Author Archives: Julia

Pain does not always equal damage

Chris Bates  M.Ost – Registered Osteopath

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Whether we are talking about Humans or Animals, pain science is an important subject to understand when we embark on a career in therapy.

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In the world of Osteopathy, pain is possibly the most obvious and prevalent sign of something affecting our patients. This doesn’t mean however that the pain is a good indicator of the severity of damage (if any) to the tissues.

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Here we will explore the phenomenon we call “Pain” and why it might be misleading in some circumstances.

What is Pain?

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It can be hard to put a short definitive answer to this question as pain is variable and depends upon the patient and their personal perception. Physiologically speaking, pain is the electrical impulses via sensory nerves that have been stimulated at nociceptors (Pain receptor nerve endings) being processed in the higher centers of the central nervous system (CNS).

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The higher centers of the CNS will process the information and decide if the pain signal requires an action to reduce further damage or create heightened awareness such as a sympathetic response (Fight, flight, fright response).

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This makes the science of pain seem simple. One could even ask, “ if it’s like flicking a switch at the receptor, how could the signal be wrong?”  That is the question that biomedical scientists have been grappling with for nearly a century.

It’s important to understand pain as it can have hugely detrimental impacts on sufferers both in acute and chronic presentations.

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The National Institute of Neurological Disorders and Stroke (2023) describes how pain has wide-reaching effects such as limiting work abilities, disrupting relationships and social activity, mental health concerns, and rendering daily tasks difficult or impossible.

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Within the animal care world, pain has equally far-reaching consequences. Horses that are ridden, driven, and possibly competed can present with performance issues, time out of competition, and worsening behavioral traits.

Dogs may find regular walking activities difficult and consequently end up lacking in general health. For people working with animals in conservation, pain could reduce or inhibit breeding behaviors. Animals in pain will often exhibit “stereotypic” behaviors which are repetitive movements or actions that seem to have no intended goal.

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These behaviors can become physically damaging. Horses for example might “crib” and “windsuck”. This can damage teeth, lead to colic, or exacerbate ulcers. Dogs may damage furniture or pace leading to nail and paw injuries or repetitive strain.

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Of course, pain in animals can also put owners and handlers (even the public) at risk if the animal’s behavior becomes dangerous.

Does Imaging Help?

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Medical and Veterinary science has benefited immensely from the development of various imaging methods such as ultrasound, X-ray, and MRI. There is no doubt that putting as many pieces of the puzzle together as possible is the sensible thing to do when looking to make a diagnosis.

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However, many studies of human pathology and radiology have found that a large proportion of positive radiology findings are asymptomatic (pain-free) and many cases of severe pain have no radiological signs to find.

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Many of us as pet owners will have experienced taking our beloved animal to the vet only for them to say that there are no obvious signs of damage, injury, or degeneration. So why is this?

While invaluable, imaging can only show us one aspect of the process of pain. Yes, there are obviously going to be times that osteoarthritis (cartilage degeneration), an osteophyte (bone spurs), or a disc prolapse are visible and match up perfectly with the presenting pain and disability.

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The problem with relying too heavily on imaging when assessing pain is that there are other subtle influences on pain severity and location.

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Referred Pain.

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I often say to my patients, “If you are standing on a cat’s tail, the cat will make a lot of noise, but it’s not where the noise is coming out that the problem lies”.

Ok, this might sound a bit crude and I certainly don’t go around standing on a cat’s tail, but think about the metaphor here. Some dogs such as German Shepard are more prone to hip and lower back dysfunction as they age.

This is often due to the morphology we have bred into them which makes them stand their hind limbs far out behind, extending the hips and leaving the tensegrity of the spine and hind kinetic chain to support gravitational forces.

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In Osteopathy we are well aware of how damage, inflammation, and compromised tissues in one location can create symptoms in other locations.  If there were to develop a compression at the nerve root due to excessive spinal extension or distortion to the nerve passing the hypertonic psoas muscle then the distal (further from central) reaches of the nerve could display symptoms.

In this case, the area where pain, numbness, or changes in sensation occur wouldn’t actually be where the focus of intervention should be. 

There are various ways in which the course of a nerve can be perverted, join our courses to find out how.

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Central Sensitization. 

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When pain does occur as a result of trauma, illness, or another input, the body will react by trying to reduce the effects of the damage and trying to avoid the same thing happening again.

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We have reflex actions to quickly get ourselves out of danger that require no conscious control. We develop psychological aversions to situations that caused pain before, this is part of the holistic model of Osteopathy that considers psychological and physical interrelated and inseparable.

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Unfortunately, chronic pain or repeated exposure to the stimulus can cause the body to essentially “tune-up” the pain volume dial in our higher centers. This means that it takes less of the stimulus to evoke the pain felt.

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This can also mean that sensations that would not normally feel painful become extremely uncomfortable or painful. We call this Hyperalgesia. Imagine a horse who has a vast history of hoof problems and poor care.

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This horse may get rescued and begin to receive the right hoof care and trimming but the ground had already been laid for the chronic repeated pain stimulus to “tune-up” sensitivity.

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This could make riding on roads difficult, lead to unwanted behaviors, or cause lameness after visits from the farrier.

I tend to describe it to owners with another metaphor. If the nerve is like a path through the forests, a path that gets walked along a lot will be easier to walk down, and a path that is not used so much will become overgrown. A nerve pathway that is stimulated over and over can lead to changes in the processing sensitivity.

Join our courses to find out how Osteopathy can help pathways downregulate again and function better. 

