Athlete sidelined with an injured tendon, ligament, or a chip fracture of a carpal bone? Surgery may or may not be part of the treatment, but rehabilitation therapy most likely is—whether the athlete has two legs or four.
“Physical therapy and rehabilitation play an important role in performance enhancement, injury prevention, and restoration of full function during recovery from injury,” says Santiago Gutierrez-Nibeyro, DVM, MS, Dipl. ACVS, ACVSMR, an equine surgeon at the University of Illinois Veterinary Teaching Hospital in Urbana. Gutierrez-Nibeyro, who is boarded in equine surgery, recently also became a diplomate of the American College of Veterinary Sports Medicine and Rehabilitation.
“Similar to high-performance human athletes, performance horses frequently encounter musculoskeletal injuries of various severities,” says Gutierrez-Nibeyro. “Restoration of functional limb movement is the key to recovery from these sports-related injuries.”
Typically, a horse must be rested after an injury, and this period of inactivity can cause disuse atrophy—a decrease in the size of a muscle, cartilage, ligaments, and so on. Inactivity also leads to decreased range of motion of the joints as well as shortening and decreased range of motion in the muscles.
Most horses that have been rested in a stall due to an injury have shortened limb excursion, lack of agility, and visible signs of discomfort once they are moving again. When horses undergo rehabilitation as their musculoskeletal system heals, these deficits can be lessened or prevented.
“The goal of rehabilitation is to restore the normal function of the musculoskeletal apparatus following injury while reducing the symptoms of injury and restoring range of motion and stretch,” explains Gutierrez-Nibeyro. “People board certified in equine rehabilitation understand the science behind the treatment: biomechanics, musculoskeletal and nervous systems function, and sports medicine.”
Gutierrez-Nibeyro says many therapies are used to rehabilitate performance horses, and they are essentially the same as those used in people during physical therapy or athletic training. Therapies include the use of heat and cold, extracorporeal shock waves, electricity, laser, ultrasound, hydrotherapy, massage, acupuncture, stretching, chiropractic, hyperbaric oxygen, pools, underwater treadmill, and controlled exercise.
Broadly speaking, these therapies enhance normal limb and vertebral spine function, decrease soft tissue pain and inflammation, allow the animal to regain normal limb proprioception (awareness of body position), and restore normal muscle tone and elasticity, among many other functions, just as they do in human patients.
In addition, some of these physical therapies are used to enhance the warm-up process to relax muscle and other soft tissues of the limbs and increase tissue elasticity for prevention of injuries during exercise.
“Unfortunately, scientific literature documenting the efficacy of the different physical therapies in horses is limited,” says Gutierrez-Nibeyro. “However, published reports and clinical data are growing because physical therapies and rehabilitation are an active area of clinical research in veterinary medicine.”
The American College of Veterinary Sports Medicine and Rehabilitation has been an approved specialty area in veterinary medicine since April 2010, and its diplomates can be found across Europe and North America, offering certification in either equine or canine rehabilitation.
Gutierrez-Nibeyro says the horse’s caregiver often plays an important role in the rehabilitation treatment plan: “Horses with involved caregivers tend to improve more rapidly. The caregiver may work with the injured horse at home to restore normal range of joint motion or limb movement by performing simple exercises or movements on a daily basis.”