Equine Physiotherapy: Uses, Techniques & Side Effects

Equine Physiotherapy
Uses
Techniques
Side Effects

Equine physiotherapy is a specialized profession within the field of veterinary medicine that focuses on the rehabilitation, recovery, restoration of correct movement and function, and overall physical well-being of horses.

Physiotherapy combines elements of body work, stretching, specific exercise protocols, and other adjunct therapies. This methodology is used to maintain performance and health in equine athletes and support recovery from injury, surgery, and chronic conditions.

With techniques ranging from cold and heat therapy to advanced methods such as laser and shockwave therapy, equine physiotherapy plays an important role in keeping sport horses safe and healthy.

Horse owners and caretakers should ensure they work with a qualified professional when seeking adjunct treatments such as physiotherapy. While physiotherapy is generally safe for horses and supported by veterinary science and practitioners, improper techniques can cause more harm than benefit.

Equine Physiotherapy

Equine physiotherapy, also referred to as equine physical therapy or PT, involves the application of various therapeutic techniques to improve the physical function and well-being of horses.

The primary goals of physiotherapy for horses include: ^[1]

Pain relief
Improved or restored mobility
Enhanced muscle strength
Promoting healing after injury or surgery

In addition to its rehabilitative role in addressing mobility issues, physiotherapy is also used as a preventive training and recovery protocol, aiming to maintain a horse’s condition and to prevent injuries. ^[1]

While common equine physiotherapy modalities offer many potential benefits for rehabilitation and fitness in horses, it’s important for owners, caretakers and trainers to know that some of these methods carry risk of injury and side effects.

Always work with qualified professionals and in collaboration with your veterinarian to ensure your horse’s sports rehabilitation and training is as safe and effective as possible.

Uses

In equine practice, physiotherapy is frequently used to restore normal range of motion and enhance quality of life. Equine physiotherapists work closely with veterinarians to develop individualized treatment plans that address each horse’s specific needs.

Currently, equine physiotherapy is primarily used for: ^[1]

Injury rehabilitation: Following an injury, horses may experience damage to soft tissues, including muscles and ligaments, which are some of the most common causes of back pain in horses. Fortunately, the majority of these injuries respond well to a combination of physiotherapy and rest. Techniques such as cold therapy and therapeutic ultrasound can reduce inflammation and promote healing in these cases.
Post-surgical recovery: PT plays an important role in post-surgical recovery, as it can reduce pain, prevent stiffness, and restore pre-operative levels of mobility. Techniques such as heat therapy and controlled exercises are commonly employed to improve circulation and enhance flexibility.
Pain management: Chronic conditions such as arthritis, degenerative joint disease, and tendinitis can cause severe discomfort and pain in horses. Affected animals benefit significantly from various physiotherapy techniques, especially when combined with pain management recommendations from a veterinarian.
Preventive medicine: A further use of physiotherapy is injury prevention by maintaining muscle tone, flexibility, and overall physical condition. Regular assessments can help identify potential issues in their early stages, and tailored exercise plans, along with other physiotherapy techniques, can significantly reduce the risk of severe mobility complications related to sports injuries.

Techniques

Equine physiotherapy encompasses a wide range of techniques, each with specific applications and benefits.

The most commonly used treatment modalities in physiotherapy for horses include:

Thermal therapy
Shockwave therapy
Laser therapy
Massage therapy
Hydrotherapy
Chiropractic manipulation
Controlled exercise and stretches

Thermal Therapy

Thermal therapy, which includes the application of either heat or cold, plays a significant role in equine physiotherapy, offering targeted solutions for various stages of injury and chronic conditions.

Cold therapy (cryotherapy) involves the application of cold packs, ice, or cold water to reduce inflammation, swelling, and pain in horses. Cold therapy works by constricting blood vessels, which decreases blood flow to the treatment area. This reduction in blood flow helps limit the extent of inflammation and tissue damage, providing relief from pain and aiding in recovery. ^[1]^[2]

Cold therapy is particularly beneficial for managing conditions such as laminitis, but is also used for general pain relief due to its mild analgesic effects. By cooling the affected area, this treatment numbs pain sensations and controls inflammation, which can help alleviate discomfort.

For traumatic injuries, cold therapy is most effective when applied immediately after the incident. Ideally, the treatment should be initiated within the first 30 minutes following the injury to maximize its anti-inflammatory benefits. ^[1]^[2]

After the initial application, cold therapy is typically repeated every two to four hours for the first 48 hours. Frequent application helps keep the inflammation and swelling under control, contributing to the overall healing process. ^[1]^[2]

Heat therapy (thermotherapy) involves applying heat to specific areas of a horse’s body to enhance circulation, relax affected muscles, and reduce joint stiffness. This therapeutic technique is beneficial in managing chronic injuries and conditions that involve muscle tension or stiffness.