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Conclusion

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Something we must remember is that the feeling of pain is created within our central nervous system as a way to instruct our conscious mind to take action or avoid action.

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It is a signal, not an actual manifestation of the damage (if any) itself. Pain is often not felt in the location of damage, pain is often “up-regulated” beyond what is reasonable for the condition presenting and pain is influenced by other factors such a mental state or vital reserve.

Our work as therapists, Osteopaths or coaches is to educate owners about pain in a way that makes sense to them. By the way, please feel free to use my metaphors. By understanding the science of pain and how to affect it, we take control over what can often feel overwhelming.

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Owners often feel completely helpless when caring for an animal who is experiencing pain, especially when that pain seems to not match any damage or conditions. If owners understand that the pain itself is not equal to damage and that there are ways to improve outcomes then it can really help support their care and potentially even save animals from unnecessary euthanasia.

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Bibliography: 

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Harte, S.E., Harris, R.E. and Clauw, D.J. (2018) ‘The neurobiology of central sensitization’, Journal of Applied Biobehavioral Research, 23(2). doi:10.1111/jabr.12137.

Pain (no date) National Institute of Neurological Disorders and Stroke. Available at: https://www.ninds.nih.gov/health-information/disorders/pain#:~:text=What%20is%20pain%3F,%2C%20almost%20unnoticeable%2C%20or%20explosive. (Accessed: 31 October 2023).

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Soo, M. and Worth, A. (2014) ‘Canine hip dysplasia: Phenotypic scoring and the role of estimated breeding value analysis’, New Zealand Veterinary Journal, 63(2), pp. 69–78. doi:10.1080/00480169.2014.949893.

What is pain? (no date) What is pain? | British Pain Society. Available at: https://www.britishpainsociety.org/about/what-is-pain/ (Accessed: 01 November 2023).

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By Siun Griffin, Veterinary Physiotherapist and LCAO Community Manager 

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Dogs are beloved members of our families, but their dietary needs differ significantly from ours. Some foods that are safe for humans can be highly toxic to canines due to their unique metabolism. It’s essential to be aware of these potential dangers to keep your canine companion safe. In this article, we’ll explore 10 foods that are poisonous to dogs, explain why they are toxic, and provide information on the signs of toxicity and whether veterinary attention is required.

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1. Chocolate

Toxic Ingredient: Theobromine and caffeine

Why It’s Toxic: Chocolate contains theobromine (a type of methylxanthine) and caffeine, both stimulants that can affect a dog’s heart and nervous system. The amount of theobromine varies depending on the type of chocolate with milk and white chocolate containing the least amount and unsweetened baker’s chocolate the most.

Signs of Toxicity: Vomiting, diarrhea, rapid breathing, increased heart rate, seizures, restlessness, and, in severe cases, death. It can take several hours for symptoms to present.

Veterinary Attention: Always seek immediate veterinary care if your dog consumes chocolate.

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2. Grapes and Raisins

Toxic Ingredient: Unknown

Why They’re Toxic: The exact cause of grape and raisin toxicity in dogs remains unclear, but ingestion can lead to kidney failure starting at around 24 to 72 hours post ingestion which is fatal. Even one grape or raisin can be fatal.

Signs of Toxicity: Vomiting, diarrhea, lethargy, loss of appetite, shivering, and abdominal pain. These can present from around 6 to 12 hours after ingestion.

Veterinary Attention: Consult a veterinarian if your dog consumes grapes or raisins immediately.

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3. Onions and Garlic (including Chives & Leeks)

Toxic Ingredient: Thiosulfate

Why They’re Toxic: Onions and garlic contain thiosulfate, which can damage a dog’s red blood cells, leading to anemia. They can also cause kidney damage and elevated respiratory rate. This includes any form of these plants, such as dried, cooked, fresh, and powdered.

Signs of Toxicity: Weakness, lethargy, vomiting, diarrhea, drooling, and pale gums.

Veterinary Attention: Seek veterinary care if your dog ingests onions or garlic as it is potentially fatal.

4. Xylitol

Toxic Ingredient: Xylitol

Why It’s Toxic: Xylitol is a sugar substitute commonly found in sugar-free gum, candies, and some peanut butter brands. It can cause a rapid release of insulin, leading to hypoglycemia and liver failure in dogs. It is very dangerous to dogs and it can be found in some non-food products that your dog could access, such as toothpaste.

Signs of Toxicity: Vomiting, loss of coordination, seizures, and collapse.

Veterinary Attention: Contact a veterinarian immediately if your dog ingests xylitol. Symptoms can appear from 30 minutes up to 12 hours. Immediate vet attention is necessary which can have a good prognosis if administered early.

5. Alcohol

Toxic Ingredient: Ethanol

Why It’s Toxic: Alcohol can cause alcohol poisoning in dogs, leading to depression of the central nervous system and potential organ damage.

Signs of Toxicity: Vomiting, diarrhea, difficulty breathing, tremors, and coma.

Veterinary Attention: Seek emergency veterinary care if your dog consumes alcohol.

6. Macadamia Nuts

Toxic Ingredient: Unknown

Why They’re Toxic: The exact cause of macadamia nut toxicity in dogs is unclear, but ingestion can lead to weakness, tremors, and hyperthermia.

Signs of Toxicity: Weakness, vomiting, muscle tremors, and elevated body temperature. Signs can start from 3 hours after ingestion or longer.

Veterinary Attention: Contact a veterinarian if your dog eats macadamia nuts.

