Ligament adhesions in horses - does anyone treat this?

[Demerara_Stables]

Tl;dr - does anyone treat ligament/tendon adhesions in horses or massage ligaments/tendons in response to joint pain?

Went to my long time PT this morning for some annoying knee pain that’s existed for a few months. Only acts up when I’m on my feet for many hours, moreso on concrete. Pain is accompanied by moderate effusion. I haven’t had full range of motion since May, and I basically couldn’t kneel at all. I was worried I was Getting Old™ and was going to need some sort of joint injection. I’ve not gone to the doctor for this pain, so have no idea what it looks like on x-ray. I would for sure be 4/5 lame on a stifle flexion. My incredible PT (who specializes in knees) spent an hour massaging the ligaments around my knee, with a few pauses to check range of motion and pain level. After an hour, I can squat and kneel with almost no pain.

Bodies are bodies, so I have to imagine this technique would work on horses that have similar adhesions/effusion (not degradation of cartilage/arthritis, although who knows if I have that as well?). Has anyone heard of this being done to horses? I imagine there aren’t too many joints where the ligaments are accessible for massage, but I think the stifle might be one. It just blew my mind how much it helped, and I’m certain a doctor would have gone straight to injecting (as some vets would). I’ve heard of and experienced more vets recently going straight to injections based on flexions and not X-rays, so personally I’d be well within the injection protocol.

Thoughts?

[Ghazzu]

Aside from possibly the suspensories, I’m not sure what the ligaments would be adhered to.

[Demerara_Stables]

Maybe adhesions was the wrong word - scar tissue?

“Also, if you have an MCL sprain (medial collateral knee ligament), it can possibly be helped with massage. Cross Friction Massage is the modality used on the tendon or ligament, using Deep Tissue and lighter pressure massage. This loosens the scar tissue and helps with the healing process.”

Source: https://www.healingtouchcharlotte.com/2023/08/17/can-massage-help-a-knee-injury/

(I found similar advice on a few sites, this is just the one I quoted)

[Renn_aissance]

I see a PT/massage therapist for myofascial release and scar tissue manipulation (I have a hole in one leg, it’s a problem.) We got to talking about this for horses after I’d relayed a conversation I had had with my farrier about MFR as an intervention for rotational deviation in the forelimb. Apparently, Mark Barnes (son of John Barnes, one of the major teachers of MFR) has a course on MFR in horses and there are equine body workers who specialize. My therapist thought she knew of someone in CT, but no one in MD, where we’re located.

So, if you’re going to google, equine myofascial release + Mark Barnes + your area might be a set of keywords to find somebody.

[Demerara_Stables]

Great, thank you!!

[Ghazzu]

Myofascial release is a remarkable tool.
Massage, in general, done by a well trained practitioner, can have significant beneficial effect.
I’m just trying to figure out what the stifle ligaments might be adhered to.

[Demerara_Stables]

I don’t think he meant (in my knee) adhesions to other things, I think he meant adhesions or scar tissue in the ligament itself, or fascia adhesions.

[Ghazzu]

@Demerara_Stables

adhesions or scar tissue in the ligament itself

Adhesion implies the attachment of one structure to another. Not sure how that could be within the structure itself.

[Demerara_Stables]

Well I’m not a vet or a doctor so I’m not exactly sure but he said adhesions. Maybe he’s talking about adhesions to the fascia?

[Renn_aissance]

@Demerara_Stables

Maybe he’s talking about adhesions to the fascia?

Probably. Fascial adhesions are when the fascia gets gummy, wrinkled, and lumpy instead of smooth. Depending on how your body forms fascia, they can glue muscle fibers together. I’ve currently got a combination of scar and fascia that’s binding my whole leg down from ankle to hip, which is a bit of a problem, so I’m familiar with the benefits of getting rid of these adhesions… although I haven’t figured out how to foam roll my horse. (The posture prep tool videos show some equine MFR techniques. I don’t know if they work because I’m not a professional. I do know my horse likes them.)

