Healing the Horse –Notes on the application of structural integration to the equine performance athlete
Many horses are more than just pets. They are competitive athletes, performing at levels akin to that of Olympic athletes. Endurance events require horses to demonstrate incredible stamina and cardiovascular health as they traverse distances of fifty to one hundred miles over hazardous terrain. Other equestrians compete in events placing high levels of stress on the joints of the fore- and hind limbs. In some jumping events, such as the puissance, walls can reach over seven feet tall, putting tremendous pressure on the horse’s entire structure. Western riding competitions require a horse to be light on his feet, performing sudden stops and turns to demonstrate his ability to herd cattle. Reining is a unique discipline that, amongst other maneuvers, asks the horses to complete a sliding stop where the horse “sits” on its haunches while walking with its forelimbs. Slides can go as far as thirty feet! In all of these competitive riding events, the horse performs incredible feats of strength and flexibility while balancing the weight of a rider and saddle. It’s no wonder that they need specialized care to keep their bodies functioning optimally.
Horses are not technically designed to carry the weight of a rider. Their structure naturally puts sixty percent of their body weight on the forelimb with the remaining forty percent on the hindquarter. Thus, a riding horse must learn to lift up off the shoulder and withers area and engage the hindquarter to propel his body forward in order to avoid damage to his back and the joints in his lower legs. While horses are typically bred for optimal conformation, no single one is perfect and thus must work around any structural limitations to achieve extreme levels of finesse. Damage caused to the body through trauma from birth, injury, illness, or negligence present the horse with unique performance challenges. Structural integration work optimizes the horse’s economy of movement and enables the strength and flexibility necessary to comfortably support a rider.
The principles of structural integration normally applied to human clients can be easily adapted to the equine structure given a practitioner that is comfortable working with horses. Although equine anatomy bears some resemblance to human in that many of the bones and muscles carry similar names, there are some significant differences. For example, horses have no clavicle, so the scapula is entirely supported by a sling of muscles. In addition, horses have three mechanisms that allow them to stand on their feet for long periods of time: the stay apparatus, the locking mechanism of the stifle, and the reciprocal mechanism. Thus, horses have the ability to sleep on their feet but take off at a moment’s notice should a predator arrive. These animals are highly adapted to the threats of their environment, and it is the responsibility of the practitioner to not only understand the horse’s reaction, but to be so aware of the surroundings as to be able to preempt it.
The horse is a creature of movement. Whether systematically grazing from one grassy field to the next or utilizing its highly developed musculoskeletal system for inter-herd communication, a horse is continuously using movement as a means of survival. A horse must remain light on his feet and ready to move at any moment. In a herd, there is always a dominant mare that is responsible for dictating the actions of the entire group. She uses a highly sophisticated, yet practical, body language that serves to send clear messages to other members of their herd without making noise that could alert a predator as to their location. In addition to incredibly refined musculoskeletal control, horses have finely tuned sensory perception and use this to gauge their environment. A horse will react to the weight of a tiny fly on his loin with a swish of his tail. My own mare knows the sound of my car and my footsteps; she knickers at me as I enter the barn, before I ever say a word. This perceptual level serves a bodywork practitioner in that the horse is acutely aware of and responsive to the work being done; however, he is also susceptible to jumpiness if the environment is at all chaotic or unfamiliar.
A horse is a prey animal which largely determines his reactions in life. While most horses that a structural integration practitioner works with will (hopefully) be well trained and quiet, it’s helpful to know what motivates a horse to move and how he will react to the presence of your body. Because a horse’s eyes are set on the sides of his head, he has nearly 360-degree sight, allowing him to see a predator that advances from almost any angle. Unfortunately, as the practitioner, you may be perceived as a threat for any number of reasons. You will be standing quite close to the body of the horse, so he may defend himself with a swift kick. Many people will tell you never to stand behind the horse as this is the “kicking zone” (and this is good advice), but horses are unbelievably flexible. Even if you are standing as far forward as the shoulder, the horse will be able to reach you with his hind foot, not to mention his teeth. This being the case, knowing and understanding warning signs that precede that kick or bite – and the triggers that could alarm the horse in the first place – are vital to keeping yourself safe while working.
