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Friday, May 15, 2015
Evaluation & Treatment Report of Findings Summary: Phase II
Evaluation & Treatment Report of Findings Summary
The Evaluation and Treatment Report of Findings Summary for a “Phase II” horse appears far less “bloody” than the Phase I horse’s Summary. By this time, most if not all of the muscle spasms, back, and pelvic pain have been reduced or eliminated. There is far less red ink on the Summary so it appears that the “bleeding” is under control. If I were to visit your home, I would not be surprised to find a Phase II Report card posted on your refrigerator!
Typically, when an equine patient’s muscle length, in addition to its spine, and pelvic ranges of motion have returned to being within normal limits, I consider the patient to be a candidate for “graduation” to Phase II. In spite of the fact that the Summary will show less red ink, it is not unusual for a Phase II horse to continue to have flank pain on one or both sides in front of the pelvic brim. In my observation, this is commonly the last area to regain full muscle length, and may have been the first area to lose muscle length. For this reason, I have found that it remains helpful to continue backing the horses up to 20 steps from the ground on a regular schedule and prior to riding. This exaggerates the pelvic flexion stride, and helps to gain and maintain pelvic flexion. The loss or reduction of pelvic flexion is a primary culprit in compensatory adaptive physiology due to failed spinal biomechanics.
Additional common findings on the Phase II Summary are the recurrence of knee, neck, and poll fixations. These tend to recur, I believe due to the lack of hind strength. As hind strength returns and the horse is able to manage a greater and more appropriate percentage of its weight in the hind, I commonly find less compensatory adaptive neck, poll, and knee fixations or subluxations. Chiropractic treatment will continue to focus on the reduction of the remaining and recurring fixations, but a change in emphasis will occur in the homework assignments that relate to the need for hind strengthening. Muscle strengthening in Phase II follows the muscle lengthening that was attained in Phase I. Some of the Phase II groundwork stretches and exercises will gradually replace the Phase I assignments. Backing in-hand on the level from Phase I will gradually be replaced with backing up a slight incline in Phase II. This will progressively increase the challenge for deeper pelvic flexion.
Additional ground assignments for Phase II strengthening can include leading your horse forward and perpendicular to a series of 5 or 6 ground poles which are arranged parallel to each other, and spaced slightly farther apart than the length of your horse. Periodically move the series of ground poles closer together, causing your horse to step progressively higher. If you have the luxury of hills nearby, hind strength can also be improved by gradually introducing and increasing hill work initially in hand, or ponied, then under saddle.
I have found that a well-maintained Phase II horse is less likely to have problems with recurring back and pelvic pain, and has a greater spine and pelvic range of motion, with more usable strength. Of course, there are exceptions, including saddle fit issues and trauma, but overall, I find that these Phase II equine athletes attain and maintain their optimal performance.
The “Notes” section of your Summary will provide recommendations or homework to help your horse advance to, and maintain optimal performance. Focusing on muscle strengthening stretches and exercises are key ingredients needed for me to help your horse advance and stay ahead of its work. The back of the Report of Findings Summary outlines the consult episode, and contains a reminder of the online location, username, and password for the assigned homework stretching video for your reference. If a date has been set for my return visit, it will be written on the bottom of your Summary.