[Ghazzu]

I grok the concept of fascial adhesions.
I’ve seen some excellent myofascial release performed. It’s pretty damned impressive.
.
I’m limiting my query to wondering where ligamentous adhesions would be found in the stifle joint–which ligaments, and how might they be addressed by massage?

[Demerara_Stables]

@Ghazzu

where ligamentous adhesions would be found in the stifle joint

Adhered to the fascia.

[Ghazzu]

Which ligament(s)?

[Demerara_Stables]

Seriously. Are we going to keep going round and round? I had an experience and described what my PT did, and asked if anyone does this for horses. If you don’t know of anyone doing that, say so.

[Ghazzu]

OK, then.
I don’t know of anyone using massage to break up adhesions in the ligament itself.

[CanteringCarrot]

Do you mean lesion(s)?

Although I do find fhe fascia adhesion thing interesting.

[Demerara_Stables]

No, definitely not lesions. Adhesions, presumably to fascia.

[Renn_aissance]

I think what you’re asking is whether the fascia can develop adhesions to the ligaments in the stifle region, which might contribute to difficulties with mobility of that joint; so, you wonder if MFR or other manual therapies could be useful in improving joint mobility where either the fascia or the problem tissue is accessible to the therapist. Is that right? Your question made it sound like you were wondering about adhesions inside of the ligament itself or between the ligament and the bone, but I don’t understand that to be the heart of your question.

I think the answer is yes, I tried to do some very amateur MFR for my horse when his stifles troubled him earlier this year, and I have no idea if it did anything, but he liked it.

The conversation I had with my farrier (about MFR as an intervention for rotational deviation in the forelimb) also made me wonder about fascial work for lower limb ligament injuries. Keeping the fascia moving smoothly is not going to heal the suspensory, but I wondered about regional inflammation contributing to adhesions or scar tissue development outside of the lesion itself. I imagine that that could pose a mobility challenge for the healing ligament- it’s operating at half capacity or whatever trying to do its job and there’s all this crap in the way.

@Ghazzu, since you mentioned you’ve seen this performed and you know it can be effective, I’m curious about applications where you think it might be particularly useful as a complementary therapy or where you’ve seen it make a difference in your population. For example, my particular human use case often involves my IT band, which needs to be pried up off my hamstring with a crowbar, and that and the TFL do a lot of heavy lifting in a lot of human ranges of motion and also are not super responsive to other types of soft tissue work. Are there equine structures like that that are often problematic in the equine athlete, and by their nature, might not respond to massage, but might be relieved by MFR?

I’d love to have this conversation with my vet but I also hope not to see her until it’s time for the fall physical…

[SpicyPRE]

@Demerara_Stables

. I’ve heard of and experienced more vets recently going straight to injections based on flexions and not X-rays, so personally I’d be well within the injection protocol.

If any veterinary or medical professional injects without full diagnostics, that is very problematic.

[Ghazzu]

@Renn_aissance

since you mentioned you’ve seen this performed and you know it can be effective, I’m curious about applications where you think it might be particularly useful as a complementary therapy

I’ve never seen myofascial release done on a ligament.
By definition, it is done on muscle fascia–that’s the “myo” part.
It is, IME, a very subtle and non-aggressive form of therapy.
The first time I saw a demonstration was at either an acupuncture or chiropractic conference. Was eons ago, so can’t recall which.
Done on a mare who was described as a very $$$$ fancy performance horse. (Don’t recall if it was dressage or hunter, but I think hunter.)
She was brought out and I looked at her and thought to myself that somebody got taken by paying $$$$ for that horse.
Then the massage therapist put her hands on the mare and seemed to be just standing there doing nothing.
Over about 10 minutes, that horse’s whole outline changed, she shifted her stance, the expression in her eye softened, and she looked wonderful.
Since then, I’ve seen other horses have similar reactions.
I’ve not seen it done with any force.
Certainly PT is an integral part of preventing adhesions in equine lower limb injuries.
–tendon/tendon sheath adhesions and perhaps suspensory and check ligament as well.
I’m not sure I’d call those fascial issues though.
Working with the various digital flexor or extensor muscles would likely be beneficial in treatment of injury to the associated tendons.