Sacroiliac Injuries

For some reason, I have three horses on my books currently rehabbing from sacroiliac injuries. One fell over in the field being moronic. Another, actually another did his in the field when he arrived at a new yard. And another has come to me for help after a year of battling with SI problems.

Not that I’ve become an expert, but I’ve definitely picked up a few nuggets of information about sacroiliac injuries and rehabilitation.

Symptoms of a sacroiliac injury aren’t particularly obvious – there’s no limpy leg. There is often a positive reaction to palpitation of the SI area (and by positive, I mean that the horse reacts to pressure, even in an ears back, angry way). Although some horses can be incredibly stoic and barely flinch when palpated. There’s slight shortening of the hindlimb stride, usually both, but many riders won’t notice it. I’d almost describe it as a “flat” movement. They’re going through the motions of moving their legs, but are saving themselves and not using their back muscles. Mostly, horses show unhappiness in the canter – bucking, going disunited, falling out of canter and general reluctance. A horse may find jumping harder, put in the odd refusal, or not bascule as well as normal. I think often sacroiliac injuries are noticed after a period of time, when the horse’s posture and muscle definition have deteriorated so that the saddle doesn’t fit, or the physiotherapist notices a change in posture.

The usual treatment for a sacroiliac injury is to medicate the joint, and then a rehabilitation programme to stabilise and strengthen the area. The medication lasts for six months, so there’s a good stretch of time to build up the work and improve their way of going without the horse being in pain, and then hopefully once the six months is over the SI area is strong, stable and pain free.

Vets usually recommend two weeks of box rest and then a six week rehab programme working up to introducing canter in the last fortnight. I always find that the typical vet’s programme is quite ambitious and based on the perfect scenario of seven days a week and a perfectly behaved pony in the field! If you can only work the horse five days a week, stretch out the rehab programme to factor this in. If the weather’s awful or you’ve been ill and haven’t progressed through the week, then just repeat that week of the rehab programme. My vet friend told me that the worst thing you can do when rehabbing a sacroiliac injury is to work a horse more than their fitness. So I work on the basis that if in doubt, plateau the work load for a few days and take more time. Besides, the owner usually knows their horse very well so can tell if their horse is ready for the next step of the rehabilitation programme, or if they need more time at their current stage to build their strength.

The first couple of weeks of the rehab programme is walk only. Long reining is often recommended, and hugely beneficial as the horse starts to work in a long and low frame without the weight of the rider. The horses that I’ve worked with this year have both done at least a week of pure long reining; in the arena and out on little hacks. Then we’ve introduced walk poles on the long reins and then riding. Initially, it’s been a ride every three days, and then after another week or so, alternating riding and long reining. The poles start off as only one or two every other day, to more poles, then more frequently, and then raising the poles. We make the workload harder by one factor at a time so as to develop the horse’s strength steadily. Again, if the horse seems to find it difficult then they can have an easier following couple of days, perhaps going back to just walking with no polework. We also introduced hillwork on hacks, again with small hills, and then steeper hills and more frequently in each week.

The first long reining session, where stretching long and low is quite an alien concept.
Within the first long reining session, this horse started experimenting with moving his head into different positions. Within a fortnight he stretched for the majority of his time in a long and low frame.

After two or three weeks of walking, we introduce trot in straight lines. On the long reins and under saddle. With the same approach – introduce the trot without the weight of the rider, then under saddle, then increase the number of trots, the duration of the trots, adding in polework and then hillwork. If the horse ends up feeling particularly tired when a new level is introduced, such as trotting up a hill, then the next day they can do slightly less. I like to maintain long reining a couple of days a week, and vary the work so that the horse’s brain is engaged and they don’t become bored.

Once the horse is feeling strong enough – I go on the basis that they should find three or more raised trot poles straightforward, and have their neck low, back lifting throughout – then it’s time for canter.

The day of the first canters I’m not worried about the transitions, I’m just looking for the horse to feel comfortable in the canter; and for it to be fairly rhythmical and three time. One or two canters on each rein is sufficient the first time, and the following day have an easy ride or long rein session. Once canter has been introduced I don’t think it’s necessary to canter the horse daily over the first week or so. Canter is the hardest gait for horses with sacroiliac injuries, so introducing it very slowly and steadily minimises the horse regressing or overdoing it. In the canter the horse’s pelvis moves in more of a sideways motion, whilst in the trot it’s a forwards-backwards motion so there’s new muscles being recruited and needing to strengthen. The whole pelvic area should also become more supple after canter is introduced and the horse begin to feel much more comfortable trotting in a long and low frame, with the back swinging nicely.

