It is amazing what you can learn in the course of an afternoon...especially when you WANT to listen, learn and absorb the information that is being presented to you. DVM Extraordinaire (DVME) was out yesterday afternoon to give Chester the once over...and, it was pretty cool to watch her work on him and go through the process of pinpointing the area that is causing him issues. For those who don't want to read the rest of this post (because it is a little long - sorry), in a nutshell: His original injury to his stifle + lack of mobility, is causing him to become more stiff then usual. This is causing a little bit of a fluid build up within his hocks (more specifically something called a 'jacks joint'), which is causing some mobility/movement problems through that area, which might lead to arthritis down the road, which causes his back to be ouchie when I ask him to really engage and step up under himself. It is a little more apparent to the right then it is to the left, which makes sense because the UFP was far worse through his right stifle. Clear as mud!
NOTE - The 'Jacks Joint' is the laymen term. The true or actual jack is called the Cunean Tendon, but the vets tend to use the Jacks Joint term more broadly. To be even MORE scientific: the medial branch of the insertion of the tibialis cranialis muscle in the hind limb of the horse.
Ever heard of Cunean Bursitis? Me either - until yesterday...This is inflammation of the bursa that sits between the cunean tendon and the hock, located along the lower and inside aspect of the joint. If the foot is held just slightly off the floor, weight shifted to the opposite leg so that the side being examined is unloaded with the hoof only in toe-touch position, you will be able to identify the crossing tendon easier and can check for a feeling of fullness under the skin above and below the course of the tendon. Inflammation may be a primary problem or in association with strain or bone spavin/arthritis. (http://www.coldoneinc.com/equine/hockpain.pdf)
She basically gave him the once over - checked the points on his back and really paid a lot of attention to his pelvis, hips, stifles, hocks. He reacted as he should have which was a good sign (all his vertebrae are fine and not causing him discomfort). She also wanted us to do some flexion tests...which we did. His left, he was fine and didn't take a lame step...and proceeded to act like a crazed lunatic down by 'A' and the big arena door where the horse-eating-monsters were hiding...and came back practically skipping at the end of the lead rope. With the right - she said he took 2 or 3 reallllly off steps, but then was fine. On to the lunge. We went to the right first. When she was watching, her comment was: He is stepping a little shorter with his hind right (makes sense) but there is nothing visible to me that he is in any sort of pain or discomfort. Go to the left.
So - we go to the left and he was stepping out fine. She confirmed for me that it is more mechanical then pain related. Phew. I should ride him as much as possible - 6 days a week - and even if I walk for the first 25 minutes to really let him work out of the stiffness, then that would be best. Do some cavaletti (my best friends), lateral work, get him to stretch up under himself and MAKE him do it. She also said if it feels super horrible (at the trot), to come back to walk for a couple minutes, then try again. This horse needs to be pushed. Going forward, she feels as though this is potentially going to be a continual maintenance issue during the winter because we loose our trot sets...awesome...but it is something that is obviously NOT that big of a deal if we can mange it properly and be proactive in dealing with it.
Okay - how do we deal with it?
As above - cavaletti, stretching, lateral work and - ACUPUNCTURE!!!! When I told her that I would get Dr Cove out to work on his back, she said - I think we should try something else. That something else, is acupuncture...she said to me: would you ever go to the chiro - my response - never. And she raised her eyebrows at me...point taken. I have a hard time with bones etc being manipulated and foreced to move.
Acupuncture is a practice in which needles are inserted into various traditionally determined points of the body - acupuncture points - and then manipulated, or the theory under which the practice is done. Its practitioners variously claim that it relieves pain, treats infertility, treats disease, prevents disease, promotes general health, or can be used for therapeutic purposes. The way I read that is - a technique for treating certain painful conditions. The history of equine acupuncture dates back to the years 2000-3000 BC during the Shang and Chow dynasties in China. Interestingly, one of the first veterinary textbooks, "Bai-le's Canon of Veterinary Medicine," written around 650 B.C., was based primarily on acupuncture and its derivatives. It has been practiced in the Far East for centuries but has received little attention by Western equine veterinary practitioners until the last decade in the 20th century. (http://www.equinenaturaltherapy.com/equine_acupuncture.htm)
DMVE said her clinic was working with a vet who has been trained and certified in Equine Acupuncture and thinks that Chester would benefit much more from that treatment then constantly getting adjusted. I looked at her like a light bulb had just gone off and said: when I hurt my knee - I was going through physio and did acupuncture as part of the treatments - and it worked fabulously! (Oh - AND even better - there is a 3 for 2 deal going on right now - AND - it is a little cheaper then having the chiro come out!) When it comes to this horse of mine, she feels as though the acupuncture will target the muscles/tendons/ligaments much more acutely and the ROI will be much greater. So, we are going to give it a shot! I am excited to see if it works!!!
It is amazing how much horses and humans are the same eh? From what I can gather, the hock is a complex joint of the rear legs situated between the stifle and the ankle that consists of six bones and four joints. Similar to the human ankle - but elevated and bending backward - the hock works in concert with the stifle, flexing and extending together with the stifle to achieve rear end propulsion. As the pivotal hind limb joint, the hock receives considerable forces. Knowing that - it is no surprise to me that he is building up some fluid in his Jacks Joint located within his hock.
Let's hope this doesn't turn out to be a total Pain in the Hock....ha - get it?! (Okay, that was pretty bad...)