This is part two in a series dedicated to informing horse owners on the benefits and differences between various horse treatments, specifically massage, acupuncture and chiropractic. Last week we featured Dr. Scott Hie, a doctor of chiropractic, who gave us the lowdown on his work.

This week we are featuring Sidonia McIntyre, RMT, CEMT, CCF, who is the owner/head instructor of the School of Equine Massage and Rehabilitation Therapies in Cottam, Ontario. Sidonia created the program and has run it for the last 18 years. It combines her many years of soft tissue work as a Registered Massage Therapist and her knowledge of horses from her Diploma with Distinction from the University of Guelph in Equine Health Sciences.

HC: What does massage therapy work achieve in horses?

SM: There are two major things that massage effects: increase of circulation of both blood and lymph, and increase extensibility of soft tissues.

The nutrient delivery and toxin removal system is the circulatory system. If we give the horses the proper nutrients, then the body takes care of the rest. Massage will only enhance the delivery of the nutrients and the removal of waste. The lymphatic system is used for waste removal and delivery of hormones. Again, massage can enhance the productivity of this system too! When soft tissues are correctly manipulated, they will soften and will reduce tension allowing joints to move more freely.

HC: Is the work on horses very different than work you might have done on human patients?

SM: I am also a Registered Massage Therapist (for the last 30 years). Yes, there are some big differences in working with horses as opposed to humans. To be quite blunt, horses (animals in general) are just smarter than humans. They know and understand when something just doesn’t feel right and they will become quite adamant in their objections. I cannot count how many times I have had people tell me that their therapist hurt them during a treatment. When asked why they allowed the treatment to continue, I am met with typically three answers: “I thought the pain was a good thing,” “I said nothing to the therapist because I thought they should know better,” and the most horrifying response: “the therapist told me that this intense pain way is the body’s way of getting rid of pain and they would not ease up.”

Animals are just smarter than this and do not tolerate intense pain that has no reason and no end result of relief. Now understand this fully: when we are in pain, there is a certain amount of discomfort in working with tissues that are in distress, but therapists should always let the tissues have breaks from the work and only work to the comfortable tolerance of the client.

Many people also think that animals cannot talk. They are mistaken. Animals cannot ‘speak’ but they certainly can convey their pain, annoyance, or pleasure and also give clear guidance as to where they wish the work to be done for them. They stand still when they like something, move about to position the therapist to work on areas, and even point with their noses to areas they want the work to be done. I have horses that will lift and open their hind legs to allow for access to the inner thighs!

HC: How can you assess where the issues are in a horse before a massage begins?

SM: There are specific physical assessments that are done to determine areas of concern. Range of motion, gait and physical palpation are the three main tools we have to assess.

The jaw is a common site for problems, due to a rider’s strong hands and an incorrect “vertical line.”

HC: What are the most common issues you see?

SM: Hands down, the jaw is the most common issue. This is due to strong hands and the incorrect “vertical line.” The vertical line is created when the horse is asked to come into a collected frame such that if we imagine an invisible line that goes from the centre of the ear down through the centre of the chin, we have our horse in the correct frame. When done exactly correctly, the nuchal ligament and supraspinous ligaments will do all the heavy lifting so the horse’s muscles will not become fatigued. It also gives the correct lift to the back so this also helps the rider to maintain a well-balanced seat.

When the muscles surrounding the hyoid bone are forced into isometric contraction (this is a muscle that stays in contraction without any breaks), this causes extreme pain and swelling of the tissues. It leads to refusals, severe difficulties when asking the horse to accept the bit and in the extreme, bucking from the trot-to-canter transition.

The second most common issue is a combination of irritation of the supraspinous ligament [along the spine] and damage to the lumbar region. This is directly linked to improper saddle fit, especially in two main areas: the valley is too narrow – it should be no less than 4 fingers wide from the gullet to the cantle. A horse’s spine does not narrow from the front to the back, so why are so many saddles built this way?

When the supraspinous ligament is irritated, it causes a natural ducking reflex to occur. “Cold back syndrome” is a description of this very easily-remedied issue. When the saddle tree is too long, it rests on the lumbar region where there is no bony support. The muscles and soft tissues have to work hard to maintain the weight and balance of the rider, which leads to lots of back issues and misalignment in the lumbar vertebrae.

HC: What outcome should an owner expect after one or a few sessions?

SM: After the first session, a horse may experience some soreness. This is not uncommon, as the muscles are literally being worked by the therapist during the entire session; however, most horses show amazing results after even just one session. One student who already worked in the Thoroughbred industry was given the chance to work with Inglorious just before the Queen’s Plate in 2011. The mare had never had a massage before and she was not the favourite going into the race. She ran the race at 2:02:63 ‒ the fourth-fastest time in the last 20 years!

Many people have reported these amazing transformations in their competing horses, but what I always say is that the horse should have a smoother gait. If the gait smooths out, then this means that the muscles and soft tissues are all working together to achieve the best movement possible for that horse. Nutrition, training, ambition of the horse and natural ability will contribute to the success of the horse’s work.

HC: How many sessions are necessary to correct an issue? Should horses be in a monthly or quarterly program, or just when there’s an issue?

SM: This is a tricky question, as there are so many different reasons as to why a horse has an issue. In the case of poor saddle fit or strong hands, if the owner is open to this idea and replaces the saddle with a correctly-fitting one and eases up on the strength of the hands, then the issue can be resolved fairly quickly with only a few sessions. The damage to the soft tissues must be addressed and will not simply resolve if the equipment and riding style is changed.

If there is damage that results in swelling, such as the case of a tear or severe limb swelling, it will take multiple sessions to coax the lymphatic system to remove the swelling ‒ which can be very dramatic with regular continued sessions.

If a horse is in training and in competition, truly they should be receiving regular massages to maintain optimal health and mobility. If someone is competing weekly or even more often, then I would recommend 1-2 sessions per month to keep the horse at their performance level.

Lesson horses should not be omitted from this group! They work very hard as they teach people how to ride and must tolerate imbalanced riders, hands that may not be soft and pliant as they ask the horse to yield freely. If a horse is working every week, they should be at the top of the list for receiving massages 1-2 times per month, or every other week when they are in work.

HC: How does a horse owner know when massage is needed vs. injections, chiropractic or acupuncture?

SM: The honest answer is no one can truly know until the modality is applied. If one thing doesn’t work, then we try another. Horses are not like modern cars where we simply hook them up to a computer and we get a readout that tells us where the exact issue is located. Veterinarians spend tens of thousands of dollars on hardware to help them diagnose issues to help them decide the best course of treatment. Ultrasound and portable x-ray machines are examples, along with some pretty high-tech computer systems that can detect which limb has a lameness issue.

A decent rule of thumb is: if there is no obvious reason for lameness ‒ heat, swelling or a tear in the tissue ‒ and the horse is lame, please call the veterinarian so they can assess the animal and get them out of distress.

When bones are out of alignment, there is a lack of range of motion and the physical examination will reveal an imbalance in the bone material. Typically, but not in all cases, horses that show extreme twitching in muscles need to have acupuncture.

Equine massage therapists truly should be working in conjunction with the veterinarians when there is soft tissue damage, as they have their job to do to diagnose and treat the issue with surgical or chemical intervention while the equine massage therapist can do their part in working with the soft tissues to help the soft tissues get back to good extensibility. Ideally, the horse’s mobility improves with a wonderful lameness-free, smooth gait.