This is just my story and my experience with kissing spine. I’m sure others have equally notable stories since as many as 80% of all horses have some touching of the dorsal spinous processes at some point in their life. First a little introduction. Kissing spine, otherwise known as the Overriding of the Dorsal Spinous Processes is defined in the Merck Veterinary Manual as “Impingement of the summits of the dorsal spines predisposing the horse to back pain. Pressure points between adjacent overriding spines are shown by local periosteal reaction, small bone cysts, and false joint formation. Radiographic lesions of this type are sometimes seen in horses that do not suffer from back trouble, although incidence is lower and lesions are less severe. Diagnosis can be aided by injection of local anesthetic into the affected interspinous spaces. Many cases respond to rest and physiotherapy, but treatment in persistent cases is by resection of one or more of the summits to relieve the crowding of the spines.”
Anecdotal evidence suggests various levels of success in horses returning to full work. Some horses were retired, some could return to a lower level of work and some were able to return to full work and be top competitive horses. I believe age, fitness, confirmation, severity, symptoms and amount of rehabilitation all play a role in prognosis. Each case is individual.
Symptoms include back pain, tightness in the back, being “cold backed”, girthy or agitated when saddling, bucking, bolting, exploding when mounted, refusing to jump or do certain movements, grouchy, unwillingness to perform, hollowing of the back or not accepting the bit. Obviously, these symptoms could describe numerous lamenesses or problems and a veterinary diagnosis is needed to be sure.
Treatment involves relieving pain, correcting the imbalance and problem (if possible) and rehabilitating the horse to develop strong core muscles to support the horses back and allow him/her to hold rider weight. Recently, correcting the problem via surgery is an option to discuss with your veterinarian. Please be advised, no matter what, rehabilitation is the KEY ingredient, especially after surgery. Additional treatments include:
NSAIDS: can help alleviate pain, some horses respond better than others
Injections: Corticosteroids injected in the back and between the vertebra can alleviate inflammation, reduce pain. B12 can be injected into acupuncture points and be part of a Chinese medical treatment.
Shockwave: (positive pressure acoustic waves) is shown to be good for healing bone, tendon and ligament problems. Success has been documented with kissing spine patients.
Mesotherapy: pharmaceuticals are injected in the mesoderm layer of the skin to help healing and to reduce pain.
Acupuncture: based on Chinese medicine, acupuncture relieves pain, rebalances the energetic body to speed healing in both bone and soft tissues and also works along the meridians to release the muscle, tendons, ligaments and fascia.
Myofascial Release: a manual therapy that works on correcting fascial imbalances and snares that pull on the musculoskeletal system creating lameness and pain.
Craniosacral Therapy: energetic manual therapy that concentrates on the bones of the pelvis, sacrum, lumbar/thoracic and cervical spine and cranium (head). Obviously any imbalance here could lay the foundation for developing kissing spine and be a causative factor.
Infrared Therapy/ Magnetic Therapy/ Ceramic blankets and others: all work on reducing pain and inflammation.
Surgery: surgically repairs the dorsal spinous processes and eliminates the touching between the processes.
Horses must be kept in work even if its light work. Time off, stall rest etc does not help correct the problem and may only be palliative. Core strength, muscle development over the top line, and stretching and strengthening the back are all very important factors for having success in bring a “kissing spine” horse back to solid work. However, the rider/trainer must always remember that from day to day the horse may change how he/she feels, sometimes for no apparent reason. Patience is a virtue when training these horses and listening to the horse is imperative. Never should work be demanded or forced on them. Just like other rehabilitation situations, pushing for just a little more without over facing is a very precarious balance and it is easy to cross that very fine line into over expectation.
Building the Core: one of the best ways to build the core muscles of the equine body without the added weight of the rider is through long lining, Pessoa types systems and ground exercises.
Long Lines: horse can be put through dressage exercises and stretch out the back
Core strengthening exercises on the ground
Pelvic tilts
Belly lifts
Carrot stretches
Engaging the core through weight shifts
Combining the above
Adding a leg lift
Pessoa: good to replace basic lunging especially for horses that are tight in their backs.
Riding and Beyond
Start with a long easy warmup including lots of walking. Exercises for suppleness including shoulder in, haunches in, turn on the forehand, turn on the haunches, flexion and counter flexion and frequent changes of direction. All the while encouraging a loose swinging back and no tension in the top line.
