George

George Aspinall 27 Yr Old Gelding Welsh 14.2hh Subjective    History: George is a 27-year-old Welsh gelding ridden a couple of times per week – ridden by a novice and doing low-level work for leisure. No queries re saddle or tack. Presenting issue: Reduced flexion in carpal joints, due to arthritis. Reports of stiffness – main aim is comfort and identify areas to improve. Previous hindlimb injury to straight sesamoidean ligament too. Behavioral signs: Lovely nature and temperament. Can be stiff when stood in for long periods. Objective Gait Assessment:      Walk: Hip hike on the right, tail held to the left, close movement with forelimbs and hindlimbs. Straight foot placement. Base narrow. Trot: Good rhythm; straight and slightly under tracks with stilted movement. Head carriage lowered in trot, neck has left bend with slight nose tilt right. Turning shows normal foot flight, placement, and timing. Palpation: o Tightness in left pectorals and right brachiocephalicus. o Limited neck flexion to the right. o Tender areas: Trapezius, lumbar region, hamstrings, and gracilis. Range of Motion: o Limited limb ROM, especially in the carpal joints. Hindlimb retraction left hind was difficult to lift. o Thoracic spine has limited dorsiflexion. o Pelvic motion is good. Assessment   Primary Factor: Arthritis in the carpal joints, causing decreased flexion and compensatory gait changes. Secondary Issues: o o o Muscle tightness in pectorals (left) and brachiocephalicus (right), indicating muscular imbalances possibly related to altered gait or compensatory mechanisms. Tender areas over trapezius, lumbar, hamstrings, and gracilis suggest discomfort likely due to secondary strain from altered biomechanics. Limited ROM in limb joints and thoracic spine Plan   Treatment Goals: o Increase ROM in carpal joints and limbs. o Reduce muscle tightness and discomfort. o Improve overall gait mechanics to prevent further strain and discomfort. Therapeutic Interventions: 1. Manual Therapy:  Soft tissue massage and myofascial release targeting tight pectorals, brachiocephalicus, trapezius, lumbar region, hamstrings, and gracilis. 2. Stretching:  Gentle neck and limb stretches to improve ROM.  Focus on gentle lateral and ventral flexion of the neck, and stretching of the forelimbs and hindlimbs. 3. Thermal Therapy:  Heat therapy to relax lumbar region 4. Strengthening Exercises:  Core strengthening exercises to help improve posture and stability. .