Friday 5 June 2009

Movement and rehabilitation

I was given a fantastic book at the weekend, probably one of the earliest, if not the first, books to systematically cover equine rehabilitation.  It was published in 1967 and is written by Charles Strong, who was a chartered physiotherapist who started treating horses in 1939 - he was the pioneer in his field.  

I have to quote from the introduction - thats as far as I read before getting terribly excited by this book :-)  The author is talking about soft tissue injuries, and says:

"the treatment LEAST likely to bring relief is over-rest, especially if enforced during the early stage of these injuries.  Yet this is the usual procedure despite the fact that it contributes to disability and not to its relief"

I must admit that I lost my (already shaky) belief in box rest as a therapy for these types of injuries long ago, and my goodness its nice to read an endorsement  - but why oh why, when this was written over FIFTY years ago are we still box-resting horses with tendon and ligament damage?  

Charles Strong goes on to say - and this is the critical thing for me:

"In all injuries to muscles and joints there is a range of movement...which is painless.  This painless movement may be small but neverthless it is present.  If Nature intended pain to be answered by rest throughout the full range of movement it would have made the full range of movement painful."

He goes on to conclude that the best, and most naturally effective, healing is achieved when there is "intensive movement throughout the painless range of movement immediately following the injury and subsequently".  

This makes complete sense, but he was way ahead of his time - doctors were still recommending bed-rest for bad backs in humans at this stage :-)

It was great to read, though, because it echoes what we see here, when horses are able to mooch round the tracks, in comfort, at their own pace.  Mentally and physically it does them so much more good than enforced rest or, even worse, being forced to move when they are uncomfortable. 

We had a horse here till last year called Conto, who had arrived straight from 6 months box rest.  I have never seen such a lame horse, there wasn't a single leg he was comfortable on, but we let him potter round the track and he gradually got sounder and sounder, partly as his hooves improved, but also as his body started working again.  He hunted up here for 2 seasons(there is a clip of him on here) and is now working and jumping regularly.  This is DESPITE the fact that he still has far-from-perfect hooves (relatively speaking!) and 2 fat legs, one with a bowed tendon and one with old lymphangitis.  

The point is that he is a lot healthier and a lot sounder when he is constantly moving within his comfort zone than he ever was with rest.  Its something that we see time and time again. 

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