Stretching Out the Kinks
There's nothing like a good stretch--when you wake up in the morning, during breaks at work, or before and after your workout. In human physiology, we know about stretching and its benefits for the athlete. Many practitioners and physical therapists recommend stretching for their equine clients. Are the techniques really helpful, and if so, why? Or are we endangering our horses' health with some of the stretches we make them do?
Jean-Marie Denoix, DVM, PhD, of the Centre d'Imagerie et de Recherche sur les Affections Locomotrices Equines (CIRALE), in Goustranville, France, is one of the world's leading equine anatomy and locomotion specialists. His imaging expertise and equine anatomy photographs help practitioners and horse owners visualize what happens beneath the skin of the horse.
Each year, Denoix examines hundreds of horses which come through CIRALE displaying performance problems, and after diagnosing the problem with a multitude of imaging techniques (radiographs, thermography, ultrasound, scintigraphy, and/or magnetic resonance imaging), he prescribes treatment for the animal. Often the regimen includes stretching. But besides treatment, Denoix also supports the theory that regular stretching performed by someone educated and trained in the physiology of stretching horses can increase the range of motion for a horse and make him less likely to injure himself in the future.
"I actually prefer the term 'mobilization' (to stretching)," says Denoix. "The main intention of this technique is to provide mobilization to the back, neck, and different areas. Mobilization is more the technique--stretching is a result of the technique."
The physical reaction that a horse has to stretches would suggest that it is enjoyable for them. According to Denoix, horses often chew (an accepted sign of relaxation) and are cooperative. But he says that it's very difficult to objectively or scientifically quantify the effects of mobilization because study design is difficult and quantification of the results requires precise biomechanical techniques as well as clinical studies, ideally with a controlled group.
"I think that horses are like cats and humans," says Denoix. "They like to be stretched because live anatomical structures don't like to be in the same position all of the time. Mobilization especially aids in the (promotion of) blood circulation and interfascicular shearing." (More on this later.)
Reasons for Mobilization
According to Denoix, there are two types of mobilization with two objectives--for treatment and for sport.
In patients with pathological problems, Denoix stresses that before employing mobilization techniques, the horse must undergo a complete clinical examination by a veterinarian. "I would say professional stretching designed to treat a physical problem of the horse must be done after a good diagnosis," he says. "With this therapeutic objective, I don't know if (stretching done by a non-professional without first having a precise and documented diagnosis and instruction by their veterinarian) is really useful."
There needs to be more than a good "feel" for what the horse needs, because a diagnostic examination can identify what kind of stretches shouldn't be done to avoid exacerbating a problem. The types of stretches and techniques chosen for a horse are dependent on the condition and diagnosis of the horse. One must be careful and stretch the horse only after receiving instruction from a professional for that particular patient.
"The objective of stretching for sport is to improve the mobility of the back, neck, or joints. But before doing that, you have to check and make sure the horse is not painful," he reminds owners.
"If they do not have an anatomical dysfunction, anytime there is physical contact between the horse and owner is good, as it means more care for the horse. Besides, through this physical contact with the horse on a day-to-day basis, the owner has the ability to know if the horse has movement limitations somewhere," he adds.
What Happens During a Stretch?
You might have experienced a horse groaning with pleasure when you've stretched his legs after tacking him up, or seen a horse stretch like a cat, with his front legs out in front of him and his croup high in the air. What is going on under the skin during a stretch that makes us and our horses feel good?
"What is happening is that there is an elongation of the muscle bodies and of the tendons, depending on the location of the stretch," says Denoix. "Elongation of the muscle bodies and tendons induces a greater range of motion, which leads to a reduction in muscle contraction and fibrosis, which is an increase of interstitial (situated between muscle fasciculi, slender bundles of fibers) fibrous tissue.
"In the ligament, movement occurs between the fasciculi of the ligaments, known as interfascicular movement," he adds. By changing the position of the different fasciculi of the muscle through sliding in the interfascicular spaces, you're improving the blood supply. "A lack of blood supply leads to discomfort," says Denoix. "That's why you will see horses stretch spontaneously.
"Movement is indispensable to the health of the joints," he explains. "Joints with reduced movement are not normal--pain leads to reduced movement, which leads to fibrosis (which further limits movement). Fibrosis and pain are the main causes of limitation of movement in the horse. In the horse with very strong ligaments, we're going to reduce fibrosis and provide more suppleness with the stretches."
But if working with an injured horse, Denoix emphasizes that stretching only is effective if the cause of the pain is treated or controlled first. Stretching is a complementary method to treat the muscles, ligaments, and tendons that control joints, and it should not be used in place of adequate conventional therapies.
"Stretching can be useful for the axial (along the topline of the horse) regions of the back, neck, and the proximal (upper) part of the limbs," says Denoix. "It is mainly useful for the muscles in these areas." Stretching is more useful for ligaments in the distal limbs, he adds, as there are no muscles in the lower limbs.
