Page 138 - Speedhorse April 2019

healing. There are new blood vessels forming, stem cells are migrating from the bone marrow, and the body is putting pro-healing proteins into that ligament, tendon or bone. This is the optimum time to get that tendon, ligament or bone to heal all the way. You actively train it through that initial healing process when it is ready and take it all the way to the end stage.”
If you simply let the horse be a couch potato, such as turning him out to pasture
not doing anything, at the end of that healing period the body is past its optimum window. The body quits its geared-up method of healing and you’ve lost that opportunity. “The key
to rehab is mild phases of stress to teach that tendon, ligament or bone that it has more heal- ing to do to get all the way back to high levels of exercise. This is when we can finalize our rehab, after we’ve gotten the body to realize it needs to be strong enough to do this amount of work every day,” says Easter.
This was a major breakthrough in modern rehab, realizing that we need to work with the horse all the way back to the level of perfor- mance we want. “Even in the first part of my practice career, 25 years ago, it was common
for people to think the best thing after a serious injury was to just turn the horse out for a year and let nature and time do the healing,” he says.
This worked in some instances, but often these horses would heal and then reinjure the
leg when they went back to hard work. “They’d look good for a while and then go lame again. We lost that window during the regeneration process to train that tissue back to athletic levels. Sometimes you could start over again, but you never got that whole geared-up cycle with the body in healing mode. You missed the best time, from the acute stages forward,” he explains.
The underwater treadmill has been of great benefit in equine rehab, along with being able to cool the leg effectively in the cold saltwater spa. “It is hard to ice horses’ legs enough to get them to cool to the core. The cold saltwater spa enables us to super-cool the water by adding
salt, and we can whirlpool the water around the legs after doing things that stress the tissues, such as hand-walking or underwater treadmill, while those tissues are still new and heal-
ing, to control inflammation. This halts the increased blood flow and some of the cytokine production, so we don’t get new inflammatory responses from each workout. This was another major breakthrough in equine rehab,” he says.
“Besides the basics of underwater tread- milling, theraplates, and cold saltwater spa treatments, eCore has implemented adapta- tions of human physical therapy techniques and isometric rehabilitation exercises. Some of the advanced cases can get more exercises that aid range of motion and core strength. All the injured and healed tendons, ligaments, joint capsules, etc., must have good-quality tissue that is trained properly if we want those horses to go back to high level work,” he says.
“All of the fine-tuned agility and strength exercises help in rehab and are showing a
lot of promise. The eCore group is trying to document the difference between using just the old-style rehab and adding some of these new therapies into the protocols. We are trying to produce some data that show which type of exercises are best for certain injuries. A lot of this is typical in human medicine or has been explored. People have some idea of the types
of exercises that are good for different types of injuries like rotator cuff, etc.”
Equine rehab therapy is greatly advanced compared to what it was 10 years ago, but still in its infancy. “It will continue to evolve. We’ve seen a huge difference, being able to watch these horses and monitor them and being able to do a lot of sports medicine on most of the horses we operated on, with extensive rehab therapy. This has really opened our eyes to the need for this,” says Easter.
“One of the reasons we incorporated this kind of rehab, starting in the late 1990’s, was because we could see a big difference in the horses that got rehabbed. Now, most people recognize it as
Cade McCutcheon, the youngest U.S. World Equestrian Games athlete, with his horse Custom Made Gun at mobile saltwater spa.
necessary for these horses. We can do a lot for horses that have severe suspensory tears, severe bowed tendons, or severe joint injuries. We can get them back to higher levels of exercise than what we were able to achieve with just the medical treat- ment or surgery alone,” he explains.
INNOVATIONS IN REHAB THERAPIES FOR HORSES
There are some differences between humans and horses in what can be done today. “If
the human has major orthopedic surgery or major injury and is recovering, he/she can lie
in bed. Therapists can pick that person up,
and put him/her on a walker and help them walk. Horses can’t lie in bed. When we fix a compound fracture in a cannon bone or do any major injury repair, that horse has to get up and be able to stand in the stall and put weight on that limb,” says Easter. Weight-bearing is crucial to success in equine cases.
“If the horse has to stand three-legged for any length of time, there is too much weight on the opposite leg; the horse will founder in the supporting leg. He must have constant loading and unloading of the feet to keep proper blood flow and function. We must get the injured leg back to weight-bearing, so the horse can at least stand on it comfortably,” Easter explains.
“Generally, our rehab program starts with
a horse that is already standing in a stall, as opposed to a person in a bed, and we start with
The cold saltwater spa, such as this mobile unit, uses salt to cool the water and then whirlpools the water around the legs to aid healing of stressed tissues and to control inflammation
136 SPEEDHORSE, April 2019
EQUINE HEALTH