When waking up in the morning, it’s almost first instinct to stretch and get the blood moving through your body so you can start your day. On days you don’t stretch, you feel stiff and tight. It’s no different for horses. When horses don’t access a wide range of motion, their muscles can lock up and grow tight. And it’s not just their muscles; their skin, like our clothing, can constrict blood flow over the muscles, exacerbating the problem of strained tendons, sore hooves and sensitivity to pressure. Often, problems in the muscles can start in the hoof and travel upward, causing outward-pointing elbows, inward-pointing toes and angled cannon bones.
In her 2018 International Hoof-Care Summit lecture, “Support Your Hoof Care And Open A New Dialogue With Clients,” Dr. Patricia Bona discusses the issues that arise with the rotator cuff, tennis elbow and plantar fasciitis in horses.
Equine shoulder areas are a main point in motion and alignment. If stiffness occurs there, it can create issues farther down the leg because blood isn’t flowing properly. Bona starts her discussion with the cap of the scapula, the rounder area of the shoulder blade below its withers. This important spot is where the saddle tree comes in contact with the muscles around the scapula and where there are fascial attachments of muscles that go into the crest, withers, shoulder, etc. An ill-fitting or poorly positioned saddle can create problems not just for the back, but also cause postural compensations affecting the front and back legs.
Bona describes these points as “being functional axes of rotation. And from those, spokes come off.” Such a wide range in motion begins at the cap of the scapula, so if that is blocked or hampered, the other muscles will be out of sync. Her goal is for the “spokes of the wheel,” being the muscles branching off the cap of the scapula “to be balanced well so that the horse can function symmetrically and have nice flow from that functional axis of rotation.” In comparing the horse’s shoulders to a vehicle, Bona points out that there are wheels on each side of the drive shaft, but that it is the balance of the “wheels” that helps keep the drive shaft aligned for symmetry of the horse’s front end. The cap of the scapula and the points of the hips, essentially, are the wheels of the horse and the pelvis and the withers being the connection of the drive shaft — all wheel drive and steering. When any one gets out of balance, it throws the horse out of alignment. Just like with your vehicle there will be wear and tear on the tires/soft tissue and stress and strain on the frame. The asymmetrical posture affects the horse’s musculoskeletal system including the legs and the feet.
“Optimum posture starts with the horse naturally being able to stand four-square with all four cannon bones on the vertical,” according to Dave Duckett, the International Horseshoeing Hall Of Fame member of Ambler, Pa.
Palpating, or massaging, is an excellent way to release muscle tension and promote better circulation. It’s always best to start with a light touch and feel the muscles to gauge how tight or fluid they are. Using your fingers, press lightly and watch the horse’s body language to see whether the spot is sore, sensitive or painful. If the horse snatches, paws or displays aggressive behavior, remove pressure. If the horse displays signs of licking or chewing, this means it is relaxing into your touch, and the palpation is working.
Your fingers are excellent tools to relieve tension, but Bona has developed a hand-tool to aid in the release. It is the size of a small currycomb with rubber spokes, which you rub across the horse’s coat to encourage blood flow by cross fiber massage and grooming. A different version of this is also available for humans, since the ailments that plague horses and people can overlap.
Once the horse’s muscles get warmed up, you can use your fingers to separate the muscles so they can glide over each other and create better muscle definition. It’s best to go cross-fiber to release restrictions between the skin and the muscles below and restrictions within and between muscles and tendons. You want to see and feel skin gliding over the muscle and fascia beneath. Loosening the restrictions in the fascia will help accomplish this goal.
After loosening the muscles, lift the legs, the feet and the lower joints to get them mobile. Lack of motion can be one reason why these muscles get stiff. You don’t want to spend time massaging only to lose your results. Gentle joint mobilization and gentle range of motion of the joints will help relax tight and tense muscles.
The Rotator Cuff
The rotator cuff is a series of muscles that come together over the scapular bone that we know as the shoulder. They help to open up, externally rotate and move the forelimb forward. Issues such as headaches, neck pain and stiffness that arise in humans are often not immediately linked to rotator cuff injuries; however, that doesn’t mean these problems aren’t extensions of it. The same goes for horses. Minor issues might pop up, but these issues might not be attributed to the muscular injury.