7. Avocado

Toxic Ingredient: Persin (found in the pit, skin, and leaves)

Why It’s Toxic: Persin in avocados can cause gastrointestinal upset, heart congestion, and fluid accumulation around the heart.

Signs of Toxicity: Vomiting, diarrhea, and difficulty breathing.

Veterinary Attention: Consult a veterinarian if your dog consumes avocado.

8. Caffeine

Toxic Ingredient: Caffeine

Why It’s Toxic: Like theobromine, caffeine is a stimulant that can affect a dog’s heart and nervous system.

Signs of Toxicity: Restlessness, rapid breathing, increased heart rate, seizures, and death in severe cases.

Veterinary Attention: Seek immediate veterinary care if your dog ingests caffeine.

9. Mushrooms

Toxic Ingredient: Various harmful compounds

Why They’re Toxic: While not all mushrooms are toxic to dogs, some wild mushrooms can contain harmful compounds that affect the liver, kidneys, and nervous system. Toxicity levels vary by species.

Signs of Toxicity: Symptoms can range from mild gastrointestinal upset to severe liver or kidney failure, depending on the mushroom species

Veterinary Attention: If you suspect your dog has consumed wild mushrooms, consult a veterinarian immediately. Do not attempt to identify mushroom species yourself, as some toxic varieties closely resemble safe ones.

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10. Cooked Bones

Toxic Ingredient: Splintering bones and bone fragments

Why They’re Toxic: Cooked bones, especially poultry bones, can splinter and cause choking, intestinal blockage, or perforation.

Signs of Toxicity: Choking, difficulty breathing, abdominal pain, and vomiting.

Veterinary Attention: Contact a veterinarian if your dog ingests a bone and experiences any symptoms

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Final Thoughts

Being aware of these toxic foods and their potential effects on your dog is essential for responsible pet ownership. If you suspect your dog has ingested any of these poisonous foods, contact your veterinarian or an emergency animal clinic immediately. Prompt action can save your dog’s life and prevent serious health complications. Always prioritize your dog’s safety by keeping harmful foods out of their reach.

Enhancing Veterinary Care with Animal Osteopathy: A Holistic Approach

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 By Siun Griffin, Equine Physiotherapist and LCAO Community Manager

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Animal osteopathy is an emerging field within veterinary medicine that focuses on promoting wellness and treating various health issues in animals through manual manipulation of the musculoskeletal system.

This holistic approach considers the interconnectedness of an animal’s body, aiming to restore balance and alleviate pain without solely relying on medication or surgery.

As veterinarians seek alternative and complementary methods to enhance their practice, animal osteopathy offers a valuable tool that can lead to improved patient outcomes and overall well-being.

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Understanding Animal Osteopathy

Osteopathy, in the context of veterinary medicine, involves the manipulation of bones, muscles, and other tissues to optimize an animal’s health.

Practitioners of animal osteopathy, known as animal osteopaths or osteopathic veterinarians, use their hands to assess and treat musculoskeletal issues that may be causing pain, discomfort, or limited mobility in animals.

This approach is grounded in the principle that the body possesses a natural ability to heal itself when its various systems are in balance.

Animal osteopaths believe that by addressing structural imbalances and promoting proper alignment, the body’s self-healing mechanisms can function more efficiently, aiding in recovery from injuries, chronic conditions, and other health challenges.

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Benefits of Animal Osteopathy for Veterinarians

1. Complementary Treatment Options

Incorporating animal osteopathy into a veterinary practice provides an additional avenue for treatment alongside traditional veterinary methods. This can be particularly beneficial for cases where medication or surgery may not be the most suitable option or as a complementary approach to enhance existing treatments.

2. Holistic Assessment

Animal osteopathy focuses on the entire body rather than isolated symptoms, allowing veterinarians to take a more comprehensive approach to diagnosing and treating conditions. By considering the interconnectedness of various systems, veterinarians can gain deeper insights into the root causes of certain health issues.

3. Non-Invasive Approach

Osteopathy primarily employs manual techniques that are gentle and non-invasive, making it an attractive choice for animals that may be sensitive to pharmaceuticals or surgeries. This can also be advantageous in cases where surgical risks are high due to age or preexisting conditions.

4. Pain Management

Animal osteopathy can be highly effective in managing pain associated with musculoskeletal problems. By improving alignment and reducing tension in muscles and tissues, animals often experience relief from chronic pain or discomfort.

5. Preventive Care

Incorporating osteopathic assessments into routine veterinary visits can help identify minor imbalances before they develop into more serious issues. This proactive approach can lead to early intervention and improved long-term health.

Incorporating Animal Osteopathy into Veterinary Practice

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Veterinarians looking to incorporate animal osteopathy into their practice should follow these steps:

1. Education and Training

Veterinarians interested in practicing animal osteopathy should seek specialized training from reputable institutions. These programs typically cover anatomy, physiology, osteopathic techniques, and ethical considerations specific to animal care.

2. Certification and Licensing

Depending on the region, veterinarians may need to obtain specific certifications or licenses to practice animal osteopathy legally. Compliance with local regulations is essential.

3. Collaboration

A collaborative approach between traditional veterinary methods and osteopathy can yield optimal results. Veterinarians should communicate effectively with their clients and, if needed, refer patients to other specialists when necessary.

4. Comprehensive Assessments

Incorporate osteopathic assessments into routine veterinary examinations. Consider an animal’s posture, gait, and any signs of discomfort or restricted movement.

