Sacroiliac questions....

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clairel

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I know there are quite a few posts on sacroiliac injuries on here, but I am looking for a few suggestions please?

My horse has been off work since Feb. He was diagnosed with having damaged his sacroiliac sheath and I was given a course of lunging and exercises as 'rehab' for him.

Last time out Physio said she was pleased with the progress and to up his work load, with the aim of having him back in full work in 1 months time.... that was 6 weeks ago!

Vet saw him 2 weeks ago and said there was significant damage and would expect him to be lame, he isn't and never has been. When she saw him trot on a circle, she said there didn't appear to be anything obviously painful.

He is still impossible to ride and maybe even worse than at the start, incredibly heavy in the hand and will not turn right.

I guess what I am asking is, are these symptoms of a sacroiliac injury and if so is this an average recovery time. Physio implied it wasn't serious but vet suggested 6 months field rest.

I am so confused as to what is right to do, and am at the stage of giving up with the horse!

Any help welcome?!
 
I would be astounded if any horse, having been off work for 4 months WASN'T a heavy on the hand and stiff. Antifaz gets like that after a week off!
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I don't have any close hand experience of sacroiliac injury, but I would've thought that there would be more stiffness behind and obvious discomfort. If your horse isn't lame, then that's good, isn't it?
I hope you get some more helpful answers than mine!
 
Have you checked the suspensories? So often the two injuries goes hand in hand.

And sorry to be negative but the fact that your horse is not lame means nothing. - My own horse was sound when diagnosed with hindlimb suspensory problems.

Hope you manage to sort the problem out.
 
PF- He has been worked in an outline on the lunge, and has been built up to 4 times a week.
Maybe I should have explained better, it isn't just like normal when you bring a horse back into work. He is so crooked and refuses to turn right without a major fuss!
I would be willing to try and work him through it with a bit of re-schooling, but I don't want to cause any more damage!

I thought it was good that he wasn't lame... a sign that it wasn't that bad.....

TE- I just mentioned it as everytime I look up old saroiliac posts on here it starts 'my horse was lame and vet says....'
Haven't had anything in the leg checked, but will!

What was the prognosis for your horse?
 
As TE has said, a sacroiliac injury commonly goes hand in hand with another injury.

It is very difficult to diagnose - sometimes it is clear from trotting the horse up, or watching the horse in work or its obvious from the horse's stance (dropped pelvis etc). At other times it is only diagnosable from xray or scintigraphy.

I have a horse with a very old SI injury. You couldnt tell at all from watching him work but you could tell when he jumps.

If it really is the sacroiliac ligament or joint, then yes I would expect the horse to be lame on a flexion test and to test postive to pressure on the sacral area.
 
Agree with the above posters, SI normally goes hand in hand with another problem. Mine injured his hind suspensories and later developed SI as a secondary condition because he was working incorrectly due to the hind suspensory issues. I can't help with prognosis/treatment as we decided to retire Jesper (he had an endless list of issues).
Hind suspensory damage doesn't often show as lameness. Maybe worth getting your vet out to see if nerve blocks have any impact. Have you tried a bute trial?
 
My horse had the all clear after 3 months spa treatment for the suspensory. He then suffered from a sore back. That has just been given the all clear after 2 weeks just on the walker and with a bit of laser plus using the back on track rugs and he is now allowed to be ridden again.

Have discussed the sore back with vet, physio, chiro and saddler and all think it is just soreness from horse having to use himself properly again rather than anything more sinister.

My boys suspensories was picked up due to not performing as well as he could. We nerve blocked which gave slight improvement and then went on to scan which showed the damage.
 
Julian Gaze, my EMRT man is great with these. He can tell you where its coming from and treat it. Dont know where you are but he is in Worcester. If he cant come out that far then just search EMRT website for practitioners
 
New to forum except for reading posts but not new to sacro-iliac injury unfortunately. Sorry for long post but my pet subject!
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I have been managing my horse with SI injury for about 4 years which I think was present before I got him he also has close spinal processes although they are not actually kissing. We hack and have competed successfully up to Unaff Elementary and also have done the odd hunter trial and sponsored ride so there is hope.

