Equine spa therapy

 
Equine Spa therapy and its use in the treatment of tendon injuries

Hydrotherapy is the use of water to cure, heal or improve pathologic conditions or to maintain and improve health. Water has been used in therapeutic treatments throughout history, where it was thought that the mineral concentration and the temperature of some waters would help relieve pain and improve the function of the affected area. Hydrotherapy is now widely used in both human and equine complimentary medicines to treat muscle and joint injuries, and surgical wounds.

Spa Hydrotherapy is now being used more frequently in the treatment of tendon injuries in sports horses, such as tendonitis and desmitis, and it is suggested that a horse could return to competition in little more than a year. However it is used more commonly on high value sports horses as a course of treatments is usually required, and this can be quite costly.
 

 
 
Tendon injuries, for example those caused by strain, are increasingly more common in horses, especially competitive sport horses. The tendons of the distal limb in horses are important weight bearing structures, and often during training or competition loads are placed on the tendon that are close to the physiological limit the structure can bear. Spa Hydrotherapy is being used more on horses with tendon injures, as aspects of the treatment are thought to have beneficial effects on the injured structure, these factors are listed below:

1    Temperature

Cryotherapy is the application of cold to an injured or inflamed area, and is used quite commonly to treat soft tissue injures in both humans and horses. Cryotherapy is used often on horses by cold hosing, as it is easy to apply both at home and at competitions. Cold temperatures first cause a reduction of circulating blood in an area, however when the temperature becomes too low there is a rush of arterial blood which restores the area to a normal temperature, it is this principle that causes a reduction in filling of a limb in horses, and increased circulation. The temperature of a Hydrotherapy Spa bath is usually between 5oC – 9oC.

Reducing the temperature of a soft tissue (such as tendons) helps to maintain the elastic properties of the tissue by stabilising the structure. However it can increase the stiffness which may prove to be detrimental, as a less pliable structure may be more susceptible to further injury. For this reason the horse should not be worked directly after any treatment, and allowed to rest.

A cold temperature has also been shown to have an analgesic effect, after the tissue has been cooled to between 10oC and 15oC. This is because a low temperature reduces the speed of nerve conduction, therefore relieving pain. However it is only effective for a short period of time.
Cold temperatures are also effective at reducing swelling in cases of acute inflammatory tendonpathies. it inhibits the inflammatory response by constricting blood vessels, and reducing blood flow to the treated area.
 
 

2    Salt Concentration

Salt (saline) is often used in equine spa pools for treatment of soft tissue injuries. The horse stands in a strong solution, with the water temperature between 2oC and 4oC. The water is then agitated, often using jets of air in spa pools, as this compresses the limb. Osmosis occurs within the tissue cells, and filling in the limb is reduced. Salt solutions are used frequently in the treatment of tendon breakdown, sore shins, Lymphangitis and for the treatment of superficial wounds.

3    Aeration

Hydrotherapy usually involves a massaging action produced by a current that is created by air injected through the water; the type of massage created is smoother and more constant than that conducted by a masseur.  It is suggested that underwater massage improves circulation, however this theory requires further research as the circulatory action of the lower leg is controlled by the pump action of the frog.

4    Hydrostatic Pressure and Depth

Hydrostatic pressure is the pressure exerted on a submerged object, and Pascal’s law states that fluid pressure is exerted equally on all surfaces of a body at a given depth, and that the pressure is proportional to the depth and density of the fluid. Hydrostatic pressure on a limb helps to reduce swelling by stopping blood from collecting in the lower parts of the body. It also helps to stabilise unstable joints.
 

 
Further reading:

Aquatic Exercise Therapy Bates and Hanson (1996)

Equine Injury, Therapy and Rehabilitation Bromiley (2007)

Cimbiz, A., Bayazit, V., Hallaceli, H. and Cavlak, U. (2005) The effect of combines therapy (spa and physical therapy) on pain in various chronic diseases. Complementary therapies in medicine 13 (4) pp. 244-250

Hunt, E. R. (2001) Response of twenty-seven horses with lower leg injuries to cold spa bath hydrotherapy. Journal of Equine Veterinary Science. 21 (4) pp. 188 – 193

Ramey, D. W. (1999) Cold Therapy in the Horse. Equine Practice. 21 (1) pp. 19 - 21

Scanlon, E. J. (1983) Equine Hydrotherapy. Modern Veterinary Practice. 64 (2) pp. 148 - 151