The clearest form of communication that a horse uses are ear signals. If a horse has its ears pinned back against his neck, he feels either threatened or angry and is liable to strike in some way. Ears pricked forward means that he is alert and paying attention. Of course, you should ascertain whether his focus is on you or something in the surrounding environment. If you observe an ear-forward expression and think that the horse is listening to you, but he is really hearing the hay truck coming or a rowdy group of children barreling down the aisle, you could be in for a spook (sudden jump that may be accompanied by panic and bolting). A horse that has his ears lazily flopped to the side is relaxed and comfortable. Of course, there are degrees of difference between these three states; a horse may have one ear twitched gently back, “listening” to you, while the other ear is forward as he monitors the actions of another person in the barn. You, as the practitioner, have to shift your thinking from that of a predator to that of a prey animal and become acutely aware not only of your client but also of every detail in your surroundings. This is essential to creating a safe container in which the work can be done.
While you will probably not be asked to lunge or chase a horse, learning these skills will demonstrate how a horse responds to the presence of your body with relation to his own. Lunging a horse involves attaching a long lead to the halter and asking the horse to walk, jog, and canter around you. You then ask him to reverse and perform the same gaits going the opposite direction. Because the horse is on such a long lead, you actually have very little physical control over him and must use body language to communicate. In general, to propel the horse forward, you position your body behind his hip and move toward him, facing the full front of your body at the horse. To stop the horse and reverse, you position yourself at or in front of the horse’s shoulder. When you face the full front of your body at the horse and look directly at him, you are mimicking the body language of a horse that is driving out a member of the herd; he will always move away from you. If you turn your back on the horse, you are inviting him back into the herd, and he will come toward you. I don’t recommend turning your back unless you are very comfortable with the horse or under the supervision of an instructor because if you have not adequately established dominance, there is a slight chance you could be putting yourself in danger. Learning how to maneuver a horse’s body will help you maintain control during a session. I have had horses enjoy the work so much that they flatten me up against the wall trying to get me to go deeper. In that situation, it helps to know how to tell the horse you need some breathing room.
To truly understand equine communication, you must spend hundreds of hours around them. I have been around horses for almost twenty years. I know before a horse spooks that he will do it and am able to calm him down in advance using the influence of being the dominant one in our tiny herd of two. If, for some reason, a horse catches me by surprise, I react instinctively and instantly regain control of the situation. This is all born of many hours spent in the presence of horses. Within thirty seconds of meeting a new horse, I know if he has good ground manners and is prepared to respect me. The best way I can communicate this ease around horses is that it is like driving for most people: completely subconscious but you still have to pay attention and be aware of where everyone else is on the road. I’ll bet you’re a much better driver now than you were at sixteen; working with horses also gets better with time.
In addition to facilitating proper communication between the horse and the practitioner, there are some basic safety considerations that will help the session go smoothly. First, check your equipment. Likely, you will just be working with the horse in a halter and lead rope, but you may have him cross-tied (secured with ties that attach on either side of the halter) or tied to a post. In any case, you should always make sure that all buckles, snaps, and clips are in working order. Check with the owner to see how best to work with the horse as some do not tie safely or are frightened of narrow spaces such as grooming bays.
Session 1: The Hindquarter
As has previously been mentioned, horses carry a slightly greater percentage of their bodyweight on the forehand. In order to efficiently and comfortably carry the weight of a rider and saddle, the horse must develop the strength to lift up off his front end and utilize the hindquarter to initiate forward momentum as well as launch himself over jumps. A horse with any conformation challenges will have to work around these limitations to properly collect his body, and some horses have difficulty rounding their back up at all. Add to these impediments such factors as ill-fitting saddles and imbalanced riders and it’s easy to understand why many horses exhibit soundness issues in the shoulder and forelimb.
From the perspective of the structural integration practitioner, we have a bit of a conundrum. It seems that releasing restrictions in and around the shoulder girdle would allow the horse greater freedom to lift his weight off the front end and thus more efficiently carry the rider – a distinct advantage in equine competition. However, if we first lift the horse from the front end but do not free the hind end so that the horse can properly engage it, the horse is left no further option but to fall back down upon the shoulder to support his weight. Thus, I generally begin in the hind end to develop proper support for future work to be done in the shoulder girdle.
