The importance of PT, in people and horses.
I thought this might be an interesting point to write about since I’m currently experiencing this first hand after tearing my ACL, and MCL in addition to damaging a few other muscles and tendons and there is no better case study than yourself!
If you don’t already know, I had the unfortunate experience of a horse falling on me and pinning my leg (its not always best to stay on the horse). I’ve just started physical therapy to relearn how to walk on my now pretty useless left leg. It is amazing how quickly your body adapts to hopping around on crutches, or automatically standing with all of your weight shifted onto your good leg. As much as I know about the importance of retraining movement patterns and muscle imbalances increasing the risk of re-injury; my brain still thought that as soon as the pain subsided walking would just be back to normal. I mean seriously I’ve been walking for like thirty some odd years and its the most automatic and natural thing I do all day, right? Surely this wouldn’t be that difficult. Boy was I in for a rude awakening.
Let me tell you, the brain and body have an amazing ability to reprogram to protect itself when in pain and just because the pain goes away doesn’t mean movement returns to normal like you just flipped the lights back on.
To put it simply; muscles “learn” movement patterns so that they can act efficiently. Whether that’s through training, like how to shift their center of balance back toward the hind to best align themselves under the weight of a rider. Or a learned pattern such as a limp or dominant side from protecting an injury, or pain. The movements just become automatic. The problem is when those learned compensatory patterns are not resolved they continue to put undue stress on other joints long after the original injury has healed. This will eventually cause a knock-on effect with other joints (i.e. secondary lameness issues; like how my healthy R knee is getting stressed from bearing the brunt of my weight and movement). Horses being prey animals also happen to be experts at disguising these compensatory patterns making lameness still one of the most head scratching problems to diagnose. You often won’t even be able to detect it until it’s pretty far along.
It takes work and careful exercise plans to retrain balanced relationships within your muscles so that they are all back to functioning together synergistically and in a way that protects the weak spots. I know that if I don’t carefully build back up the muscles that have atrophied from guarding my injured left knee, that I have a far greater chance of rupturing what’s left of those ligaments. Not only do I have to build strength, I also have to retrain the correct muscles to engage so that they’re all doing their jobs, no one is slacking, and no one is over working. Could I walk if a lion were chasing me? hell, I could run. But that would be missing the point. It's not that the joint CANT function, it's that the joint is now a weak link and I need better muscle strength to stabilize and protect it. The cost would be an increased risk for ruptured ligaments, surgery, and surely arthritis, probably lower back or hip problems and so on.
Just like with horses, I want to PREVENT future problems and the best way to do that is to correct these issues while they are smaller and easier to address; or able to be addressed at all. I would much rather do some quad sets than get surgery, just like I’d much rather work on a few in-hand hill exercises than end up supplementing NSAIDS for arthritis for the rest of my horses life, or worse yet have a lame retired horse at 12yo. These horses are in work for us, for our pleasure, for our jobs, for our prestige. We can’t prevent everything but we can do our best to give them a chance at a healthy comfortable life.
...and if you're anything like most horse people, please take this advice for yourself too. 😉
I hope everyone is staying safe out there. ❤️