The field of equine therapy has grown to include a broad spectrum of treatment styles and may incorporate techniques and modalities derived from the practice of physical therapy, massage therapy, chiropractic, and osteopathy, all of which can be classified under the universal umbrella referred to as manual therapy.
With the rise of competition in equine sports as well as a social-psychological growth in understanding the principles behind natural based therapies, the demand for the profession is growing (Denoix & Pailloux, 2011).
It has become widely accepted that physical therapy and massage are useful in treating various soft tissue injuries ranging from acute trauma such as muscle strains and ligamentous sprains to long term chronic conditions such as arthritis. The reason for the increased social acceptance of natural based therapies is likely due to the emerging research being conducted demonstrating the efficacy of such therapies in both humans and horses.
One of the most obvious benefits of manual therapy is the physiological effect it can have on the soft tissues which can be seen and felt almost instantly. At the cellular level, there are many processes occurring that promote tissue healing, repair, and health. These physiological effects can lead to the reduction of pain and subsequently pain induced behaviors allowing for a proper strength, conditioning or rehabilitation program to be prescribed. With the ability to work the horse safely, proper biomechanics can then be addressed. Improper biomechanics or dysfunctional movement patterns that have developed as a result of injury or weakness must be corrected for the horse to function optimally and to prevent future injuries from occurring. Pain, weakness, tissue dysfunction, and poor biomechanics can have some hugely detrimental effects on performance therefore should be eliminated before participating in any sporting pursuit which gives rise to the importance of equine therapy as a profession.
Pain is one of the most common reasons for dysfunctional movement patterns and lack of compliance of a horse. In being able to identify the source and cause of the pain a proper treatment plan may be developed that will return the horse to full function and pain free movement which in turn will improve compliance, motivation, and performance. Tissue mobilization (active & passive) as well as stretching are two very popular and simple techniques used by manual therapists to reduce pain (Denoix & Pailloux, 2011). Passive mobilization is applied by the practitioner moving the horse through specific movements, in and out of restriction, causing a stretch within the corresponding joint capsules, ligaments, and/or muscles (Denoix &Pailloux, 2011). Active mobilization is applied by using certain reflexes to stimulate voluntary movements in the horse and effectively realign bones or stretch the soft tissue structures noted above (Denoix & Pailloux, 2011). Both these techniques can help decrease a restriction in a joint or alleviate tension within a muscle almost instantly and thus remove a potentially painful stimulus. These techniques are also used as diagnostic tools and preventative treatments because of their “usefulness for identifying locomotor malfunction and lameness” (Denoix & Pailloux, 2011, p. 101). Furthermore, they “enable the practitioner to compare the difference in response between the left and right sides of a horse, or between it and other horses” (Denoix & Pailloux, 2011, p. 101). Being able to identify a tissue dysfunction before it causes intense pain is optimal because once a pain response is initiated it can be very difficult to re-wire the neurological response and may take substantially more time, training, and effort (Archer, 2007).
In terms of specific physiological benefits to the soft tissues there is supporting evidence to confirm that manual therapy can decrease adhesions and fascial restriction, increase tissue flexibility and ROM, and alleviate spasms and trigger points all while also promoting neurological relaxation (Archer, 2007). Certain techniques such as deep tendon frictions and joint manipulations can eliminate mobility restrictions by breaking down adhesions within joint capsules, tendon, and ligaments which allows full range of motion to be restored (Denoix & Pailloux, 2011). Manual therapy and specifically massage is famous for its success in “releasing” tight muscles that are causing impaired movement or compensation patterns. By breaking up specific groups of muscle fibers that have become inundated with scar tissue or trigger points then realigning the fibers along their natural lines of tension the muscle will be able to return to full length and function (Rattray, 2005). It is also a well-known fact that massage to can increase blood flow to a specific area by approximately 50% in a matter of minutes (Archer, 2007). Blood acts as a transporter of oxygen, carbon dioxide, nutrients, and hormones and can produce antibodies as well as anti-inflammatory cells (Tortora & Grabowski, 2003). Causing an increase of flow to an injured area will speed the recovery of the damaged tissue by spreading a higher volume of healing properties throughout the area as well as taking away a greater amount of waste or chemical by-products via the venous system (Tortora & Grabowski, 2003). There are also various lymphatic drainage techniques that can be used in the event of acute or chronic edema (swelling). When applied precisely and systematically the techniques utilizes the one- way pump system of lymphatic vessels to facilitate increased drainage back to the heart (Tortora & Grabowski, 2003). Most of the above techniques are relatively non-invasive increasing the likelihood that the horse will tolerate the treatment easily allowing for immediate pain relief and increased function.
