My Injured Horse – Part 5

Part 5 of an honest reflection coping with injury and rehab

Everything was under control, so just to risk it all, he needed to come home. A change of ponies at home meant it was time. I had to be away teaching in the middle of the next month and my family usually look after the animals. We decided that it would be too challenging initially for them, so coming home was back on hold. I’m not very patient so this waiting was a trial for me, despite the sound reasoning! However it gave time to create four little paddocks within my flattest field. I’m grateful to my husband, his friend and my son as they were fence post donking whilst I was at Hartpury teaching horse behaviour… how ironic!

As soon as I could after that, with nerves and trepidation, I brought him home. On the same day my daughter’s 13.2 pony went to his new home. A seriously emotional day, I don’t do things by halves! Sadness from saying goodbye to one but the joy of seeing his handsome face (I’m biased!) in his stable was amazing.

Electric fence plugged into the mains and boots on, he went out. The first area was about 10m square and new 14.2 was next to him. This pony was the one we thought had caused the injury in the first place, however they had been out together before his diagnosis with no problems. One hour of turnout on the first day, then two and then up to four. A week later the grass was running a bit low and perhaps a bit of boredom or confidence set in. The external electric tape was powered just fine but the strip between the two horses was possibly not working because I looked at the camera (yes I know, I’m lucky to be able to watch them when I’m not there) and the tape between them was down! Immediate panic set in and I expected to find them both trying to kill each other. However it turns out that they were far more settled and were eating next to each other quite happily. He’d made his own decision to join her – potentially not the best way for it to happen but he’d taken that next step and decision from me.

Hand walking and longreining continued daily and the vet had said that I could ride him. No schooling and mostly walking hacks but nevertheless I was allowed on his back. I have limited time due to family commitments and work so the time and day to ride arrived. Couldn’t be helped that it was a wet, wild and windy September day though. He’d worn his full tack already and I’d checked the saddle fitted but as for getting back on, well I’m definitely not as confident as I used to be.

Body protector on and with a few deep breaths, and a handful of pony nuts in my pocket, I actually got on in the stable. Mine are large with no roof and he’d been backed in there so I thought this was a good option. I wasn’t allowed in the arena and getting on for the first time in the driveway way slightly concerning for me!

I needn’t have worried. He remembered how to approach the mounting block then stood still waiting for his reward. I got on walked a circle and got off, no worries, what a relief. By this time it was torrential rain but it was then or the next weekend so we braved it. I thought we would be nannyed by my daughter on her pony but it turned out she was left behind as we stride off down the driveway!

It was almost as if he was saying, thank goodness, we are finally doing something proper! Ears forward and with his usual upbeat bounce we were off. It was such a great feeling, I was not in a dressage arena or jumping a course but the feeling was just as great. I didn’t even know if he would ever do any more than go out at walk but it finally felt like there was progress. It was 14 weeks since the operation and no where near the end of rehab but it felt like a massive step in the right direction.

I think the short terms goals and mini achievements have been the reason I have been able to manage this whole situation emotionally. I do like a good to-do list so getting it down on paper has really helped me. Does anyone else write down goals and a plan?

My Injured Horse – Part 4

Part 4 of an honest reflection coping with injury and reha

bOnce we were at 8 weeks post op, there were no signs of anything wrong happening with two 5 minute inhand walks a day. If you know me and my research area you’ll know how frustrating I was finding the lack of knowledge about progress of the healing. I knew it wouldn’t really change anything but if I’d had my own imaging equipment, I’d have been rescanning and x-raying weekly!

As my horse’s behaviour was good and all feet were either on the ground or stepping as required and not launching around it was time to think about more movement. Controlled exercise was required. Fortunately the decision to have him on rehab livery @devonequinehydrotherapyspa was working out better than I could have hoped for. Because I am away from home for long periods there’s no way I could have been able to build up the exercise gradually, or certainly more than once a day. The irony of needing to work to afford to pay for rehab for my own horse was not lost on me!