5. Treatment Plans

Develop individualized treatment plans that integrate osteopathic techniques as appropriate. Regular evaluations can help monitor progress and adjust the treatment strategy accordingly.

Final Thoughts

Animal osteopathy offers veterinarians a holistic approach to diagnosis, treatment, and overall wellness for their patients.

By considering the body’s interconnected systems and promoting natural healing mechanisms, veterinary professionals can enhance their ability to provide comprehensive care.

As this field continues to gain recognition, animal osteopathy is poised to contribute significantly to the advancement of veterinary medicine, offering a complementary approach that focuses on the well-being of animals in a profound and holistic manner.

For more information about LCAO’s PG Diploma in Animal Osteopathy for veterinarians please visit here or don’t hesitate to get in touch via email at info@aosteocollege.com

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By Christopher Bates  M.Ost  (Registered Osteopath), LCAO Contributor

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Whether they are rushing about chasing tennis balls or challenging you to a tugging match with a toy, dogs are a joy to watch. However, their playful movements make these exuberant animals far more prone to lateral (sideways) forces and injuries than any other domesticated animal.

While evidence to support the claim that dogs are more susceptible to lateral injuries is slim, the anatomical, behavioral, and biomechanical principles for this statement are sound.  Let’s examine why.

The playful behavior that our domesticated dogs show stems from evolutionary traits that developed from being a predatory animal.

Imagine a wild predator chasing down a large mammal as its prey; the prey has often a size and speed advantage over the predator, but the predator has other tricks. Predatory animals are in an evolutionary arms race with their prey. They have to create traps, be faster, work as a team, and become more agile.

Canines evolved to work in teams (packs) in order to bring down larger and often faster prey. Instead of tiring their prey, they would play the long game. And while prey may be fast over short distances, the pack could take turns leading the chase over a longer stretch. As a result, the prey got tired.

Once the speed factor is cut out, there is one thing left to do- close in. At this point in the hunt, canines have a fantastic ability to alter direction quickly to shut off escape routes. We see it today in the herding work of sheep dogs- a skill that no technology can yet replicate. Let’s take a look at the science.

Biomechanics:

In the image, we have a determined Border Collie rounding up sheep. A very precise and fast change of direction is about to occur.  The forces being transferred through the tissues here are very strong.

As a quadruped, abduction (limb moving away from the midline) of the shoulder is limited, around 30 degrees. This is the average angle the limb can reach before other mechanical changes occur such as trunk rotation or valgus (bowing) stresses on the distal joints.

To accommodate those forces, the tissues undergo micro and macro changes. Over time these changes can become more permanent and this is simply the adaptation of “fitness” for a task, the reason that appropriate training is so important for sporting dogs.

Unfortunately, there will often be times when the tissues are pushed just beyond their vital capacity and damage will occur. As stated above, other joints and body regions can flex, alter, and accommodate forces as well.

We have all seen this posture and to us, it looks playful and cute. But this position is a perfect example of the dog lowering its center of gravity in preparation to move in any direction quickly, just like its ancestors.

The body is lowered and inclined back to distribute weight evenly over the four feet building potential energy in the elastic muscles and taught tendons. Notice the front legs are splayed to the sides to accommodate lateral (sideways) shifts.

Muscles and tendons and joints….

So, what might we find as therapists, owners, and trainers? Those lateral forces will be sent through the complex structure which is the thoracic sling supporting the front limb.

Our courses teach the anatomy of this area in great detail and we use high-quality teaching materials to engage you in what can seem to be an overwhelming subject. But for now, let’s think simple.

The limb gets strained laterally then the muscles retaining the limb to the midline will get stretched. This could create the chance for minor tears or damage to the pectoral muscles.

Our courses teach in-depth palpation and Osteopathic assessment to allow you to ascertain if these muscles are damaged or experiencing pain (“Or” is important – Pain does not = damage, let us look at that in another article).

A joint that is built to have a greater range in flexion and extension than inside bending such as the carpal complex (essentially the wrist) could get over-exerted in that fast or excessive sideways darting movement.

The carpus is surrounded by a network of small fibrous ligaments that while elastic, have end ranges beyond which they can sprain or even snap.

Closing thoughts:

Should we stop doing agility classes with dogs? Should we stop our dogs from playing? Of course not!

The behaviors that dogs show in play and the skills they train in agility, working farm dogs, and other canine sports are natural and animals thrive mentally and physically when allowed to express their innate behaviors.

This article is not about suppressing those movements, it is to show how useful Osteopathy and therapeutic intervention can be for our four-legged friends. Educating ourselves in how to recognize injury, understanding the mechanics involved in canine movement, and knowing how to support good fitness is how to ensure dogs can live well.

Even if you don’t wish to become a professional Animal Osteopath (AO), we offer a range of short courses and diplomas that would be of great benefit to any dog trainer, breeder, or owner. 

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Click on the thumbnail below to read an excellent dissertation by LCAO graduate Bianca Coutts on the efficacy of osteopathic manual treatment for the treatment of canine osteoarthritis.

For more information on how you can become an Equine Osteopath, click here

By Chris Bates, DO and Animal Therapist

Last time in Part One, I introduced you to a case of a horse with recurrent neck problems, and I discovered over my observations and assessments that the causative impact was from the rider/owner.

Of course, this is not an uncommon thing to discover when working with horses. When I worked as a riding instructor, I often saw riders who would explain to me that their horse was “badly behaved” or that they had had numerous therapists and vets out but could never isolate what was causing their horses to play up.