In assessing the hind end, it’s useful to evaluate the horse both moving and standing. Ideally, the practitioner should watch the horse move freely in an arena or round pen, but this is not always possible as not every barn has these facilities available or they may be occupied during your session. In this case, ask the handler to walk the horse in a straight line away from and then toward you. Look for balance and symmetry in the pelvis as far as movement. For example, observe the point of the hip as the horse’s hooves strike the ground. Both the right and the left sides should shift equilaterally. If there is limited or no movement side to side, this indicates a severe restriction in the hips and lumbar spine. After observing the pelvic movement, check for balance in standing. Ask the horse to square up (stand with all four feet lined up in a perfect square – or reasonably close) and place one hand on each of the hips. You will have to stand directly behind the horse to do this, and if you are not comfortable doing so, you may want to take an assessment from further away. Check the height of your hands. One side will most likely be higher than the other. This is a common factor in lumbar pain, or what riders call “cold backed.” While you may want to go directly to the sacrum to address this imbalance, it is more often attributable to a tear or strain in the adductor region.
Next, watch the hind hooves as the horse travels away. Do they land and take off in a straight line? Does one side spiral as the horse pushes off from that leg? How much space does the horse have between his legs compared with the width of his pelvis? Many horses have a narrow base of support that makes it difficult to fully engage the powerful gluteal and quadriceps muscles. Another great indicator of balance through the hind limbs is the hoof. Commonly considered a rock-solid structure akin to a natural steel-toed boot, the hooves are actually extremely elastic and change rapidly in response to the stresses placed upon them. Any misalignment in the leg will reflect in an asymmetrical hoof. You can also pick up the hoof (with caution) and examine the sole. If the horse is shod, look at the wear pattern along the edge of the shoe. Does the horse take off straight across the toe or is most of the pressure along the lateral edge? Working with a good farrier will help a practitioner learn to “read” the hoof.
One of the most common complaints you will hear from riders and trainers is, “My horse is sore in the hocks.” The hock joint in the horse is similar to the ankle in humans. A terrific amount of stress is placed upon this joint in equestrian sports, and any misalignment will contribute to the deterioration of the synovial fluid and articular cartilage. In recent years, equine professionals have become increasingly savvy about supplements containing glucosamine, chondroitin, MSM, and yucca, all designed to inhibit joint deterioration and inflammation. Many riders have their veterinarian perform periodic intravenous injections of hyaluronic acid (a natural component of synovial joint fluid) and intramuscular injections of polysulfated glycosaminoglycans (comprised mostly of chondroitin sulfate and a normal constituent of articular cartilage) in order to prevent inflammation and boost a horse’s performance and longevity. Structural integration is essential in maintaining proper alignment, which in turn aids in the preservation of a healthy joint. When evaluating the hock for movement, look to see if the horse is bending fully through the joint. Some horses will lift the leg from the hip to avoid flexing a sore hock. Next, feel the joint. Is there fluid built up or is the tissue tough and dehydrated? Are there “guitar strings” running through the soft tissue? Ideally, compare the joints of horses of different ages. The hock of a foal feels much different than that of a twenty-year-old retired jumper; understanding the various levels of tension and how they affect range of motion available will aid in your evaluations.
Finally, I evaluate the lumbar spine to see how any and all misalignments in the pelvis are affecting this vulnerable area. Because there are no ribs to support this region of the spine, it is most prone to extreme compression or twisting. Often you will see what is referred to as “hunter’s bump” or “roached back.” In this case, the lumbar has shifted upward, causing a lumpy appearance. This always corresponds to a downward shift elsewhere in the spine. The opposite case is a dropped lumbar region (swayback). Of course this always corresponds to an upward shift elsewhere, often – but not always – in the sacrum. If the pelvis is rotated (the first item on the evaluation checklist), there is generally a corresponding rotation in the lumbar spine. This may straighten out somewhat as you release the pelvic twist. Gentle work along the lumbar fascia will also help decrease compensations in the spine. This is similar to releasing the quadratus lumborum in session three of the human Rolfing series.
Session 2: The Shoulder and Forelimb
In the second session with the horse, the practitioner is now able to effectively address compensations in the shoulder girdle and forelimb. We’ve previously noted that this region is particularly prone to strain. Poor saddle fit is a common cause of impingement around the scapula. Just like different clothes fit different human body types, no one saddle will fit every horse. There are hundreds of saddle pads, flexible tree saddles, and other gimmicks to help riders relieve strain on the withers and lumbar. The majority of riders, especially those that compete in high-level shows, are aware of the importance of saddle fit; however, if the horse exhibits signs that indicate he might not be most comfortable with his tack, it doesn’t hurt to ask a few questions. The most glaring indicator of improper tack are open sores or white scars along the withers (the spinous processes of the first few thoracic vertebra), which indicate that the saddle is rubbing inappropriately. First, ask the rider if they’ve checked the fit of their saddle. This sounds rather basic, but you might be surprised how many people have never even thought that the trusted saddle they used on their last three horses might not fit the newest one. If they say that they have, ask if the saddle leaves an even sweat pattern when they remove it after riding. If so, the saddle may not be the issue, but if you still suspect improper tack as an ongoing cause of soreness in the horse, recommend that the rider consult with a professional saddle fitter.