When my horse was younger he was taken on lots of hacks inhand. He had previously been very comfortable long-reining so it was decided that was the way forward now. So his programme outside of box rest was increased to include longer duration walking on the long-reins. Once this was going well the next step was to plan his return home. How to transition from the safety of the rehab yard, back to my care, was something that kept me awake at night. I knew I wanted him home but what if I wasn’t able to keep up the good work? The only way I could cope with him home and for him to cope without causing him stress was for him to be able to be turned out.

We had to bite the bullet and give him his freedom. But what if he injured himself in the field? What if the ‘frayed’ suspensory or the bone healing was damaged even more? All these questions and risks needing consideration. If I didn’t consider his mental well-being or had the knowledge that graduated increased loading was needed, I would have stuck with the box rest forever! However, frustratingly, I know that bed rest doesn’t help humans and immobility has its own longer term consequences.

After the decision was made it actually turned out that turning out was a non-event! The trick it appears is to put them in a small area, with a stable neighbour in the next paddock, and with lots of buckets containing a little bit of food. Such a simple but effective idea. I awaited photos of him out and could have cried when I saw him head down mouching about. Finally a bit of freedom for him.

I’m not sure if decision fatigue by proxy is a thing but by this stage I was definitely exhausted from lying awake at night worrying. I am not sure which is worse, worrying about children or your horses? Being told that the outcome of all of this is likely to be ok, not 100% of course but probable it’ll be fine, didn’t stop me being really fretting about the future for him.

As I’m writing this I still don’t know if he will be ok. I wish I had a crystal ball. But at this stage you can’t do anything else but stick to the process and be brave.

My Injured Horse – Part 3

My injured horse: Part 3 of an honest reflection coping with the injury and rehab.

The box rest went well, except for the occasional eating of therapy equipment, boots and bandages, he seemed to be managing. He put on weight because it is a real struggle trying to balance keeping them eating and not getting stomach ulcers. I would rather he had ad-lib hay and was able to keep up his foraging behaviour and fibre intake than start any stereotypical behaviour. The change of environment and amount of movement was already a risk factor in the development of behaviours such as cribbing and weaving. However the benefit of the yard he went to was that there was activity enough to ‘enrich’ his view but not too much to be considered manic and stressful. There was an air of calm there and all the horses seemed relaxed and settled or well managed if not. Where horses can’t have their friends, forage and freedom we have a responsibility to try and meet their needs as maximally as we can.

After one month of complete box rest, I took my horse back to the surgeon at Western Counties Equine Hospital for a re-scan. I am not sure at this point what I was anticipating as the result. My logical professional brain knew what was realistic but I admit I was disappointed when the results were ‘as good as can be expected for this stage of healing’. In my heart I wanted it to be that everything was fixed and we could skip all the next phases of rehab. Unrealistic I know though.

The good news was that he was allowed to start walking, just for 5 minutes twice a day though. This did cement my choice of the yard because they were there and had the driveway and tracks available to walk him. I dreaded the start of walking though. I feared he would not be able to stay calm and that would put the staff at Devon Equine Hydrotherapy spa at risk. I knew they were capable but what if their handling methods differed from my own, and my horse would get confused. He is bred to have a fun foreleg action and has been known to wave his legs in the air. He did stay calm but what if the healing would be damaged by walking. I know all the theory of the healing process, I know that graduated loading is essential to optimise the tissue repair but I also know that too much too soon would be risky.

I think my dilemmas often come from overthinking and the background knowledge I have. But I appreciate knowledge is power so it’s a fine line! Do you think it’s better to know too much or not enough? Have you had to manage a horse that’s starting work after box rest?

What strategies did you use? Safety is paramount, so hats/gloves and bridle and or the use of medication for sedation. There are lots of options and one that is right for your horse.

My Injured Horse – Part 2

My injured horse: Part 2 of an honest reflection coping with the injury and rehab.

