Equine Hydrotherapy:Treatment for lower leg injuries and lameness in horses.
Hydrotherapy: Why it works.» Click for Video «
For centuries, the use of sea water has been recognised as an aid to the treatment and prevention of leg problems in horses.
According to his trainer, the infamous Grand National winner, Red Rum would not have been racing at all except for the benefits of training on the beach.
Cold water hosing, a common modality, cools the skin surface, but the temperature is uncontrolled and might not be cold enough to affect the structures most often involved in injury.
Cold sea water in particular has an anti-inflammatory effect which facilitates healing and helps guard against injury. Consequently, over the last 150 years or so, inventors have been patenting various devices for replicating the benefits of exposure to cold sea water in a controlled manner.
To comprehend how cold water hydrotherapy works we first need to understand how the body reacts to trauma such as strains, cuts, bruises etc.
Enzymes and proteins are released when cells are injured through a cut or tear, or by concussive trauma, causing the blood vessel walls in that vicinity to dilate and become more porous. Then lymphocytes are directed to the site of the trauma passing through the porous membranes and entering the injured tissues to begin fighting the infection. Extra fluids, carrying oxygen and proteins for tissue repair, also pool around the injured area. Tissue damage also triggers the secretion of hormones which are responsible for much of the pain the horse feels.
Pain, heat, and swelling, the three main symptoms of inflammation, occur in varying degrees, depending on the site, nature, and severity of the injury. Pain helps prevent overuse of the affected area. Heat results from the increased blood flow to the injury site, and swelling (or edema) helps immobilise the area.
The danger is that inflammation rages out of control and hinders the healing process resulting in secondary tissue damage called hypoxic injury, which can compound the problem. In addition, blood vessels in the area are put under increasing pressure by the fluid build-up, so the flow of blood and lymph tends to stall.
The safest way to break the destructive cycle of secondary cell injury and excess edema is to use the horse's circulatory system to sweep away excess fluids that have collected in the tissues. While anti-inflammatory agents like bute can reduce swelling and heat, they also can mask pain and confuse the diagnostic picture. There are two natural ways of encouraging the dispersal of excess fluids - applying heat, and applying cold. Heat, however, should never be applied to an acute injury which leaves us with cold in many cases.
Cold Water Therapy
The application of cold hydrotherapy triggers three basic reactions. At a cellular level, the metabolic response of the cells is reduced, so the cells need less oxygen to function and thereby suffer less hypoxic injury. Cold therapy also decreases the permeability of the blood vessel walls, thus reducing the amount of fluid that accumulates in the injured area. And thirdly, the cold numbs the area to a certain degree, acting as a topical analgesic.
Cold hosing is one of the simplest forms of hydrotherapy and a new injury can benefit from being cold-hosed for about 20 minutes at a time, as many times a day as possible. Shorter periods aren't as beneficial, as they don't give the blood vessels enough time to react fully.
Ice can provide a really concentrated cold response, which can stimulate faster results. The only disadvantage being the propensity for the horse's body to heat them up, rendering them ineffective after a few minutes.
Applying the ice for 15 to 20 minutes, every two hours, seems to have the best effect. Longer applications can lead to tissue damage and it is not suitable for prolonged treatment of open wounds. For open wounds, apply cold only until the swelling subsides otherwise it can retard the formation of new tissue around the area of the wound. One of the best things about cold is that, unlike some other approaches such as drug therapy, it will not override the beneficial effects of the healing process. Heat and inflammation, can be reduced by corticosteroids, for example, but they do it by shutting down the whole healing process, while cold therapy merely controls and regulates it.
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