Heat therapy can be administered in two primary ways: by immersing the horse in warm water or by using hot packs, ideally around 75°C (167°F), applied directly to the affected area. Heat therapy is usually applied in multiple sessions for 20 to 30 minutes at a time. ^[2]

Shockwave Therapy & PEMF

Extracorporeal shockwave therapy (ESWT) is a non-invasive PT treatment that requires a specific machine that produces high-energy shockwaves.

There is limited scientific evidence supporting ESWT in horses. Despite this, extracorporeal shockwave therapy is used widely by veterinarians and equine physiotherapists, and has emerging anecdotal success. Shockwave therapy is believed to increase blood flow and stimulate tissue repair. ^[3]

Equine conditions treated with ESWT include: ^[3]

Osteoarthritis
Tendon injury
Back pain
Ligament injury
Bone fractures
Skin lesions

A similar modality to shockwave is Pulsed Electro Magnetic Therapy (PEMF), which operates under similar principles to shockwave, but the waves are generated electromagnetically.

Laser Therapy

Laser therapy, or low-level laser therapy (LLLT), is an increasingly popular tool in equine physiotherapy, providing a non-invasive treatment option for a range of musculoskeletal conditions in horses.

This therapeutic approach employs focused light energy to penetrate tissues, promoting cell repair, reducing inflammation, and alleviating pain. The mechanism of laser therapy involves the application of a laser beam to the affected area, where the light energy is absorbed by the cells. ^[4]

Once absorbed by the tissue, the focused light has the following effects on the treatment area: ^[4]

Stimulates cellular activity
Enhances blood circulation
Accelerates the body’s natural healing processes

The specific effects of laser therapy are dependent on the wavelength and power of the laser, which are carefully selected on the basis of the condition being treated. ^[4]

Laser therapy can be beneficial in managing chronic conditions in horses such as osteoarthritis and tendinitis. It is also an effective recovery tool, helping alleviate muscle pain and stiffness after injury or intense exercise. ^[4]

As with all therapeutic interventions, the effectiveness of laser therapy is enhanced when it is integrated into a comprehensive rehabilitation program. This includes combining laser therapy with other PT techniques such as manual therapy and controlled exercise. ^[4]

Massage Therapy

Massage therapy is a fundamental component of equine physiotherapy, focusing on manual manipulation of soft tissues (muscles and tendons) to relieve tension, improve blood and fluid circulation, and enhance performance and mobility.

This modality is particularly beneficial for performance horses, helping maintain muscle health, prevent injuries, and support recovery from strenuous activities. Additionally, massage therapy is a valuable rehabilitation tool for horses recovering from injuries or surgery, as it can reduce muscle soreness, enhance flexibility, and contribute to overall well-being. ^[5]^[6]

Massage therapy in horses involves several specialized techniques, each tailored to achieve specific therapeutic goals. These techniques are applied with varying intensity and duration, depending on the horse’s needs and responses during the massage session.

Common techniques include: ^[5]

Compression: This method involves the application of rhythmic pressure to muscles, compressing them against underlying bones to reduce tension. Compression helps relieve muscle tightness and promote relaxation, making it a useful technique for performance horses that endure high levels of physical stress.
Direct pressure: A technique that applies sustained pressure to a specific muscle area. By temporarily altering blood flow, this technique helps redistribute fluids within the muscle tissue, reducing tension and alleviating pain.
Effleurage: Unlike direct pressure and compression techniques, effleurage involves a wider area of the horse’s body. Effleurage requires a gliding stroke over the area and is often used as a preparatory phase for a more specific technique focusing on a smaller area. Besides its use as a “warm up” method, effleurage is effective in promoting lymphatic drainage and increases circulation.
Friction: Friction is a technique that involves the application of perpendicular pressure to specific muscle fibers. This action creates heat and increases circulation within the targeted area. Friction is effective in treating muscle spasms and stiffness as it breaks down muscle knots.
Myofascial release: Myofascial release is a specialized technique aimed at addressing issues affecting the fascia (the connective tissue that surrounds muscles). Myofascial release techniques include movements referred to as the C-stroke and skin rolling; these techniques aid proper muscle function and pain reduction. This method is particularly useful for addressing localized muscle “knots” or areas suffering from chronic stiffness, providing relief and improving muscle function.

Hydrotherapy

Hydrotherapy, which utilizes the physical properties of water such as temperature, pressure, viscosity, and buoyancy, plays a significant role in equine physiotherapy. This modality offers versatile therapeutic benefits for horses recovering from various conditions, including musculoskeletal injuries, arthritis, and nerve disorders.

Hydrotherapy can be applied in different forms, with two of the most common methods being swimming and the use of an underwater treadmill.

Swimming is sometimes used to provide active exercise opportunities for horses. However, swimming is contraindicated in horses with back pain or spinal diseases due to their natural swimming posture, which involves an extended thoracolumbar spine and raised neck. This position can exacerbate back issues rather than alleviate them. ^[7]

On the other hand, the underwater treadmill offers a more controlled environment for rehabilitation. Horses walk or trot on a motorized belt within a chamber filled with water, allowing for both active and assisted exercise. ^[8]

As the horse walks, the water’s buoyancy reduces the load on the limbs, making it an ideal tool for rehabilitation, particularly for conditions such as osteoarthritis, tendon injuries, and ligament damage. The controlled environment also enables precise adjustments to water depth and treadmill speed, allowing for tailored rehabilitation protocols that address specific injuries and recovery stages. ^[8]

Chiropractic Care

Chiropractic care is a therapeutic approach focused on alleviating pain and reducing lameness in horses. This specialized treatment aims to improve the overall well-being and mobility by addressing issues related to the spine and joints.