After surgery and 2 nights at hospital, an intense period of rehab loomed. I would like to say I was able to take this in my stride but I have a job, a family and other ponies at home and it wasn’t that easy. I had to make some tough and quick decisions. How would I be able to manage a horse on box rest whilst turning out the others as that was their normal routine. How would my horse feel with the others being out and him not going out? Would I have the time to muck him out? What about boredom when I was out all day, would that lead to new behaviours such as cribbing or box walking? Also, I go away for work occasionally and would I be able to ask my family to look after him. Would he be safe in the stable? So, so many questions?

If I kept him a home, we would all be compromised, the other ponies, the family and I as well as him. But what were the alternatives? I tried to be as objective and weigh up the cost v benefits. So I came to a decision, I needed a professional yard. Luckily I knew of one and after speaking Izzie who runs it my mind was made up. My horse went to Devon Equine Hydrotherapy Spa. I drove my horse from the hospital to there and literally took a large in breadth when it came to unloading him.

My precious cargo walked down the ramp, into the yard and straight into the stable where he was to stay for a long while. I took off his headcollar in the stable, he walked around once and then tucked into the hay there for him. The reasons for my decision were based on the yard set up. All the stables allow visibility of the horses in the six block he was in. I knew there were small paddocks for turnout when we got to that point but I figured that my horse wouldn’t know they were there so no expectations of being allowed out.

I think that makes sense, but how was I to know how my horse felt. It was the right decision in hindsight, Izzie let me know he took a day or two to fully settle and that they kept a friend near him at all times, they also were around all day to check on him and change his dressings and replace his bandages when he ate them!! He initially only walked out of his box for the vet to see him and then straight back in again. He was on full box rest for the first month.

It took a lot of weeks to start to emotionally get over him going to the yard. I felt I was letting him down, surely I was the one to look after him? I was professionally capable after all. What if he was stressed and upset by the change of yards, it would have been my fault. I also felt guilty for sending him away but in a way it was like I was putting him out of sight. We were to go eventing this summer, I was definitely grieving for the loss of these fun plans.

Trying to decide on the best course of action is tough. How do you know what is right before you know what is right because you have been though it?

My Injured Horse

Part 1 of an honest reflection coping with injury and rehab.

I am a physio who specialises in the treatment and rehabilitation of horses with twenty years of practice. I have worked with hundreds, maybe thousands, of horses and owners who have needed my help to progress back to ‘normal’. I am not writing about these horses, I am now writing about my own.

In May my horse, my baby – the one – the horse of a lifetime, showed up at the field gate with a fat leg. I am not one to panic so I brought him in, had a good feel and decided to see what would happen with it. There was heat and swelling above the fetlock but he wasn’t lame. Over the next few days the swelling went down and I resumed ridden work. The swelling stuck around on the outside of his cannon but didn’t get worse with exercise so we carried on. He still was not lame and was his usual self for a couple of weeks but then got a bit grumpy in the arena. I had kept my eye on the leg and a small wound over the swelling opened up so I called the vet.

Although, not being allowed to diagnose because of the Vet Act, I asked the vet to bring their xray equipment as I had a nagging and worrying feeling.

Sadly I was right, what initially looked like a little knock when it didn’t get better I suspected a splint fracture. This was clearly visible on xray. Immediate box rest and referral to an orthopaedic surgeon led to a plan for surgery to remove the fragments as soon as possible. Not only was there a fracture the edge of the suspensory was also a bit ruffled.

I have been through this before but not with this horse. Looking back, at this stage my feelings were mainly of guilt because the injury was due to a kick from a new horse in the field. It was my fault because it was my choice to put them in the field together. I have always put my horses in together without any issues but not that day.

The guilt was painful, it makes me choke thinking of it. Have you ever felt this guilt and blamed yourself for something that has happened to your horse? I would be interested to know because it’s not a component of rehab that is within my scope of physio practice when I work with clients, except to be there to listen and discuss with empathy.

