Patella maltracking (or patella femoral pain) is a common occurrence in the sporting knee. It is an overuse injury where the patella is slightly pulled out of its normal position causing irritation and inflammation under the knee cap as it rubs against other structures.
Patella maltracking can be caused by tightness in soft tissue such as the tensor facea latae, rectus femoris, vastus lateralis and potentially bicep femoris. As a result the vastus medialis may also be weak and unable to counter act the tight muscles pulling the patella out or up. As a result the tight muscles need to be released of through soft tissue work and the vastus medialis strengthened. With the primary cause being dealt with taping the knee can help reduce pain and re-educate the movement patterns required.
Below is a video on how to tape your knee to reduce pain and allow you to exercise and strengthen your knee.
It is a real shame that our horses can’t tell us they are in pain, where the pain is or how painful something is. As a result we may miss when they are actually experiencing pain. Which as a horse owner I hate the idea of. The last thing I want is my horse suffering because I was unable to identify when something was not quite right. Well there may be a way of identifying pain in your equine friend. Read on to find out more
Horses tend to be described as stoic creatures. What is meant by this some may say? Well, horses are a herd animal and as a result they tend not to show when they are in pain, or sore, so that predators don’t single them out. It helps them survive, as a result it makes it quite difficult as owners to see if they are in pain. Some horses are more stoic than others.
So how as owners can we read the subtle signs horses might give out when they are is discomfort or pain? Lameness is often a big sign that something is wrong but can we identify the issue before the lameness becomes so apparent, well yes we can.
Sue Dyson and colleagues have been carrying out numerous studies to identify behavioural markers, that can help predict lameness and musculoskeletal pain being experienced by horses. It is termed the Ridden Horse Pain Ethogram and consists of 24 behaviours that consistently predict lameness in horses. Generally if there are more than 8 of these behaviours then the horse is considered to be in pain and there is probably an underlying lameness which may not be apparent to untrained eye
These behaviours include some of the following;
Ears back
Mouth open
Tongue out
Tilting the head
Crookedness
Tail swishing
Clamping tail
Holding tail to one side
Head tossing
Head under or over the vertical/bit
Unwillingness to go forward
Resistance
Stumbling
Toe drag
Intense stare
Eyelid half closed
White of the eye showing
Spontaneously changing gait
Bit pulled through to one side
Poor quality canter
Hurrying
Bucking/rearing
These are all behaviours that our horses have exhibited at some point but this may only be for seconds, however if for instance the ears are back for longer than 10 seconds and regularly through a ride then this may be a sign that something is uncomfortable for them.
Horses are not inherently naughty, and if people or you are describing your horse like this then perhaps they are experiencing musculoskeletal discomfort. As horse owners we need to make it a priority to be better at identifying pain related behaviours and this will allow our horses to lead a much better quality of life.
By knowing the behaviours above, you as an owner can identify any potential musculoskeletal issues sooner, which in the long run may reduce vet bills. If your horse isn’t showing any lameness but is exhibiting some of the above behaviours, either regularly, or perhaps they have occurred out of the blue, then your horse may benefit from a soft tissue therapist (equine massage therapist/bodyworker) to come and relieve any musculoskeletal soreness. This is something that all horses in regular work should get.
This post isn’t to scare you as an owner but to make you more aware. You don’t all need to think that you have to stop riding your horses because they show some of the above behaviours. Horses like humans can have muscle soreness from exercise or something they may have done that they are not used to. Humans, however are able to do something about this unlike horses. So it maybe that as an owner you make sure your horse gets regular bodywork, or that you stretch your horse and give them days where you ride them on a lose rein to help them recover.
You may wonder sometimes how you sustained an injury when you didn’t have a noticeable traumatic event like a fall. Generally injuries that have no obvious event and build up over time are called overuse injuries. They are really common and can be caused by a number of things. Read on if you want to find out more.
