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Massage versus Rehabilitation

So you massage horses? This is often the first thing people ask; when I say I’m an Equine Physio.

Physiotherapy is not just massage. It is assessing the whole horse to know when, where, why and what therapy or intervention will help resolve the current problem. Massage may be one of those therapies, as can joint mobilisations, stretches, strength exercises, education and advice on training, tack and management ... the mainstay of what Physiotherapists do is bespoke exercise and education.

When is massage appropriate?

Massage is useful for mental relaxation, to release muscle tension and to decrease DOMS (delayed onset muscle soreness). Massage helps restore normal muscle tone after hard work or riding on jarring ground. Tight muscles can constrict blood flow, as massage releases this tension blood flow improves helping delivery of nutrients and dispersal of waste products.

There is a wide variety of massage techniques; each has a slightly different effect on the body. For example: deep tissue or sports massage, trigger point techniques, percussion, myofascial release techniques ... Therapists will choose to use different techniques at different times to get the desired effect eg. waking up muscles before a competition, versus general relaxation, or restoring muscle balance around a joint.

Limitations of Massage.

If you are getting regular massages to keep your horse feeling good, pause ... and consider what is happening between massages that is making your horse feel not so good?

“If you constantly want massage, you have to ask; Why are your muscles tense all the time?” Professor Peter O’Sullivan. Generally tension arises due to overload. Physical workload, mental or emotional stressors all contribute to overload. Massage may give short term relief. But because massage is only a small part of the whole picture it could be masking an issue and delaying seeking solutions to the real problem – the reason why your horse is tense.

To avoid excessive physical tension we need to modify and manage training loads and optimise recovery between workouts. Poor biomechanics can also cause overload of some structures. This leads to questions like: is the saddle restricting movement, how balanced are you in the saddle, do you apply your aids asymmetrically, is your horse naturally crooked or mildly lame, is your horse protecting and guarding a previous injury...

Mental and emotional stressors can cause anxiety and therefore physical tension. Questions to ask include: are we progressing training too quickly, is my horse confident at the current level of competition, is my horse settled in the herd, does my horse lack grazing time and the opportunity to express normal horse behaviours, like mutual grooming...

Now I’m not suggesting you cancel the massages, I’m just saying be careful you are not missing the opportunity to change something to improve your horse's life.

Once a physiotherapist has assessed the horse from head to toe, a rehabilitation plan will be formulated. Hands on therapies like massage may be used in the early stages to desensitise overloaded tissues. But to prevent the symptoms returning treatment needs to progress to more active rehabilitation exercises to address biomechanical issues.

Once major issues or injuries are dealt with and the horse is symptom free, rehabilitation works on building appropriate strength and co-ordination to return to sport without risking re-injury. With these steps achieved successfully the focus shifts to performance enhancement, looking for all the little 1% gains possible to help the horse reach and maintain its highest level.

This whole process is rehabilitation; massage is just one tiny part.

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