Why I train my horse with the principles of equitation science

The horse I bought six months ago has challenged me more that any of the horses I have had in the last ten years.  I have never competed at high levels and am firmly in the amateur rider category.  However, I push myself to be able to do the best with my horse. I also, because of my role with my clients, am asked questions on training.  I feel I have a responsibility to be able to provide answers to their questions but within my scope of evidence-based practice.

Equitation Science (ES) is the name given for an approach to horse training and management that uses information gained from research into how horses learn and how their behaviour impacts the horse/human relationship to inform.  It is not linked to any ‘brand’ of training but is part of all ‘brands’ training.

ES suits my bias as it is logical, there is clarity, it prioritises horses’ welfare and is evidence based.

To read more about the principles of learning theory in equitation, go to https://equitationscience.com/about/ises-training-principles

And a video here: https://youtu.be/yaiWX47FMKs

I first came across ES seven years ago and although it made sense to me I wasn’t on the lookout for any help a that time, in my mind I had it all sorted and was progressing well with the horse I had.  He was obedient, he didn’t present me with any training challenges and all was going well.  However, I was interested to learn about how horse’s learn, how their internal instruction manual influences them and also how the main famous handling approaches work.  I learnt to evaluate these methods and I used a fusion of the best bits without any issues.

Then along came a Lusitano who is quick, prone to tension and reactions based on fear and very, very clever!

I needed to up my game to match his training needs.  And so far so good!  We are following a training plan, starting with re-education of simple but essential responses to my cues (aids) such as his stop and go response.  I started training these inhand and then under saddle.  This has progressed to being able to change tempo and stride length whilst staying relaxed and it is very easy to tell when we are not relaxed!  We have proved our training at a few low-key events, to start with from the ground (I was not about to get on a stressed and horse influenced by fear) and at the last dressage, I let my 8 year old girl hack him back to the horsebox – how about that for confidence in his learning!

We use training of direct and in-direct turns as well as yields to progress his training and strength.  The goal I’m working towards at the moment is the Royal Cornwall Show. Six months ago I could never have conceived that my young, green, stressy horse would be able to cope in such an environment.  Thanks to an ES approach, we are shaping his training to get to that point and for us both to be happy.

I believe a horse trained with consideration of his mental wellbeing as well as his physical wellbeing will be a healthier horse.  Suits me – I would rather be involved in routine care of happy comfortable horses then horses struggling with their musculoskeletal system due to their training approach.

For more information see Equicoach.life and also Equitation Science International

I am more than just the ‘back lady’!

As an equine physio I am more than just the back lady!

Did you know that:

Each time I assess a horse I look at its movement. In-hand walk, trot, circles and rein back tell me about how their musculoskeletal system is working and highlights any areas of concern that need more closer inspection. Seeing your horse lunged is preferred too as this changes the way your horse has to move and allows assessment of bend, transitions and canter.

I am looking for asymmetrical movement and therefore lameness. But it is often the subtle differences between left and right that show is where to look when moving on to the next stage of the assessment.

It also gives me a chance to see how your horse moves his body dynamically. This can include visualisation of core stability, muscle strength, power and their training

And did you know that;

Every time I see a horse I use a consistent and structured palpation assessment. My palpation assessment is the process of checking over the parts of your horse that I can get my hands on. I generally start at the front and work head to tail. If the horse will allow I start at the poll, the upper neck and across the jaw, and the front of the head. I can always come back to this region if a horse takes a little while to become confident which my touch. I then work through each of the superficial muscles which are the ones closest to the surface. Whilst I can’t get my hands onto the deep muscles, the ones above them, often give signs of issues in deeper structures.  But it’s not just muscles I can feel, there is the connecting tissues such as the fascia, ligaments, tendons and I can feel across the joint lines.

I am looking for the most obvious reaction which would be due to pain but also differences from one area to the next, from one side to the next, and differences to what I would expect, based on the horse in front of me. These differences might be in muscle tone, reaction to touch, size or signs of heat or swelling.

