Old sacroiliac injuries

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CBAnglo

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My horse has just been diagnosed with aggravating an old (unknown to me) sacroiliac injury - he is 1/10ths lame.

Does anyone have experience of dealing with a horse long term with this injury? Vet says nothing can be done and we will just have to cope with it for the rest of his life.
 
i know its totally different but ive injured my sacroiliac and go to physio. he says its a case of correcting it and re-building it up (correctly) surely as we are all mammals something could be done? i may be totally off on this one lol.
 
there really is nothing you can do apart from be aware of it and not do something that will obviously agravate it. My old cob has a bone cyst on his SI which has been there for the 16 years I have owned him. It has never 'seemed' to affect him but Im sure it will have affected his way of going or given him some sort of gyp at some point over the years.

A lot will depend on what the actual injury is. I have come across horses who have never been sound and have deteriorated with this type of problem, one of whom, sadly was pts last year as he was never going to be truly comfortable even as a field ornament.

Unless your vet can outline exactly what is damaged and how (and often thats not really possible) then all you can do is monitor how the horse is day by day and see what happens.
 
Right... here goes I could write a book on this
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My mare was diagnosed with this about 5 years ago. The vet basically told me to turn her away for 3 months and see if there was a change. There wasn't. By chance I found a brilliant phyios who came to look at her and said she would treat her twice and if no improvement we would call it a day.

Luckily, she responded very, very well and has gone from strength to strength. Once she felt more comfortable she began to work correctly and she got better from there. I am very strict about making sure she's working for behind and she does rather a lot of work to keep her going. There's nothing she can't do she does dressage, XC and sj.

Like Spaniel said though it will be different in every case. My tip would be to find a good physio. Whereabouts are you?
 
The vet says that he had a minor injury to the muscle some years ago - probably a field injury (he does bomb about the field) and that he is fine for general purpose riding and will let me know if/when something hurts.

I have had him 18months - I found him in a field in Kent and took him home (not vetted). He was not lame but in very poor condition so he had 2 months to put weight on and sort out really bad feet. He was then in work for about 2 months (lunging, light work) and then he had 6 months off due to a back injury (completely unrelated). He was brought back into work last September and then had another month off ridden work due to rider injury (I did lunge him a couple of times a week though to keep him ticking over). All this time not lame.

Finally, we started working him properly in November and he has been in work ever since. He is schooled 3-4 times a week. Two sessions of 30 mins, one of 45 mins and one of an hour (lesson).

Vet says I need to work him long and low (which is what I do now) and that he will never work correctly from behind and will struggle with collected work and jumping.

I have been doing bits of collected work in walk and trot (we are working on the canter) and I am not bothered about jumping although he loves it (he is an ex-sj). Not sure now what to do with him work wise. How often, what work etc. I dont keep him very fit but vet says should keep him in work but what kind of work (other than low and low etc). What about lunging? Hacking? Hill work etc? I only know what to do with a horse when I want the back end to work - what am I supposed to do with a horse when I dont want the back end to work?
 
Some years ago I had an ex-steeplechaser that unbeknownst to me had had a bad fall and damaged its sacroiliac. It showed up when I started doing serious endurance with him. We have an excellent physio who had him for a week's intensive therapy and then sent him home to me with a list of in-hand exercises to do for the next six months.

Basically the exercises consisted of mind-numbing oodles of pole work, both straighforward grids and some lateral work, and some rein-back. Also grids of poles with alternate raised ends to really make him pick up. I worked out that at the end of every (daily) session he and I had stepped over 480 poles ... But the whole point was to get the hind end working.

It did work in that he came sound and was able to be a light hack, but we stopped jumping and anything other than pleasure rides as I was never confident that he wasn't in pain.

Hope your boy continues to improve.
 
The vet says that this is a common injury with sj.

I have always lunged him over poles - with raised ends and he really picks up and I have also used them to extend the trot etc. He has always worked so well over them which is why it is so heartbreaking to know that the whole time he was in pain. I completely underestimated how generous he is/was in the school and now I feel so bad that on the odd occasions when he didnt work well on the right (he always struggled a bit on this side but thought it was just his one sidedness) and I made him work until I was satisifed that I had an improvement in the right bend. And the whole time he was in pain and asking him to bend to the right made it even worse. And worse, making him work down hills when really he must have been in agony.

Dont get me wrong - I dont ride him every day and I certainly dont bomb about on him but I have asked him to work correctly and from the vet has told me this is what makes the pain worse. He has said that his topline needs a bit of work (which I know but it is so much better than what it was) so I will continue to work him long and low. But just thinking that maybe I should just lunge and not ride?

when you say pleasure rides, what did that entail?

