Anushka

Anushka - Notes for Veterinary Physiotherapy Session – 14/11/24 Subjective Anushka presented for ongoing back pain. Her posture is good and her body condition score has dropped to 6/9. Saddle fit was assessed and was noted to be acceptable, with slight tipping back and mild loss of flocking contact in the middle. No new concerns reported from owner. Improved over pole work exercises and looks to be happier in facial expressions. Objective Gait Evaluation: o o o o o Walk: Left hip hike observed with increased weight placed on left hindlimb. Tail held to the left, suggesting possible discomfort or postural compensation. Trot: Mild toe drag bilaterally observed. Movement was relatively straight and even, with good tracking up and no forging. Lunge: Canter transition was braced but more willing compared to previous sessions. Less pain expression and overall improvement in comfort. Sand School: Mild lameness noted in the right forelimb, more evident in sand surface compared to firm ground. Turning: Left turn stilted and shuffled with hindlimbs, reluctant to move and bend, better right. Palpation: o o o o o  Left hindlimb:. Left patella unlocking on palpation, suggesting instability or weakness in the left stifle Left Lumbar Region: Palpation revealed muscle spasming and tenderness, especially in the lumbar region. Right thoracic region: Right-sided stuck rib heads and mild mid-thoracic pain. Patella: Left patella unlocking on palpation, suggesting instability or weakness in the left stifle. Quadriceps: Weakness observed in both hindlimbs, particularly left side. Likely contributing to compensatory gait patterns and posture. Progress since last assessment o Anushka is showing improved willingness in the canter transition and less pain expression overall. o Gait abnormalities have decreased (no forging) but mild toe drag and mild lameness remain. o Less pain in the lumbar region than in previous sessions but still significant muscular tension. Plan   Physical Therapy Plan: o Strengthening: Begin targeted strengthening of the quadriceps, focusing on both hindlimbs to improve muscle tone and stability. Specific exercises will include hill work, trotting poles, and transitions to improve impulsion without overloading the back. o Stretching and Flexibility: Implement a stretching regime to address the lumbar stiffness and improve lateral spinal mobility. Gentle stretching exercises will help alleviate spasming and improve flexibility. o Saddle Assessment Follow-up: Recommend a follow-up saddle fitting, particularly to address the tipping back and loss of flocking contact. The saddle should be checked to ensure it is not contributing to the back discomfort – Wait until next visit. Exercise Recommendations: o Hacking: Begin with 10-15 minute hacking sessions twice a week, walking only, to gently increase fitness and allow the horse to move freely in a lowimpact environment. This will promote mobility. o Massage or heat pack to be used alongside stretching. o Remain in walk/trot for now, canter should be able to be included after next session if the back pain and stifle are improved. Monday Tuesday Wednesday Thursday Friday Saturday Sunday Support Stretches Back ups Heat and massage pad Stretches Back ups Heat and massage pad Stretches Back ups Stretches Back ups Heat and massage pad Exercises Long rein Pessoa Hack 20 mins Long rein, Rest Polework Hack 20 - Ladders mins -Mazes or Polewalks