What is an overuse injury
Overuse injuries are a build up of micro trauma to a certain area. The body goes through a process of remodelling to help adapt to stresses placed on it. Through this process we get fitter and stronger. However if this process is disrupted we can’t remodel correctly, as a result we sustain an injury if it continues. Often overuse injuries have inflammation along with the micro trauma.
Examples of overuse injuries
Tennis elbow
Golfers elbow
Runners knee
Achilles tendinopathy
Shin splints
Stress fractures
Patella tendon tendinopathy
Patella maltracking
Causes of overuse injuries
Increased load
Frequency of training
Not enough rest
Poor diet
Old or poorly fitting footwear
Incorrect equipment
If you want to reduce the risk of sustaining an overuse injury then making sure you increase your training load and frequency gradually with enough rest in between sessions will allow your body to react well to exercise, having regular massages can also help this process. Also making sure you eat a healthy balanced diet to give your body the building blocks to remodel and lastly making sure your equipment is up to the job I.e. fits you and is not worn otherwise this can change your biomechanics and loading of certain tissues.
If you find that you are suffering from an overuse injury then do consult a physio, sport therapist or doctor to help with management and rehabilitation.
In recent years the core of a rider is being highlighted and discussed more than it ever has. People are starting to understand the importance of a good core and how it can help with riding. So often none horsey people think that you just sit on a horse and give it a squeeze and then the horse gets on with it and the rider just sits there being fairly inactive. This is far from the truth. So what muscles are involved with riding and how can we improve our bodies to help our horses?
What are core muscles?
Generally when talking about the core it is the deep core that is being referred to. The deep core encompasses the pelvic floor (and gentlemen you do possess one), transverse abdominis and multifidi.
The pelvic floor and transverse abdominis are quite easy to teach people how to engage as they are easy to feel. However the mutlifidi are a bit harder due to the fact that they are made up of lots of little muscles attached to the spine so trying to isolate to activate is difficult. By activating the pelvic floor and the transverse abdominis the multifid also activate and help to stabilise through the back.
The transverse abdominis is like a corset wrapping from the spine to the front between the ribs and hips. It is classed as one of the abdominal muscles. The pelvic floor spans the inside floor of the pelvis it supports the abdominal and pelvic contents.
How to activate your core
Pelvis floor
To activate your pelvic floor you want to draw up as though you are trying to stop peeing mid flow. For guys the best way to describe it is ‘nuts to guts’. A really good way to see if you pelvic floor is functioning is to actually try to stop peeing mid flow. If you find this difficult than working on engaging your pelvic floor will be really beneficial. You will also find it helps hugely with you riding.
Transverse abdominis
The best way to start is lying on your back with your knees bent. Find the front of your hip bones. Slide the fingertip to the inside of the hip bones and you should find it soft. If you then try drawing in as though you are trying to get a pair of trousers on that are a bit to tight you will feel the muscle activate underneath your finger tips. You want to make sure you are activating below the belly button.
Practice activating both the pelvic floor and transverse abdominis and try and hold for 10 seconds repeat this a couple of times. Once you feel you have achieved this try activating them together.
Try activating your core when riding. You may find the first time you activate your horse might stop. Using your core in this way helps control your horse through your seat. Once you get used to activating the core you will be able to adjust the amount of activation to allow you to fine tune the response you get from you horse. Have a play around with this.
The above outlines the deep core and some very basic exercises you can do to start improving your core activation and ultimately your seat when riding. In future blogs we will delve into more complex exercises and discuss other muscles that can also help with your riding.
You may be wondering what the female triad is and why stress fractures can be more common in women? The female athlete triad is an important area to discuss with female athletes and also something that male athletes and coaches should be aware of to help support women in sport.
The female athlete triad is defined in regards to energy availability, menstrual function and bone strength. This description is quite broad to encompass several different disorders that can lead to the female athlete triad being diagnosed. Energy availability refers to disordered eating this can be dieting at one end of the spectrum and anorexia nervous or Bulmeia at the other. This may come about where sports require specific weight requirements or appearance such as gymnastics, judo, dance and many others. As a result the diet impacts on the body in so many ways and can affect bone density.