He is only 9 and to be truthful I think he doesnt enjoy schoolwork as he finds going in a circle so boring and he is not the kind of horse I could hack once a week. He loves jumping (obviously wont be doing that anymore). Maybe the best thing to do would be to retire him? But then the vet said to keep him in work - he has managed to deal with it for this long so he will cope with as much as he is able to and then he will tell me when to stop. But that seems so horrible and selfish. I just dont know what to do for the best. He said he will always be 1/10th lame in that leg when there is a flare up (probably when he runs about in the field or jumps the fence as he is prone to do). That suggests to me that he should be retired.
 
I bought a horse a few years ago that turned out to have SI issues... I spent a few months fixing him with help from Vet, Physio and Chiropractor and we managed to get him back to 99% right. He was ridden daily, jumped, hacked and done everything he should have been able to do, sadly though him and I we not a good combination and I decided to sell him to a friend who knew his history. He wasnt comfortable working in an outline due to damage to his poll (vet said that it was all casued by being worked too hard too young and probably in draw reins) so I sold him to this perticular person as she wanted to jump. He was fine for a year then I noticed him being stiff again. She hasnt done anything about it appart from buying a new saddle and he is gradually getting worse, he now struggles to walk across the field, never mind jump or even be ridden... I fear she has ruined him but I cannot do anything about it...

He was very bad when I got him but we did get him right and we kept him sound and in full work so it definately is possible, you just need to be prepared to keep on top of it...

Good luck!
 
The worst thing you could do is retire him. Keep him working in the way you are doing. Your vet sounds as if he is giving good advice. I was told to avoid too much hill work and continue with schooling and physio. You cant really hurry things up but you do need to keep up the schooling as his reluctance is more than likely due to the SI than boredom. You need to build up his muscles through his tummy and back to support the injury. So keep working long, low and forward. Have you got some physio exercises to do? I try to school my mare 2 to 3 times a week with rest/hacking in between and find this works well for her. I dont do lots of hill work but cant avoid it completely. I tend to trot her up hills as it is easier than walk or canter.
 
SI injuries can be from one exteme to the other unfortunately there are important ligaments that can get impinged causing the horse at best to go slightly lame and at worst to loose the use in one leg for a short while.
I have a gelding that jumped off an 8ft wall and caused damage to his SI, this was 7yrs ago, he still trains at Advanced level dressage but I don't compete him because at the higher level they have to be very supple and he unfortunately looks marginally stiff when doing more advanced lateral work, however, I do an hours schooling or teaching on him everyday and then a 2hr hack Sat & Sun, he is very well muscled.

I give him 1 sachet of bute every evening which my husband advised me to do (Vet) and I also feed Cortaflex HA as this is the only Scientifically proven supplement that actually stays in the gut long enough to do some good! If I give him time off he goes very stiff and unlevel so it is important that I keep his work load up, when people see him performing in the school they can't believe there is anything wrong with him. His schooling consists of lungeing in the pessoa for 15 mins each day then I do loads of transitions, walk to canter, half pass in trot & canter, shoulder in, Travers & Renvers, flying changes.

So as you can see if your horse has muscle or any soft tissue damage then you can still work them hard on the flat as it helps to build all the other muscles that can take over the work load of the damaged muscle. Jumping is hard for them as once you tend to have an old SI injury there can be boney changes which is uncomfortable on impact of landing. Hope this helps, oh my horse is 14yrs now and also has Kissing spines!
 
My Ex Chaser has an unlevel sacrioliac (which is very obvious from the back) - about 1/2'' difference. This was caused in a fall while race training, and he also fractured his front leg (non - displaced) iun the same incident.

My vets said that he would be fine as long as he didnt jump over 3ft, and wasnt overused. Unfortunately kissing spine and navicular have caused me to retire him at 12.

Mind you the sacrioliac is fine and has never - even when in work caused any lameness - injury is about 3-4yrs old now. He was sometimes a bit short on a back leg in trot every so many strides, and didnt have alot of bounce in canter sometimes- but it didnt seem top bother him at all.
 
Thanks everyone for your replies.