Chiropractic treatments in horses typically involve two key components: ^[9]

Joint Manipulation: Involves application of a rapid, controlled force to a joint, pushing it beyond its normal passive range of motion but within its anatomical limits. Joint manipulation is designed to address localized pain and stiffness, helping to restore proper function and alleviate discomfort in the affected area.
Joint Mobilization: This approach entails the repetitive movement of a joint through its passive range of motion to stretch the surrounding connective tissues and promote joint symmetry. The primary objectives of joint mobilization are to reduce pain, enhance joint flexibility, and improve overall mobility, thereby contributing to the horse’s comfort and performance.

Chiropractic care is generally used to address musculoskeletal conditions and associated pain.

Chiropractic care carries significant risk of severe injury if not performed properly by a qualified professional

Controlled Exercise & Stretching

Exercise therapy is a fundamental physical therapy technique and is generally present in all rehabilitation programs.

Healing is a complex process involving multiple phases, with different types of tissue requiring specific healing processes. Individualized exercise programs are tailored to support the unique needs of specific tissues: ^[10]

Muscle injuries benefit from controlled exercise to prevent atrophy and restore strength.
Bone healing involves a phased process of callus formation and remodeling. Resistance and load bearing exercise helps stimulate new bone growth.
Tendon and ligament injuries require mechanical stress to ensure proper fiber alignment and strength. However, it is important for the practitioner to gradually increase the level of strain, as excessive stress can be detrimental to the healing process.
Joint cartilage has a limited healing capacity, which makes rehabilitation of this tissue particularly challenging, even with a comprehensive exercise program in place.

Stretching is a cornerstone of controlled exercise in rehabilitative settings. Stretching helps alleviate tension or stiffness that occurs when a muscle is overworked. By bringing the muscle back to its natural length and flexibility, stretching can ease discomfort, restore full range of motion, and enhance your horse’s overall recovery. ^[11]

Controlled exercise such as hand-walking is usually preferred over turnout during injury recovery. Unsupervised exercise can lead to uncontrolled and potentially harmful movements. ^[2]^[10]

Effective rehabilitation programs gradually introduce controlled exercise to support tissue repair, while also avoiding prolonged immobilization, which can negatively affect the musculoskeletal system. This approach aims to optimize healing while minimizing the risk of further injury, ensuring a better prognosis for the horse’s return to athletic function. ^[2]^[10]

The primary goal of exercise and stretching in a rehabilitation setting is to prevent further injury and enhance tissue recovery. The rehabilitation program must be tailored to the specific injury and the horse’s overall condition, including their tolerance for stall rest. ^[2]^[10]

Side Effects

While equine physiotherapy is generally safe and effective, it is not without potential side effects. These can include: ^[1]

Soreness or discomfort: Some horses may experience temporary soreness or discomfort following a physiotherapy session
Inflammation: Techniques like shockwave or therapeutic ultrasound can sometimes cause localized inflammation, especially if used too aggressively. It is essential to monitor the horse closely after such treatments and apply cold therapy if needed.
Fatigue: Horses may become fatigued after physiotherapy, particularly if the session involves intense exercises or multiple techniques. Adequate rest and recovery time should be provided to prevent overexertion.
Adverse reactions: In rare cases, horses may have adverse reactions to certain therapies, such as skin irritation from cold or heat therapy, or sensitivity to laser treatment.
Exacerbation of existing condition: If not performed correctly, physiotherapy can potentially worsen existing conditions, particularly in cases of severe injury or chronic illness. A thorough assessment by a qualified veterinary physiotherapist is essential before starting any treatment.
Injuries: Some modalities, particularly chiropractic care, carry an inherent risk of injury if not performed properly by a qualified professional. Attempting to accelerate exercise programs without sufficient rest or conditioning also increases the risk of injury.

Working with a qualified professional is the best way to minimize the risk of side effects from any adjunct or alternative therapy. Your veterinarian can help you find a practitioner who is experienced and qualified so you can be sure your horse has the best possibility of making a full recovery.

Summary

Equine physiotherapy or physical therapy is fundamental to injury rehabilitation and sports recovery for performance horses.

PT covers a wide range of adjunct therapies employed by veterinarians and other qualified practitioners as part of a horse’s larger recovery and training regimen
The primary goals of physiotherapy are reducing pain and promoting healing
Common techniques include thermal therapy, hydrotherapy, shockwave therapy, massage therapy, chiropractic care, laser therapy, and controlled exercise
While effective, some modalities carry inherent risk, which underscores the importance of working with a qualified practicitioner