I firmly believe that however clear-headed and open-minded people can be, the human ego is far too strong for people to consider that they might be the problem.

Not to say that people are arrogantly assuming they are perfect, it is simply that they don’t see themselves mirrored in the horse’s physicality.

Osteopathy teaches us that form is a result of a combination of the material present and the afferent inputs upon it. Essentially, anything is a product of its make-up and environment interaction.

This dynamic interplay is ever changeable (luckily) and it shows us exactly what we need to see if we take the time to step back and observe. That really is the key word here, “Observe”. Step back and see and you have moved from where you were, where we only saw part of the whole.

The case I was covering in part 1 was clear if I “stepped back” and saw the whole picture. I had seen the horse ridden but only by the owner’s friend, not her herself.

If you have not yet read part one “It’s the Rider – Part 1”, I recommend you do so to fully appreciate this article.

It is not necessary to be a riding instructor to observe a rider’s impact on the horse. We can use our Osteopathic thinking to consider the forces such as gravity, tensegrity, and momentum and this will give us a good idea of what is happening.

Of course, it is essential to have a high degree of knowledge of anatomy and how the biomechanics of the horse function.

So, what was the rider in part 1 doing?

This particular rider was eager to enhance her flatwork (dressage) and did some light jumping. She used a general-purpose English saddle that was well-fitted.

One clue as to the way she rode was the worn line on the stirrup leathers; the friend I had seen ride had to shorten the stirrups two holes before she rode.

It is quite common for trainers and the advice of other riders to suggest riding longer in the stirrups for a “deep seat” and “better posture”. Unfortunately, many fail to consider the rider’s biomechanics and their level of competence when making these suggestions.

If a rider lacks the independent seat and balance that is required to ride with a longer leg position, they will make other adjustments when attempting to ride with a longer stirrup. These adjustments may give the rider a sense of control and stability (temporarily), however the connection to the horse becomes distorted.

The rider/owner in this case was falling into the trap of trying to run before she could walk. When the rider lacks the ability to connect through the seat effectively, they are actually better off easing themselves into the process by using the support available to them, in this case – slightly shorter stirrups.

Now I’m not suggesting that riders should become dependent upon stirrups and devices to maintain stability; consider a child learning to ride a bike and using stabilizers (training wheels). The experience gained through gradually lengthening stirrups over time allows the rider to develop better balance and proprioception without overburdening the horse.

This rider in particular had gone into what I used to call the “water ski” position. Because the stirrups were too long and the style of the saddle allowed for the leg to swing forward (to accommodate jumping seats), she had stretched her legs forward to seek the stirrups and therefore security.

We know in Osteopathy that one thing has to affect the other and of course, this does! In response to her forward leg position, the rider’s pelvis was tucked under too far causing her to straighten and brace her back, this conversely leads to the horse sensing more pressure in movement due to her lack of shock absorption.

The rider had to counter the forward leg by leaning backward behind the vertical and so distributing her center of gravity over the horse’s lower spine (lower thoracic and lumbar regions).

The horse can carry the rider’s weight quite well and without too much compensation when they are sat over the horse’s center of gravity. This is due to the balance being better and the intrinsic stability of the horse’s thoracic region and ribs, large areas of firm connectivity create a strong structure here.

The horse’s centre of gravity (COG) in natural (un-ridden) locomotion is located just caudal (behind) the heart and roughly mid-way between the dorsal and ventral lines. This obviously changes slightly when we mount up and changes again when horses develop to high levels of riding or different disciplines.

Our rider was sitting their weight way behind the COG and so the horse’s threats to the rear were completely understandable as that’s where the weight was going. This is a very common fault in riders and almost always leads to the horse hollowing their back.

The hyper-extended neck of this particular horse would certainly have been connected to the overall hollowing. However, there is another aspect to consider, the reins.

When this rider was in the “water ski” position as described earlier, the arms would be drawn back with her. This led to her having long reins yet braced and tense. The effect of the rein aid always being “on” meant that the horse was getting mixed signals when asked to move forward.

This is a little like driving the car with the hand brake on. The overuse of contact through the reins in any riding position will lead to altered ways of going in the horse.

The contact is meant to be offered in front of the horse and the energy of movement is pushed into the rein, unfortunately, many riders will bring the contact back to the horse reversing this principle. This can cause jaw tension (TMJ), hollowed back, shortened strides, lack of engagement, and of course, behavioral “issues”.

This particular horse was adding some rotation to his neck to evade the contact being applied. This way he could take hold of the rein and essentially nullify its impact to a degree.

This tilting/rotation is often seen and should be considered as a sign of pain, poor riding, tack fit issues, or even dental problems.

Osteopathically, it was clear to me that this rotation reduced his ability to bend laterally (Fryette’s laws of spinal motion). This coupled movement was what was likely creating the lesion that was recurring time and time again.

So where are they now? Well, the rider took my advice to have some training with the professional I had recommended. This trainer was actually very professional in that she worked with the owner’s current trainer to discuss a plan forward rather than just replace her.

This is obviously a great learning opportunity for the previous trainer and she took this very well. The rider has been attending Pilates classes focused on rider position and has made leaps forward in her riding abilities.

And the horse? He is now moving well, getting stronger and even winning at local dressage competitions. His shape has changed to one much more conducive to ridden work and a healthy spine.

The take-home…

It is very important for any practitioner to understand their limitations. Although I am a qualified trainer and riding instructor, I felt my place was better served as the therapist. Referring to another professional is not a case of losing work, in fact, it’s quite the opposite.