Another important benefit of equine therapy includes the capacity treatment can have in facilitating improved biomechanics which leads to improved performance and reduced risk of injury. As a prey animal, the horse is designed for fast and efficient movement, however when one piece of the physical system if dysfunctional or injured the effect can be deadly. In the domesticated horse, the negative effect of a biomechanical breakdown will generally be related to a change or decrease in performance as well as a potential change in behavior or willingness of the horse to participate in certain movements. The main physical factors that affect performance and biomechanics are flexibility, strength, and conditioning (Higgins, 2012). For example, the reason flexibility is so important when trying to improve horse performance is because it determines the range of motion available to a joint (Higgins, 2012). With less available range the horse will have reduced ability with movements that require maximal elongation such as galloping and jumping. This inability can then lead to altered biomechanics and compensation patterns if the horse is required to perform these tasks regularly. Shortened or tight muscles will also put additional strain on the specific involved muscles as they pull at the origin and insertion sites sometimes causing them to tear or fully rupture (Higgins, 2012). Once this happens it is a lengthy and painful rehabilitation process. A preventative practice applied by many equine therapists is massage to the affected muscles as well as a series of stretches and Pilates based movements designed to improve suppleness and stability as well as reduce tension (Higgins, 2012). Since most horses are used for riding (in various disciplines) it is also of utmost importance that the core and back muscles are sufficiently strong to carry this additional weight and that the individual vertebrae which comprise the spine are correctly aligned (Higgins, 2012). When the horse can stabilize this weight without causing an increase in pressure to the back, the movement becomes very smooth and almost effortless enabling a positive effect on performance (Higgins, 2012). By physically manipulating the tissues an increase in blood flow to that area occurs which brings more oxygen to the tissue and subsequently improves its ability to stretch and/or contract (Denoix & Pailloux, 2011) both of which contribute to the strength and flexibility of a given muscle. Improving strength in weakened muscles and reducing tension in shortened muscles are two of the key factors when seeking to correct an imbalance that affects the biomechanics of a movement pattern.
As discussed above, there are many physiological benefits that can arise from the application of manual and exercise based equine therapy. It is becoming a widely accepted belief that strength and conditioning exercises used in combination with manual therapy are the most effective in building core stability, increasing flexibility, improving muscle tone and therefore improving performance (Denoix & Pailloux, 2011). Aside from being useful in promoting tissue health, reducing pain, inflammation, and improving strength and endurance there are also proposed mental and emotional benefits of therapy. According to studies in equine neuroanatomy reported by Peters & Black (2012), the removal of a negative stimulus such as pain which is perceived as pressure to the horse can have profound effects on compliance, motor learning, and performance. Since the field of horse psychology is relatively new more research is needed to prove these theories, however the scientific evidence is already being discovered. Based on this existing body of knowledge surrounding the known benefits and effects of equine therapy it is an exciting time to be delving into the profession as research and social acceptance will likely continue to develop making way for future growth in the industry.
References
Archer, P. A. (2007). Therapeutic Massage in Athletics. Baltimore, MD: Lippincott Williams &
Wilkins.
Denoix, J., & Pailloux, J. (2011). Physical therapy and massage for the horse. London: Manson
Publishing
Higgins, G., & Martin, S. (2012). How your horse moves: a unique visual guide to improving
performance. Newton Abbot: David & Charles.
Peters, S., & Black, M. (2012). Evidence-based horsemanship. Shelbyville, KY: Wasteland Press.
Rattray, F. S., Ludwig, L., & Beglin, G. (2005). Clinical massage therapy: understanding, assessing
and treating over 70 conditions. Toronto: Talus Inc.
Tortora, G. J., & Grabowski, S. R. (2000). Principles of anatomy and physiology. New York, NY:
Wiley.