GLOBAL PHYSIOTHERAPEUTIC ASSESSMENT OF THE LOCOMOTOR SYSTEM OF THE HORSE: POSTURAL STATIC ANALYSIS

It is important to note that this blog intends to modify the classic analytical approach of the assessment and treatment of injuries for a global treatment approach. For that reason when an injury occurs we must avoid evaluating and treating the alteration as a singular part as muscles, tendons, ligaments and other soft tissues are directly and indirectly interconnected from the head to the tail through the myofascial system as we have already described in the previous posts.

An example is found when we evaluate the primary sign of lameness and find other secondary muscular alterations throughout the musculoskeletal system; Treatment of secondary areas can relieve pain but if the initial problem is not treated, pain in those areas will persist.

Below you can find a detailed description of how to carry out a global assessment of the horse following a postural analysis of the sagittal plane according to a grade III of scientific evidence by Alba Lozano:

  • Position of the fetlock in relation to the hoof: in order to analyze it we need a plumb.  Its line will be drawn from the midpoint of the fetlock to the ground. Physiological position places on the vertical line at the back of the hoof. If the distance is increased or decreased, non-physiological tensions will occur at the musculoskeletal and articular level.
  • Position of the cannon in relation to the fetlock: the plumb line will be drawn from the midpoint of the carpus / hock to the midpoint of the fetlock. Physiological position of the cannon places the plumb bob without deviations with the points previously described. If deviations occurs in any direction non-physiological tensions will occur at the musculoskeletal and articular level.
  • Position of the ulna and radius in relation to the cannon: the plumb line will be drawn from the midpoint of the articular line of the elbow to the midpoint of the carpus. Physiological position of the ulna and radius places the plumb bob without deviations between the points previously described. If there are notable deviations in any direction non-physiological tensions will occur at the musculoskeletal and articular level.
  • Antero / posterior inclination of the humerus in relation to the ulna and radius: the plumb line will be drawn from the greater tubercle of the humerus to the midpoint of the articular line of the elbow. Physiological position places the analyzed line forming an angle of 30⁰ in relation to the correct vertical that runs through the entire forelimb up to the withers. If there are notable angular deviations in any direction non-physiological tensions will be produced at the musculoskeletal and articular level.
  • Antero / posterior inclination of the humerus with respect to the hoof: the plumb line will be drawn from the midpoint of the humerus to the ground. Specifically:
    • Humerus neutral if plumb line of the midpoint of the humerus is located at the midpoint of the hoof.
    • Humerus inclined anteriorly if plumb line of the midpoint of the humerus is located in front of the midpoint of the hoof.
    • Humerus inclined posteriorly if plumb line of the midpoint of the humerus is located behind the midpoint of the hoof.
  • Antero / posterior inclination of the scapula in relation to the humerus: the plumb line will be drawn from the midpoint of the spine of the scapula to the greater tubercle of the humerus. Physiological position places the analyzed line between the aforementioned bone structures forming an angle of 45⁰. If there are notable angular deviations in any directions non-physiological tensions will be produced at the musculoskeletal and articular level
  • Antero / posterior inclination of the scapula in relation to the hoof: the plumb line will be drawn from the midpoint of the spine of the scapula to the ground. Specifically:
    • Neutral scapula if the plumb line of the midpoint of the spine of the scapula is located at the midpoint of the hoof.
    • Scapula inclined anteriorly if the plumb line of the midpoint of the spine of the scapula is located in front of the midpoint of the hoof.
    • Scapula tilted posteriorly if the plumb line of the midpoint of the spine of the scapula is located behind the midpoint of the hoof.
  • Antero / posterior inclination of the tibia in relation to the cannon: the plumb line will be drawn from the head of the fibula to the midpoint of the hock. Physiological position places the analyzed line between the aforementioned bone structures forming an angle of 65⁰. If there are notable angular deviations in any directions non-physiological tensions will be produced at the musculoskeletal and articular level.
  • Antero / posterior inclination of the tibia in relation to the hoof: the plumb line will be drawn from the midpoint of the tibia to the ground. Specifically:
    • Neutral tibia if the plumb line of the midpoint of the tibia is located at the midpoint of the hoof.
    • Tibia inclined anteriorly if the plumb bob of the midpoint of the tibia is located in front of the midpoint of the hoof.
    • Tibia tilted posteriorly if the plumb line of the midpoint of the tibia is located behind the midpoint of the hoof.
  • Anterior / posterior translation of the stifle joint: to assess if exists a translation of the knee we must observe the position of the tibia. Specifically:
    • If the tibia is in a neutral position, the knee will be in a neutral position.
    • If the tibia is in anterior inclination, the knee will be in anterior translation.
    • If the tibia is in posterior inclination, the knee will be in posterior translation.
  • Antero / posterior inclination of the femur in relation to the tibia: the plumb line will be drawn from the trochanter of the femur to the head of the fibula. Physiological position places the analyzed line between the previously mentioned bone structures forming an angle of 10 degrees. If there are notable angular deviations in any directions non-physiological tensions will be produced at the musculoskeletal and articular level.
  • Antero / posterior inclination of the femur in relation to the hoof: the plumb line will be drawn from the trochanter of the femur to the ground. Specifically:
    • Neutral femur if the plumb bob of the trochanter of the femur is located at the midpoint of the hoof.
    • Femur inclined anteriorly if the plumb line of the trochanter of the femur is located in front of the midpoint of the hoof.
    • Femur tilted posteriorly if the plumb bob of the trochanter of the femur is located behind the midpoint of the hoof.

  • Analyzing the position of the femur we can extract that:
    • When the femur is located in a neutral position the pelvis is neutral.
    • When the femur is tilted anteriorly, an anterior translation of the pelvis occurs.
    • When the femur is tilted posteriorly, there is a posterior translation of the pelvis occurs.
  • Antero / posterior tilt of the pelvis in relation to the femur: to analyze pelvic-femoral myofascial tensions, it is important to assess the position of the pelvis with respect to the femur and not with respect to space. In order to make a correct assessment, we must draw a plumb line from the coxal tuberosity of the pelvis to the trochanter of the femur. Physiological position places the analyzed line between the aforementioned bone structures forming an angle of 105⁰. If there are notable angular deviations in any directions non-physiological tensions will occur at the musculoskeletal and articular level, specifically:
    • Anterior inclination of the pelvis if the angle of the pelvis with the femur is less than 105⁰.
    • Posterior inclination of the pelvis if the angle of the pelvis with the femur is greater than 105⁰.
  • Antero / posterior translation of the thorax in relation to the pelvis: to assess a possible translation, it is necessary to analyze where the thoracic apex is located (highest point of the thoracic vertebrae or withers) in relation to the sacral apex (sacral tuberosities). Plumb line will join the two apexes. The possibilities that we find are:
    • Neutral thorax if the thoracic apex is located vertically from the sacral apex.
    • Thorax in posterior translation if the thoracic apex is located above the sacral apex. In certain equestrian disciplines this type of conformation is preferable.
    • Thorax in anterior translation if the thoracic apex is located below the sacral apex.
  • Antero / posterior translation of the head in relation to the thorax: to assess the possible translation of the head with respect to the thorax, it is necessary to analyze where the cranial apex is located (highest point of the skull) in relation to the thoracic apex (highest point of the thoracic vertebrae or cross). Specifically:
    • Neutral head if the cranial apex is located vertically to the thoracic apex.
    • Head in posterior translation if the cranial apex is located posterior to the thoracic apex.
    • Head in anterior translation if the cranial apex is located anterior to the thoracic apex.

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