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Resources for Physicians/PTs/etc

I recently had ankle surgery, and while my surgeon and physical therapist have cleared me to ride, the caveat is only if I do six months no stirrups (Fine back in the day, but crawling back on a horse after being off for 8 months sans stirrups is quickly reminding me that I am no longer a junior!)

While I have fabulous physicians, one thing I am coming across again and again is the age-old issue that if you have never really ridden, it is very hard to comprehend what muscles are used and how. I can explain a lot, but I feel like a lot of the small details get lost in translation to a non-riding medical professional - particularly fine muscle movements that we use on a horse that are not easily visible to a spectator. Has anyone ever come across a medical-type explanation of riding that you could share? Most of the resources I am finding just essentially say we activate all the muscle groups – duh!!

TIA!

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Did they say WHY no stirrups? That seems like a weird restriction…

Well, it IS easy to tweak an ankle in your stirrup if you ride with short stirrups and your horse takes a misstep or a hard spook. But if you’re keeping on the flat and riding with relatively long stirrups your ankle should be loose. It needs to flex a little but not much more thank walking or hiking really. I have an old Achilles injury and hiking aggravates it way more than riding.

What’s your disciple? If dressage, maybe you could show your PTS some videos of your riding if you have some? If it’s jumpers they’re gonna say no lol.

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Is there a Sports Medicine Clinic near you? There are two in my area, both operated by orthopedic surgeons - one a former major college quarterback, and the other a skier. I expected these clinics to be filled with football jock patients, but was amazed to find many , many riders there for physical therapy. And the PT staff really know the ins and outs of riding, and consider riding a sport. And they even know that there are different types of stirrups.

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I had a huge osteochondral lesion debridement and patched up with stem cells and new donor cartilage but I think the no stirrups restriction is due to the ATFL repair they did along with it. My surgeon had a riding patient blow out all of his repairs once before so he is a bit horse-shy. PT is worried about me rolling my ankle outward in the stirrup which I don’t really see as an issue but I’m following directions.

Surgery was done by a fantastic surgeon at University of Maryland, which is about a 3 hour drive. I am in a pretty rural area but I am happy with the PT I found. My boyfriend also does post-rehab work (but apparently I don’t listen to him well hmpphh!).

If I could find a medical based resource to explain some of these subtle rider movements I think it could be useful for a lot of people! Most sports medicine people can look at an athlete and understand the main muscle movements easily (and my family owns a sports performance company so we see a lot of this) but its the smaller stuff I want to explain to the medically minded. I even asked a doctor friend who rides and he was a bit stumped on a resource too. All of my googling resulted in extensive research papers on horse muscle movement ha!

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What kinds of thing do you think they won’t understand?

I spent a lot of time in PT last year as preventative to a running issue the prior season, and would talk to the therapist a lot about his patients. He said he could tell you what kind of job they did within a minute or two of hands on treatment. Their muscle tone, balance, strength, flexibility, etc. were all very obvious to him.

While he was a runner himself, and treated a lot of runners and athletes, I definitely think he would care less about the sport itself than your range of motion and comparative strength/weakness areas.

So it might seem to you that the riding specific muscles are most important, but your physical therapist might consider weak glutes to be your biggest liability, regardless of your discipline. (Or core, or something else). For me it was tight hip flexors. Still working on them, but all it takes is one thing out of balance to make you prone to injury/reinjury.

Oh I agree with you 100%. For me, I have a nasty left hip drop (chronic life long issue that I have to keep up with on exercises) that creates ankle instability. They have no problem tackling those issues.

More so I am trying to explain how we use ourselves in the saddle. For example this morning in PT we discussed me using stirrups (still a no go, ugg.) and we we’re using my PT’s hands as a pretend stirrup so I could show her where and how I am applying pressure on my foot/ankle. She was surprised to learn we put the stirrup on the ball of our foot and not the center of our feet, and that led into a discussion of how and when my ankle is at higher risk for instability.

Anyway, with all the great material we have for how horses use their muscles and bodies during different activities I thought it would be useful if there was a similar riding specific resources for humans. Years ago I saw one and can’t find it again.