25/01/2024
If you are a horse owner, please read this. This is spot on. In my integrative therapy journey over the past four years, I have found this to be spot on in many of the horses that I have worked on. The primary source of pain is not always the problem.
What is the diagnosis?
This is a common question we are asked. It is a fair and expected question. The trouble is – I don’t always have an answer for you. Why? Body Lameness is complicated and is rarely clear. In order to fix the body we have to know and understand its complexity. We also must appreciate the concept of biotensegrity.
Small areas of dysfunction can cause lameness and dysfunction in completely different regions of the body. I struggle with periodic left foot pain. I randomly (i.e. no specific event, sound familiar?) get a sharp pressure and pain in my left heal or arch of my foot. It feels like plantar fasciitis. I bought the insoles, I changed shoes- I got mild improvement. I was a 2/5 AAEP lameness. It wasn’t until I saw a human physio that I had relief of my foot pain. She quickly looked at me and explained my foot problem was due to a lower lumbar mild subluxation (my back did not hurt!) which lead to a pull on my fascia and change on my medial tibia which lead to the foot pain. Within one session my foot pain was resolved. I likely would have blocked to my foot. I would have definitely had a response to hoof testers. If I were a horse I would have been offered farrier changes and coffin joint injections, likely with mild improvement. My foot was a secondary issue but a primary concern. My back was the primary source of pain and yet a non-clinical issue. Until you discover the root cause, you will never truly resolve the pain.
Horses are the same. I treat horses based on my clinical exam and diagnostic imaging (to the best of my abilities). However, the important part is treating them based on their biomechanical failure points. It’s important to recognize that the body works as a whole and not individual pieces. If there is one region of pain or dysfunction, you must treat the entire area- not one spot. You also must consider how a horse’s biomechanics and biotensegrity play into their movement, posture and overall athleticism. If they cannot sit and use their lumbar-sacral junction correctly they cannot relieve tension in their thoracic sling. If their shoulder girdle is dysfunctional, you need to treat the entire region- the neck does not work independently from the first few ribs or shoulder. It all works together and in balance of each other. Additionally we must consider things like nutritional deficiency/toxicity, diet plans, exercise routines, saddle fit, gastrointestinal issues and muscle diseases. Often horses have some combination of all of these things. To get the best results or treat the difficult cases, we have to look at all areas.
On top of these concepts, we cannot image everything. The assumption that there is only an issue if you can image it, is ignorance. Necropsies have proven this to me repeatedly. We find so many things- nerve impingements, muscle changes, fascia changes, scar restrictions, disc problems, boney changes - all can be clinically significant and not found in the live horse. This doesn’t mean they aren’t part of the problem. The body can frequently compensate with little things over time, and then with age and addition of injuries sudden decompensation occurs- leading to acute pain on a chronic issue.
So when clients ask me, what was the diagnosis? I frequently say things like shoulder girdle dysfunction, lumbar sacral dysfunction, neuritis, rib cage dysfunction. I may sometimes be able to pinpoint specifics like T16 articular facet arthritis or lumbar intertransverse joint stepping. However, I know these individual things are part of a much larger picture of dysfunction. I treat the dysfunctional segments as a whole and that’s how we can get big results, where owners have been struggling. That’s how we can take a behavioral horse, who passed lameness exams but wasn’t right and turn them quickly into a happy relaxed working horse. Results matter to me more than individual diagnoses.
Image below is the brachial plexus- cannot be imaged well, cannot be blocked out, yet can be a huge source of pain and lameness in a horse. It’s frequently affected by other areas causing incorrect pressure, pull or tension on this region. It can be treated. Until you solve why it’s under incorrect forces, you will never resolve its pain.
