I get knocked down, but I get up again...
So today was one of those days! I was watching a friend (who also happens to be a client) in the showjumping warm up when she came down over a big oxer. The mare considerately ejected her rider out of harm’s way before landing heavily on her side. Both horse and rider got straight up and all seemed well. The rider got back on and trotted the horse around, she looked great and popped over the practice fences again before jumping a respectable round with just 4 faults in the jump off.
So, a lucky escape! Maybe...
We often witness nasty falls, bangs and bumps, perhaps a leg caught between a partition in the lorry during transport (this happened to one of my horses), which we worry about initially, but are quickly reassured when the horse appears fine immediately or even days afterwards.
However, the process of recovery is not always as straight forward as this. We may see immediate inflammation and pain in some cases, which all being well subsides over a number of days, but what is happening in the body after this?
All tissue undergoes a period of remodeling as part of the healing process, which is essentially the process of replacing damaged tissue with new (scar) tissue. In soft tissues such as muscle, tendons and ligaments, this new tissue is inferior to the original tissue, with less elasticity and reduced function. This can cause further pain and strain on surrounding areas of healthy tissue which have to take up the slack – an effect that can radiate to other areas of the body that seemingly have no relation to the area of the original injury or trauma.
Bone remodeling is a different story, tissue is replaced like for like – as strong as the original. However, trauma to joints can cause additional bone growth (a process stimulated by inflammation, not just fracture), which may result in obstruction of the joint, reduced range of motion and osteoarthritis.
When we consider that this remodeling process can take up to a year or more, it becomes clear that changes may be occurring under the surface, often completely unbeknownst to us, long after we have forgotten about that fall in the collecting ring 6 months ago.
That’s not to say that every seemingly innocuous incident will result in chronic injury, however, it is all too easy to forget those ‘near misses’ (not to mention those incidents we don’t see, such as falls in the field) when we are experiencing problems further down the line for which there is no obvious explanation.
So, what does this mean for my friend’s horse following her fall today? She will be carefully monitored over the next few days with appropriate exercise, therapy, and veterinary care as required. Going forward, today’s events will be taken into account during her regular physio sessions to help ensure there are no long-lasting issues or compensations arising from her fall.