New clients often ask what a Physio assessment consists of, so I thought it might be beneficial to tell anyone who doesn’t know…
As Physiotherapists in the human world we routinely work on restoring function, whether that be in an elite athlete with an acute knee injury wanting to return to high level sport , or an elderly patient that is struggling to get up from a chair, the clinical reasoning is the same, assess, identify potential problems, formulate a treatment plan and treat accordingly. Treating horses is very similar by observing and palpating the animal the problem list can be formulated specific to the needs of that animal – a veteran hacking horse will not need to be rehabilitated to the same level as a top level eventer, But this isn’t to say that the end goal is any less important to either animal, or owner.
Of course the obvious difference between my human and equine clients is that only one species can tell me where the pain is located! Although saying that we cannot discount the important information we can gain from the owners or riders of the animal.
I start by getting a full subjective assessment on the horse, in basic terms this means that I ask about the horse’s problems, medical history, routine, ridden work, general behaviour, diet, saddle, feet and dentistry! Have there been any changes to the animals husbandry however subtle?
We then look at the horses comformation, looking at how the horse is put together, length of neck, back and hindquarters, leg correctness, general muscle tone ‘topline’ and abdominals. Here I am observing for any asymmetry and/or muscle atrophy. This can be one shoulder ‘built up’ more than the other, muscular imbalance over the hindquarters or a subtle difference in bony landmarks in the pelvis.
Seeing the horse move is imperative to the assessment. Here I look at walk and trot in hand, rein back, small tight circles, I will sometimes see the horses on the lunge, and even ridden if needed – here I’m looking for track up, lameness, and general straightness. The ability for the horses to move freely through their back and use their hind-quarters effectively.
The ability for a horse to use itself correctly is very important for soundness, are the hind quarters active? does the horse move on two tracks or three? is the horse able to cross over with his hind limbs on a small circle, or is there a restriction in the cervical, thoracic or hind quarters affecting this? looking at quality of movement is the key here – exactly the same as in our human work, pain and restriction results in minor compensation in the way out bodies function, identifying these compensations, however small can be key to keeping your horse fit and functioning at the intended level.As Physiotherapists in the human world we routinely work on restoring function, whether that be in an elite athlete with an acute knee injury, or an elderly patient that is struggling to get up from a chair, the clinical reasoning is the same, assess, identify potential problems, formulate a treatment plan and treat accordingly. Horses as very similar by observing and palpating the animal the problem list can be formulated specific to the needs of that animal – a veteran hacking horse will not need to be rehabilitated to the same level as a top level eventer, But this isn’t to say that the end goal is any less important to either animal, or owner.
Next is palpation of soft tissue from head to tail -looking for pain, spasm or tension. Touch is such an important part, this is where I find my human training invaluable, being able to feel subtle changes in the tissues is vital for deciding the plan of action when it comes to treatment!
Then I look at range of movement of the head and neck, thoracic and lumbar spine, forelimbs and hindlimb – looking for quality of movement, symmetry or pain in the joints and any restriction in range of motion. Horses as very good at compensating, I often find the most ‘bendy’ horses actually lack movement in specific directions, carrot stretches are great….but horses know how to cheat, lifting legs, snatching or twisting through their necks to achieve the goal of the treat!
I then check the saddle, I can normally get an idea of the saddle fit by the palpation of the soft tissues around where the saddle sits! I do not confess to be a saddle fitter! But I am competent through training with the ‘Society of Master Saddlers’ to tell whether the saddle needs addressing urgently, believe it or not I see a whole host of the good, the bad and the ugly out there! and you have to remember that horses change shape…. a lot! How would you like to wear a pair of shoes 2 sizes to small? Saddle fit IS important, and the days of one saddle fits all are long gone,
From ALL this I then formulate an individual problem list, treatment plan and set goals for any rehab that is needed or that specific horse….
Then treat the horse accordingly!
Basically a thorough assessment of the whole body to highlight any current or potential issues!
And you thought the Physio was just ‘the back lady!’