When assessing a horse for equine rehabilitation, one of the questions I ask myself is not ‘where does it hurt?’ but ‘what chain of events and circumstances has led us here?’.
Yet, the more complex our world is becoming, the easier the solutions we are looking for or so it seems. The same seems to apply in the horse world where many people are looking for quick fixes and simple solutions both in training and when it comes to therapeutic modalities. Unfortunately, this usually is not how things work. Horses and their bodies are complex and in order to support them in the best possible manner this complexity must be understood by us or those who are part of our support team such as vets, therapists, farriers, dentists, etc.
Considering manual therapies and bodywork, every other month, there seems to be another modality or method that gains a lot of attention and is widely promoted as the solution and fix for so many issues. Suddenly, the majority of horses appear to suffer from conditions that respond to exactly these types of intervention. And while such interventions may be effective and have their place in some cases, what most of them have in common is that they compartmentalise. They focus on certain parts or structures or systems of the body excluding and not considering the rest of it.
If it was just that simple.
I believe we are doing our horses a disservice when we focus primarily on a particular problem, structure, system or part of the body rather than assessing and investigating how this problem came to be. And yes, there are common patterns and problem areas and – together with a good understanding of the body as a whole – they may give us ideas on what to look for to confirm our assumptions and resolve imbalances and dysfunctions. Yet, an infallible gospel or recipe they are not. As mentioned before, horses and their bodies are complex and while a certain issue may respond to a simple solution, there is no one size fits all approach that will work for every horse. We – the practitioners of manual therapy, bodywork and other medical interventions – need to understand this complexity to ask the right questions to assess and identify what we are dealing with. And then to decide on the best route address the factors maintaining the problem. A limited blanket approach is unlikely to achieve that in more complex cases. One of the reasons a problem reappears is that an important contributing factor has not yet been identified or addressed.
Many physical problems in horses that are eventually noticed by us are compensation patterns that started at one place in the body and manifested elsewhere noticed by us as soreness or other symptoms or indications. Or they may be a primary issue yet are connected to another part of the body that is part of the dysfunctional pattern. Or the underlying problem lies in another system or organ of the body but shows up as muscle soreness. Or they are upheld by inappropriate training and/or management practises. The list goes on. Horses are prey animals and tend to hide and compensate for discomfort to protect themselves. There may be subtle signs but if we miss them, we may only become aware of the issue much later.
So the challenge lies first in identifying and then resolving the actual problem including its associated and connected imbalances and dysfunctions. For complex or persistent cases, understanding how different parts and structures and functions of the body influence one another becomes increasingly important so that we can identify compensations and the factors contributing to and maintaining dysfunctional patterns.
A one size fits all approach or a method only focusing on certain parts or structures of the body is unlikely to achieve that in more complex cases.
As practitioners, we also should be honest and tell the truth: depending on the dysfunction or contributing factors of the issue, it may take more than one or two sessions to resolve something that has built up over weeks, months or even years. And, if necessary, it may ask your cooperation and contribution in managing and training your horse for optimal results. Though, what you may get is a long-term solution which expresses in a sound and healthy horse rather than a short-term band-aid.
In order to increase our likelihood to achieve this, I do not need to ask how to fix the problem but why is it there in the first place. Integrated clinical reasoning will do just that.
An integrative approach considers the horse as a whole: its body, its movement, its training, its history, its management and the way these influence one another. Learning to think and work this way takes years of study and, perhaps more importantly, a commitment to keep learning throughout one’s professional life.
Ultimately, good rehabilitation is not only about applying the right technique. It is about asking the right questions, understanding the whole picture and choosing the most appropriate path for the individual horse in front of us.