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  Discussion on Back muscle strain? Best management/treatment?
Author Message
Member:
kayfry

Posted on Sunday, Apr 1, 2007 - 6:33 pm:

I'll try to make a long story short: On December 2, my horse sustained an injury in his paddock from an accidental kick. He had a fracture of the medial splint bone on his right front leg. It was thought initially that he might need surgery to remove bone fragments from the fracture, but on the advice of Dean Richardson at New Bolton Center, we treated it conservatively with stall rest, bandaging, a short course of bute. He was in the stall for about 10 weeks then, and the splint bone healed up great. My vet monitored it every few weeks with x-rays, finally gave me the okay to start back with very controlled turnout in a small area at first and controlled riding, gradually ramping up his exercise. He did great for 3 weeks on this program - was always sound the entire time since the initial injury. Then he played really hard one morning after we'd had a late snow with some ice mixed in over mud - ugh. He seemed okay when he came in but when I rode him that day he was moving strangely, cocking his hind end to the right. I could straighten it and he was entirely sound, but there was something wrong, definitely.
It was somewhat puzzling to me, my trainer, and my vets. At first he seemed reactive to his upper left hind, above the hock. The vet who came out that day was afraid he might have a stress fracture of the tibia. However, by the time my regular vet came two days later, that reactivity seemed to have gone away and he was bearing full weight on that leg, although still traveling somewhat crooked, with hind end cocked to the right. After a little over a week of stall rest and a few days of bute, he was about 85 percent better - still not lame, still bearing full weight, etc., just holding his body very slightly crooked - very slightly. My vet was somwhat concerned with the possibility of a neurolgical problem - possibly EPM - but the fact that he'd improved that much in a few days with no other treatment, and the history, seemed to suggest otherwise. The other explanation is a simple muscle strain - he'd lost a lot of condition, of course, from being on stall rest for those weeks for the splint bone injury, and then he twisted and bucked in the snow. He seems normal in every other way, and now feels entirely normal (though still out of shape) except for just the slightest stiffness on the right side - really only today when it got cold and damp again. He moves normally in his pasture, etc., doesn't resent the saddle being put on, picks up and holds both leads, etc. I'm thinking this is all consistent with a muscle injury in his back on the left side - he does seem to have a trigger point in that area. I've been getting massage for him and am thinking of getting my vet who does acupuncture to do that, as well. And just gradually trying to get him fit again, of course. Does all this seem right to you? Anything else I should do?
Moderator:
DrO

Posted on Monday, Apr 2, 2007 - 7:22 am:

The trouble is with the problem list Kay. With the only problem being "the horse does not track straight under saddle" there are so many possibilities it is difficult to know where to start. Until a more specific problem is identified any diagnosis/treatment regimen is highly conjectural. If this remains the only problem identified training and tack are high on the suspect list.
DrO
Member:
kayfry

Posted on Monday, Apr 2, 2007 - 8:13 am:

Right. I should have said that both vets and massage therapist have identified one or two areas along the left side of his back - but mostly behind the saddle - where he seems to have some muscle soreness - since he doesn't react the same way on the corresponding right side it seems to be some soreness. The tack hasn't changed - his saddle fits. As for training, it's possible he may have developed some soreness from returning to work after 10 weeks of stall rest - although I was doing that gradually under supervision of my trainer, and the vets think the program was okay. But I think he may have been slightly sore in his back - he lost a lot of muscle in his topline while on stall rest - and then when he bucked and twisted in the snow he pulled something. At least, that seems to make about as much sense as anything. He's doing much better, though.
Member:
kayfry

Posted on Monday, Apr 2, 2007 - 8:36 am:

Sorry - I forgot to say that it's possible, of course, that his saddle fit did change a little bit as a result of losing muscle in his topline while he was confined. I'm padding it for now when I ride him and plan to get it checked by my saddle fitter ASAP.
Moderator:
DrO

Posted on Tuesday, Apr 3, 2007 - 6:34 am:

I see, there is increased sensitivity to hand pressure along the lower back on the left side. Though I have certainly used such a finding to make similar diagnosis you have to be very careful with this as horses seem naturally adverse to such examination. The total lack of other findings may make it the best thing you have to go on.

Concerning treatment for lower back pain there are recommendations in the article and you will find a link to a list a of summaries on the effectiveness of acupuncture for chronic back pain.
DrO
Member:
kayfry

Posted on Tuesday, Apr 3, 2007 - 10:12 am:

My horse had his second massage last night, and he's much improved. He feels pretty normal under tack now except a bit stiff in the back when ridden in cold weather - seems reasonable that this could tend to make any sore muscles stiffen or spasm more, I guess. I've read the links on acupuncture and am interested in pursuing that if the problem doesn't continue to resolve. Actually, my massage therapist does use laser on some of the acupuncture points along with massage, so maybe we're already getting some benefit of this. I may have him checked by a chiropractor, just to cover all bases because he's now recovering from more than one musculoskeletal injury and is quite unfit from the previous stall rest. But I think he's doing well at this point. Thanks for your help.
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