By making the right referrals and creating a network with other professionals, you can become a real hub of knowledge for your patients. Pointing people in the right direction for their animals is often what we as therapists of all kinds do.

The skills and abilities acquired through a course like the LCAO Diploma serve just as much to tell you when not to intervene as when to do so.

Most importantly, our courses give you the philosophical understanding and technical knowledge to see way beyond just the bit where symptoms show. If you treat a cat’s tail, the noise will come out of the mouth, but the mouth isn’t the problem!

My advice? Step back and see more, be open to referrals to other people, ask opinions, and be a detective. It can be so simple when we have much more information, such a huge part of Osteopathy is the examinations, assessment, and development of a hypothesis.

As Andrew Taylor Still himself said, “Keep digging”…

For more information on how you can become an Equine Osteopath, click here

Healing Horse Tendon Injuries: Working as a Team, Vet, Phyio, and Osteopath

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By Siun Griffin, Veterinary Physiotherapist and LCAO Community Manager

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Horse tendon injuries can be a significant cause of concern for horse owners and trainers alike, as these injuries can lead to decreased performance, prolonged rest periods, and sometimes even retirement.

Tendons are crucial components of the equine musculoskeletal system, responsible for transmitting the force generated by the muscles to the bones and enabling movement.

When a tendon injury occurs, prompt and effective treatment is essential to ensure a successful recovery. Here, we will explore common veterinary approaches to healing horse tendon injuries, including traditional methods and emerging techniques.

Additionally, we will delve into the role of equine physiotherapists and osteopaths in developing comprehensive rehabilitation plans for these injuries.

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Common Veterinary Approaches to Healing Tendon Injuries

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Traditionally, horse tendon injuries have been managed using a combination of rest, controlled exercise, anti-inflammatory medications, and sometimes, surgical intervention.

Rest is a fundamental aspect of tendon healing, as it allows the injured tissue to undergo a controlled remodeling process. Controlled exercise, often in the form of hand-walking or controlled turnout, is gradually introduced to stimulate collagen alignment and strengthen the healing tendon.

New Techniques in Tendon Injury Rehabilitation

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Recent advancements in veterinary medicine have led to the development of innovative techniques to enhance tendon healing. Platelet-rich plasma (PRP) and stem cell therapies are gaining popularity.

PRP involves drawing the horse’s blood, processing it to concentrate platelets, growth factors, and anti-inflammatory molecules, and injecting the resulting PRP solution directly into the injured tendon.

Stem cell therapy, on the other hand, uses the horse’s own stem cells to promote tissue repair and reduce inflammation.

Additionally, extracorporeal shockwave therapy (ESWT) is being used to stimulate blood flow and cell activity in injured tendons. This non-invasive procedure involves applying high-energy shockwaves to the affected area, which can accelerate healing and enhance tissue regeneration.

The Role of Equine Physiotherapists in Rehabilitation

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Equine physiotherapists play a crucial role in the rehabilitation process after a tendon injury. They work closely with veterinarians and horse owners to design tailored exercise programs that aid in promoting healing, improving range of motion, and preventing muscle atrophy.

Physiotherapists may utilize techniques such as passive stretches, active exercises, and hydrotherapy to gradually reintroduce the horse to controlled movement.

Equine physiotherapists also employ modalities like therapeutic ultrasound and low-level laser therapy to enhance blood circulation, reduce inflammation, and accelerate tissue repair.

These professionals closely monitor the horse’s progress, adjusting the rehabilitation plan as needed to ensure a safe and effective recovery.

Equine Osteopathy in Tendon Injury Rehabilitation

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Equine osteopathy is another valuable component of the rehabilitation process for tendon injuries. Osteopaths specialize in manipulating the musculoskeletal system to promote overall health and healing.

In the context of tendon injuries, equine osteopaths focus on restoring proper biomechanics, alleviating tension, and facilitating tissue recovery.

Techniques used by equine osteopaths may include myofascial release, joint mobilization, and soft tissue manipulation.

These methods aim to enhance tissue flexibility, reduce adhesions, and optimize biomechanical function, ultimately supporting the healing process of the injured tendon.

Final Thoughts

Horse tendon injuries remain a significant concern for the equine industry, but advancements in veterinary medicine and rehabilitation techniques offer promising avenues for improved outcomes.

From traditional approaches to cutting-edge therapies, the healing process for tendon injuries has evolved to encompass a holistic and multidisciplinary approach.

Equine physiotherapists and osteopaths play vital roles in developing comprehensive rehabilitation plans, tailored to the individual horse’s needs.

By leveraging the expertise of veterinarians, physiotherapists, and osteopaths, horse owners and trainers can provide their equine athletes with the best possible chance of a successful recovery and a return to optimal performance.

‍For more information on how you can become an Equine Osteopath, click here

By Chris Bates, DO and Animal Therapist

Quite often in equine therapy, we can find ourselves looking way beyond the biological limits of the horse (i.e., the horse’s physical body) and seeking answers to our questions in the external impacts upon them. It is par for the course to assess the horse’s living situation, feeding regime, and exercise, but what if the horse is ridden?

While some horses that we visit will be retired, too young to ride, or maybe even carriage-driving horses, a large number of clientele are likely to be regularly ridden horses.

Clearly, it is important to only work within your scope of practice and the LCAO Diplomas do not cover the treatment of humans; however, it can pay dividends to investigate the rider’s disciplines, style, training level, and effectiveness in the saddle.

