This week with Jenna has been amazing! She has started opening up to me, which has allowed us to forge a much deeper connection during therapy. In listening to the subtle (and sometimes not so subtle) feedback she is giving me I have been able to gain some trust and work on things she wasn’t so keen on me touching in week one. The goals for this week were to increase movement tolerance via walking, free up the thoracic spine, and continuing to work on the organs of digestion. I have had some great successes in all three areas.
The Power of Movement
In my opinion, the first step (and most important) to helping a horse recover is to stimulate their body’s innate ability to heal itself through pain free movement. Having spent the greater part of my first career as an exercise physiologist and personal trainer I am extremely dedicated to the practice of movement. Movement is the key to healing a great deal of issues that can arise within the body. There is substantial literature in support of exercise over medication in treating a variety of human conditions. This led me to ponder why rehabilitative exercise isn’t at the forefront of most equine therapy programs. Just search this topic on the internet and you will find a vast array of scholarly articles in support of the efficacy in treating common metabolic issues by combining exercise with proper nutrition. It is my goal to implement these strategies with our equine partners as they suffer many of the same pathologies for many of the same reasons. Horses in the wild would be covering roughly 30-40 miles a day – so it’s really no surprise that domesticated horses getting an hour of exercise a day are prone to a variety of health issues.
Improving movement tolerance and variation is also key to hoof rehabilitation. The internal structures of the foot grow in response to load and stimulation. This principle in human physiology is known as the “The Principle of Progressive Overload”. Simply stated, in order for soft tissues, such as muscles, bones, joints, and tendons to grow and strengthen, a load that exceeds regular daily tolerance must be applied. By adding just enough load to push the system a little bit the body’s natural response to the stressor is to lay down more tissue or strengthen the tissue it already has. This is a huge part of the science behind high performance training - think professional athletes and bodybuilders. This principle, of course, applies to our equine friends as we are both mammals and share the same cellular physiology of muscles, bones, etc.
Variation in terrains allows the proprioceptors in the foot to be stimulated. Proprioception is the how the body senses limb position and movement in space. The central nervous system (brain) receives messages from proprioceptors and then is able to output motor control (movement). In order to execute a movement such as walking, proprioceptors are giving us continuous feedback of limb position every millisecond so we know just how much and where to step. Without adequate proprioception, motor co-ordination in the body is lost (i.e. we would not be able to walk straight). Horses similarly have proprioceptors all throughout their bodies and many within each hoof. The frog, sole of the foot, digital cushion and so on all require stimulation for growth and development. Without stimulation to these structures as well as the joints and muscles that make up the lower leg they would not be able to sense where their bodies are in space. Over time this lack of stimulation can present as movement dysfunction or perhaps an unwillingness to move. All of these factors are especially important for the laminitic horse as much of their rehab needs to be tailored to encourage growth and development in the hoof tissues that have been disrupted by inflammation.
Jenna’s Exercise Routine
I formulated an exercise routine for Jenna that involves days of long slow walking (approx. 1hr) alternated with days of shorter bouts (30-45 min) of higher intensity walk/run intervals, as well as training on some varied surfaces to stimulate her feet. Prior to any exercise session I do 5-10 reps of belly lifts, focusing through the thoracic spine (also known as the withers) and the joint mobility exercises demonstrated in last week’s video. Doing the belly lifts prior to exercise fires up the muscles I’m aiming to engage during movement. By activating the abdominal muscles (belly lifts) the nervous system is able to integrate the pathway more efficiently which translates to her having greater core activation while we are out on our run. This helps her body understand how to carry itself more efficiently. The joint mobility work is to promote fluid production prior to exercise with the intent of reducing stiffness and pain within the joints. Since starting this structured exercise program, I can see that Jenna’s body is definitely ready for the challenge. She is always willing to pick up a run and is full of enthusiasm on each and every outing without showing any signs of lameness or discomfort.
My daily routine with Jenna is usually checking her feet in the AM for elevated pulses and warmth. After about 10 days I started to notice a very obvious trend. She tends to have warmth in both fronts first thing in morning and on a few occasions elevated pulses in both as well. Following her check, I do the above exercises then take her for a walk/run and recheck around 9 or 10am and both feet are at cool, if not almost cold. I can only attribute the decrease in warmth to the movement protocol she is on as I couldn’t find any other variable that could be affecting this outcome. In my opinion, this is a huge indication of the efficacy of movement in the management of laminitis.
I had a huge breakthrough with Jenna this week when I worked on her thoracic cage. If you watched the flinch test video in week 1 you may remember that there was some very strong nerve patterning showing up when I flinched around her digestive system and around her heart and lung points. This week she very kindly showed me exactly where I need to be to help free this up and I was lucky enough to catch this magic on video! As I palpated around trying to find the area of greatest restriction she showed me by moving her own body to the point while I applied a steady force (meaning I did not push any harder) – she then pushed into me when she found the exact spot needed for release. As I held there, I felt a ton of neural activity under my hand and in the slowed down clip I have included (its near the end of the video) if you watch very closely at where my hand is you will see a large clunk of the tissue around the scapula. It literally clunks and unwinds right in front of your eyes. This is one of the best examples I can give of a nerve being released from its entrapment and the surrounding structures that were held hostage becoming free. I would like to make clear I never apply additional force; I provide a stable fulcrum for the horse to work around and they determine the amount of force necessary by leaning in at which point I may or may not give the tissue a nudge but this is in no way an “adjustment”. It’s truly amazing how much information the horse will give if you only stop to listen. I hope you enjoy the video and most importantly hope something was learned. The huge release shown in this video below has helped to free up some space in her thoracic cage (withers region of spine) which is becoming very evident in her ease with the belly lifts and the increased range of motion I am seeing in her. She is beginning to move with more freedom in her shoulders and spine which is incredibly rewarding to see.
My goals for week 3 are to continue increasing movement tolerance and addressing the specific cranial and cervical issues she presented with in the assessment. Working to free up the head and neck as well as decrease the flinch test responses seen around C0-C1-C2.