Historically, equine musculoskeletal practice has been centred around manual therapies. Mobilisation of soft tissue and joints, brings about a positive change in muscle balance and movement but how permanent is this change and is manual treatment enough?
Posture and biomechanics
Shortened, hypertonic muscles pull structures out of alignment causing poor posture and biomechanics. Pain points also lead to altered movement. The release of soft tissues will allow the underlying structures to realign and therefore offer a platform for better biomechanics and posture; however, this does not mean the latter is inevitable. Manual therapy does not address the lengthened, weakened and inactive muscles which contribute an equal amount to the problem. If these muscles are not activated and strengthened then the opposing shortened, overactive and dominant muscles will take up the slack and very quickly return to their pretreatment state. The only way to ensure the effect of manual treatment sticks, is to activate and strengthen the opposing muscles. Manual treatment ‘allows’ the structures to realign but it is the targeted exercise prescription that keeps them there. So in answer to the above question “is manual treatment enough?” the answer is no!
Functionally correct movement
To consider the importance of correct function let’s take an example from the field of human exercise training. For many, the aim of going to the gym is to improve strength and muscle mass. But very often, the target exercises are of poor quality and function. A common example is using squats to strengthen weak gluteal muscles. Due to the fact that the gluteal muscles can not resist internal rotation of the femur - it would be difficult, if not impossible, to perform a functionally correct squat without valgus collapse of the knees. Valgus stress is a cause of collateral ligament and meniscal injury - repeating this movement is bad! Additionally, completing this poor exercise over and over again will only reinforce a functionally incorrect movement pattern and do nothing to activate the gluteal muscles. Not only does this reinforce a poor squat but also reinforces a poor gait. Exercises under the guidance of an exercise rehabilitation therapist, would encourage very small movements to activate muscles, only in the range of functionally correct movement. As soon as poor function creeps in, the exercise would be discontinued or changed. This approach encourages the right muscles to fire and reinforces a correct movement pattern. Only when the gluteal muscles are strong and active enough to resist internal rotation of the femur and valgus stress on the knees, would a full squat be prescribed; and even then, the amount of repetitions would be determined by how functionally correct the movement was. If after three reps, function becomes poor, then three reps is enough. This example highlights the importance of exercise rehabilitation. Generally, exercise for horses during rehabilitation is focussed around a general progression towards fitness. But we should be taking time to identify the biomechanical origin of the injury and prescribing very targeted exercises to correct these dysfunctions during the rehabilitation process. This principle can also be used in the prevention of injury. For example, a horse with weakness in his left gluteal muscle group will be suffering from torque stresses to the thoracolumbar spine and lumbosacral joint. There will be a gait compensation and ultimately this could cause a performance limiting injury. Exercises to target the asymmetrical muscle mass would reduce these referred stresses, therefore reducing the chance of injury.
Diploma in Equine Exercise Rehabilitation
With our Diploma you will learn exercise techniques for the rehabilitation and prevention of spinal and limb conditions and how you can integrate exercise prescription into your current practice. By adding Equine Exercise Rehabilitation Therapist to your title, you can offer a more holistic treatment and shift the emphasis towards a longer term treatment for your patients.
The Diploma comprises four units:
- Foundation in Equine Exercise Rehabilitation
- Equine Exercise Rehabilitation for limb conditions
- Equine Exercise Rehabilitation for spinal and pelvic conditions
- Clinical Practice in Equine Exercise Rehabilitation
This provides learners with the opportunity to study the Diploma as a whole, or the unit certificates of interest individually. Study is flexible and online for the most part with a final clinical workshop which can be taken from anywhere in the world.