My advice to LCAO students and graduates would be to work closely with their trainer/coach and perhaps ask if you can watch during one of their lessons. You could even ask to observe them riding as part of your assessment but be sure not to offer riding advice or tuition unless you are qualified and insured to do so and only with consent and understanding from the rider.

Knowing a little more about the rider’s impact on the horse can really help to inform your Osteopathic hypothesis with regards to the horse. The following is an account of my work with one particular horse and rider with whom I discovered that treatment can start with a well-placed referral.

The case of the recurring neck issues

It was a hot summer that year. I had been extremely busy with various horses trying to keep them fit and well during a full-on competition season. I don’t think my phone stopped ringing from early in the morning until the evening but I was glad to be helping so many lovely horses.

One horse however would play on my mind even after my work week was done. This particular horse was continually exhibiting the same issues returning time and time again. He was an 11-year-old TB X gelding with a great temperament, I had a real soft spot for him as he was always very obvious in his appreciation of my work.

At the beginning of my work with him, I had asked for the vet to visit prior to my assessment as was the requirement in the UK at the time. The vet couldn’t find anything that he could address and suggested speaking with me and her trainer.

When I first visited, the owner told me that he was very “upside down” under saddle and that when asking for a right lateral bend, he would stutter suddenly to a halt and threaten to rear up.

Now I am lucky in that I am also a qualified Osteopath for humans and a riding instructor so I do often ask to see clients riding if the complaint is riding-related. However, on this occasion, the owner was also injured so asked her friend to ride for me to observe.

I did indeed notice that the horse was underdeveloped in his topline and under saddle, he would hollow very easily. Right bend was an obvious issue for him but not showing much pain behavior.

I have noticed both in humans and horses that pain is not always the thing that the patient notices most, sometimes it’s lack of ability or lack of strength.

It wouldn’t be uncommon for a human patient who runs a lot to come in and mention in their presenting complaint that they just can’t manage the same distances and times they used to when running.

So, let us transfer this to the horse in this case. Perhaps the lack of pain behaviors and signs could indicate that his “way of going” and tendency to stop and rear were actually based on frustration at lack of ability.

Imagine going to the gym and having a personal training session; now, the trainer starts you off with a great warm-up and everything is going well. You are enjoying your session and feel positive with the trainer’s encouragement.

Suddenly, the trainer asks you to move to the bench press and sets up a huge weight on the bar! You think “Surely not!? I can’t possibly do that…”. But low and behold your trainer asks you to bench press 2 sets of 8.

You manage a few good presses but then your body just won’t cooperate and your stamina is clearly not sufficient for this level of intensity yet…. “YET” (very important word – health and fitness are dynamic).

What would you do? Your trainer is continuing to suggest you lift it. Do you keep going until you get an injury? That would be foolish and let’s remember horses are NOT foolish.

You protest and stop! Now, how might a horse protest? They can’t speak as such, so they use non-verbal communication in as clear a way as possible.

The horse I was seeing was showing non-verbal communication to indicate that he was simply incapable of holding the frame the rider was asking for and he was also unable to sustain a bend.

It is certainly not likely for a horse to bend laterally in a comfortable and sustainable way if they cannot work over their topline and engage their trunk, thoracic sling, and hindquarters. At LCAO, our courses cover behavior and certainly teach how pain is displayed.

So, if we don’t see obvious pain but the disruptive behaviors persist, we must consider if the horse is actually physically and mentally fit to undertake the activity. I found this a very interesting opportunity to start a referral.

Of course, I continued to assess and indeed treat the horse. I found that the horse was presenting with cervical spine restriction and pain sensitivity with a reduced range of motion in the right side bend.

This issue was focused on the C3-4 and C4-5 motion segments. If you want to learn about lesion types and how they are present then LCAO Diplomas have great detail on this and Professor McGregor has a great lecture on this Osteopathic principle.

This lesion was certainly exacerbated if not caused by a repeated hyperextension but I also considered that the type of lesion was impacted by rotation (the horse’s way of trying to negotiate movement and sustain posture under the demand), this is informed by Fryette’s principles of spinal motion (also taught at LCAO).

Two other therapists (one Physiotherapist and one Chiropractor) had also found this lesion in their assessments, or at least they identified a neck complaint.

The issue had continued to occur and the poor owner had spent a considerable sum of money for practitioners to come back time and time again to treat this it.

The problem was that these other practitioners had seen the behaviors as symptoms of the neck issue; I needed to see it the other way around.

The behaviors were causing the neck issue, or put it more Osteopathically “The behaviors WERE the neck issue”.  This is where Osteopaths try to see the whole, the bigger picture, and how the form is a result of forces, structure, and function are reciprocally interrelated.

Now, I would certainly not say to an owner to stop using a certain trainer but I did suggest consulting a different trainer with whom I had worked before on a similar case.

This trainer was very good at seeing weaknesses in locomotion and had an excellent understanding of equine psychology and behaviors. The owner agreed and the new trainer helped her to instill a regime of strengthening and stamina work incorporating mobility and stretching.

Within only a month, the horse had completely stopped the worrying behaviors and the owner was over the moon. I returned for a follow-up treatment and all that remained of the previous issue was minor fibrous tissue that had developed to maintain the lesion’s integrity.

I used soft tissue techniques to assist in the remodeling of this region and educated the owner in some self-management. Horse = Happy, Rider = Happy… Me? = Very Happy.