Diet also affects menstrual function and hormone levels. This can be in the form of oligomenorrhea (irregular menstrual cycle) and amenorrhea (the absence of cycles). A female needs to be over a certain weight to have a menstrual cycle and to be able to sustain being pregnant. If the body doesn’t have this then menstrual cycles can become disrupted or cease.
As a result of not eating properly bone density can be affected. Normally the body recycles bone, which is called remodelling. Bone is reabsorbed and then new bone laid down. If an athlete is not getting the right nutrients or energy levels then the bone is reabsorbed and not laid down causing the bone density to decrease. This can make the prevalence of stress fracture more common in women and osteoporosis in older life if it is not caught and treated at a young age.
In sport there is pressure on young women to conform to certain ideals and body shapes, causing distorted body images and ideals. As a result the female athlete triad does come about. Young males can also experience distorted body images but it tends to be towards gaining muscle mass and the use of steroids which also can affect bone density and other health issues.
Sport as a whole needs to consider what psychological impact it can have on young people and that as adults we need to make sure that young people are accepted as they are and not made to conform to ideals that would harm their health. Openly talking about eating healthy balanced meals is key and not discussing diets in a restrictive manner. By educating young athletes and parents on what food is good for them and help performance will allow a much more positive mindset. I don’t think this is addressed enough in sport and is one reason why we see physical and psychological signs of restrictive eating in young adults.
The area of supplements for horses is quite a minefield and its difficult to know what to give or not to give your horse. I know as a horse owner I have looked at many a product wondering whether it would actually benefit my horse. I have a 19 year old horse and have often looked into joint supplements but its hard to know which are beneficial or not. This post will hopefully help you as an owner to make a more informed decision on the matter
Horse joints
The main areas of focus would be the joints of the legs as they are predominantly weight bearing and therefore undergo a lot of wear and tear. Synovial joints are the most mobile so are often affected the most. Synovial joints are generally composed of a joint capsule with articular cartilage on the surfaces of the bones that meet. The synovial capsule allows fluid to be retained in the joint helping with lubrication and the articular cartilage is a smooth surface that allows the bony ends to glide over each other. These structures can become damaged over time through repetitive use and traumatic damage. Osteoarthritis (OA) can also develop which can cause painful and stiff joints.
Risk factors of joint damage and OA
High intensity activities
High volume of exercise
How many years training at a high level
Training surfaces- training on hard ground would have an impact on joints
Type of training- Jumping exercises would carry a much greater impact than leisure hacking
Conformation- how a horse is put together will affect stress placed on certain joints
Hoof balance- How a horse is shod and trimmed will also affect load on joints
From the above list it can be seen that as an owner you can reduce the risk to your horses joints by making decisions not to gallop, canter or jump your horse when the ground is to hard. Making sure you have a balanced training plan that allows recovery time. Allowing your horse to have regular bodywork sessions to reduce any muscle tension and to help with any conformational issues. Having a good farrier or foot specialist. Also a well balanced diet. All these can help reduce the impact to your horses joints without having to spend lots of money on specific joint supplements.
Joint Supplements
Above I mentioned what you can do to reduce the risk, which is the long run can be a cheaper way to maintain a healthy active horse into old age. However you may feel your horse needs a helping hand so what should you be looking for in a joint supplement. Below are some of the key ingredients that should probably be present for it to have any benefit.
Chondrotin Sulphate
Chondrotin sulphate is anti inflammatory, helps protect joints, controls water content in cartilage and reduces friction in a joint. There is some research to indicate that it can be absorbed allowing it to have some bioavailability to horses and helps with osteoarthritis. Combined with glucosamine it is thought to be more effective.