Any horse owner or farrier can learn to release these muscles in their equine without requiring a veterinarian or chiropractor. Bona includes information on how to release these muscles from this video she made while at the American Veterinary Chiropractic Association (AVCA).
Before working out the muscles, Bona works with the horse to see what condition they’re in. She begins by seeing whether they’ll bend their neck.
“You might find if you get the horse to bend its neck,” says Bona, “that it ends up shifting weight to the opposite forelimb because it doesn’t want to put any muscle contraction or stress on the strained muscles and fascia of the affected rotator cuff.”
The horse shifts its weight to accommodate for the discomfort in the muscles. When that tight area is activated, the fascia, or the thin tissue membrane covering muscles, constricts like a shrunken shirt. The horse is going to shift weight to alleviate pressure, and in doing so, it is setting itself off balance, which further tightens the muscles in the rotator cuff. Riders will comment that the horse is “popping its shoulder.”
Because this response comes from bending the horse’s neck, one might believe the problem is in the neck. Bona noted this, and she looked further into the source while lecturing at the AVCA. She had been trying to release the neck but found the neck was just one of the problem spots down the road from the source. If she could release the muscles at the source, results could spread from there and help to improve the horse’s comfort and posture.
Before Bona starts the massage, she uses scans to look for any other outlying problems. This could include dents and dings on the withers, shoulders and the forearm. She also looks for scar tissue or signs of old trauma. Dents and dings can come from getting kicked, bumping into fences or rolling in a stony field. These dents are actually scar tissue, most likely from a hematoma. While it might look healed, it can still create problems for the horse. Compromising blood from properly flowing through the tissue causing restriction and even pain liken to a trigger point in the muscle. Often creating and perpetuating compensations in posture, gait and overall well-being. All of which can influence the weight distribution to the hoof.
After scanning, Bona begins by using her fingers to look for the spine of the scapula. With short strokes, going cross spinal, across the edge of the scapular spine, she palpates into the infraspinatus and supraspinatus muscles. She notes the horse can be a little reactive with this spot, so she pulls on its withers to keep it steady. This technique can tell her how things are feeling for the horse at this spot and down because it is centrally tied to other muscles — including those in the elbow.
In humans, tennis elbow occurs when the elbow becomes sore due to overuse of the forearm and hand. This is another instance where pain arises from an indirectly affected area. Horses can get something similar to tennis elbow; they can’t extend their elbow completely, which prevents other muscles from aligning the joints of the limb.
“In order to supinate and pronate, move our wrist and forearm completely, we need to be able to extend that arm/elbow completely,” Bona says. “If it’s bent, I cannot get that full range of motion because the body is guarding to protect that joint.”
Much like how scar tissues appear when the body is healing, tennis elbow forms to protect the ailing muscles and joints of the elbow. However, this does more harm than good because protecting the muscle isn’t allowing movement and proper alignment, much like how scar tissue doesn’t allow blood flow. The elbow that gets used to being stiff will stay stiff and cause other postural compensations.
Monitoring the elbow in horses can be as simple as looking at the horse’s legs. A normal horse’s elbows should be aligned with its body, including its toes. Horses with postural problems might have toes pointing inward and elbows pointing outward.
“If I can’t lift and extend from the shoulder and lift its toe up completely and rotate it outward ... then I know there’s something stuck in that kinetic chain,” says Bona. Much like when a horse stretches it forelimb out while it is on a hoof stand.
Bona releases the elbow by lifting the leg and palpating the muscles while holding the leg in flexion. She only lifts the leg, does not pull, staying in the horse’s range of motion at first. It’s best to work cross-fiber, across the main shoulder muscles such as the triceps, the brachioradialis and the biceps. Working on the release should be within the tolerance of the horse for its own safety — and yours.