So, everything turned out great, right? Well… I wouldn’t be very holistic if I didn’t ask myself “Why was the horse not developing the strength and correct locomotion under saddle?” would I?

The horse’s nutrition was certainly adequate and well monitored, he had a good manner and temperament. There was no veterinary diagnosis of a systemic condition that would explain weakness or myopathy.

So, what were the onset and the causative factors? Then I remembered when I watched the horse being ridden, I saw the owner’s friend ride and not the owner. It struck me! “It’s so obvious now! It’s the rider!”.

In the next part of this series “It’s the Rider”, we will explore how this particular rider had been the reason for the horse’s ridden frame, locomotion, and subsequent weaknesses. Look out for part two coming soon.

For more information on how you can become an Equine Osteopath, click here 

By Siun Griffin, Veterinary Physiotherapist and LCAO Community Manager 

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Tendons and ligaments are vital components of a horse’s musculoskeletal system, playing crucial roles in supporting and stabilizing their limbs during movement.

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However, they are susceptible to injuries that can be severe and difficult to treat. As responsible horse owners, it is essential to understand what tendons and ligaments are, recognize signs of injury, and implement preventive measures to ensure the well-being and performance of our equine companions.

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What are Tendons and Ligaments?

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1. Tendons

Tendons are tough, fibrous connective tissues that attach muscles to bones. They transmit the force generated by muscles to the bones, enabling movement and providing stability to the joints.

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2. Ligaments

Ligaments are similar to tendons but differ in their function. They connect bones to other bones and are essential for stabilizing joints, limiting excessive movement, and preventing injuries during strenuous activities.

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Signs of Tendon or Ligament Injuries

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• Lameness: A horse with a tendon or ligament injury may exhibit lameness, which can vary in severity depending on the extent of the injury.

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• Swelling: Swelling around the affected area is a common sign of an injury. It may be localized or diffuse, depending on the severity and location of the damage.

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• Heat and Pain: Injured tendons or ligaments can cause heat and pain, which can be detected through palpation.

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• Reluctance to Bear Weight: Horses with tendon or ligament injuries may be reluctant to put weight on the affected limb, particularly when turning or on uneven surfaces.

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• Changes in Gait: A horse with an injury may show alterations in its gait, such as shortened strides or uneven movement.

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• Decreased Performance: Tendon and ligament injuries can lead to reduced performance levels, making it difficult for the horse to perform its usual activities.

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• Reluctance to work: Sometimes tension and ligament injuries have much more subtle signs. Some horses might show what would be considered behavioral problems under saddle, but not show some of the signs listed above.

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Preventing Tendon and Ligament Injuries in Horses

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1. Proper Warm-Up and Cool-Down

Always begin any exercise session with a proper warm-up routine and conclude with a gradual cool-down to prepare the tendons and ligaments for work and reduce the risk of injury.

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2. Regular Exercise

Consistent, appropriate exercise helps strengthen the tendons and ligaments, making them more resilient to injury.

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3. Balanced Nutrition

Provide a well-balanced diet with essential nutrients like proteins, vitamins, and minerals to support overall musculoskeletal health.

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4. Correct Footing

Ensure that the footing in training and exercise areas is suitable for the horse’s activity level, as inappropriate footing can stress tendons and ligaments.

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5. Proper Hoof Care

Regular hoof trimming and shoeing by a skilled farrier can aid in maintaining proper limb alignment, reducing the risk of injuries. Poor hoof balance puts more stress on the limbs and body.

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6. Gradual Conditioning

Avoid sudden increases in workload, as this can strain the tendons and ligaments. Gradually increase exercise intensity and duration to allow the body to adapt. Doing too much too soon can increase the risk of injury.

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7. Regular Veterinary Checkups

Schedule regular checkups with a qualified equine veterinarian to detect and address any potential issues before they escalate.

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8. Quality Tack and Equipment

Ensure that saddles, bridles, and other tack fit properly to minimize pressure on the horse’s limbs during exercise.

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9. Cross-Training

Engage in a variety of activities to avoid repetitive stress on specific tendons and ligaments, promoting overall strength and flexibility.

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10. Weight Management

We all want our horses to hold a nice condition but being too fat will add more strain on the tendons, ligaments, and joints which can lead to several issues, not just increase the risk of tendon injury.

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11. Limb Protection

It is a good idea to always use front tendon boots on a horse when it is doing work. Of course, there are some exceptions, such as long trail rides where the boots might not be suitable and no fast work is being done.

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Boots reduce the risk of strike injuries to the vulnerable lower limb. Try to use boots that offer some ventilation and always remove them immediately after exercise as they create heat in the tendons.

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Choose boots carefully to ensure you are using ones that offer less heat build-up and avoid working a horse with bandages.

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It is also a good idea to use overreach boots when lunging as doing fast work on a circle increases the likelihood of overreach injuries.

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12. Cool the Limbs

Studies have shown that as temperature increases in the limb’s tendons and ligaments with exercise so does the risk of injury. This is why it is important to remove boots immediately.

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Cooling the legs with cold water or ice after exercise will help bring temperatures down more quickly and reduce injury risk.

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Final Thoughts

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Preventing tendon and ligament injuries in horses is crucial for maintaining their well-being and performance.

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Understanding the signs of injuries and implementing preventive measures, such as proper warm-up, balanced nutrition, and regular exercise, will go a long way in ensuring your horse’s health and longevity.

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Always consult with equine experts and veterinarians for personalized advice and guidance in caring for your horse’s musculoskeletal system.

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