Glucosamine
Glucosamine helps with collagen synthesis, and reduces joint degradation. It has very good availability to be absorbed in the gut
MSM
MSM is available in the horses natural diet and provides sulphur which helps repair collagen, however through processing and drying this can be lost. It is anti inflammatory and has analgesic properties. As horses get older then their levels of MSM decrease so supplementing them may have some benefit.
Omega-3 and -6 fatty acids
Omega-6 fatty acids are considered pro inflammatory due to the fact that they are involved in vital body functions such as blood pressure, blood clotting and immune responses which are needed in the body.
Omega-3 fatty acids are deemed anti inflammatory because they decrease blood clotting and inflammatory responses as a result omega-3 can help to reduce inflammation in joints. Good sources of omega-3 are from linseed and fish oil.
So the above products in a supplement can potentially have a beneficial affect on joints but more research needs to be done. One thing you do need to look out for is the quantities of each ingredient in some products. If the product doesn’t have enough then it is pointless and you will be wasting money. Chondrotin sulphate glucosamine and MSM are not cheap ingredients so expect to pay a lot of money for a product that will be effective. Adding Omega oils to a well balanced diet and reducing the risk factors of joint damage will probably be a much more cost effective and simple way of keeping your horse fit and healthy into old age.
Autumn definitely feels like it is coming and I don’t know about you but my horses are telling me about it. One of my horses Travis has always been very opinionated about the arrival of Autumn, quite frequently all four legs will leave the floor followed by a grunt to say “I am not happy about this change in weather”. He seems to get a sudden fear of dogs alone in the woods, which the rest of the year is absolutely fine. Do you find that your horse has any behavioural changes or perhaps physical changes other than a thicker coat.
Another of my horses doesn’t change his mood or behaviour but is showing more signs of back stiffness. The colder nights can cause muscles to tighten and present as sensitive or sore to touch. Your horse may be showing signs of being uncomfortable when being saddled. Such as trying to bite, dipping away when the saddle is placed on the back, pinning years back, showing the white of the eye, tossing their heads. The list can go on. This can be quite mild or severe.
The above signs can also be indicative of ulcers present but if this is sporadic and coincides with when the temperature drops it could just be some tightness or stiffness due to the cold. Horses sometimes shiver to help keep themselves warm or tighten through their muscles when the temperatures are low. Try and think how you feel when cold. Your body closes down your muscles feel tight and tired this is the same for the horse.
So what can you do to help your horse
Rug or not to rug!
This is always a difficult thing at this time of year. My general rule is to rug when under 7 degrees or if below 10 degrees and it is raining if not clipped. However if your horse has shelter then rugging can be much less if at all (this does depend on breed). This is a matter of preference but as owners we do tend to over rug horses. The only exception I have been making recently with one of my own horses is because he has been showing some soreness through his back and it correlates with the colder nights. As a result I would suggest rugging in this instance so that his muscles don’t tighten up. This could also be applied to older horses, who generally experience more muscle stiffness. A light rug or sheet would just help keep the back warm during the night and hopefully reduce the occurrence of a sore back.
Massage
It might not be your horses back but a hind leg or shoulder that they suffer stiffness. Massaging the muscles around this area before tacking up can really helps loosen up by increasing blood flow into the area. If you are unsure what to do ask your body worker or massage therapist to show you.
Carrot stretches
Using carrot stretches before work can also help to loosen and engage the core. Keep them gentle and don’t hold them for long periods of time. We want the horses to mobilise through the body rather than hold a stretch. This will create a horse than is ready for exercise. In hand exercise such as stepping under, belly lifts, pelvic tucks, walking backwards can all help as well.