Another important aspect is very correct work in short duration. Taking ideas from physical therapy for humans, it is best to do very correct training for 5-10 minutes with walk breaks in between than to haphazardly ride around for 30 minutes. For instance, riding the horse correctly over the top line for 5 minutes (while they can actually hold their body correctly) then free walk for 3 minutes and repeat. When this becomes easy time can always be increased. The same goes for ground exercises. Duration and frequency can always be increased as the horse gains strength and flexibility. For anyone who has trained for a marathon or picked up a new sport, you understand how starting slowly and building is a key component to success. Let me also stress frequency. Rehab doesn’t work if you only do it once a week. Instead, think of riding 5-6 times per week for 15 minutes with sets of quality work for 3-5 minutes. Building this until you reach 45 min rides with 10 minute sets.
Cross training and Building Strength
Not only does cross training keep the horse mentally fresh but it also encourages building of good stability muscles and general conditioning. Navigating trails, logs, jumps, hills etc will greatly increase your horses athleticism all on its own. No amount of ring work can replace this type of conditioning. Starting at the walk, as the horse gains strength trot and canter can be introduced. Hill work even at the walk is hard work and great conditioning exercise. Eventually trot poles, jumping and return to regular work can be introduced as the horse builds strength.
Long term prognosis
How easily your horse progresses through rehab, the better you learn to ride, the more diligent you are in the rehab schedule, the better the horses confirmation and the response to treatment all dictate the prognosis. I find the worst case scenario develops because the rider/trainer was inconsistent in their riding schedule, not because the horse couldn’t succeed.
My own personal experience:
When my horse was first diagnosed (and it took a long time for the vets to find it) surgery was not an option. We opted instead for treating with corticosteroid injections between the spinous processes, mesotherapy, acupuncture, core strengthening exercises, long lining, lunging with the Pessoa system, careful consistent dressage work, cross training and mindful conditioning. It took 3 years of consistent, patient training to get him back. Keep in mind, he had 2 years of rest because the kissing spine was not found originally. In that 2 years he lost all conditioning and all his core strength. I basically had to build him back from nothing. After many years of not thinking he would ever be sound again, he now is back doing 2nd level dressage and enjoying his work. Would he have made it further if he hadn’t had kissing spine… probably. But for a 15h Morgan not bred for dressage, I am really pleased.
September 30th, 2011
I love to read about healthy eating and trying new recipes. Everything from organic, to gluten free and the max…raw food. When I come up with an easy but delicious recipe, I love to pass it on. Here’s my latest new healthy smoothie recipe. Make sure to check my web page for additional ones.
Coconut Smoothie
2tbsp raw organic coconut oil (slightly warmed until liquid)
1 1/2 cups of coconut water
Coconut flesh or re-hydrated organic (unsweetened) coconut flakes
1 vanilla bean or 1 tbsp of vanilla extract
4 pitted raw organic dates
Mix until smooth than add 1-2 cups of ice for a nice cool treat on these really hot days of summer!
June 1st, 2011
Did you know that in 12 hours kinesio tape can drastically reduce bruising? As some of you already know, I recently attended a training seminar on the Kinesio Taping Method. I want to share with you some of the valuable information and techniques I learned. First lets cover just a little history and brief introduction to kinesio taping.
After extensive research, the Kinesio Taping Method was developed by Kenzo Kase DC in 1979. Dr Kase was looking for a method of prevention and injury treatment that continued long after the client left the office. Kinesio tape is an elastic therapeutic tape that mimics human skin. Therefore it does not bind or restrict movement. It is latex free and is meant to be worn for 3-5 days at a time. In addition, it can withstand swimming, showering and fierce competition. Kinesio tape is being used by top athletes in the Olympic games, Tour de France, Kentucky Derby, Pro Soccer, Football and Tennis etc. to enhance performance and protect from muscle injury and fatigue.
Depending on how the tape is applied it can affect skin, circulation, lymphatics, fascia, muscles and joints. It can be used post operative and in the acute, chronic or rehabilitative phase of therapy. Basically it treats the body from the outside in for not only injury but also prevention.
After an assessment by the KT practitioner, the tape is applied according to its principles. KT can (1) Create space to increase movement, blood flow and circulation of lymph (2) Reduce swelling and alleviate pain (3) Provide tactile cue for posture and proper use of the body (4) Increase range of motion and normalize muscle length and tension (5) Assist in tissue recovery and reduce fatigue (6) Improve joint biomechanics (7) Facilitate tendon and ligament function (8) Re-educate muscles and (9) Re-align fascia and fascial meridians. For instance, KT can improve muscle contraction in a weak or atrophied muscle or it can stimulate relaxation in over contracted muscles. It all depends on how the tape is applied.
The list of structures helped by KT is enormous. Basically, you name a body part, muscle, tendon, ligament or joint and KT can help it. And, although new to the horse arena, KT is becoming quite popular and proven effective on horses too. Check it out by visiting www.kinesiotaping.com.