Yes, I believe the degree of injury is different for different horses. I would love him to be able to work to medium level - DB I may be inundating you with questions about exercises! at the moment he seems to work really well from behind, doesnt show unlevelness in the trot and can do collected and extended walk and trot. However he cannot hold the collection for very long, and he doesnt round as much as he should. In the canter he rushes the first couple of transitions but then is able to take more weight on his back legs. He is worse on the right rein, made obvious by the fact that he works so well on the left rein. he is fine on a 20m circle but on a 10m circle he struggles to hold the correct bend. He can do basic lateral work but vet says that is very difficult for him and that I shouldnt push him. He also said that there was no need to work him on bute as pain is more of a stiffness.

he is 1/10th lame on the flexion which can be made to be 3/10th lame if he holds the leg out and high - he really objected to this. Thing is, no-one even thinks he is lame and from behind he doesnt look uneven although he does on the flexion test. I had a brilliant lesson with him on Saturday - the best he has ever gone and on Sunday everyone was saying how well he went when I schooled him (including lots of collected trot - I shudder now) and I only had the vet out to look at my other horse (another long story) and asked him to check this horse’s foreleg as he had bruised a heel in the field that day! He said heel fine (although thinks shorter toes will help the SI??) but that he was 1/10ths lame on flexion and when he pulled his leg out high and to the side he was 3/10ths lame.

He is 9 years old and is 3/4 TB 1/4 Arab. Previous owners only jumped him (he was very green when I got him) and vet says this injury is common in sj but equally so occurs falling down etc but he thought it was from being overjumped.

Am thinking joint supplement might help (especially if he were overjumped) - what would anyone recommend? vet said it isnt going to make any difference and that he will always be 1/10ths lame but I would rather try everything. I have used them all on my other gelding and had/have good results with superflex so will try that first. Vet said he does not recommend newmarket joint supplement and says that cortaflex is the best? I tried that one years ago and didnt seem to do anything but willing to give anything a go. Also hoping to get Theresa_F’s chiro out to see him in 2 weeks when he is in the area. Until then would be grateful for any exercises people can suggest, both ridden and in hand. I already do about 10 mins of in hand schooling before I ride or lunge and we do carrot stretches.

I dont really hack him and hills are unavoidable where I am stabled. On the occasions I have hacked him I noticed that he wanted to trot downhill (and I made him walk slowly so that he had to really use himself - again I am shuddering) and going uphill he wanted to drag himself up on the forehand and I made him walk up long and low. Am I right in thinking that I really should avoid all hill work, and if necessary let him trot uphill and then going downhill let him have his head and let him stop every now and then? or should I just let him jog downhill at his own pace and not stop him as that requires shifting weight back onto the back legs? Opinions gratefully received.
 
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I will continue to work him long and low. But just thinking that maybe I should just lunge and not ride?

when you say pleasure rides, what did that entail?


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Pleasure rides - anything from 10-16 miles at speeds of up to 10mph. Mainly trot and canter. He coped well with all types of terrain and showed no resistance to going up or down hill which would have been the most painful for him.

But I didn't ride at all for 6 months, just did the inhand pole work described in my first post. I was advised not to lunge either. When we started ridden work it was all walk/trot, roads and hills.

I retired him at age 14 because despite everyone's reassurance I couldn't get rid of the guilty feeling that he was still in pain. He had two years of living the life of Riley, put weight on, careered around the field with the youngsters and generally had a ball. Yours at 9 is too young for that - hopefully he will recover to lead a full and active life.
 
Hmm, the problem is that according to the vet he had this injury some years ago. So I am not sure what they did in terms of recovery but ridden he does not appear unlevel but he shows a resistence occasionally to the right rein (usually when asked to make a tight turn or in a 10 m circle) and also the inability to hold a collection for a long period of time. He also rushes into the canter although does become more balanced and willing to work more from behind. But in the canter it is more obvious that he is on the forehand. Originally I thought this was a schooling issue, but now I realise I must have been pushing him too hard and he just couldnt do it. And that is the main worry for me, whether I am pushing him too hard or because he is green in the school, he just doesnt have the training. He didnt understand flexion or bending when I got him but now will do it on both reins and will do simple lateral work and also work on the contact etc. He was also on the forehand but through schooling we have suppled him up a lot and he know will work correctly from behind in walk and trot (but with a lot of suppling up in the walk first). But thinking back, at the end of a session he can sometimes become very heavy in the hand and wants to just go on the forehand and I always thought this was laziness and made him work until he took the weight on his back legs. Now I know that is when he has had enough and to walk him off.
 
