Equine therapist Mimi Porter explains how all horsemen can keep their equine athletes healthy and supple

by Denise Steffanus

SPORTS therapy has been a crucial factor in human athletics since the Olympic Games began in ancient Greece. Olympic athletes in 776 B.C. were massaged before competing in their events, and in the second century A.D., the muscles of Roman gladiators were kneaded before they entered combat. But only in the past few decades has sports therapy been recognized as an integral part of the equine athlete's training program.

Equine therapist Mimi Porter is regarded as the pioneer in bringing the same type of therapy used in modern sports medicine to the world of competitive horses. In 1982, she adapted the skills she had learned during ten years as an athletic trainer for the University of Kentucky to promote the health and comfort of performance horses through the application of therapeutic modalities previously used only in human athletics. She now offers her therapeutic services to horsemen through her practice Equine Health Care in Lexington.

Porter said every horseman, regardless of financial means, can establish an equine therapy program for his or her horses. The minimum requirement is a pair of sensitive hands; at the other end of the spectrum are high-tech modalities for stables whose budgets can afford them.

Sensitive hands

Running your hands over the horse's body from nose to tail should become part of the morning grooming ritual, Porter said. This practice will enable you to detect two early signs of subtle injury or a brewing problem: inflammation and edema (fluid filling) that causes the tissues to swell.

"Before you even touch the horse with the brush, it would be good to just go over the horse with a flat hand--long strokes, moving from the head toward the tail and just feel the body," Porter said. "You are just stroking the horse down his neck, down his back, down his chest, down his shoulders into the legs, across the ribs, across the hips, down the side of the legs. And that just gives your hand a chance to become familiar with the way the horse feels so that you'll notice if something feels a little bit full of fluid, and it doesn't have to be a lot full of fluid before you can recognize the change. If you're doing that every day, your touch becomes educated, and you can pick up things much quicker."

Also part of Porter's protocol is to check the digital pulse in the feet. A bounding pulse can be an indication of foot pain.

"These are all signs that you can use before lameness and dysfunction occur," Porter said, "and that's the easiest time for a non-veterinarian to address the problem. Once you have a dysfunction, it is more of a challenge to make a change, but in those early stages where edema and heat are pretty much the only signs, you have a shot at really helping.

"Inflammation is the first early sign of injury. You want to always be on the lookout for increased temperature in the skin or around a joint; you want to be always on the lookout for increased swelling under the skin and around the joints. And then, of course, you're going to look for dysfunction. But often the first two signs--heat and swelling-- come before dysfunction, so that would be where you want to pick up an injury."

Stretching

As with human athletes, stretching should be the foundation of a good warm-up routine. But in addition to aiding blood flow to muscles and making tendons and ligaments more supple, stretching can be a diagnostic tool to identify areas of the body the horse may be guarding or reluctant to move.

Porter recommends starting with a "carrot stretch," coaxing the horse with a treat or morsel of hay to bend its neck and head around to its girth on both sides.

"If the horse doesn't do that exactly the same way on both sides, that indicates a problem in the lower neck, the shoulders, or the forelimb," Porter said. "Some horses will duck their chin under and come around arcing downward instead of staying in that nice level plane coming toward the back. That's a very good indicator of a problem."

Next, Porter stretches each forelimb by grasping it at the ankle and helping the horse to extend it forward and then arc it backward in a striding motion until it extends comfortably toward the ground under the horse's girth.

For each hind-limb stretch, Porter grasps the leg at the ankle and lifts it as if she were going to pick out the foot. She then extends the leg underneath the horse's barrel and toward the other side. For the backward stretch, she extends the limb behind the horse in a stride-like motion. For each limb, Porter allows the horse to comfortably enjoy the stretch.

During the stretching exercises, Porter pays particular attention to how symmetrically the horse moves.

"The lack of symmetry is a red flag that you have a tightness somewhere," she said. "The body should have symmetry everywhere--medial to lateral, front to back, left to right. All the different interfaces of body tissues should be symmetrical in their strength and in their flexibility or extensibility."

Dental problems and imbalanced shoeing can cause lack of symmetry, so Porter emphasized the importance of a thorough dental examination, regular dental care, and proper shoeing and trimming.

A horse with dental problems tends to tilt its head, which, in turn, throws the rest of the body out of balance. Likewise, improperly balanced feet will cause a horse to alter its gait and the mechanics of its stride.

Finally, for an older horse, Porter adds an exercise designed to keep the spine supple and strengthen the abdominal muscles. She alternately tickles the horse's belly and then presses down on the spine to cause the horse to arch its back and flex its lumbar region.

"At first, you'll think there isn't any movement," Porter said, "and there probably isn't any movement in the early going. But if you keep working at it, they'll become tremendously flexible."

Ground exercises follow stretching. For this, Porter asks the horse to engage and disengage its shoulders and hips. This simple exercise that causes the horse to abduct and adduct its muscles is accomplished by standing beside the horse and asking it to move laterally away from the handler. First, Porter works with the forehand and then with the hindquarters.

She ends the ground exercises by asking the horse to make a serpentine movement with its body that Porter calls "the waltz."