Palpation is just one part of the assessment, alongside assessing how your horse moves both actively during gait assessment and when I move the joints through their range of movement when your horse is stood still

And did you know that:

At each assessment I will check through joint range of motion. Range of motion is how much a joint can move, as well as how easily that movement occurs. We can measure the actual degrees of movement with a tool called a goniometer but this is pretty tricky on a horse. So when I am with a horse I compare the amount of bend in the joints of the legs from left to right for example. I can also compare the lateral flexion of the neck to each side. I can also test how much flexion and extension (lifting and lowering) the main region of the back has.

It is not only the amount of movement but quality of movement both when I move the joints and if I ask the horse to. I am looking to see if there is any stiffness, any restriction or any pain associated with the movement.

I then combine this information with the findings from the gait assessment and palpation assessment to build a picture about your horse

And did you know that:

I have studied and continue to learn more about the principles of horse behaviour. I understand that the instincts of a horse are as a prey species, and this affects the human-horse interaction and training. They have evolved to be survivalists and the potential for behaviour as a consequence of this will be intensified if the horse is in pain or stressed. The horse’s first response to a potentially threatening situation is to attempt to flee. Moving their feet quickly to run away from danger is likely to be limited by the handler and that may mean the next option is the fight response. Flight and fight can be combined and the horse can ‘walk over’ the handler, push them, knock them or mouth and bite them, progressing to kicking or rearing to escape the pressure they are feeling.

A horse in this state will have a raised heart rate, chemicals flooding their body in response to the stress (for instance; adrenaline and cortisol) and an increased circulation to the muscles, ready to flee. The horse’s posture will be altered so that the head and neck are raised and the muscles along the topline will be tense, ready for the movement to escape.

This behaviour, in response to fear or stress, may be the only cause of issues when being ridden or handled, but when in combination with pain, there is a huge overlap between how the signs and symptoms are presented. This is why, during the assessment, I will ask a whole series of questions about the nature of the issue, the history and the behavioural signs shown by your horse.

No matter what I want to, or need to do to your horse, the environment and their handling needs to be calm. Understanding how a horse may react to my presence and intervention influences my approach and choice of treatment. Saying that, I very rarely have a horse react to the extremes as mentioned above. However, even the behaviour of a slightly reactive horse needs to be noticed, acknowledged and managed so we get the best outcome for your horse.

 

And did you know that:

I have studied the principles of how horses learn.  It is important that I know about learning so that I can use techniques to help me carry out my assessment and the person handling the horse, perform the gait assessment I need to see.  Horses have a different brain to us but the theories about how they learn and respond to signals or cues are well explored.  They can learn by association, for example, the sight (and smell!) of the vet can result in some interesting behaviours but some of my horsey clients have a much more positive response when they recognize what I might be doing with them! They also learn as a result of the consequence to their behaviour.  If they flee, without stopping to think about it, from a monster and they survive, they will run next time they think they’ve heard or seen a monster.  They learn from positive consequences as well for instance the good feelings from mutual grooming is a nice outcome when being social in a herd situation.

The behaviours that the owner/rider describes to me, about their horse, can be due to learned behaviour.  This can be in response to pain, for example the horse learns to avoid a particular activity as this means less pain, this may cause the horse to avoid the activity with an even stronger reaction.  This activity could be jumping, or going from trot to canter, or anything that requires you to ask your horse to do anything that may make it hurt. However, this behaviour can continue when the pain has gone, so we have to understand your horse, work out what is driving the behaviour and have a plan about how to modify the behaviour once we are confident there is no pain.

One approach I consider when treating horses is habituation. This is where the response to certain stimuli is reduced or de-sensitised. I may have to de-sensitize the horse to my approach, the techniques or equipment I use.  Sometimes I need to stand on a step on the right hand side of the horse.  This is often a new situation for the horse, so I need to break the process of my appearing up above the horse on the ‘wrong’ side.  Accepting the step, accepting me standing on the step, accepting seeing me above their back, out of their left eye, and accepting me standing in different places to where you would mount or plait the mane, are all markers I need to be sure the horse is comfortable with.

