as myself are trained to identify and manage problems where there may be no pathology, just abnormal physiology. In other words your horse's musculo-skeletal system is under strain and is behaving abnormally, but hasn't reached the point where it "breaks down" in some way (becomes pathological).

Your vet, trainer, or a friend might suggest you contact a back man, because many of these "repetitive strain" type injuries will end up causing symptoms of back stiffness or pain.
At a guess about 75% of the horses I see have back symptoms that are caused by a problem somewhere else, frequently the lower legs or feet.So you can see why it may be important for us to work in conjunction with your vet, your farrier, your saddler and others. Indeed we can't treat your horse without your vet's prior approval, and I hope it is now clearer why.
 

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