"You start out moving the horse in a circle just like you're lunging him," she said. "Then you reach over and get the rope and bring his head across in front of you. So you're asking the horse to bend its body and go the other direction. So he has to make a kind of serpentine turn around you."

Massage

Massage therapy was introduced to horsemen in the 1980s when the modestly produced, spiral-bound book Beating Muscle Injuries for Horses gained popularity. Written by human sports therapist Jack Meagher, the paperback presented the principle of deep massage to horsemen in a clear and logical way.

"Jack Meagher's book is a classic," Porter said. "Absolutely. It's very clear for the horseman."

In his book, Meagher explains the why and how of deep massage in step-by-step directions, along with diagrams of muscles and stress points. The book also includes a troubleshooting section that presents a problem, such as shortened stride, and then outlines the stress point involved and the type of therapy to apply to achieve the muscle action needed to resolve the problem.

Porter views massage as a holistic therapy that aids horse and horseman. According to her, not only does massage aid the horse physically, but it also provides a medium by which the horse and the horseman can form a bond while promoting relaxation for both.

"Massage is a great way for you to bond with your horse," she said. "Horses love it; it's relaxing. People can do it in a Zen sort of way so they relax their own minds and their own bodies at the same time. They'll find that they really meld with their horses and their horses meld with them."

Porter theorized that massage may release neurochemicals in the brains of the horse and the horseman that have a positive effect on both.

"It doesn't have to be an hour-long massage, but just something hands-on that is intimate and peaceful with your horse," Porter said. "It's a wonderful thing."

Horsemen can become familiar with massage techniques for horses through books and videos. Those who want to become more proficient can attend massage courses offered by various schools around the country.

Tools that soothe

In her equine therapy practice, Porter also employs the same type of high-tech modalities that sports therapists use in human medicine.

"One thing that has been well-researched is light therapy," Porter said. "Light energy is absorbed by the cells of the endothelium, and they are the cells around the inside of the blood vessels. All light has to do is reach the first layer of capillaries to stimulate a neurochemical called nitric oxide. It is a molecule that causes vasodilation and pain relief. It is also an antiviral and antibacterial agent.

"Years ago, researchers realized that there were receptors in the body that absorbed morphine and used it to reduce pain. They also realized that the body had to naturally produce a substance like morphine or there would be no need for those receptors to exist. That was how endorphins were discovered. So these tools we use can stimulate production of those neurochemicals."

With the tools at her disposal, Porter can reduce pain, cause vasodilation to bring more blood and oxygen to injured tissues, cause relaxation of muscle spasms, and reduce swelling. These tools include:

•Cold laser: Therapeutic device that delivers a low-intensity, focused beam of light to reduce inflammation and promote circulation. The low-level or "cold" laser does not cause heating of tissues. Light energy (photon) is absorbed by various enzymes within the cell (chromophores) that react to light. Energy entering the cell as light is used to produce adenosine triphosphate (ATP), the energy currency of the cell.

Cold lasers increase the production of connective tissue and improve connective-tissue repair. They also increase skin production and blood-vessel formation within tissue, decrease scar-tissue formation and scar adhesions, reduce pain, and resolve inflammation. Cold lasers also may aid nerve regeneration, promote muscle relaxation, and reduce muscle spasms;

•Therapeutic ultrasound: Device delivers high-frequency sound waves that excite the molecules in tissues, creating a rise in temperature. Ultrasound increases the permeability of membranes, which reduces swelling and inflammation by allowing the evacuation of fluid buildup. It also can break down the fibers that knit together to form scar tissue.

The affected area is spread with a conducive gel, and an ultrasound wand is moved back and forth over the area. Intensity and frequency of pulse can be adjusted for optimum therapeutic results.

Porter warns that therapeutic ultrasound has the capability of causing damage, especially to bone, if not employed properly, so only individuals trained in its proper application should use this modality;

•Electrical stimulation: Electrodes are attached to the body via adhesive pads spread with conducive gel. The pads deliver a comfortable level of smooth electrical current to evoke an endorphin response that induces a deep state of relaxation.

It is ideal therapy for relaxing muscle spasms, and it may aid the repair of damaged nerves by enhancing blood flow in the tissue surrounding them. Electrical stimulation at a higher current can be used to make muscles contract to keep them full of blood and muscle-contraction enzymes to avoid atrophy; and

•Electromagnetic therapy: Pulsing electromagnetic field therapy is typically applied to the horse through boots or blankets. Several experimental and clinical studies have established that an alternating magnetic field improves blood circulation.

One theory states this effect is a result of movements of ions in blood. These movements increase pressure from inside blood vessels, leading to vasodilation. Increased circulation facilitates restoration of nerve and muscle function, bone healing, nerve regeneration, wound healing, and pain relief.

Complementary therapy

While much of the work Porter performs is designed to keep a horse healthy and resolve issues at first recognition before they become serious problems, she stressed that if a condition persists, it is time to call a veterinarian.

"I would ice massage it for a day or two and see if that resolves it; if it does, it was a very local and self-limited problem that wasn't necessary for a vet to look at," she said. "But if two days of ice massage twice a day doesn't change things, then you probably better find out what's going on."

Denise Steffanus is a contributing editor of Thoroughbred Times who writes frequently on veterinary and farm management topics.