Tips/Questions on SI Joint Rehab Preparation

[Ellietotz]

Sadly but not surprisingly, after the recent visit to my vets, he believes it is likely that my mare has sacroiliac pain which will be confirmed next week after the ridden assessment to see if the steroid injections have worked or not.
I have a tonne of questions and I would be so grateful if someone can help me with them.

- The reason they suspect that she has an SI issue is due to her conformation. Her croup is higher than her wither, hind legs are quite straight and she is quite long. With this in mind, what is the likelihood that she can actually be put right again?

- Are there any invaluable items that I should invest in to help with recovery? I.e. any gadgets, any particular supplements (the vet said she will need a decent range of amino acids to start building up the muscle), an exercise sheet etc.

- What exercises are good? I.e. raised poles and if so, how many should be used in a row to have effect? Any type of stretches?

- She is fine on the lunge for walk and trot and becomes a little more short at the back in canter but it only becomes really obvious when there is a rider so how can this be changed in order for it not to be a struggle to bear weight? Is saddle weight an issue? The saddle is quite heavy but it has been fitted very well to her and it's so comfy, I'm just wondering if a lightweight synthetic saddle might be better although I'd hate to have to get rid of it.

I know I will get a rehab program from the vet but I want to get prepared physically and mentally.

Thank you.

 

[be positive]

Mine was not allowed to be lunged, he hacked daily in walk for 4 weeks then gradually started trotting building up little by little much as you would if bringing any horse back from a long time off, he didn't canter until he had done around 10 weeks but had been off work a couple of months before treatment and I knew if I didn't get the rehab right he had no other options for treatment so I went very slowly to ensure he had the best chance possible.

I had my physio come in regularly to work with him, he did the targeted exercises/ stretches she gave twice a day and on top of that I did daily in hand work over poles and he was strapped almost every day.

It was later in the year so warm weather, longer days to fit it all in, he was out 24/7 but if hot he stayed in after ridden exercise and I spent longer doing the in hand stuff in the afternoon, he had steroid injections into both sides although only one was really affected, he was visibly unlevel and gradually evened up but it did take about 6 months before he was totally level.

 

[Ellietotz]

Mine was not allowed to be lunged, he hacked daily in walk for 4 weeks then gradually started trotting building up little by little much as you would if bringing any horse back from a long time off, he didn't canter until he had done around 10 weeks but had been off work a couple of months before treatment and I knew if I didn't get the rehab right he had no other options for treatment so I went very slowly to ensure he had the best chance possible.

I had my physio come in regularly to work with him, he did the targeted exercises/ stretches she gave twice a day and on top of that I did daily in hand work over poles and he was strapped almost every day.

It was later in the year so warm weather, longer days to fit it all in, he was out 24/7 but if hot he stayed in after ridden exercise and I spent longer doing the in hand stuff in the afternoon, he had steroid injections into both sides although only one was really affected, he was visibly unlevel and gradually evened up but it did take about 6 months before he was totally level.

Thank you, that's really interesting and helpful to know. Sorry, what do you mean by strapped? My mare isn't uneven luckily, I'm just worried that due to her conformation that she's always going to have this issue. Is it right that my understanding is that it's good to keep that area warm during exercise etc in order to bring the blood to the surface to help regenerate muscle tissue etc?

 

[be positive]

Thank you, that's really interesting and helpful to know. Sorry, what do you mean by strapped? My mare isn't uneven luckily, I'm just worried that due to her conformation that she's always going to have this issue. Is it right that my understanding is that it's good to keep that area warm during exercise etc in order to bring the blood to the surface to help regenerate muscle tissue etc?

A good old fashioned groom using a body brush and strong sweeps, slightly firmer than normal over the main muscle areas.
Yes keeping them warm is important, mine had a quarter sheet if it was cooler and I bought a fly rug with a waterproof top to use in showery weather while it was too hot for a rain sheet, I think he was injected early May so easier to keep him warm than this time of year.

Mine did his in an accident so I cannot help on the confo issue, she may always be weak there but the more you can build her up the better her chances of a useful life.

 

[BBP]

As above. Zero lunging. Mine was on straight line hacking for months building up from 10mins walk to an hour, then adding in trot a few strides at a time, then once up to full trot work a little canter on straight lines, and only then starting to bring in big circles (like around whole arena, not 20m). No gadgets! Horse is not physically strong enough to hold itself in a forced outline for minutes at a time, those muscles and connective tissues need to build up gradually rather than fatiguing them. So pick the horse up to ‘work’ properly for a couple of strides, then release and reward, then ask again. Gradually increase the duration. (I think of it in human terms, if you have a weak core and sore back and your physio says you need to do the plank. They say you need to do it for 10mins, and to stop you cheating they put a pointy stick under your belly so if you drop down you get jabbed. Your muscles just aren’t strong enough so they fatigue, you start to shuffle and change your position and posture to place the emphasis on other muscles, you’re miserable and hate it, and your back hurts more. Or, your physio gets you to hold the plank for a few seconds, release, and repeat. The quality of the work is better and your muscles are learning to do the work properly. Over time you extend the hold until you can hold it for 10mins).

The injections merely reduce inflammation long enough for you to do some correct work to build the strength in the correct posture. The injections do not fix any underlying mechanical or structural weaknesses. So the work is the key to coming back to health, not the steroids. So key for me is to get a really excellent osteopath on side who can work with my horse regularly to improve the mechanical and soft tissue functionality of the horse.

Other things include keeping the back and quarters warm (rug/quarter sheet, I love my thermatex one!). In hand work that focuses on straightness and shifting weight back off the forehand. Pole work once the horse is ready. I would prefer a well fitted heavier saddle to a lighter less perfect one, you want to be encouraging her to engage her abs and lift her back, so any saddle discomfort hinders this a lot.

 

[Ellietotz]

As above. Zero lunging. Mine was on straight line hacking for months building up from 10mins walk to an hour, then adding in trot a few strides at a time, then once up to full trot work a little canter on straight lines, and only then starting to bring in big circles (like around whole arena, not 20m). No gadgets! Horse is not physically strong enough to hold itself in a forced outline for minutes at a time, those muscles and connective tissues need to build up gradually rather than fatiguing them. So pick the horse up to ‘work’ properly for a couple of strides, then release and reward, then ask again. Gradually increase the duration. (I think of it in human terms, if you have a weak core and sore back and your physio says you need to do the plank. They say you need to do it for 10mins, and to stop you cheating they put a pointy stick under your belly so if you drop down you get jabbed. Your muscles just aren’t strong enough so they fatigue, you start to shuffle and change your position and posture to place the emphasis on other muscles, you’re miserable and hate it, and your back hurts more. Or, your physio gets you to hold the plank for a few seconds, release, and repeat. The quality of the work is better and your muscles are learning to do the work properly. Over time you extend the hold until you can hold it for 10mins).

The injections merely reduce inflammation long enough for you to do some correct work to build the strength in the correct posture. The injections do not fix any underlying mechanical or structural weaknesses. So the work is the key to coming back to health, not the steroids. So key for me is to get a really excellent osteopath on side who can work with my horse regularly to improve the mechanical and soft tissue functionality of the horse.

Other things include keeping the back and quarters warm (rug/quarter sheet, I love my thermatex one!). In hand work that focuses on straightness and shifting weight back off the forehand. Pole work once the horse is ready. I would prefer a well fitted heavier saddle to a lighter less perfect one, you want to be encouraging her to engage her abs and lift her back, so any saddle discomfort hinders this a lot.

Thank you for this.
Should I be concerned about the recovery likelihood considering all we do is hack and this still ends up being the issue?