Again, ask to see the horse walk. The first pattern to observe is movement of the scapula. Does the superior aspect rotate backwards as the horse lifts his leg? Does it move at all? The shoulder blade should slide along the thorax the way a fan blade or pinwheel rotates, as though it were anchored about in the center. Also, observe the horse walking directly toward you. How much space does he have between the shoulder blades (for now, disregard the placement of the hooves). Look at the width of his rib cage in comparison with the width of his shoulders. It’s not uncommon for one side to be extremely narrow and for the other to have hypertrophy in the trapezius and deltoid muscles. If this is the case, the horse is unable to engage the narrow shoulder; it’s glued to the thorax, and the other shoulder is compensating. Remember, horses have no clavicle, so their shoulders are entirely supported in a sling of soft tissue. Thus, they cannot rely on a bony attachment for support should one shoulder be weaker or injured in any way.
Next, let your eyes travel downward to the carpus, often referred to as the knee. This joint is actually equivalent to the human wrist. Its double row of hinges allows tremendous flexibility so that the horse is able to lift his leg off the ground while running or fold it under himself when sleeping. The strong ligaments supporting the bones contribute to the joint’s stability while running as it must be able to carry the weight of the entire body at one point during the stride. The long bone of the horse’s lower leg, just distal to the carpus, is the canon bone, or third metacarpal. Look at the relationship between the carpus and the canon bone. Does the knee point straight ahead? Is there a rotation and counter rotation between the joint and the bone? Generally, if there is a restriction above, the fascial wrapping along the bone (the periosteum) carries the compensation all the way down to the hoof. Gently unwinding these twists before beginning work on the scapula will help any work you do above to hold longer.
As in the hindquarter, the front hooves can be a tremendous source of information about how the horse is traveling. Look to see if the hooves are flared to one side or another. Does the weight of the horse fall down the midline of the hoof? Check the bottom of the hoof or shoe. Does he toe off from the center? Laterally? Medially? Now would also be the time to watch how the horse sets his hooves down when he is walking. Do the hooves swing straight forward? Does he walk like a super model, placing one hoof in front of another? Do his toes or his heels land first? Also, check the horse’s standing pattern. Can he set up his feet with the toes pointing straight ahead in line with his knees? If not, this is a serious twist that is causing undue strain above. Although I recommend assessing the horse from the top of the shoulder down, I also recommend beginning the work from the bottom up. Looking at how the horse places his feet on the ground and working from there will give you much more information about his neuromuscular patterns above, but it helps to have a vague notion of what’s going on further up in the shoulder before you begin to unwind the tissue.
After completing your assessment, keep in mind that your main goal for session two is to release the shoulder girdle in such a way that the horse has both flexibility to move his scapula and strength to shift his weight backward into the hindquarter. Regardless of the findings of my assessment, there are three places I never fail to touch on during this session: the canon bone and surrounding tissue, the axilla and serratus muscle, and the upper trapezius. All of these areas are fairly consistently restricted in every riding horse. I then release additional restrictions per my earlier findings, keeping in mind the goals.
Session 3: Connection Through the Thorax
The third session focuses mainly on the thorax, drawing a connection between work you have done on the hind end and the balancing you did in the shoulder girdle. Imbalances in the rib cage present themselves more subtly than pelvic or shoulder misalignments, and the best assessment is completed while the horse is moving.
It is ideal to observe a horse moving freely to see how the thorax and spine relate to the pelvis and shoulder girdle as this area acts like a “shock absorber,” transmitting movement from the limbs through the body. Two signs of disintegration of the thorax are excessive movement or a complete lack of movement (i.e. stillness or bracing) through the ribs and spine. Both signs present best at the jog or trot. After watching a horse move freely, or if you are not able to utilize a round pen for your observations, have the handler walk the horse in a straight line away from you. You should be looking at the rib cage to see if it swings equidistantly from side to side. If the thorax moves more to the right or to the left, it may be rotated. Check the horse in standing to confirm that this is the case. Additionally, if the ribs are rotated and the horse has difficulty bending to one side or the other (you can ask the rider or trainer for this information), it may indicate that there is a slight side bend through the spine.
