I was called to work on a horse that had a mystery lameness in the hind leg. The chiropractor and farrier were both puzzled by the discomfort the horse was demonstrating. He looked very stiff in the hock area, and I wondered if maybe he needed hock injections, as he is in his teens. I found an area of tightness and proceeded to work gently, as the horse flinched when I touched the muscle, which is the peroneus tertius.
This muscle extends the hock and flexes the stifle simultaneously. After a few minutes of massage and cross fiber friction, I had the owner walk him out. He looked better, and I did another round of deep pressure massage. This muscle is very stringy and tendinous, so can easily become tight. It is not naturally a pliable spot on the horse. Massage in the area of the peroneus tertius and gastricnemius is good insurance against such a build up of tightening and stress that a rupture is unavoidable.
The owner has reported that her gelding is moving normally and returning to light work. I will be returning for another treatment very soon, as this is an area that takes several sessions to improve.
Right behind the stifle, you can see three lumpy looking muscles. Those are the lower end of the biceps femoris. The top of this muscle attaches to the sacrum, and is responsible for the motion of the stifle and the hock. I focus a lot of attention on the biceps femoris during massage sessions at horse shows when the horse has to pass a jog. Tightness will cause an up and down, short stride. Release of the tension will suddenly produce a lovely, forward stride.
If your horse is swinging his lower leg outward, it can be that a tight lower biceps femoris attachment is actually causing the stifle to rotate. Again, releasing tight muscles will restore balance and movement.
If the horses head bobs while trotting, the head will go down when the leg in pain hits the ground.
Watching from behind: the hip that looks higher is the side where the problem is, since the hip will come up to relieve pressure.
A hind leg travels inside: There could be hock pain, low back pain, or muscle spasms of the semimembranosus.
Throws hind leg outwards: There could be pain in the stifle or hip, or spasms in the tensor fascia latae.
The front leg travels inside: there could be knee pain, or tight pectoral muscles.
The front leg arcs out: there could be back or shoulder pain, or spasms in the spinatus muscles. (see first diagram)
Short stride in front: spasm in the triceps.
Short stride behind: if it is on one side, there could be a problem with that hip. If both hind legs are short and tight, there could be a problem with the sacroiliac joint, or the muscles surrounding that joint.
Many of the problems described here can be resolved through massage, cold laser, and/or chiropractic treatment.
The hocks are the joints most responsible for the forward motion of the horse. The hocks work in conjunction with the stifles. When the horse flexes the stifle, the hock automatically flexes. When the hock is straightened, the stifle automatically straightens.
There are two muscles responsible for these actions: the gastricnemius and the flexor metatarsi. The gastricnemius is a short muscle which works to straighten the hock. It is not always easy to massage, as it is tendonous and hard to reach , but I always include it in every massage session. The flexor metatarsi flexes the hock. This muscle is impossible to isolate in massage, but benefits when other leg muscles are worked, such as the quadriceps
The stifle joint, which is the equivalent of the human knee, is subject to the same injuries and pains. Cartilage can be damaged. Ligaments can be torn, etc. If the joint is not shaped perfectly, with good angles,the chance of unsoundness is greatly increased. Horses with too straight stifles may be fast sprinters, but they are prone to luxations/dislocations.
Another thing to consider when choosing your horse is the age that the horse started strenuous work. It takes a full five years for the spine and major joints, such as hocks and stifle, to mature.
Equine massage and cold laser therapy are extremely helpful in reducing swelling, pain, and inflammation when problems arise. Structural integration keeps the body structure aligned so stress on the joints is minimized.
When standing, does your horse stand square, or do his hind legs appear to be trailing out behind? When trotting or cantering, does your horse feel strung out? The cause could be that the pelvis has rotated. This can happen when a horse jumps a jump that is too big for his fitness level. Also, if the horse lands with his feet out behind and the rider sits down hard at the same time, the pelvis can be shoved into a position that causes pain in the stifle, hocks, croup, lower back, and even the withers. Myofascial release and stress point therapy can reverse this condition. Hand walking down a steep hill will encourage the horse to maintain the position after it is corrected. It may be necessary to include chiropractic treatment if the condition is severe.
A client being treated (successfully) for knee pain asked how the laser alleviated pain immediately. While there has been extensive research to show that the laser works to relieve pain, there are no definitive answers as to how. What is known is that cold laser therapy increases the release of endorphins, blocks firing of pain fibers, increases nitric oxide production, increases the levels of acetylcholine (which regenerates damaged nerves), and decreases levels of inflammatory chemicals.
Horses and dogs can’t tell me that their pain is gone, but when I see them licking their lips and closing their eyes so peacefully, I get the message!
Yesterday I saw a pony who struggled to walk up a steep hill. He over flexed one of his hind legs at every step. Once he got to level ground, he walked more evenly, but he still did not look completely comfortable. When I checked his leg, I found some very tight fascia right behind the stifle. I massaged it, but didn’t feel that I had done everything possible, so I got out the cold laser. The laser emits no heat, but his leg became very warm to the touch. What that told me was that circulation was being stimulated to the area. If a muscle is so tight that blood can’t squeeze through to the capillaries, massage to loosen tight fibers and then the cold laser to stimulate blood flow is an ideal combination. The pony has a big show next week and I will be watching to see how he is feeling now.
The stifle is the equivalent of the human knee, and just like our knees, the stifle is prone to injury. It is a large and complex joint with bones and cartilage and ligaments. It is the largest synovial joint, which means it is filled with fluid.
I have an equine client who periodically goes off on the left hind. The first time it happened, the vet came out , identified it as a stifle issue, and said he wasn’t too worried about it. But the horse was still lame for a couple of weeks. There was soreness and swelling in the area. This horse has a wicked buck, a mild rear, and he plays roughly with the horse in the stall next door. So the injury could have happened anywhere, anytime. Eventually, he got better, went back to work. And then it happened again. Here is what the owner and I have come up with to keep this crazy guy sound:
Regular cold laser of the stifle area. We see immediate relief and improvement.
Traumeel: the owner slathers it on the area daily.
Massage. The gluteus and the tensor fascia latae muscles need to be supple for the stifle to move smoothly. The biceps femoris also is responsible for moving the stifle, and I showed the owner how to keep it moving freely, as we found a few knots during his session.
Knock on wood! My red headed friend is competing this weekend at Twin Rivers. I am not there, but I worked on him on Wednesday evening and he was in perfect shape for the event.
Update: They scored 28.6 in dressage at Training Level. She reports he was happy and rhythmic.
Don’t worry about pronouncing the name of this muscle: tensor fascia latae. But if you notice that your horse is throwing his hind leg out instead of tracking under, it could be that this stress point is in spasm. (No. 7 in the diagram). The tensor fascia latae flexes the hip and extends the stifle. It also is very active in lateral work, so when you feel resistance there, it may be time for some body work. This muscle does not get as much blood supply as a more fibrous muscle, so it is prone to getting tight. The tensor fascia latae works in partnership with the semitendinosus, so a balance between the two muscles is crucial for even and free movement.
A muscle running parallel to the semitendinosus is the semimembranosus. This muscle attaches near the side of the tail and inserts into the femur. It is used to extend the hip and stifle. I always check this muscle when I see the tail being held stiffly to one side, or when there is a loss of range of motion in the hind leg, or when the horse struggles with lateral movement. If this stress point is tight, there is great danger of a strain or tear to the hamstring or inner thigh. Many of the event horses that I work on seem prone to tightness in this area. Once injured, it is very susceptible to re-injury, so again, prevention is key. Stress point therapy, or structural integration, can help avoid disaster.