The response to certain behaviours can be conditioned by the consequence that occurs.  The traditional manner of training is by pressure and release, whereby the removal of the pressure is the release, and this is termed negative reinforcement.  Think about how we lead our horses as well as how we apply leg and also rein aids.  These examples use negative reinforcement, which is then how the horse learns.  When the pressure is removed ie the leg taken away as soon as the desired movement response occurs, or the ‘pull’ of the rope is reduced, then to the horse it seems that ‘if I do that then this happens’.

I know during treatment that if the horse is standing as asked, it is a good to reward the horse and this I can do with positive reinforcement. A simple scratch at the withers is a nice option or piece of food.  Carrot stretches are a great example of positive reinforcement, so long as the choice of treat is favoured!

When prescribing exercises I am experienced, with a number of different horses, ages, breeds and levels of training. This means it is good for me to know how to teach a horse so I can provide practical advice.  I am always happy to work with you and teach both you and your horse how best to do the exercises and what a good version of the exercises looks like.

So there you are, the many aspects of a Vet Physio!

I’m more than just a back lady!

If you would like to have a chat about how I can help you and your horse, please do get in touch

A new website and a new chapter for Gillian Tabor Physiotherapist!

I am really excited to launch my new website.  It’s basic right now but the great news is that I can update it more easily.  It will be the place for my thoughts on how you can achieve, not just the physical wellbeing but the mental wellbeing for your horse too.  I am keen to support you and your horses, with their musculoskeletal health as I always have, but I’m looking forward to adding a new dimension to my ability to help you.

For many years I have sought to combine competing my own horse, alongside my business and my family.  I have dreamt of tails and top hats but in reality my goals have been much more aligned with achieving the best I can with the knowledge, skills, time and support (and money!) I have.

I had a plan about 5 years ago and started putting the pieces in place to achieve them and that was to own a lusitano.  And now I have two! That wasn’t the plan but the journey so far has changed my outlook on what I want to achieve.   Bear with me as this evolution affects my physio too!

So here it is, this is what I want:

I want a great relationship with my horse.

I want my horse to be the best he can be physically and mentally.

I want to compete and achieve success but only if the above two are in place.

Are these similar to your goals or vision of you and your horse?

I needed to learn more about training, so I have be collecting information and experiences from  talented trainers. My influences started with straightness training (Marijke de Jong) during the time I had my daughter as a new baby gave me free time, ironically!  I had training with my old horse, Neo, and one of the straightness training instructors as well as being a member of the home study course.   I then felt a need to find out more, so I followed Manolo Mendez and was able to see him in action, alongside Dr Kerry Ridgeway and Cnl Christian Carde, a few years ago.

I have had amazing chances to observe and be trained in Portugal, learning more in a few hours with great teachers than ever before.  More recently I have been interested in the work of Bent Brenderup. I have even been reading the original texts of the old masters, Xenophon, Pluvinel, de la Gueriniere.

My background and knowledge of equine biomechanics allows me to select the perfect exercise to work with your horses problem, if they have one.  I know which can be used to work towards your performance goal even if you don’t have any problems.  I also have an understanding of how horses learn (equine learning theory) and plan to follow this up with further study of equitation science in 2018.

I have seen that physical and often called ‘Classical’ exercises can be the physiotherapy that a horse needs.  I am planning a way of adding these to how I treat your horses.  I will often leave a client with a list of suggested exercises, but whether I’ve explained them clearly or with enough detail, depends so much on how I communicate the instructions.

So coming in 2018:

Horse movement therapy – classical exercises blended with equine biomechanics to improve posture, strength, balance, coordination and partnership.

Now its over to you – how would you like me to share this information with you?  Online? Video? Audio? A book? Let me know!!