Doing Rehab Right
The 5-Part Guide to digging deeper in order to heal the whole horse
(and coming out the other side with your sanity intact)
The Camel, The Performance Horse & The Last Straw
Part 1 (or: how did we end up here?)
[insert doom and gloom diagnosis with uncertain prognosis here].
You can’t believe your luck… How do these things seem to come out of nowhere, just when you think your training goals and competition plans are coming together?
“At some point, everything’s going to go south on you. You’re going to say, ‘This is it. This is how [it ends.]’
Now, you can either accept that, or you can get to work…”
“That’s all it is. You just begin. You do the math. You solve one problem and you solve the next one, and then the next.”
Meet your guinea pig…
This handsome fellow is the (in?)famous Ollivander. Ours is a long story, and I often say that if all my other horses were sent to teach me, Ollie was sent to test me on everything I learned… and take that teaching to the next level. I won’t lie, it has been an incredibly tough journey, but it has also been one of the most rewarding relationships I have ever built with a horse. The physical progress is just one side; what has made my heart sing is seeing a horse I would put on the severe end of the autism spectrum blossom into a friendly, humorous and outgoing soul with a few quirks and a very clever mind (he keeps me on my toes!).
Ollie’s main injury was a chronic one, complicated by other long term issues and a poorly timed fence injury. It is the most intensive rehab program I’ve undertaken with one of my own, so this series will also look at some of the lessons from Ollivander as they fit in with what I see in my bodywork practice and in my research.
Some major discussion points will include how a horse’s individual case, quirks and challenges might influence your choice of techniques, exercises and interventions. It’s also important to have realistic expectations about what the future will hold, particularly if there are soundness issues that will require long-term management. But fear not; these factors are all essential ingredients in any rehab recipe.
The essentials kit:
- poles and risers (#IKEAhack here)
- comfy bedding for the patient
- bandages to use as body wraps
- good walking boots
- gloves for the moments your horse decides he’s really over it all while handwalking
- more wine
- a sense of humour
- gin, for when your horse expresses his disgust by dancing on his back legs, when all Houdini attempts are thwarted…
How did this happen?
Think of our proverbial camel. Day in and day out, he carried heavy loads to market. And one day, as per usual, his owner piled up the straw on the reliable beast’s back. Just a little more, and that’ll do, thought the owner as he threw one last piece on top. Little did he know that the camel was one wisp of straw away from collapsing to the ground.
Is it the last piece of straw that tips a horse over the edge to catastrophic failure and acute injury? Or is it the repetitive strain, chronic compensation and gradual wearing down of the body’s ability to tolerate significant loads and biomechanical insults?
Sometimes, it is the freak accident or the unlucky slip that causes a “true” acute injury. But frequently, that last straw and breaking point can be traced to a chronic weakness or subclinical injury that has gone undetected until you realised your horse was in serious trouble.
Chronic, acute and subclinical injuries
What are they, and what exactly do they mean for rehab?
Definition: persisting for a long time; the period is undefined and varies with circumstances… Also has the sense of the disease showing little change or very slow progression over a long period.
A.K.A.: it’s been brewing for a while and you (and your horse!) may or may not be aware of it; in fact, one or both of you may even be compensating for it pretty well at a totally subconscious level!
Which means: it might come as a nasty surprise if the stars align to create an unlucky opportunity for that last wisp of straw to wreak havoc.
Definition: referring to any specific, sharp pain that is of rapid onset or results from a specific traumatic incident; the acute phase of an injury refers to the immediate period of time following the onset of symptoms [often defined as hours to days].
A.K.A.: [in the context of this piece] the dramatic lameness, inflammation or weakness that has you tearing your hair out; or the end-stage, sudden-onset not-quite-rightness that has progressed from chronic or subclinical to “uh-oh…”
Which means: you might be in for a long haul return-to-work plan… but keep reading, because the success of that plan might just ride on how deeply you dig to unearth the contributing factors.
Definition: without clinical manifestations; said of the early stages or a very mild form of a disease, or when a disease is detectable by clinicopathological tests but not by a clinical examination.
A.K.A.: easily obliterated if detected, but this poisonous species of career-ending creeper will sneakily set trouble in motion unless dealt with before its tendrils spread.
Which means: it will gleefully take hold right under your nose unless your management team includes open-minded practitioners (vet, farrier/trimmer and bodyworker as a minimum) who uses their eyes, hands and lateral-thinking as well as all the tools at their disposal to detect small changes and red flags before they become clinically obvious. It also means that you and your dream team need to know what is normal for your individual horse.
What is our diagnosis?
This is where your veterinarian comes in. While this might be an expensive and frustrating part of the journey, it is critical to have a clear picture of what is occurring underneath the skin before you proceed with a rehab program. This isn’t the place to get up on my soapbox, so if you want to know why this is something I stomp my foot down (hard) over, read the final section of this piece. I don’t care what Joe Bloggs with the magic wand says; you need answers before you get started, so please find out what is really going on. Seriously.
But wait…is the diagnosis the primary problem, or is it just a symptom? If not, then where the heck is the nucleus?
Like the camel’s broken back, our horse’s diagnosis may simply be the depressing reflection of the moment their body was no longer able to mask, protect or compensate for an underlying problem. Moreover, chronic biomechanical dysfunction and incorrect movement also have a way of spreading tendrils throughout the body; reducing room for error and silently inching closer to the point at which it only takes that last straw to blow a tendon below a muscle that cannot lengthen enough, or a twist too far to tear a meniscus that could have been protected by the muscles that would normally stabilise the stifle joint.
As my veterinary dictionary puts it:
the mathematical basis for the study of large changes in a total system which may result from small changes in a critical variable in the system.
What, then, do we have to treat? The fresh injury? Or the root cause?
Yep, you guessed it — both, and all the tendrils in between.
Good rehab is about healing the whole horse and restoring them to a higher standard of soundness – raising the benchmark and striving for the greatest degree of improvement you can achieve, not just trying to heal the acute injury or the most obvious problem. Why?
Because soundness is (or should be…):
- whole horse health and wellbeing
- comfort and relaxation
- body and mind
- fascial connections
- demeanour and willingness
- straightness, symmetry and, above all…
Rehab and training are not two separate channels
All rehab and usual training should be about protection and preservation of long-term soundness, well being and overall whole horse health. First, do no harm: preserve; protect; improve; and, above all, always reach higher for your horse. Can you raise the benchmark?