Page 48 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.1 A pproach to the lame horse 23

VetBooks.ir 1.45 1.46

Fig. 1.45 Arthroscopic surgery of the right Fig. 1.46 Tenoscopic view of an acutely inflamed
intercarpal joint being performed in dorsal carpal sheath showing considerable synovial proliferation,
recumbency under general anaesthesia. haemorrhage and fibrin clots, and in the background
damaged fibres of the deep digital flexor tendon.

of techniques that are utilised, depending on the Controlled exercise
lameness being treated, and combinations are often Controlled exercise can range from simply walking
used. Recently, there has been an increasing number out in-hand through to schooling over poles or using
of evidence-based studies into these techniques and a treadmill. It allows a graduated increase in strength
this has helped to support and guide the use of cer- and coordination and is timed to coincide with the
tain aspects of this therapy. natural healing processes of recovering tissues.

Massage Swimming
Massage is used to promote muscle relaxation Swimming exercises the cardiovascular system
and good circulation. It is useful for relieving while reducing load on the limbs and allowing
focal muscle spasm in longissimus dorsi and neck muscle groups to work. It can be carried out in a
musculature. specially designed swimming pool environment,
with or without a treadmill, or even in the sea in
Muscle (‘Faradic’) stimulation some countries.
Transcutaneous electrical nerve stimulation
(TENS) can stimulate muscle groups and is used Therapeutic ultrasound
for neurogenic atrophy cases (e.g. supraspinatus and Therapeutic ultrasound utilises high-frequency
infraspinatus atrophy following suprascapular nerve sound waves to promote tissue healing, although
damage [‘Sweeney’]). This technique is also useful the exact mechanisms of action are unknown. The
for improving muscle tone and mass to atrophied sound energy is converted to thermal and vibrational
muscles seen as a result of chronic back problems energy on contact with tissue, and these may have
(after pain has been resolved) and contralateral limb biomechanical effects that produce positive healing
disuse (e.g. after fracture repair or chronic poor/ processes in damaged tissue. The first author has
non-weight-bearing lameness). It has also been used had good results with adjunct ultrasound treatment
as a diagnostic tool. of haematomas in various locations.