Chronic Sacroiliac Damage & Arthritis - REHAB ADVICE!

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Hizzo28

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Hello,

I have already read through a lot of the posts about SI pain and options - please bare with me, I've been at this for a year and don't seem to be able to break the muscle tremor/pain cycle!! My boy is an eventer, competing at 1* when I bought him - he quickly showed soreness through his lumbar region - new saddle, lots of physio etc - come to the end of the season and two weeks off and he started to refuse when jumping. This was a year ago - he's had the full works:
- bone scan
- gait analysis
- x-rays & nerve blocks
- shockwave
- medication x3 SI joint, hocks and stifles
- mesotherapy
- arthroscopy left stifle
- box rest and small paddock turn out

He has been diagnosed with:
- hock osteoarthritis
- arthritis left stifle (operated on August 2017)
- T18/L1 damage - although not painful on bone scan
- major SI damage pain

He's also on 4cyte as his joint supplement

After his surgery in August he did a further 6 weeks box rest, 3 weeks walking in hand, 1 week in a small sand paddock followed by 6 weeks in a small grass paddock (we're currently on week 5 of that) - so all was looking good, muscles soft and pelvis looking more symmetrical - then he went out on grass and the chronic muscle tremors started in his lumbar region AGAIN!!

Back to the vets - SI re-medicated for the 3rd time and lumbar medicated & mesotherapy. Vet has now given an 8 week rehab plan to get him back into work in the hope the muscle will support the SI and stop an further pain.

We just seem stuck in a loop of muscle tremors and pain which is preventing us moving forward......I fully realise I am fighting an uphill battle with all his problems, but I want to try and get in him back into work to see if he can sustain.

He is now sound behind....whoop!!

So I'm looking for advise on rehabbing - what has everyone else done and what complementary therapies/supplements did you use?

My current plan is:
- straight lines in a band for resistance
- long reigning in a equi-ami
- muscle builder (tried myoplast and science supps muscle builder but they make him loopy)
- acupuncture
- physio
- mesotherapy

What am I missing??????

I would really appreciate any advice on this - he has a chronic condition and psychological/muscle memory to fight against, but I want to give him one last try!
 
I'd get Rob Jackson the horseback vet out to see him. I'd want to be completely certain that he was totally straight with no underlying issues.

Whats his foot balance like?
 
Hi

Poor you, and very much poor him. You don't say how old he is. If he was mine, I'd take his shoes off and throw him in a field for a year before starting any rehab. Dr Green, movement and rest is, in my opinion, much the best form of rehab. I have one (was eventing Novice when I bought him, he broke within 2 months, the day my new event saddle arrived so I had never even jumped more than a couple of X poles with him) with a very bad SI injury and it took a good 18 months before we saw any improvement. A year of that was in a huge field. Sadly, he's still in that field but that's due to personal circumstances and not through any fault of his own. His damage was in the lumbo-sacral joint rather than the SI joint and medicating would have been a nightmare.

If I had the time and circumstances again, the shoes would be off (again). I'd still do a 9 month - 1 year stint in the field. Then, on reassessment, Cartrophen would be given, and I would build him up like a hunter with 8 weeks build up to 2 hours of walking before anything else. Wary that you have hock issues as well, I would probably do half on the roads, and half on varied surfaces, careful not to dwell in the school for too long. It's obvious you have been prescribed long and low for him, so some of this could be done on that score. Ask your vet about water treadmills - they might suggest the hock action could be too much.

I recall that myoplast is quite high in sugar, along with its amino acid concoction. If you go the barefoot route, I don't think the myoplast will be that helpful. What does the vet say about some straightness training and horsey yoga? Is he allowed to go sideways? I use this on my mare whose hocks are a little stiff on occasion. The difference is amazing and, on the last saddle fit check, we discovered a 2cm improvement in the sway of her back. Not that she's sway backed, particularly, it has just straightened a fair bit.

Good luck. I am so sorry for all you have been through.
 
Myoplast is one of the biggest marketing cons there is at the moment. It is 20% spirulina and 80% sugar.

If you want to feed spirulina, feed it straight. Most horses don't have any issues with it if you introduce it slowly.

Or, you could feed whey protein as an alternative protein source

Or you could feed separate amino acids (The main ones being Lysine, Methionine and Threonine).

Any of these are more economically sound than feeding Myoplast :)
 
Thanks Leo. I've not heard of Rob so I will look him up.

He now has good foot balance - it has taken us nearly 2 years to achieve. His front feet were "concave" when I bought him but they are balanced and quality is much better now.
 
Sounds like your experience is very similar! So frustrating, really sorry!

I've considered cartrophen as an option before my insurance runs out in December.

He's had his back shoes off - he can't have his front's off as he's 7/8th TB and has thin, weak feet and is immediately crippled!!

I've started to think about turning him away - two major concerns:
1) he doesn't like being out - I've struggled to get him settled, he was so used to going out for 4 hours a day. He's now happy being out longer but I'm not sure he'd cope with 24/7 turnout.
2) he quickly gets an over development of muscle in his lumbar so my physio is concerned he wound't build up correctly.

It's such a difficult one as I think 12 months down time would let everything "settle".

He's only 11!!
 
So I've gathered!! He's quite a tense, buzzy horse but not one that takes his feet off the ground! He went up vertically, which was very scary for us both!

I've heard good stuff about spirulina.....I'll do some more research, thank you!
 