Apply heat
The use of heat can also help. Use a heat pad or hot water bottle but make sure it is not to hot. Placing over the area that is often stiff will help draw blood into the area and soften the tissue. Massage will have a similar effect
Warm up slowly
When starting your ridden work start off in walk for longer asking your horse to stretch long and low before collecting them up. Get your horse to bend to either side while still on a lose rein. This will encourage lengthening through the back and sides, engage the core and mobile joints. You can carry this into a trot as well, once you have loosened the horse then you should find that their movement should be loser. You may find that lunging before ridden work may also help. It also allows you to see how your horse is moving and where they might be stiff.
Lateral work further into your ridden session can also help to loosen up.
Stretching
Holding stretches is something you want to avoid when your horse is not warm. Always think of dynamic stretches i.e. movement through a range rather than static holds. Static stretching doesn’t prepare the body as well for exercise as dynamic stretches do. At the end of exercise when the horse is still warm or through massage then static stretches can be used to help ease tension in an area. Again this is something your body worker or massage therapist can show you.
If your horse does show signs of discomfort on a regular basis then a vet should be consulted to make sure there are no other underlying issues. Always make sure you have your saddle regularly checked especially at seasonal changes as your horse can change shape. Lastly regular massages can really help all horses from field companions to top level competition horses throughout the year.
If you would like to discuss any musculoskeletal issues your horse is experiencing please do get in touch with Pollyanna by using the buttons below
Below is a video on how to tape your ankle when you are returning to play sport after an ankle sprain. The techniques used below helps to limit the amount of inversion at the ankle meaning a player is less likely to roll the ankle during play.
The taping technique should only be applied before a warmup, game or training and remove it after the activity is finished. It’s not like Ktape which can be left on for longer periods of time.
The video demonstrates the stirrup and heel lock techniques but also looks at a figure of 8 if needed. I have demonstrated on myself so that you can see how to do on yourself when you haven’t got a professional to do it for you. I hope this is helpful
If you have any questions regarding ankles or taping please do get in contact with Pollyanna
You may be asking what is acupressure and how can it help my horse? If so then the following post will help answer this question.
Equine acupressure has the same roots and theory as acupuncture. It involves the application of pressure from fingers rather than the use of needles making it safe and noninvasive (acupuncture in the UK can only be performed by equine vets). It can be used as a stand alone treatment or integrated into a sport massage to help support your horses health.
Acupressure is based on traditional Chinese medicine, which offers a method of natural healing by trying to maintain the innate balance of the body. Acupressure uses invisible lines of energy flow called meridians, and along these lines are specific points which can influence the body when pressure is applied. There are 14 meridians connecting organs with other parts of the body. It is thought that energy (Chi) that flows along these meridians can get blocked causing symptoms to develop. By applying pressure the balance and energy flow can be restored. Chi (energy) is composed of Yin and Yang, which are two dynamic forces that are the opposite to each other. Yin is seen to be represented by water, wet, cold, nourishing, and dark (to name a few), whereas Yang is fire, dry, hot, active, red and consumes. When Yin and yang are in balance chi is flowing harmoniously and the body is healthy, however when they are not in balance there is disharmony and disease develops. Acupressure can help restore balance and act as a preventive.
Acupressure can have the following benefits
Releases natural occurring pain relieving chemicals in the body
Reduces inflammation and swelling
Increases blood flow allowing an increased rate of recovery from injury
Increase energy levels and wellbeing
Decrease anxiety
Encourage relaxation
Help joint lubrications and movement
When working on equine clients I often integrate acupressure points into my bodywork (massage) sessions to help create a bespoke and more holistic approach. I frequently find horses relax hugely with use of acupressure by their eyes softening, heads lowering, muscles relaxing and often dosing off. This allows me to be more effective in treating areas of discomfort as well as supporting the horses overall health.
If you would like to discuss the potential use of acupressure in your horses treatment then do contact Pollyanna using the form below
In the the first blog of this series we looked at anatomy and function of the foot and then proceeded to discuss some common injuries in part two. This part looks into exercises that can help keep your feet supple and strong for everyday life.
Video on exercises to help keep your feet supple and strong
I hope the video was helpful if you have any questions then do please get in touch