Like the others I too could write a book on SI. My mare was diagonosed when she was 5. She is now 10 and has just had her first foal. When ridden I work her on her more sound side during warm up then spend longer on her weaker side and warm her down on her good side. Lateral work can be difficult and some days are better than others. I know how far to ask her and wouldn't go too far into her pain threshold. However I treat my riding like physio so sometimes I do ask her to go further than she wants to keep her supple. I try to maintain collection as walking along in 'anyold manner' doesn't do her or her SI any favours.
In the winter she has a magnetic rug and has had monthly physio.
When she was covered the vet and I decided a natural covering would be too dangerous for her so opted for AI and she produced a beautiful filly last week. She is on a very good joint supplement and I am paranoid about keeping her back warm and dry all year round. I care for her in the same way I would if you or I had a back problem and try to maintain it so it doesn't get worse.
Hope this helps.
 
I am reading this post wth emense interest

My horse was reviewed by Leahurst who, although couldnt find a specific SI injury using scintigraphy and ultrasound, agreed that she had a problem so injected her sacro region with steriods, pain killers, anti inflams and gave us a months course of muscle relaxant tablets to come home with. We had a programme of fitness : Week 1 and 2 - turned out during day, Week 3 & 4 - Long reining 15-20 mins twice a day, Week 5 to 6 - begin ridden work (30 mins hacking out, alternating with schooling - on days not ridden had to lunge in side reins.

I doubled the time taken for the "work" part of this as I could not lunge her twice a day due to work committments.

I have been back on board for a few months now and try to ride or lunge her every day apart from Monday and we hack out at the weekend. But to me her canter does not feel right although she is not bucking any more. Even on the lunge she can look "awkward" but she is quite happy to do it.

Mark Smith - (our instructor and Team Chase chappie as seen in Horse magazine) has seen her and did some pole work with her and said that she seemed to be moving well. But I think next time we see him I will get him to actually ride her for me and see what he thinks then ... as I think she still doesnt feel "right" in canter but she is excellent in trot etc.

Right hand bend is more difficult than left and she will work in an outline (better than she used to before the injury
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) in trot and a bit in canter.

I am just soooo unsure of how much to push her - how much of it is "remembered" so she may be "protecting" herself or if she is honestly still uncomfortable in the canter.

I was interested to read about the amount of pole work done in the post above - I think I will try and do more. We cant avoid hills but she does seem happy enough going up and down them. Its just this bloody canter - esp in the outdoor school (sand and rubber surface).

We have a big show coming up in August - and I just dont know whether to take her or not - she usually does really well in her class - but is it worth it - will the gallop hurt her - etc etc.

I just wish I knew !!! It is such a horrible dilema and with being stuck where I am and with a vet, who is excellant, but a bit of a "doom and gloom" merchant and I am no where near very expert assistance (like Leahurst) and having to rely on visiting physios or chiros - who dont always come over here or come once and never come again - plus only seeing Mark Smith (who is bloody excellent) every couple of months - it is very very depressing indeed.

Any advice or tales of similar problems would be appreciated !

MaverickMD
 
CBAnglo: Your'e very welcome to PM me for exercises etc, I like in the South West with loads of seriously steep hills but I use them to our advantage, he walks up them, I dont allow him to trot as it makes it easier for him and also encourages his head up in trot which means he is pulling himself along, he goes up on a mission but at the end of the buckle long and low. Down hills I try to avoid purely from a slipping point of view as this can jar his back and SI but I keep his head up at shoulder height to prevent falling if I have to go down hill.

I use bute purely for stiffness, not because he is in pain as 1 sachet would not work for pain relief on such a big horse. A Pessoa is superb for engaging the back end and building top line muscle which really helps with the SI also. This was recommended by my husband and Svend Kold from Willersley. Good luck and PM me if you need to.
 
My vet has said to work on strengthening topline - this is where the long and low and pole work come in. I have always ridden him long and low (instructor is classical so she would kill me otherwise) and as I said, he now after several months of schooling works well in an outline in walk and trot on both reins. If the circle is too small or corner too tight on the bad rein he breaks out of trot and sort of bunny hops behind as he tries to get his back legs into position and then starts trotting again. Initially I thought this was his muscle atrophy as it was severe (one of the worst cases I have seen and as a saddle fitter I have seen some heartbreaking examples) and he improved so much with the correct work. His topline is almost perfect and I have been chasing that elusive topline which the vet now says will never come. Also when I am riding him and he is really powering from behind I have always felt there something more that he could offer but he held himself back. And now I know why.

The vet says walk and trot are fine. It is the canter and jumping where he will struggle and I need to learn not to push him too much. Because I have spent so much time on the walk and trot to get some balance, before I even attempted the canter in the school, I missed how much he struggled on corners. out hacking in a straight line its different and he loves a good gallop. Are your mare's hips even? If I make my boy stand completely square, I can see one is ever so slightly dropped and also the muscle isnt as developed on that side. Only visible now he is in good condition and he has muscled up.