Want to try it out? Give me a call.
We have so many really great alternative modalities to choose from. So much research supporting nutrition, body biomechanics, energy work, holistic medicine, even changing DNA via your brain and beliefs. Its an amazing time to live. Did you realize that in 3 days our body replaces all the cells in the intestines? Or that in 7 years our body slowly replaces our skeleton? WOW! So how do you want to influence your body over the next 3 days to 7 years?
October 4th, 2010
I probably annoy clients with my incessant preaching on frequency of treatment. Whether due to lack of finances or lack of understanding, I find that horses and riders as major athletes are not tending to their bodies enough. Complementary and alternative therapies are not meant to be a once in a while kind of treatment. It is almost impossible for a body to remain in balance on its own. Especially when subjected to stress, wear and tear and the hectic life of today’s culture. Lack of body balance can cause a whole host of issues from muscle and connective tissue injuries to insomnia, headaches, digestive upset, organ dysfunction, emotional upset… the list is endless.
There are many ways to bring the body back into balance including massage, myofascial release, craniosacral therapy, acupuncture, asian body work, yoga, pilates, qi gong, tai chi, alexander technique, feldenkrais, nutritional therapy and herbal therapy to name just a few.
And yes, I even need to remind myself not to neglect my body or my horses’ body because I run out of time, have too much going on or just plain too tired. Luckily, my horses are always my best teachers and yet again they have taught me a valuable lesson. Most of you know how valuable acupuncture and craniosacral therapy has been to my black horse (Indy) that deals with chronic pain issues. Even me, who sees the results on a regular basis, still tends to forget that energetic work is my best line of defense when things go wrong. But my chestnut (Dancer) has been quick to remind me. In the past, he has received regular treatments because (1) I know how important they are for prevention (2) I see his performance blossom when he gets them and (3) well just because I can! 
Most recently, Dancer started acting sore behind from starting more collected work. Being the beginnings of an issue, he is not lame (so a vet probably wouldn’t be helpful) but I wanted to act quickly to prevent a major injury. So, I rested him… no help. Tried medication… no help. Finally I went back to his regularly scheduled treatments and viola… Dancer is back to his ole self.
OK off of my soapbox. The message… get regular treatments for you and your horse. Your body & your horse’s will thank you. Believe me when I say that some prevention now will be well worth the savings in the long run. I have seen it time and time again with clients both human and horse.
October 4th, 2010
How many of us have an imbalance between the right and left sides of our body? Probably just about everyone. It particulary shows up when riding. I myself have trouble with my left shoulder girdle and my right hip, Interestingly, I recently came across a theory in “Anatomy Trains” by Thomas Myers that explains some of these disparities between our right and left sides. First let me give some background in myofascial release.
What exactly is fascia?
Fascia is the fibrous body or connective tissue that holds the body together. It is a mesh or web that infiltrates every part of the living body and acts as a glue. Without it the body would be a puddle of gooey mess and bones on the floor. If one could remove all of the other components in the body and just leave the fascia you would still have the shape and look of the body. Damage to this system causes distortions in the system and therefore compensations and pain. Sometimes these symptoms are not near the located site of distortion. Strain on muscles or fascia for whatever reason (injury, improper posture and training, overuse etc.) will create trigger points and also a electric charge. This electric charge will travel through the fascia to surrounding muscles and beyond (in both directions along the meridians lines) causing distortions along these lines. This snag in fascia is communicated across the entire system below conscious awareness and the body creates a change in shape in the connective tissue that stays unless altered for better or worse. Releasing these restrictions not only bring the body back into balance and allows us to use our body more properly and efficiently but also relieves pain.
Thomas Myers writes about the lines along the body called fascial meridians where the strain will “run” and connect to various body parts. This is why one may have a pain in one part of the body but need a fascial release in another part of the body to relieve it. One such meridian that I want to discuss today is the Spiral Line. First let me say that dysfunction in the spiral line usually involves and affects other fascial meridians lines. However, as it relates to my own body’s imbalance I found it extremely interesting.
The spiral line begins at the junction of the occipital bone with the temporal bone on the back of the head. It crosses over the mid line and wraps underneath the opposite scapula, around the rib cage, crossing the mid line again to the iliac crest. From here traverses down the anterior lateral part of the leg, into the arch of the medial foot, across the foot to the lateral side of the heel, up the lateral side of the leg, across the buttocks then up the back alongside the spinal column and finally ending on the occipital. Remember this runs bilaterally connecting each shoulder to the opposite iliac crest. The spiral line also plays a role in the diagonal pair lameness we commonly see in horses.
