Remy

Physiotherapy Notes and Exercises – Remy Watson - 221124 S: Subjective History of neglect as a youngster. Weight and BCS good. 6/9. History of mites and of scabs on heels, some present but not painful. Saddle fit not a concern. Remy has been displaying some head tipping behaviour and holding his neck to one side in the canter and is reluctant to canter with the correct footfall. Recently came out of the stable and was 8/10 lame on his left hindlimb. No obvious injury or event. Better with exercise. Remy presented today a little lethargic and 3/10 lame left hindlimb. He has had a previous episode of similar onset 12 months ago which resolved with NSAIDs and rest with gentle work. Hindlimb retraction, protraction, and flexion appeared good. Right hamstring increased in tone. O: Objective Gait Assessment: Overall straight movement.Bilateral forelimbs demonstrate lateral circumduction at the carpal joint. Turning maintained a good rhythm; however, hindlimbs were stilted and reluctant. Neck bend appeared restricted on the turn. Mild left hindlimb lameness present but less severe than originally seen. Right hip pulled cranially and left side had a drop. Palpation: Tight fascia noted in the left neck region. Neck bend appeared restricted. Reduced lateral neck bend bilaterally, more so on the right at C3-5. Left trapezius and longissimus muscles reactive, more pronounced on the left. Pelvic motion observed to be good in both flexion and extension. Left stifle: Mild effusion noted in the middle to lateral patella ligament space, but no heat or pain upon palpation. Mild tension and effusion observed medial to the tarsus on the left hindlimb. A: Assessment Restricted neck mobility with a focus on C3-5 may be contributing to head tilt when ridden. Tension here will travel through the body and may be primary or secondary in cause. Back pain on the left more than the right feels compensatory as range of movement is good. Left stifle muscles were markedly reduced compared to the right hand side. This shows this is potentially a chronic injury which is flaring as show by the effusion of the stifle and tardal joint. Flexion of the joints is not an issue as there is no crepitus or pain signals from Remy, albeit he is reluctant to pick up the limb. Increased hamstring tone will be compensatory. P: Plan