Additionally, Denoix says that stretching should not be used in several specific situations. First, it can elongate the supraspinal ligament, which covers all of the spinal processes (projections of bone) on top of the back from the withers to the sacrum. In horses with supraspinal desmopathies (disease of this ligament), one should avoid flexing the horse's back to avoid aggravating the lesion. You also should never perform mobilization techniques on a horse when he has a complete or partial rupture of a tendon. According to Denoix, this can worsen the lesion.
Aggressive stretching of the neck is strongly discouraged because the neck is such a mobile and sensitive structure in the horse. Applying leverage on the neck can injure the vertebral structure. As the neck is long and mobile, every manipulation is more effective than in other areas; moreover, vertebral lesions (pathological or traumatic injuries of the vertebral bodies) in the neck are often underestimated and can be worsened by excessive mobilization. Intervertebral lesions (pathological or traumatic injuries of tissue between two contiguous vertebrae) caused by such handling can exacerbate inflammation induced by osteochondrosis dissecans (OCD, a cartilage disorder characterized by the presence of large flaps of cartilage or loose cartilage bodies within a joint) of the articular processes, meaning even more problems for the horse down the road. The OCD lesions are developmental in nature and they induce secondary troubles such as synovitis and fluid effusion responsible for pain and nerve compression in this area.
Mobilization for Sport
A very popular sport stretch that many have included in their routines before riding includes a brief forward stretch of each foreleg. While some do this stretch for the purpose of "un-wrinkling" the skin that is under the girth or cinch, others consider it an athletic stretch.
"A short stretch (regime) is not very effective," says Denoix. "In order to have a mobilization reflected in the horse's athleticism, you have to do the stretching at least five minutes every day in total. The horse is stronger than you, and when you're stretching your own body, you can induce beneficial effects, but with the horse--there is more result from the time (you spend on the stretching) than on your force. This is for all stretches. Stretching can be used as a warm-up before exercise or as a complementary physical preparation at the end of the working period."
How long you hold each stretch depends on the reason for the stretch and any injury that might be present. Work with your veterinarian to decide how long to stretch various body parts.
Different disciplines of riding place different demands on the horse's body. A jumper has entirely different stresses on his body than a dressage horse--both disciplines are strenuous for the horse, but in different ways. A horse which gallops and jumps might be limited by fibrosis in the back and therefore might not be reaching his potential in the sport, but after mobilization techniques, not only will an improvement of his athleticism be apparent, but he will be less susceptible to injury because he will be more prepared for wide movements that are difficult to reproduce on a daily basis during conventional training, such as unusual flexion from twisting the body over a jump or an exceptionally long takeoff or landing.
The range of movement resulting from stretching is higher than during exercise at gaits, and the wide movements produced by stretching techniques are made slowly, avoiding any sudden tension or pressure and therefore protecting anatomical structures. The stretching program and techniques should be adapted to the horse's discipline. This is why it is very important to consider what kind of stresses the horse's body will experience in your chosen discipline.
"You've considered the objectives, the elongation, and the medical indications, now consider the sport," says Denoix. For example, a jumper needs a wide range of flexion and extension as well as lateroflexion in the back, while a dressage horse performs more rotation, especially during side displacement.
A good time to begin stretching a horse for suppleness is after a 15-minute warm-up period of putting the horse through his gaits. "This allows better elongation of anatomical structures," says Denoix.
But by far the best time for these stretches is after the horse finishes a workout. According to Denoix, the horse's structures are very warm, and there is a reduced risk of injury at this time. This is explained by the viscoelasticity of the horse's soft tissues, a physiological property that allows residual elongation in parts of the horse's body, when they are submitted to mechanical stresses. Therefore, after a warm-up period, the body is more prepared to stretch.
However, he realizes that some horse owners might have horses which are stiff and cannot work. "You have to begin progressively with these horses and induce more elongation," he explains.
"You're going to improve suppleness and amount of movement allowed in the horse," Denoix explains, "and you're going to allow the jumper, for example, to be prepared in an unusual situation, perhaps when he hits the fence and it falls. Suddenly there will be an exaggeration of his movement, and because of the mobilization, he will be more prepared for this kind of accident."
For example, "if a horse is suddenly experiencing a wide flexion of his spine, it can injure the supraspinal ligament, but if the horse is prepared (for this type of stress), this horse is likely to avoid injury," he says.
Stretching to Treat Injury
Denoix says that the main use of mobilization at CIRALE is for the management of joint conditions and back problems, rather than athletic conditioning. "The stretching of the upper part--back, muscles, shoulder, hindquarters, and other proximal aspects of the limb--is mainly done through training and exercise when the horse is working," he explains.
Denoix says that he first will diagnose the horse through various imaging techniques to detect the exact problem.