However, more importantly is the common compensatory postures that arise from restrictions anywhere along this line. They include ankle pronation or supination, knee rotation, ilio tibial (IT) band problems, pelvic rotation, rib rotation in relation to the pelvis, one shoulder lifted or anteriorly displaced, and a head tilt or rotation. In me this manifests as a problem with my right shoulder high, left shoulder girdle including ribs displaced and pulled to my right iliac crest which makes my right hip seems to float in nowhereville. To compensate then I have trouble with uneven leg length issues.
Body work is needed on the splenius, rhomboids, all the attachments on the anterior spine of the iliac crest, iliotibial tract, tibialis major, peroneus, biceps femoris, sacral tuberous ligament, sacral fascia and erector spinae muscles.
So what does this all mean? It means that the fascial restrictions in the spiral line and sometimes other fascial meridian lines are responsible for the postural rotation or spinal twist we feel and see in our riding. For instance, if the rib cage is restricted and protracted on one side it will involve the shoulder pulling the upper back and lower neck toward the shoulder. In relation the opposite side of the pelvis will also shift toward the lower shoulder. The sternum may collapse and the head tilt forward. Finally one or more knees may rotate inward or outward, and the ankles may develop tightness.
How do we correct it? One by working on it while riding and teaching yourself to let go of holding patterns. This can be a slow and painful process but teaching yourself positional awareness is an important tool in body balance. Second, yoga exercises. In particular, spinal twist poses like the Triangle pose and the Seated twist, Warrior pose and Upward Dog. Third, go for treatment in acupressure, acupuncture, craniosacral therapy that release myo fascial restrictions.
June 17th, 2010
In my quest to not only become a better practitioner but also a better rider, I am constantly engrossed in journeys to expand my knowledge. Therefore, I feel compelled to share some quotes and notes from my most recent book readings. The following info is applicable to all horse owners but especially those wanting to better understand the physiology of horse movement and biomechanics.
Usually when vets treat musculoskeletal problems they can only concentrate on resolving the changes that have already taken place in the body. For example, treating bony changes in the hock and usually the accompaning hock pain. They usually don’t treat or speculate about the causes that precipitated these changes. Alternative practitioners and riders should be asking what predisposed this horse to these changes. What imbalances in the body or the riding has precipitated this diagnosis. Sara Wyche states in The Horses Muscles in Motion that “the only way we can ride the horse without causing him permanent damage is by utilizing the way in which he, himself, raises the forehand off the ground: namely by using the muscles of the back and of the hind limbs.” Sara goes on to say that degenerative changes in the bones of the horses back are a sad reflection of the way we ride. Personally in my practice, I have found this to be a major reason why most horses suffer from restrictions in their sacrum, pelvis and lumbar regions. Sometimes it is from past experience and riders but non the less precipitated by humans.
So along this thought pattern, we concern ourselves about the condition of the muscles for they propel the horse forward and are responsible for self carriage, the condition of the ligaments and tendons for they allow the muscles to properly influence the bones, and the bones for they supply the structural foundation. Especially important is the pelvis for it protects the internal organs and is the powerhouse of the horse, being responsible for attachment of large muscles that transfer movement to the spine and forward. Therefore, the pelvis, sacrum and their fibrous junction, the sacro iliac joint , is truly the bottom line and one of the most important structures in the ridden equine.
The psoas and iliopsoas are deep muscles which are important in the horses ability to raise the forehand. The psoas muscle begins inside the ribcage. “Its origin covers the area of the last three ribs, including part of the diaphragm muscle, and the underside of four of the lumbar vertebrae. From here it narrows to insert on the medial side of the ilium. The iliopsoas consists of two parts, one that begins under the lumbar vertebrae and one that begins under the ilium and sacrum. The two parts unite, and insert on the medial side of the femur.” (Taken from the Horse Muscles in Motion by Wyche) The psoas minor and iliopsoas muscles are perhaps the most important muscles in the ridden horse. The successful transfer of power and impulsion from the hindquarters is dependent upon them. In addition, the quadriceps femoris which extends the stifle and is linked to the hock aids in the horses ability to collect. This dynamic interaction of muscles is apparent in engagement of the hindquarters. For in order for the horse to bring his hocks under his body, the pelvis must be lowered and the lumbar spine stabilized. This is in large part the responsibility of the psoas minor and iliopsoas muscles.
This brief description is not comprehensive but allows us to start thinking in a biomechanical way (1) how we ride the horse, (2) how we train them to use themselves and (3) how we prevent injury by encouraging the proper use of self. Maybe next time we will cover rider biomechanics . Until then,
Rebecca
April 26th, 2010