If the injury is in the acute stage then restricted turn-out and excercise is recommended. Mine was investigated at the AHT and he had steroid injections to SI and spinal processes. After that the only way to bring them back to fitness after any pain and inflammation has subsided is to strengthen the muscles and ligaments that surround the SI "joint" to stabilise it by controlled excercise. Rest is then bad for them (my vet and physio both say so) because then they soon become weak again. Typically the horse wants to work on the forehand as his backend is weak and it can feel as if the hand-brake is on. Mine typically doesn't want to go to the left. Pessoa lunging, working over poles to stretch down but encourage use of hind legs, gradually building up strength by schooling in sympathetic classical way, regular physio. I also use a small battery operated muscle stimulator at times recommended by physio and carrot stretches etc. Tried a bute trial but did not make any difference so think it is weakness not pain although I still do worry. Took more like 6 months to get to reasonable level of fitness and strength and we still have ups and downs but have managed really well for 3 years until recently when we have had a few set backs but every horse has its problems. Mine has a character and presence to die for so I just didn't want to give up but really understand how you feel - last week he had a loon on the lunge and fell over I thought I can't go through this again but physio said yes sore but give a few days and back to work..........
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I am the OP's mum - and her horse is an eventer who had been competing at 2*level. I suppose the question for us at the moment is will he ever be able to compete like that again or is it a matter of adjusting our ambitions for him. Do horses with this kind of injury ever get back to the level they were at? Do we accept that he will only be capable of a lower level of work, even with all the rehab and tlc. It's just not knowing that is the worst.
 
Sometimes Sacroiliac probs can be secondary to a lameness or something not being right somewhere else ie suspensory/ hock/foot issues.

I wouldn't give up, my horse has suffered from this because of other issues that were going on , and we got those problems sorted as best we could and carried on to get him fitter and stronger behind with lots of hacking and walking up hills etc, with the schooling it has been about getting him gymnastically correct and carrying himself more, it took about 4-5 months to get him back to normal. There are exercises you can get them to do as well to help them loosen up the area too. good luck!
 
[ QUOTE ]
I am the OP's mum - and her horse is an eventer who had been competing at 2*level. I suppose the question for us at the moment is will he ever be able to compete like that again or is it a matter of adjusting our ambitions for him. Do horses with this kind of injury ever get back to the level they were at? Do we accept that he will only be capable of a lower level of work, even with all the rehab and tlc. It's just not knowing that is the worst.

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The short answer is no. A SI strain means that they wont be able to ever work correctly from behind which is why they never full develop their topline, consequently are weak through the back and hindquarters. They cannot properly bascule over a jump.

Depending on the severity, some horses never jump again.

My one with the chronic injury did it several years ago, and I have to keep him fit and maximise topline by lunging twice a week, once over poles, and riding very gymnastically (classical style) to get him to use himself as much as possible. He tends to just lean and go on the forehand so it is a real struggle to get him to work properly.

Even if you manage the horse according the chiro, physio and vet recommendations, there will always be continual set backs. My own lunatic fell in the field and had 2 months off. Brought back into work 6 weeks lunging then went lame again so had 4 months off. We are now back on 6 weeks of lunging and I have started ridden work over the last 3 weeks. He is still a bit stiff on that side but I have to keep him moving and try to build fitness otherwise he will get worse.

You get to learn when your horse needs work and when he needs time off.
 
Will he go to the right on the lunge and if so, have you checked the things that are different between lungeing and riding ie bit (teeth) and saddle? Perhaps that problem isn't related to the sacroiliac problem at all?
 
He goes fine on the lunge, working through his back and tracking up. This is partly why it is so confusing. He had his teeth done by an expert a couple of weeks ago and the saddler was out this week and said saddle is fine. It is incredibly frustrating - wish he could talk! He is a very talented horse but is also very good to hack out etc, forward going but not naughty, for example I have ridden him on the beach and I'm a rusty, nervous oldie, so he would be a good horse for someone who didn't want to compete. On the other hand he would be wasted doing that if there was any chance of him coming right. To be honest I can't afford to spend a lot more money on him and it is kind of knowing when to cut our losses. We have thought of sending to someone else to ride but don't want to do that if he is still in pain - which the physio says he isn't. Sorry I'm just rambling now but don't know where to go from here. Daughter is very upset as her whole season eventing has just been nonexistent - but again if she knew it would be alright eventually, that would be easier to cope with.
 
To be honest, I dont think you have really fully investigated the problem.

If he is insured, take him to a vet hospital for a full work up.

When you say "cut your losses" do you mean sell him on? I wouldnt in your position - there is something wrong with your horse and it is your responsibility to put it right or retire him/lightly hack him. I woudnt pass my horse's problems onto the next owner.

I have just had to retire a really nice 7 yr old - he will be kept in full livery until it is time for him to be pts. When I bought him I took on the responsibility of looking after him, no matter what, and I wouldnt dream of just disposing of him now, just because he is no longer able to be ridden. Even one of the army of vets that I have had look at him suggested I just get rid of him - got rid of the vet instead.
 