At this stage, whether it’s taken six weeks or ten weeks, the basic rehab programme from the vets is essentially over. But that doesn’t mean it’s back to pre-injury work. Especially if the pre-injury workload caused the injury. Time needs to be spent on the canter, getting the horse to better use their back and develop the muscles over the sacroiliac area, using canter poles, both on the ground and raised, before recommencing jumping. Realistically, it’s another month before the horse is back at their usual level of work and able to stay sound.

I find it really satisfying rehabbing horses, and enjoy reflecting on the changes to their posture, muscle tone and way of going. Although I don’t think I’d have the patience I have with client’s horses with my own!

Lunging With Two Reins

I’ve fallen back in love with lunging with two reins for a number of reasons, but in all the cases I’ve used it with there has been a huge improvement.

My first victim, I mean client, was a mare who has always struggled with straightness due to previous injuries, but is becoming much better under saddle. However I don’t find her lunging sessions as beneficial to her because she drifts out, bananas her body, gets a bit stuck on the track and is a touch lazy. I felt that she needed an outside rein contact to reduce how much she could twist and pull me out on the lunge. I also hoped that the outside lunge line going around her hindquarters would be a prompt for her to go forwards.

She was not impressed. When I flicked the outside rein over her rump and she felt it come into contact with her haunches she stopped, tail facing me, swishing it angrily. I let her tell me how upset she was before asking her to walk on, and initially I had my work cut out to keep her walking and on my circle, not drifting to the fence line. After arguing with me for a circuit she started to relax, and I felt she was straighter through her body and not holding her hindquarters in so I asked her to trot. Again, she grumbled for a few minutes until she aligned herself and began to move with more impulsion and efficiency. Combined with her circles becoming rounder and her inside hind leg becoming more engaged, the trot improved in cadence and she started to use her abdominal muscles and topline.

The next time her owner rode, she felt a huge difference in her mare’s vertical balance; she had a uniform bend throughout her body and had an engaged inside hind leg. The mare was also less fixated on staying on the track, which triggered my next lesson of working on the inner track, and my rider had more of a response from her outside aids.

I suggested double lunging to another client with her young horse who long reins well, but tries to turn in on the lunge. The outside rein will prevent him turning in to his handler, which means he can be taught how to lunge and then just lunged with one rein as required. This will allow his owner to introduce canter work safely on the lunge.

Double-line lunging a little pony in rehab has really helped her learn to seek the contact forwards and stretch over her back and subsequently develop her topline.

Then last week I decided to lunge a horse who I often school, to change things up a bit. He’s a long horse, who finds it hard to connect his back end to his front end and wiggles to avoid doing so. I’ve done a lot of work improving his rider’s outside aids to help stabilise the wiggles, and I felt lunging with two reins would complement this work.

This horse was the only one I felt was ready to canter in the double lines, and where I felt would benefit the most. You can see in the video how balanced this horse is with the outside lunge line supporting him.

Lunging with two reins helps bring the outside shoulder around on the circle, so improves the horse’s straightness, understanding of the outside aids, engagement and connection. This results in an improvement to the horse’s vertical balance and way of going as they use their body correctly.

So how do you lunge with two reins? Fit a bridle and roller to the horse, and run the lunge lines from the bit through the rings on the roller. The outside lunge line then runs round the horse’s hindquarters and into your hand which is nearest the tail as you stand in the usual lunging stance. The inside rein is held in your hand closest to the horse’s head. The horse is sent forwards with the voice, a flick of the lunge whip, or the outside lunge line against the hindquarters. Once you’ve got used to handling the two reins (experience with long lining is helpful!) Lunging with double reins is not that difficult, and has remarkable benefits to the horses when ridden. Definitely worth trying as a change to your usual lunging technique.

Working a Young Horse

I’ve been working with a young horse all summer, who has really tested the patience and determination of his owner and rider, but thankfully she’s starting to reap the benefits.

He came to her as lightly backed, but we soon discovered that he’d been missing a key element in his training: consistency.