Basically it means that anything which requires him to take the weight on his back end will be a struggle i.e. riding him correctly, jumping anything over 2'3" which he can just hop over rather than have to properly bascule over the jump, and doing tight corners on the right rein. saying that though, he does move really well, and everyone always stops to watch him in the school because his trot is so floating and expressive.

Chiro is definitely something you need to have - and often. I have been recommended a good one so I am waiting for him rather than letting someone else touch him. In the meantime I shall alternate between riding him in big circles/straight lines and lunge over raised poles. He is already on superflex as well as I am concerned about the other joints which must be compensating for this joint.

I had no idea that this injury was so common amongst showjumpers - i did a google search and hardly anything came up so I thought my poor boy was the only one. my vet is very matter of fact and to the point - not exactly doom and gloom but he isnt exactly warm and cuddly so like you it is reassuring to know other people have come out of the other end of all of this, and if I can make him comfortable for the work I want to do (would love him to be working medium) then great. Otherwise I will just have to adapt my riding to the work he can do.

DB - making them walk uphill surely puts the weight on the back end - wouldnt this = pain? and going downhill is worse? I'm afraid that if I go up a hill I must eventually come down another so I want to know the best approach.
 
My boy damaged his sacroilliac about 5 years ago falling in a ditch. The vet told me to do fitness work etc. so we did pole and flat work and hacking and to be honest even after 2 years it still wasn't right. Then I got a chiro to take a look at him and she gave him a few tweaks and then gave me a set of leg exercises to do with him that seem to have been the initial break through.

Stand about in line with where his girth is and lean forewards and pick up his hind leg. Gentley circle the foot in both directions. I did 10 circles one way and 10 th eother then repeated it over and over again. Did this with both hind legs. When I first started doing the exercise I had to do so many cicrcles that it took 2 of us to do it taking turns (it is realy hard work on your own back), Only do it after work so that the muscles are warmed up. I did it every day for 18 months. As he got stronger the circles became larger and further forewards.

I then started with a new sports physio / instructor who has got him really well muscled up through correct work - it has taken over a year. Now he is great. We did our first intro event last month and he flew! So there is hope. I do get him regularly check to make sure that everything is still ok.

Good luck
 
One thing I forgot to mention was the manipulative exercises that nearly wrecked my back - lifting each hind leg and rotating it 10 times in each direction twice a day. I had no idea a 16.3 TB's hind leg could be so heavy!

I agree with Dressage_babe that hill work is very beneficial provided the horse drops his head and neck and really engages his hindquarters. If you're worried about coming downhill then why not get off and walk? I think I spent more time on my feet than riding in the initial weeks of what was meant to be ridden work.

It sounds as though you and your horse are doing the best you can with such an injury. Maybe by seeking to do even more you're chasing a rainbow?
 
Thanks for those exercises Twilight. I shall start on those immediately.

How long did you do them for after riding? I.e. 20 mins each leg alternating?

I am just afraid that because this injury is so old, according to the vet, that really nothing can be done to improve him and the only thing I can do now is manage it. This means keeping him at a certain level of fitness and trying to keep him/make him more supple. I know that when I first brought him back into work he was like a plank of wood and could not bend on either rein. with the correct work he has improved so much and as I have said, no-one can even tell that his is 1/10th lame at all. Admittedly now I know why I have never been able to get a consistently rounded and upward canter from him but when he does manage to take the weight on his back legs he does cover the ground really well.

But I think there is always someway to improve him, even if it means that he is slightly less stiff. Will also try magnet rug (ordered one today).
 
Regarding exercises. I think its better to get a physio to come and show you what/how many is needed and direct you befoe you start as things can change as your horse becomes more flexible. When first treated I did Toffees rotation exrcises 10 per leg in each direction then carrot exercises to help her stretch her top line.
We eventually moved onto to diagonal pulls of her hind legs to the opposite fore leg. It was several months before she was able to do this. Be prepared to exercise yourself too! Horses legs are very heavy!
I'm glad you are going to try out a magnetic rug. The first night Toff wore hers she came out of the stable bucking and behaving like a youngster.
Don't be afraid to use bute if you need to. I'd rather she was feeling ok than stiffening up overnight.
Finally you asked about how far to push your horse when riding. We went through many months after she had her steroid injection of being scared of potential pain too. This took a while and eventually her confidence came back. I found my Pessoa was invaluable as it helped her recognise she does have a back end. I also found some of the T TEam ideas very interesting and highly recommend what this teaches. Again good luck!
 
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