Clinical TechniqueStretching Exercises for Horses: Are They Effective?
Introduction
Stretching is a common practice before participation in human sports and competitive activities. Athletic directors, physical therapists, coaches, and trainers recommend exercise programs that include stretching in an effort to improve flexibility, relieve pain, prevent injury, and enhance performance. Flexibility (lack of tightness) is an intrinsic property of the body tissue that determines the absolute ROM in a joint or series of joints that is attainable in a momentary effort with the help of a partner or piece of equipment. It is specific to the type of action performed at the joint.1
Static flexibility of a joint is measured by tools such as a goniometer, and is reported as degrees of ROM, commonly of flexion or extension.2 The improvement of short-term flexibility that results from stretching has been documented.3, 4, 5, 6, 7 Dynamic flexibility is the ability to perform dynamic (or kinetic) movements of the muscles to bring a limb through it a full ROM in the joints. This is seen when a cancan dancer swings her leg around from the hip and then twirls the knee. Active flexibility is the ability to assume and maintain extended positions using only the tension of the agonists and synergists while the antagonists are being stretched. An example here is the splits. Passive flexibility is the ability to assume extended positions and then maintain them using only your weight, the support of your limbs, or some other apparatus.1 With horses this would be your support aiding the stretch of a leg.
Stretching exercises are designed for athletes to target specific body regions or tissue related to sporting activities based on the joints and muscles most commonly affected. Availability of this information has led veterinarians, therapists, horse owners, trainers, and riders to use stretching exercises with similar reported benefits for their horses.
Some benefits include regaining proper balance (right to left and front to rear proportions), flexibility, and body awareness, proprioception, or limb placement.7 Proprioception can improve with exercises and stretching specifically designed to stimulate the central nervous system's primary input fields such as the mental status and sensory input from the surroundings along with the body's relationship in space to that environment. In addition, stretching of specific muscles and joints for specific activities might enhance the effectiveness of other pre-exercise activities (eg, in horses these could be lounging, bringing the head around while in the saddle, walking, and loping as a warm-up), which is an approach consistent with a multifactorial model for injury prevention.8
Evidence demonstrates that stretching increases flexibility and might improve performance or decrease the risk of injury.3, 6, 9 Compared to control study groups those that performed stretching exercises had an increase in ROM and stretch tolerance after 4 weeks of stretching, with no change in muscle stiffness, work absorption, or delayed onset muscle soreness. After eccentric exercise, they also had greater ROM and stretch tolerance.10
The purpose of this manuscript is to discuss the following issues.
- 1.
Review of literature and proposed mechanism of action to assess whether stretching can actually improve ROM and prevent injury.
- 2.
What evidence exists that stretching can relieve pain?
- 3.
When are stretching exercises appropriate?
- 4.
What types of stretching exercises are appropriate for horses?
- 5.
Provide an example of a stretching exercise protocol.
Section snippets
Review of Mechanisms of Action
Stretching increases the joint ROM through increases in the compliance and decreases in the viscoelasticity of resting muscle.5, 6, 11, 12, 13, 14 Compliance is the willingness of tissue to lengthen with very little force and is the reciprocal of stiffness. Compliance is most necessary during the active phase of muscle contraction as that is when most injuries occur.11, 12, 13, 15, 16
Viscoelasticity refers to the presence of both elasticity and viscous behavior. An elastic substance will
Stretching Methods
Important steps to preventing muscle strain injuries include warming the muscles and joints prior to exercise, stretching (pre-exercise, postexercise, time outside of exercise) and improved flexibility.11, 13, 22, 26, 27
Warming up tissue before stretching has consistently shown to produce improved benefits for increased ROM and flexibility.3, 5, 19 Heating augments the increase in ROM achieved by stretching by increasing the extensibility of collagen within the tendon and joint capsule. Heat
Clinical Applications
A regular stretching routine for prevention of injuries is important for all performance horses but is especially important for stalled horses. These horses do not have the opportunity to graze, flex, and extend joints through their ROM, or engage muscle groups throughout the day outside of their training program. If a program is not based on cross training, many muscle groups may rarely be engaged, if at all. The in-saddle training “warm-up” does not compensate for good regular ground
Case History
A 7-year-old 3-day Eventing Warmblood with a 2-month history of changes in willingness to take a right lead and flex to the left, loss of tone in gluteal muscles, tenderness over lumbar region, slight kyphosis, base narrow stance, shifts weight off right rear. PEX: No soft-tissue trauma, joint flexion tests normal, chiropractic adjustments to correct; restricted dorsoventral motion in right pelvis, low lumbar spinous process left rotation, mid lumbar dorsoventral restriction, upper lumbar left
I. Rear Leg Stretch Series
- A.