Once the muscles are released, it’ll be easier for the horse to move and extend the limb through to its toe to cover more ground and land efficiently. If the horse is uncomfortable in the feet, this can cause tension in the triceps, chest muscles and shoulders as it tries to hold itself up, to limit weight on the hooves and instead carrying it in the shoulders and sling apparatus. Even if barefoot horses don’t display soreness in their hooves, walking across gravel or other rocky surfaces can lead to problems higher in their legs, in their muscles as they are “foot smart” to not become foot sore.
“Even if you have a pretty foot, a healthy-looking foot when the horse’s body is that tight, that horse is protecting itself,” says Bona.
Heel pain, associated with the thin muscular tissue fascia, is called plantar fasciitis in humans. Much like tennis elbow, plantar fasciitis problems can also occur in horses. Plantar fasciitis can affect a hoof from the hock to the toe. Bona focuses on the hind legs and the gaskins, or thighs, to examine how horses with this issue stand and why.
Exercises requiring deceleration in sport horses can cause tightness in the hind muscles, especially the hamstring group, but that’s not the only cause. Often, shoeing and saddle fit issues and soreness in the feet can create an imbalance in the muscles. If a horse isn’t comfortable on its feet, it’s going to shift its weight and exacerbate any imbalances.
Looking at the horse’s hind legs, the cannon bones can indicate an issue. Bona looks at them to see whether they are vertical, or whether the horse is standing in front of what would be vertical, putting the legs at an angle. If the legs are at an angle, they need to be checked as strain will be on the suspensory, flexor tendons, sesamoid bones. Optimum posture is standing four-square with all four cannon bones on the vertical.
With the horse’s hoof on the ground, Bona begins by palpating the suspensory ligament and the deep and superficial flexor tendons.
“They need to work in unison, kind of like pistons,” says Bona. “That’s how all our muscles should be gliding.”
She compares the parallel alignment of the suspensory ligament and the flexor tendons to that of a stringed instrument, pulling her fingers gently over the tendons to release any adhesions or restrictions between them. If that doesn’t release well it might require some palpating in the gaskin area, the Achilles tendon and the gastrocnemius, or the calf muscles. The goal is to get the system to be able to glide and move freely for more fluid movement through the hind limb and down the entire leg.
Plantar fasciitis is something that can occur in horses of any age and at any time. Depending on the environment, nutrition, saddle-fit, general well-being and age, horses can develop painful heels in response to a sudden issue. Some veterinarians perform a fasciotomy, which is a surgical cut in the fascia to relieve tension and promote blood flow. However, this can be more detrimental than doing nothing because fasciotomies can create scar tissue, repeating the problem with proper blood flow. Bona first encourages cross fiber massage because it can provide superficial and deeper fascial release for immediate improvement to circulation and lymphatic drainage of the apparatus down to the foot and help improve joint mobility and alignment.
In addition to her fingers, Bona uses a tool that looks like a rubber currycomb with rubber points. Advised to use during grooming, the tool can massage the joints like a brush, but it can go a little deeper with better results. Also, she may use a class 2 cold laser to aid in the massaging of the muscles and releasing adhesions.
What To Do
Observe the whole horse with “soft eyes.” Look at the horse as a fluid system, observing whether the skin glides freely as the horse moves, and overall posture, especially over boney protuberances. Don’t focus on just one area of the horse; cover the entire horse and the legs twice. Loosening up one area is a great start, but all areas need to be covered to ensure tension is released in a balanced manner. Also, it’s good to repeat these palpations every 5 to 6 weeks — sometimes sooner depending on the condition of the horse and the goals set for that particular horse. Yet always observe daily for restrictions.
- Optimum posture starts with the horse naturally being able to stand four-square with all four cannon bones on the vertical.
- If the horse is having difficulty lifting its leg and pointing its toe, try palpating the muscles softly at first. Then try raising its leg again to see whether it can achieve more mobility.
- Look for inward toes, outward elbows and angled cannon bones. These can all be signs of sore hooves.
- Look at the horse as a whole, as some areas showing affliction might not be the source. It might be the site of old traumas including dents, dings and scar tissue that is perpetuating or creating compensations.
- After palpating, lift the legs within the horse’s comfort zone to promote circulation and mobility.
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