He’s just a little slow in his changes, shows a little resistance at the trot, swishes his tail, kicks out occasionally. Maybe he’s just a little stiff one way; works out of it after a few minutes. Or maybe he just flat refuses to work. He’s been looked at by his veterinarian, with no overt lameness, no swelling, no heat. Your vet doesn’t think there is anything wrong, but you know your horse, and he’s just not right. Maybe you’ve even had a bone scan and an expensive lameness workup with no answers. Do you just settle for "he’s not good enough?" or could there be answers with an alternative approach?
Conventional (aka Western) Veterinary Medicine is an excellent approach to disease, such as infections or fractures, but the scientific approach fails us when the problem is subtle. As a veterinarian and scientist, I have sought the answers to frustrating subtle equine problems for years. After Veterinary School, an Internal medicine residency program, a Master’s degree, and a PhD, I found myself continuing to search for answers to the unidentifiable and evasive subtle equine performance problems.
Integrated (or Integrative) Medicine combines the problem-based, scientific approach with the whole animal (or Holistic, Alternative, Complementary) approach, to provide the best of all available modalities to optimize performance and well being of the horse. The modalities of Acupuncture and Chiropractic are particularly powerful techniques for the subtle performance problem, which vastly outnumber overt disease in
equine athletes.
Traditional Chinese Veterinary Medicine
(Acupuncture and Herbal Therapy)
TCVM has been around in some form for over 5000 years. During the Cultural Revolution in Red China, Chairman Mao specifically organized the various fractured practices of Acupuncture into an organized framework that we recognize today as the basis for TCVM. Many of the diagnostic systems in TCVM are unrecognizable to Western Medical practitioners, but in many specific instances, where the scientific method has been applied, acupuncture has been proven to be effective. Currently, the scientific evaluation of acupuncture methods lags far behind its successful practice, but those of us with experience in its methods, find incredible success.
Integrated medicine and TCVM in particular look at the whole animal, rather than focusing on a "broken" part that needs to be fixed. For example, a horse that has stomach ulcers may need Gastrogard. In Western Medicine, Gastrogard is the "solution" to the "problem." In TCVM, the approach is to determine what aberration in the horse’s system or environment led to the manifestation of stomach ulcers. A typical scenario in TCVM for stomach ulcers is Liver Over controlling Spleen. While I might go ahead and treat this horse with Gastrogard, (nothing fixes overt disease like Western Medicine), I might also use Acupuncture treatment to sedate (or calm) the liver points, thus helping to address the primary problem.
TCVM views the animal as a whole, consisting of not just individual organs, but a series of energy channels that tie the organs to each other and also to the outside world. Many of the channels run along the course of nerves, which explains the reflex responses that we get when we stimulate acupuncture points. Most of the energy channels or meridians are named by their controlling organs. TCVM attributes characteristics to organs which may not be identifiable in Western Medicine, but they are characteristics of the meridian, rather than necessarily being specifically associated with the organ. A good example of this is the heart meridian which is responsible for the movement of blood, but also for the state of the Shen, or mental state. Both mentation/mood and the movement of blood are attributed to the heart in TCVM, but only the movement of blood is attributed to the heart in Western Medicine.
Life force, electromagnetic energy or Qi (pronounced "Chi") circulates through the body along the TCVM meridians in a predictable pattern. Consequently, Qi blockage or stagnation can be identified by finding specific painful or reactive acupuncture points. For example, an acupuncture point along the jugular groove just below the angle of the jaw (Large Intestine 18 or LI-18) is consistently reactive in horses with pain (Qi Stagnation) of the foot on the same side. This point is identifiable over and over, and if the foot is blocked with a numbing agent (novacaine or lidocaine), the point reactivity disappears until the block wears off.
Let’s get back to your slightly off horse. He’s kicking out, not switching leads, tail swishing, but not obviously lame at any gait. Now, we have a diagnostic capability that doesn’t rely on a horse being lame to find the source of a subtle performance problem. If the location of the problem can be identified, it can be treated, either with Acupuncture to restore normal Qi flow, chiropractic to restore normal joint function, or Western Medical methods such as joint injection to restore normal fluid or shock wave therapy to stimulate healing. The first step is to identify the location of the problem.
Chiropractic (Spinal/Joint Manipulation)
Manipulation of some kind has been practiced in many cultures (including TCVM) for hundreds of years, but developed into the specific discipline of Chiropractic in the late 1800's. There is considerably less scientific evidence to support Chiropractic than Acupuncture, but at least part of the reason is that Chiropractic doesn’t lend itself well to the scientific method. The methods work best in horses that are not overtly lame, making nonsubjective evaluation difficult.
It is often suggested that Chiropractic adjustments actually replace bones into alignment that are out of place. In reality, the adjustment restores normal motion to joints that are not moving normally. In some cases, the joints might be completely immobile and in others, the joints might be submobile. This abnormal motion is commonly associated with pain, which then results in muscle spasms.
The Chiropractic evaluation involves the careful motioning of each joint in order to identify abnormal motion. As the abnormal joints are identified, a high velocity, short lever thrust is applied to the joint directly opposite the direction of the fixation. This resets the spasmed muscles, restoring the joint to normal motion. Often, when a submobile joint has been abnormal for awhile, the muscles have muscle memory of the abnormal position. This results in the return to the submobile position. This is why Chiropractic adjustments often must be repeated within 4 -6 weeks of the first adjustment. Typically, a specific problem is successfully addressed with 2 -3 treatments, unless the horse has a conformation or career that leads to the submobile joint problem.
Let’s return to the subtly lame horse. Let’s say that he has a left Posterior Inferior Ilium (or PI-Ilium), which is a description of the direction of immobility of the sacroiliac joint. The sacroiliac joint is the major connection between the hind limb and the vertebral column (the thing that is carrying all the weight during riding!). Now, a major weight bearing joint is immobile, and there is associated muscle spasm and pain. The sacroiliac joint stuck in this position also gives the horse a functional short leg on this side. Now, there is compensatory rotation of the vertebral column to accommodate for the short leg. With his entire vertebral column rotated left in this way, he cannot properly take the right lead, and will tell you by a show of resistance on that lead or at least asymmetry of gait. But there is no lameness. This pattern of "fixations" leads to performance problems without an identifiable source of lameness by conventional (Western) medicine. Chiropractic adjustment restores normal motion, and the horse's gait and performance responds quickly, often improving by the following day, and returning to normal within a week.
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