Since the goal of this third session is to relate the thorax to the shoulders and hips, you should assess the effects of any rotations on these structures. If there is a side bend present, it may be directly related to a pelvic rotation. Thus, working around the sacrum and sacroiliac joints prior to balancing the ribs will encourage the work to hold. Similarly, shoulder immobility can be related to thoracic rotations. Now that you’ve peeled the scapula away from the ribs, there is freedom for the thorax to change. Keep in mind also that the thorax needs to be mobile enough to “round” up and collect when the horse is under saddle. As you work, try to feel for fascial adhesions that would prevent this sort of mobility and release them.
Because the horse’s spinal vertebra are so large and located deep within their massive paraspinal muscles, it is far easier to effect changes to them by using the ribs as a handle. Saddles balance on the rib cage (well-fitted saddles, that is), so imbalances in the rider’s own body often show up here, and horse ribs are just as tender as humans’. Releasing the ribs at their angle, about eight to ten inches lateral to the spine, is a good place to start. Then check the horse’s costal arch and sternum. These areas can be difficult to reach and require sufficient hand strength to access completely, but they’re often overlooked. Hernia surgeries are commonplace on foals, so be sure to check the abdominal wall for scars. Scar tissue around the surgery site will torque the rib cage if it is strong enough. Colic surgery scars, though perhaps less common, have an immense impact on the horse’s thorax and viscera, and the horse receives great benefit from work on the surrounding fascia.
I realize that I have made little reference to the neck and head. It is not to say that I do not work on these; however, the first three sessions I complete with a horse are devoted to releasing the main inhibitors of movement. Often, once the body is balanced, strain in the neck and head is greatly reduced or changed. I more specifically address any remaining issues in these structures in later sessions.
Processing – healing process belongs to the horse
Fortunately for our human clients, they have the volition to engage in self-care after their sessions. Horses do not have the same option as they are at the mercy of their owners and trainers; some are on a rigorous conditioning schedule and their caretakers are loathe to sacrifice even a day for rest. Thus, it’s vital to educate a horse’s owner and handler on the purpose of rest post-session. Once understanding has been reached, the owner can then make choices that will balance the needs of the horse with performance goals. I generally recommend a minimum of two to three days rest post-session. This allows the horse to move about naturally and ingrain the new neuromuscular patterns in his body without the influence of a rider on his back.
In addition to the need for physical rest, horses need time to process their sessions mentally and emotionally, especially when a significant trauma has been released such as abuse or debilitating injury. Each horse processes at his own speed, and sometimes this does not match the desires of the owner. It’s easy to generalize that most horses take about three or four or five sessions to resolve a particular issue; however, just as some people have difficulty letting go of their trauma, some horses just don’t seem to want to heal. There are any number of factors affecting this. For example, perhaps the horse doesn’t feel safe in his current home. He may be highly stressed by a demanding show schedule. Do not dismiss the idea that the horse may be taking on stress from the rider; there is often a direct correlation between the physical habits of a horse’s owner and those of the horse. In any case, the equine structural integration practitioner must walk the fine line between facilitating a horse’s healing process and molding the horse to the rider’s performance goals.
Because of the incredible athletic endeavors that performance horses are asked to complete in today’s equestrian events, they are subject to physical deterioration, injury, and trauma, just as human athletes would be. Myriad therapies exist within conventional and alternative veterinary medicine for the treatment of dis-ease in the performance horse, from nutritional supplements to applications of lasers and ultrasound devices for tendon recovery. With the sensitive application of structural integration, Rolfers and other structural integration practitioners will be of tremendous benefit in increasing the longevity of a horse’s performance career as well as his overall health. In three basic sessions, we can effectively address the overarching issues present in most riding horses, freeing the horse from intense physical pain and emotional stress. Additional treatments can be applied to issues specific in each horse and on a tune-up basis to combat the physical and mental stress of a demanding show schedule. However, it is vital to emphasize that the horse is not a tool, nor a machine, but a sentient creature. Learning and understanding his thought patterns and world view are just as important to creating a therapeutic environment in the barn as they are in creating a container for our human clientele. Maintaining this perspective reminds the practitioner to value the horse’s individual process while also considering the rider’s goals.