Image 1 (Figure 1): Forward Pull–Hind limb protraction exercise. The gluteal muscles and tensor fascia latae work to pull the rear limb forward and flex the hip. The hamstring muscles will be extended and stretched during this exercise. It will also engage the lumbar region to extend.
- B.
Image 2 (Figure 2): Quadriceps Extension–Hind limb retraction exercise. Extension of the hip is controlled by the semitendinosus, semimembranosus, and biceps femoris. The quadriceps group will extend and be
Pelvic Rock
This stretching exercise retracts the entire leg in a somewhat flexed position with a gentle protraction/retraction rocking motion that encourages ventral (anterior) movement of the pelvis on the same side. It is used to facilitate ventral motion of the pelvis after a posterior fixated pelvic adjustment.
A. Image 4 (Figure 4): Position of horse and administrator, note placement of forward (superior) hand on the stifle.
B. Image 5 (Figure 5): Position of caudal (inferior) hand on the hock.
The
Summary
Muscles and connective tissue respond to overuse by shrinking and tightening. Its response to underuse is much the same. Stiffness can result in injury, lead to inactivity, and eventually speed up the aging process of the musculoskeletal system. To remain supple the connective tissue and muscles need regular stretching. Stretching helps resist the gradual shortening and tightening of tissue that otherwise sets in from both overuse and underuse, reducing the discomfort and slowing the
Definitions
Concentric exercise – A type of muscle contraction in which the muscles shorten while generating force
Dynamic flexibility – Movement of a joint that depends on the strength of antagonist muscles to move the limb and on the freedom of the limb to move
Eccentric exercise – A voluntary muscle activity in which there is an overall lengthening of the muscle in response to external resistance
Flexibility – The absolute ROM in a joint or series of joints and muscles that is attainable in a momentary
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2022, Veterinary Clinics of North America - Equine PracticeCitation Excerpt :Manual therapies such as massage, myofascial release, or trigger point therapy may aid in postexercise recovery, pain reduction, and improved range of motion.31 Similarly, stretching may decrease tissue scarring and improve range of motion and flexibility post-injury.32 Both therapeutic ultrasound and extracorporeal shockwave therapy have an effect at both the tissue and cellular level that may aid in tissue healing.26,33,34
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2018, Journal of Equine Veterinary ScienceCitation Excerpt :However, the canter data for the right-hand circle reveal an imbalance that occurs when a weaker left hind limb is engaged through proprioception in addition to the activity of powering the horse through the right-hand circle. This loss of balance seen during the right-hand circle (rein) after training for the left hind limb during periods of canter is most likely a form of overcompensation to the proprioception regimen [12]. It is documented that adaptations occur in muscles and joints as the result of disturbances induced by training itself [26].
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2010, Veterinary Clinics of North America - Equine PracticeCitation Excerpt :Therefore, thorough patient evaluation and formulation of a proper stretching program are required before implementing any stretching exercises. Stretching soft tissues is believed to increase joint range of motion, enhance flexibility, improve coordination and motor control, increase blood flow to muscles, and helps to prevent injuries.72 Systematic reviews of the human literature suggest that stretching may have beneficial effects on increasing joint range of motion, reducing pain, and preventing work-related musculoskeletal disorders.71,73
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