"One example is semitendinosus muscle fibrotic myopathy, a pathologic condition characterized by the presence of fibrous scar tissue in the muscle body, preventing elongation of the muscle during the protraction (forward displacement) of the limb," he says. This is a common problem affecting one of the hamstring muscles in the back of the pelvic limb. It manifests itself with the horse appearing to be "slapping" the ground with a short stride of his hind limb.
"In this situation, the horse's mobility is completely altered by the problem," says Denoix. "The horse cannot protract his hind legs (bring them forward) because the structures are completely fibrotic. When you have a specific diagnosis such as this, the (stretching) movement that is useful for the horse is protraction to allow restoration of a wider engagement."
Another example of types of stretches for particular maladies would be a horse with a fracture of the tuber coxae, the easily palpable bone that protrudes on each side of the pelvis. This traumatic fracture is often accompanied by a rupture of the ligaments and muscle attached to the ilium (the top part of the hip bone) wing, which is often accompanied by a dropping of the tuber coxae and a shortening of the tensor fasciae latae muscle (near the flank area and going down to the patella). "These horses demonstrate shortening of the caudal stride (as the leg swings back to achieve propulsion). Retraction of the hind legs (stretching them out behind the hindquarters) would be indicated in this situation, says Denoix.
"I think that first, if you want to efficiently stretch the horse, you have to do it regularly. If not, there is no justification for it," he emphasizes. "You must do it every day for at least five minutes. There is no reason to stretch your horse every week or month. (The requirement for regularity) is the main limitation of this technique. If you do not do that regularly, you cannot change significantly the muscle or ligament length, which is the goal to improve the range of motion."
If you've ever been on an athletic team or in an exercise class, you've probably heard a coach or instructor remind you to not "bounce" for a longer reach on a stretch, but to slowly exhale into a stretch. Stretching technique matters in the horse, too, even though their structures are larger, stronger, and sturdier than ours. With the horse, as with stretching your own body, you begin slowly, then progress to a greater flexibility. Specific stretches will enhance each specific movement that a horse makes as an athlete.
"Mobilization should be done softly in order to be accepted by horses," explains Denoix. "If you do a stretch too quickly, you are less likely to maintain cooperation of the horse. It is also important not to induce pain. Have the respect (of the horse) and a warm-up period of 15 minutes before stretching. Then do five to 10 minutes of effective stretching. You can do more if you wish, but be realistic."
Of course, the technique is completely dependent on the structure that you want to elongate. A thorough knowledge of functional anatomy aids in this process.
"There is no sense or justification (for the mobilization) if you don't know your specific objective. Each anatomical structure can be stretched in a horse, and there are hundreds of anatomical structures, and each element is quite simple," he says. (See "Mobilizing the Forelimb" on page 33, "Mobilizing the Hindlimb" on page 35, and "Mobilizing the Back" on page 36 for examples of different mobilization techniques that Denoix employs.)
"An example is the longissimus dorsi muscle, which is the wider, stronger muscle of the horse's back," Denoix explains. "You have to induce flexion of the back combined with the right lateral (side to side) flexion (see page 36). So it has to be a combination of associated movements able to induce elongation of the longissimus muscle."
Without a thorough understanding of how this muscle works, your mobilization techniques will not be useful. Therefore, before stretching your horse, you need to get your veterinarian to tell you which structures need to be stretched for your chosen discipline or your horse's particular needs. Then have him/her show you how to properly stretch those structures.
One might be concerned about "overstretching" their horse--a valid concern, even though most horse owners don't have enough strength to cause a problem for an uninjured structure (except in the neck!). The horse typically will show his natural range with his reaction to your asking him to stretch. If the horse seems uncomfortable, or if there is a possible manifestation of pain from injury, such as yanking the limb back to a more comfortable spot, stretching is not recommended. "It is only safely performed in horses without pain," reminds Denoix.
Mobilization or stretching is a useful aid in the healing of soft tissue injury in the back, neck, and proximal limbs if it is performed under the supervision of a trained professional with a working knowledge of functional anatomy of the horse. A five- to 10-minute mobilization regime each day can improve the athleticism of your horse and prevent injuries that might otherwise occur in unforeseen riding or pasture incidents when these muscles could be overstressed.
- Protraction--Stretching forward.
- Retraction--Stretching backward.
- Flexion--Bending of a joint.
- Extension--Straightening of a joint.
- Adduction--Stretching toward the midline of the body.
- Abduction--Stretching away from the midline of the body.
About the Author
Stephanie L. Church, Editor-in-Chief, received a B.A. in Journalism and Equestrian Studies from Averett College in Danville, Virginia. A Pony Club and 4-H graduate, her background is in eventing, and she is schooling her recently retired Thoroughbred racehorse, Happy, toward a career in that discipline. She also enjoys traveling, photography, cycling, and cooking in her free time.
POLL: Holiday Horse Care