23/06/2019
Why no cause is found in some lame horses ...
and why often a problem is found in the legs of lame horses, although this is not THE CAUSE.
As a veterinarian, I was trained with the idea that horses rarely have problems with their backs. There were even teachers who claimed that horses cannot be bothered by their backs because their vertebrae are so large and strong and are stabilized by strong ligaments.
Based on these assumptions, it means that lameness in a horse comes by definition from the leg. In practice, this is also the area that is primarily looked at.
I probably just had a bit of bad luck, but I soon came across a fair number of horses that were lame, but where nothing was found in the legs during the research.
That meant that I had to think a bit wider and let go of current ideas. Meanwhile, from a veterinary point of view, the idea of back pain has also broadened somewhat. When horses are lame for a long time, they can also have back problems was the idea… ..
I dare to say that in many cases it is the other way around and I will explain why! When horses have back problems for a long period of time, they often develop injuries in their legs.
First of all, this thought is confirmed by all those horses that I came across that were lame or irregular, but for which no explanation could be found. These horses were turned inside out at one or more clinics.
Secondly, these horses responded very well to bodywork with the emphasis on the structures in and around the skull, neck, back and pelvis.
Thirdly, I often saw people with back problems walking very lame. So why would that be different for horses?
If we look at the movement possibilities of the pelvis of the horse, we see that the pelvis, seen from behind, goes up and down. So left goes down while right goes up at the same time and the other way around. In addition, the pelvis moves from left to right and the pelvis can assume flexion (bulging) and extension (hollow). In the next post I will post a video on which you can clearly see how the pelvis moves.
BUT the pelvis itself cannot move, at least not very much. It consists of several bone parts that are firmly connected to each other by connective tissue. As a result, for example, some shock absorption is possible, but large movements are not. The pelvis is attached to the spine with the help of the sacrum. This means that the pelvis can only move if the spine can move. See figure; schematic drawing of the spine.
The pelvis can be lowered to the left and to the right and raised again because the spine can rotate. The lateral movement of the pelvis is possible because the vertebral column can assume lateral bending.
Where does the pelvis movement come from? In other words, which part of the body makes the pelvis move? .... That is the hindleg. If the left hind leg is lifted during movement, the left pelvis sinks. When the left hind leg is brought forward, lateral bending to the left occurs and when the left hind leg is put down, the left pelvis rises.
Now there may be abnormalities in the spine such as kissing spines or osteoarthritis that affect the vertebrae themselves, but much more often the structures around the vertebrae are overloaded and painful. These can be the muscles, the fascia and all kinds of ligaments. Back pain usually starts with soft tissue pain (everything that is not bone). These complaints can be very painful because the fascia in particular contain many nerve endings. If there is pressure or strain on the fascia, this can give a strong pain sensation.
If a part of the body hurts, a self-protection system comes into effect. The painful part is immobilized or the movement is limited. If a horse has back pain, the movement that starts in the hindleg and continues in the pelvis cannot be continued. The movement of the spine is limited by the pain complaints. The pelvis cannot move, but because that movement occurs from the movement of the hindleg, the hindleg cannot complete the normal movement pattern.
What are the consequences?
These deviations in the movement pattern are only subtle and are often not observed. Until they get worse. Then the horse can show behavioral problems in the training, a stiff start-up, show slightly increased muscle enzymes in the blood, be sensitive on the back, react to the girth, bad mood, reduced general health, etc. etc. Some horses show after a longer period of time a clear visible lameness, others are injured by the abnormal movement pattern of which problems in the tendon, the check ligament, the knee, the hock and the calf joint are the most common.
With these horses, a problem is indeed found in the leg itself that requires attention! BUT for a successful rehabilitation it is necessary to look at the whole horse !!
There are almost always problems higher up in the body that are THE cause of the injury in the leg itself. If we do not resolve this, the injury will return or a compensatory injury will develop somewhere else.
Horses can walk mildly to clearly lame from back complaints. That is why it is important that the back is properly viewed in the case of lameness. Pain complaints in the muscles and fascia cannot be seen on x-rays and ultrasound. With the help of these diagnostic tools we can only find tissue damage, but not painful fascia.
However, the horse can perceive this pain very well and therefore we can find the cause! We can read the body of the horse with our eyes and hands. The reactions of the horse in combination with his facial expressions tell us where the problem is.
