Managing Early Hock Degeneration in Equine Athletes: A Physiotherapy Approach

Equine Physiotherapy Case Study: 9-Year-Old Mare with Early Signs of Athletic Changes in the Left Hock Joint

hock

Case Overview

Patient: Bella

Age: 9 years

Breed: Warmblood

Discipline: Show Jumping

Presenting Issue: Subtle signs of discomfort during lateral movements and reluctance to engage the hindquarters effectively, particularly on tight turns to the left. Slight intermittent lameness observed after intense training sessions.

Veterinary Diagnosis: Early signs of degenerative joint changes (arthritic tendencies) in the left hock, confirmed via radiographs revealing minor osteophyte formation and mild synovitis.

#Physiotherapy Assessment

Initial Observations:

- Posture: The mare was noted to rest the left hind limb more frequently than the right when standing.

- Gait Analysis: Shortened stride length in the left hind limb, with reduced flexion during the swing phase. Reluctance to extend fully during push-off.

- Palpation Findings: Tension and mild pain in the musculature surrounding the left hock, hamstrings, and lumbar region. Stiffness identified in the sacroiliac joint region, likely compensatory.

- Muscle Symmetry: Reduced muscle mass on the left gluteal and semitendinosus muscles compared to the right side.

Physiotherapy Objectives

1. Alleviate Pain and Discomfort: Reduce inflammation and pain in the left hock to improve comfort and prevent further deterioration.

2. Improve Mobility: Enhance the range of motion (ROM) in the left hock and overall hind limb functionality.

3. Address Compensatory Patterns: Correct compensatory muscle imbalances to prevent secondary issues in the back and pelvis.

4. Strengthen Support Structures: Improve muscular support around the affected joint to stabilise the hock and distribute loading forces more effectively.

5. Enhance Overall Performance: Maintain athletic performance while managing the degenerative changes conservatively.

Physiotherapy Treatment Plan

1. Manual Therapy:

- Soft Tissue Mobilisation: Targeted massage to reduce tension in the hamstrings, gluteals, and lumbar muscles compensating for the hock discomfort.

- Joint Mobilisation Techniques: Gentle oscillatory mobilisation to the hock to improve joint capsule flexibility and decrease stiffness.

2. Electrotherapy:

- Laser Therapy: Low-level laser therapy applied to the hock joint to reduce inflammation and promote healing.

- TENS: Electrical stimulation used on the left hind limb to manage pain and encourage muscle activation in atrophied areas.

3. Therapeutic Exercises:

- Proprioceptive Training: Incorporation of pole work and cavaletti exercises to improve joint awareness and coordination.

- Strengthening: Gradual introduction of uphill walking and resisted band exercises to rebuild muscle strength around the hock.

- Stretching: Passive and active stretches targeting the hamstrings and flexors of the hock to maintain flexibility.

4. Environmental and Training Modifications:

- Adjusting the mare’s training schedule to include more rest days and low-impact sessions.

- Ensuring footing is even and forgiving to reduce unnecessary strain on the hock joint.

5. Nutritional Support and Supplements:

- Collaboration with the veterinarian to ensure adequate joint health support through chondroprotective agents (e.g., glucosamine, chondroitin, omega-3 fatty acids).

#Progress and Outcomes

After six weeks of physiotherapy and a modified training regimen:

- The mare showed improvement in stride length and symmetry.

- Resistance during flexion tests decreased, indicating reduced discomfort in the hock joint.

- Improved muscle mass and tone in the left hind limb, along with more consistant engagement during transitions and lateral movements.

- Rider feedback noted enhanced willingness to perform collection and extension exercises, as well as an overall happier demeanor during work.

#Preventive Care: The Key to Athletic Longevity

This case underscores the importance of early intervention and preventive physiotherapy in managing degenerative joint conditions in equine athletes. Overuse injuries and premature wear-and-tear are common in horses introduced to intensive training or sport at a young age. These early stressors can predispose joints to chronic issues like osteoarthritis, particularly in high-motion joints like the hock.

Recommendations for Preventive Care:

1. Delayed Introduction to Work: Allowing young horses adequate time to mature physically before starting strenuous ridden work reduces the risk of joint damage. Growth plates in horses remain open until about 5-6 years old, and premature stress can have lifelong consequences.

2. Balanced Conditioning: Emphasising cross-training and varied exercise routines helps build balanced musculature and reduces strain on specific joints.

3. Routine Monitoring: Regular veterinary and physiotherapy check-ups can identify subtle issues early, before they escalate.

4. Focus on Recovery: Incorporating adequate rest, massage, and stretching into the training program can optimise muscle recovery and joint health.

5. Nutritional Management: Proper nutrition play a crucial role in maintaining the structural integrity of joints in athletic horses.

Closing Notes

Physiotherapy is a cornerstone of both managing degenerative joint conditions and promoting long-term athletic health. Early signs of discomfort, like those seen in this case, should never be overlooked. By addressing biomechanical issues and implementing a comprehensive care plan, we can not only extend the horse's competitive career but also ensure their comfort and well-being well into retirement.

This case serves as a reminder that a proactive approach—built on careful observation, routine care, and responsible training practices—can mitigate the risks of degenerative changes and foster longevity in equine athletes.