Medication of joints for the relief of pain from osteoarthritis and other conditions has become common place, but once your vet has administered the steroid this isn’t always the end of the story. We often see horses following joint medications and while there has been a reduction in joint pain and inflammation, the horse’s movement remains restricted or compromised. So why is this?
In the lead up to diagnosis of a joint condition, the likelihood is the horse has adapted their posture and movement to compensate for the pain and restricted movement in the joint. These postural and movement adaptations can manifest themselves in a number of ways, including muscle atrophy (wasting) and hypertrophy (over-development), shortening of the muscles, muscular pain and tension and diminished proprioception.
The aim of joint medication is to relieve pain and inflammation in the joint, facilitating pain-free movement. However, with the aforementioned muscular changes often well-established it is important we do not neglect the second, equally important stage of the process – rehabilitation.
Flexibility
Painful or arthritic joints move less; when a joint's movement is compromised, so too are the muscles associated with them, therefore a joint’s range of motion is not only dictated by the mobility of the joint itself but also by the flexibility of the muscles. Muscles that have become restricted due to joint pain become shorter, while guarding of a painful joint leads to muscular pain and tension. For example, osteoarthritis in the hock will often lead to short, tight hamstrings due to the reduced flexion of the hock joint. By releasing these areas of tension through manual therapy and stretching we enable the joint to move freely without muscular restriction.
Core stabilisation
The core muscles lie deep beneath the surface, surrounding and stabilising the joints. By strengthening these core muscles, we can help reduce further damage and degradation of the joint surfaces and cartilage. Furthermore, when the core muscles are functioning correctly, the superficial muscles are free to do their job of generating power and movement; in horses with weak core strength, we often see pain in tension in the superficial muscles which have taken over the job of stabilisation. Core strengthening exercises are low-impact, can be started early in the rehabilitation process and are particularly useful for horses on box rest where exercise options are limited.
Muscle building and rebalancing
Compensatory movement patterns lead to atrophy of the muscles that are not fully functioning, while those muscles that have to take up the strain may become over developed (hypertrophied) due to overuse. Muscular imbalance is often one of the first signs of an underlying issue, since even a subtle offloading of a painful limb or incorrect movement of the spine will be reflected in the condition of the associated muscles. Once the pain in the joint has been addressed, we can target the affected muscles through therapy and remedial exercises to correct compensatory movement patterns and muscular imbalances, with the ultimate aim of returning the horse to full function.