Physical therapy is an interesting medical specialty in that a lot of things claim to be “physical therapy” but unfortunately are more pseudo-scientific than true evidence-based treatment strategies. When it comes to equestrian physical therapy, it’s important to understand what types of strategies you can expect to see as part of your comprehensive treatment plan.
Prescribed Exercise
At-home exercises are the meat and potatoes of a good treatment plan. These exercises require commitment from the patient, but they can restore full health to an injured equestrian and strengthen weak areas of the musculoskeletal system.
A Doctor of Physical Therapy will prescribe at-home exercises after performing a comprehensive evaluation and discovering the source of asymmetrical muscling, pain, or other biomechanical imbalances. Generic online equestrian exercise programs are not the same as a prescribed exercise program. With generic programs, you can actually create injuries if you’re performing the movements incorrectly or increasing the difficulty too fast.
Prescribed exercises can include stretching, foam rolling, and workouts with a focus on form. When performing the movements it’s important to remember that prescribed exercise is not the at-home version of CrossFit. The focus should always be on form and function, not on hammering out reps or burning calories.
Manual Therapy
A Doctor of Physical Therapy will use manual therapy or hand movements coupled with passive movements of joints and soft tissue to improve tissue extensibility, increase range of motion, increase mobility of joint, treat pain, and reduce soft tissue swelling. Unlike a massage therapist, a physical therapist will select, prescribe, and implement manual therapy techniques based on your individual exam findings that are specific to your injury.
When a Doctor of Physical Therapy uses manual therapy as a technique, it’s important to remember we’re not discussing your average “spa-style” massage. In equestrian physical therapy, manual therapy is used to increase blood flow, increase joint mobility, and decrease tension in problem areas of the musculo-skeletal system. If your physical therapist does use massage style techniques, don’t expect a hot towel and Enya-music-infused experience. Massage performed by a DPT is done for a purpose and can be painful when working in a particularly tight or stressed area of the body.
MyoFascial Release
Specific physical therapy techniques include myofascial release. Myofascial release focuses on using gentle pressure to encourage the fascia surrounding a rider’s muscles to elongate. This can be done in either hands-on therapy from the physical therapist or the equestrian can even perform some of their own myofascial release at home with a little help from a foam roller.
Scientific studies have found myofascial release to be an evidence-based treatment strategy that provides real relief to patients. Another systematic review of peer-reviewed scientific studies on myofascial release therapy found positive results when used for orthopedic conditions in adult patients.
Joint Mobilization
Joint mobilization is used in equestrian physical therapy to increase the range of motion in a joint and decrease pain. It’s a very useful evaluation tool and allows your physical therapist to discover possible asymmetrical range of motion in joints.
In order to mobilize the joint, the doctor will apply manual force to the joint. These forces should be applied slowly and smoothly in order to avoid injuring the joint further. The doctor will test out the flexion, extension, rotation, and any other dimensions of movement within the joint as applicable.
This is not a therapy that should be performed by your average layperson. Joint mobilization techniques should always be performed by a knowledgeable and experienced Doctor of Physical Therapy.
Strain-Counterstrain Technique
Activation of the correct muscle at the right time is crucial for horseback riders. Strain-Counterstrain is a hands on treatment strategy that can be performed with help from a licensed physical therapist. This neuro-muscular system technique is used to alleviate muscle, joint, and soft tissue tightness in order to prevent injuries.
Stretching
Flexibility training has big benefits as a treatment strategy. After surgery or injury, muscles that have become inactive during recovery can contract, losing their muscle tone and ability to elongate. Stretching can increase blood flow to unused muscles and prevent further or future injury.
It’s important to stretch with guidance from a Doctor of Physical Therapy. Some forms of stretching, such as PNF stretching, can do more harm than good when performed with an unknowledgeable partner.
Stretching is a treatment strategy that can be performed at home as part of a prescribed exercise program or as a hands-on technique with help from a licensed physical therapist. Often, it is used before working out as a way to warm up and after exercise to cool down in order to prevent injuries.
Use of Class IV Laser
A Class IV Laser has huge benefits for both horses and humans alike. In fact, it’s even commonly used on small animals like dogs and cats. When it comes to equestrian physical therapy, a Class IV laser is instrumental in increasing blood flow, reducing pain, and enhancing cell regeneration. It’s prescribed by a Doctor of Physical Therapy in cases where pain, stiffness, or injury has occurred. Unlike ultrasound therapy, the risk of burning or other injury is extremely low. Often it’s called a “cold laser” because of the low grade non-thermal therapy that is significantly less likely to burn the skin.
Class IV lasers provide deeper infrared energy to more targeted areas in order to provide more efficient treatment. While some people consider laser therapy to be controversial, there is good scientific evidence behind it. One scientific study even found it to be effective pain relief after major artery bypass surgery.
Alternative “Treatment Strategies”
Just like any other medical professional, it’s important to work with a doctor of physical therapy that you trust. When choosing which doctor to work with, evaluate what treatment strategies they offer.
Ask yourself the following three questions:
- Are the treatments offered backed by scientific evidence?
- Is the physical therapist a Doctor of Physical Therapy?
- Is your physical therapist being paid by the manufacturer in order to offer the treatment?
If you’re happy with the answer to each question, then it’s probably a viable treatment option to look into. However, when it comes to your health it always pays to do your research before choosing who to work with and what treatments to pursue.