Hizzo28 said:
Sounds like your experience is very similar! So frustrating, really sorry!

I've considered cartrophen as an option before my insurance runs out in December.

He's had his back shoes off - he can't have his front's off as he's 7/8th TB and has thin, weak feet and is immediately crippled!!

I've started to think about turning him away - two major concerns:
1) he doesn't like being out - I've struggled to get him settled, he was so used to going out for 4 hours a day. He's now happy being out longer but I'm not sure he'd cope with 24/7 turnout.
2) he quickly gets an over development of muscle in his lumbar so my physio is concerned he wound't build up correctly.

It's such a difficult one as I think 12 months down time would let everything "settle".

He's only 11!!
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Sorry, but this (in bold) is a bit of a miss-direction from whomever informed you of such. You mentioned further up that his feet were concave - which is what they should be, really. If he has thin, weak feet and is crippled without shoes then you can address this with appropriate, sugar-free diet and hoof boots to start off with. The more the whole hoof is used, the better he will be able to develop the appropriate muscles without compromising other structures. Your choice, of course. I won't preach to those who don't wish to entertain such things.

Second, my horse, the one of which I wrote further up the page, was equally unsettled in stable or field. Within 15 minutes of turning him out at his rehab place he was settled within a herd and didn't think about anything worrying ever again. If they have the space, they are generally fine. I don't think he even saw a rug last winter. He is 7/8 TB, 1/8 Irish with what were appalling feet. We were worried about an over-development of muscle as he had also torn a hind suspensory. The huge field (4+ acres) and continual movement up and down hills with the herd ensured this never happened. So, on that score, I think you'd be doing a good thing. If he comes sound you can always work on the redistribution of muscle when you bring him back into work. At 11, I'd give it a punt.
 
I wish now, I'd taken some photos when I bought him! He couldn't keep shoes on at all and his feet were incredibly brittle. They are all round a lot healthier now, although I'd still be very nervous of taking them off - I suppose I just think he'd go lame and that would cause us lots of problems with him shutting down, but it's something I will discuss with my farrier - winter would be the best time to do it.

I have a place in mind and think he could probably cope - my other mare had a year out and it really helped her suspensories. Really interesting to hear your experiences on muscle development.....that is my biggest concern I think. He's sound currently, but it's the tremors that keep coming back and he's too weak/unstable behind to even think about getting back on him! Did yours suffer with arthritis at all? I'm assuming the more gentle movement the better on that front.....
 
I feed straight amino acids to my one with muscle problems (pssm). They have a bit of a pong but I think I notice it more than she does. Cheaper than myoplast and easy to buy from Bulk Powders or other body building sites.
 
Hizzo28 said:
I wish now, I'd taken some photos when I bought him! He couldn't keep shoes on at all and his feet were incredibly brittle. They are all round a lot healthier now, although I'd still be very nervous of taking them off - I suppose I just think he'd go lame and that would cause us lots of problems with him shutting down, but it's something I will discuss with my farrier - winter would be the best time to do it.

I have a place in mind and think he could probably cope - my other mare had a year out and it really helped her suspensories. Really interesting to hear your experiences on muscle development.....that is my biggest concern I think. He's sound currently, but it's the tremors that keep coming back and he's too weak/unstable behind to even think about getting back on him! Did yours suffer with arthritis at all? I'm assuming the more gentle movement the better on that front.....
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Hi. In my post above I meant 45+acres. Gah.

Do ask your farrier, but bear in mind that if he is not pro-barefoot, he might not be receptive to the idea. Why not have a read of some of the Rockley Farm blogs to get a bit more of a grip on the benefits and then ask a professional trimmer what they think.

Mine did not suffer from arthritis that I know of; however, his lumbosacral joint is so compromised I wouldn't be surprised if it does become an issue. Movement and diet are key to recovery and maintenance anyway, (and his hoof health if you go down that route).

Good luck with whatever you decide.
 
I have an ex eventer and he was very sore in his SI area when i got him. I had a chartered physio out to him on vets recommendation to treat him. She gave me this exercise to do to help:

Walk over poles in straight line with right or left side of pole elevated or alternative sides elevated. The poles should be one walking stride length apart i.e. 3 fairy steps. Poles raised ideally to knee height.
The exercises are done in walk only since walking is the best gait to improve the strength of the stability muscles of the pelvis and abdominal area due to the reciprocal action of walking. The exercise will be done on both reins and 6 good repetitions are needed per exercise. “Good repetitions” mean rhythmically, active, without knocking or rushing over the poles. This might mean 10 repetitions were done to achieve 6 good repetitions. You might find the “weaker” hind limb or rein would need more repetitions to achieve the required 6 repetitions.

I found it easier doing this long reining, then progressed to using it within the warm up of ridden work too. It did help him along with the treatment she gave him.
 
i'd a similar one and i threw him out on grass for a year with no shoes and it was the making of him. When he came back into action it was lots of inhand and pole work. And he also needed osteo every 6 weeks to keep him functioning right. In the end I ended up retiring him as he wasn't capable of withstanding the work I wanted him to do.

I tried every supplement under the sun, but found the only helpful things were good shoeing, a good osteo and correct work.
 
I use a vet chiropractor for my mare with a multitude of issues - Alvaro Vela. His treatment especially helps her in her SI region which gets locked up and stops moving. I have always used physios or sports massage and although helpful, none of them have made my mare as comfortable as the chiropractic treatment does.
 
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