So we took him right back to square one, and the first couple of weeks were spent with them building a relationship and him learning the routine in his new home. He’s a tense, nervous little guy, and it comes out in bolshy behaviour, so his owner had to establish ground manners and wait until he started to feel confident before starting to work him.

Now because he had already been introduced to tack, lunging and long reining, not a huge amount of time needed to be spent notching up the girth hole by hole as he got used to the feel of the saddle on his back, but we soon found out that he had some undesirable behaviours when being worked in hand, such as napping, twisting his body, bunny hopping, and charging at you. The same when he was ridden.

When I first met them they’d had some positive in hand sessions, but not so positive ridden sessions and his owner had realised she’d bitten off more than she could chew and needed help.

We decided to step back and focus on their long reining. They’d done some long reining around the farm tracks, which were going well, but weren’t doing any long reining in the arena, only riding, which wasn’t going so well. I completely agree that young horses should be educated outside the arena as much as possible, but this little horse didn’t have good associations with the arena. I believe this was because he was upset and confused about the ridden process and it was in a less familiar environment.

I think it stemmed from the lack of consistency in his backing process, as well as his individual personality, but as soon as the youngster was out of his comfort zone he displayed his “naughty behaviours” of napping and not going forwards. Starting to understand his personality and behaviour, we began to formulate a plan.

The horse wasn’t comfortable or confident in the indoor arena. Neither was he confident about being ridden. So putting the two together was a recipe for disaster. I sent my client home with the homework of long-reining in the indoor arena, doing basic circles, changes of reins and serpentines to build her horse’s confidence of being in that space. By doing some basic ridden movements from the ground they will become familiar, so hopefully when his owner rides him and rides these movements they will be more familiar and hopefully less stressful so he doesn’t exhibit any of his insecurity behaviours.

They continued to long rein out of the arena too, and the next lesson we began in his comfort zone with long-reining. They did ten minutes of this until he settled. Then his rider mounted, and we did exactly the same from the saddle as from the ground. So what he was being asked to do was familiar, but with the ridden part being unfamiliar. He was dipping his toe out of his comfort zone.

You can almost think of the comfort zone as an island, and the aim is for the sea to recede, so the island becomes bigger as the horse grows in confidence and experience.

Anyway, they had a positive ridden session, with him starting to relax. They didn’t need to trot until walking under saddle was within his comfort zone. The next few rides involved less long-reining and more in the saddle time, adding in short trots when the conditions were right.

They got to the point in the next few weeks that his owner could get on at the yard, enjoyed their rides round the farm, and were having positive sessions in the school. I think it was to their benefit not to increase the ridden work until the consistency was established. The horse began to relax into his work: he knew what to expect, was familiar with his surroundings and handlers, so stopped napping and responded correctly to the aids.

Once the consistency was established, we started to develop the ridden work. We introduced trots for longer and longer periods, transitions, circles and changes of rein. I was pleased that he was taking it all in his stride because he was growing in confidence.

Unfortunately, they had a blip and the youngster started napping again. Instead of persevering from the saddle, I suggested they returned to long-reining for a few days. I’m not sure what caused the blip, but the horse strikes me as a worrier, so it’s best to reaffirm his comfort zone and then start to ask the questions again, and be on the lookout for the first signs that he isn’t understanding, before his behaviour escalates.

It didn’t take long to get them back on track, and this will be the first thing we do if he has a sudden lack of confidence again.

Bearing in mind that this horse doesn’t have the best mindset to new experiences, and isn’t overly confident, we need to teach him to open his mind to new experiences. So we need to reduce the stress involved. I suggested that his owner introduced the outdoor arena by long-reining in there first, and then to ride in there after doing most of their work in the indoor until the horse relaxes in that environment. Then she can begin to work him properly in that arena. Hopefully by not throwing him in the deep end and asking him to swim, he will benefit in the long term because the relationship between him and his rider will strengthen as he gets more confident, and then we can ask him to step into deeper water more quickly and he won’t sink.

Next up is to continue establishing the basics, improving his rhythm and suppleness, adding in more school movements and getting the correct response from her aids. Being naturally tense, I want to see him starting to relax his topline and become more free in his body before we move on from each stage as that change in his body language tells us that he is more confident and understands his work.