Don't lecture me please on responsibility to my horses - I am fully aware of my duty of care. I would only sell on this horse if it was proven that he could no longer event but could have a happy and productive life as a hacker instead. Surely it would be better for hin to have a low key job which he could happily do, than to run in a field for the rest of his life. We have horses for competition and if we had to buy another horse to event we would not have time to hack this boy around and have no inclination to go to pleasure rides etc which other people might enjoy doing on him. If he can't compete we need to find him another home and failing that he would be pts rather than sold on indiscriminately. I have had ponies and horses all my life and neither me nor my family have ever sold on a horse without very careful consideration and honesty, both to the buyer and the horse. I would not dream of selling this horse on as an event horse - that would be dishonest and cruel. My previous post was expressing my frustration and perhaps open to misinterpretation - however I want to make it very clear that whatever decision we come to will be based on the needs of the horse.
 
It wasnt a lecture - just a comparison of situations.

I have a horse with a chronic SI problem and I have had to learn to manage it. He is an ex-competition horse - his injury is too severe for him to realistically compete. He doesnt have the temperament to be a light hack, and in any case, he needs to be kept fit and maximise his topline for him to be able to work. I dont believe a horse with a SI injury can be a happy hack, as part of keeping them in work is doing a lot of suppling exercises and lunging to keep topline. Yes, a lot of this can be done on hacks, but most vets and physios would recommend regular work with the pessoa etc. Whatever topline you can build up tends to disappear very quickly - so a week off really does have a significant impact on the horse.

I dont know what investigations you have done for this horse, but a full lameness work up sounds like it is required, including xrays and possibly nerve blocks. SI injuries are very commonly secondary injuries as the horse compensates for something else, it strains the sacroiliac ligament/joint. You may find that you are able to fix an underlying problem, and manage the SI problem. Perhaps your horse will event again - I have heard of lots of horses with SI problems continue to hunt etc with steroid injections and regular physio etc. In my case, my horse's ligament was too far gone for me to feel comfortable jumping him anymore, although for the first 18 mths he was ok jumping up to about 3ft - anything else required him to properly bascule over the jump which he couldnt do.
 
Thanks for getting back on this - I'm a bit touchy about it as we have had vets, physios, massage, magnetic rugs, dentists, saddlers, reiki, animal communicators rehab exercises galore etc etc to try to get to the bottom of this problem. He works well in a pessoa, has good topline, overtracks but under saddle is still not working well enough to do a decent dressage or jump round a novice track, never mind an intermediate. He has no underlying hindleg issues. He was bought for serious work and if he can no longer do the job he was bought for we do not have the inclination or time to put lots of work into him. Someone else who wanted to compete at a lower level might well though and if he could hunt on medication that would be great for someone(he loves hunting) but that is not what we want to do and he can't event on steroid injections. We have two horses here who have retired, one a super connemara pony who had to be retired at 7 and he is 18 now, and the other an event horse who had to be retired last year after a virus left her with a serious heart problem. They will both have a home with us for life but I cannot afford either financially or emotionally to keep filling the place with retired horses. So if we can't get him right I need to either find him the right home or consider pts. Part of my touchiness is that it is such a hard call to make, particularly as there are no definitive answers to be had at the moment. Having said that we haven't given up on him yet. I'm very fond of him, he's a brave bold horse with a very generous nature and you can be assured he will have every chance. Thank you for your input, I do appreciate it and I appreciate you have had to make hard decisions about your horse. It's not easy is it!
 
How did your vet diagnose the SI problem? One vet told me that my horse has a SI problem and it turned out to be a hock problem. Unless you have had xrays/scintigraphy then I would be reluctant to treat this is a SI problem.

If you are insured I would just take him to a clinic for a full work up before your claim runs out. It took me 18months to get to the bottom of one of my horse's problems and it was very frustrating and very emotional - but I think the sooner you can resolve it the better.
 
Mine jumps but will never be able to go to more than 3 ft realistically as she cant engage behind. We use the jumping to help her canter work. She is 16.2hh. She can use her momentum and height to get over 3 ft but it really wouldnt be safe to ask much more. But she can do dressage and low level stuff as she isnt lame. If my hacking was better I could easily justify keeping her as a happy hacker.

I would get it properly diagnosed with scintigraphy and go from there. If it is SI then it is a long hard road to not a lot really. If your daughter wants to compete at a level higher than intro then you probably need to think about another horse.

Years ago these horses could give loads of fun whizzing round 2'6 hunter trial courses etc. Nowadays these sorts of comps are few and far between.
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SI is very frustrating tbh.
 
Thanks CBAnglo and dozzie - The physio is coming back out and says she will make a referral if necessary - sounds like more investigations are necessary. It is the emotion and frustration that are getting to us at the moment - so thanks for your support and understanding.
 
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