Life is Movement: Physical Therapy as a Necessary Tool in Equine Rehab

Introduction
Physical therapy or physiotherapy is a specialised paramedic support that is well known in human medicine and one that has gained its rightful place, and it is also becoming an increasingly impor- tant component of veterinary care(1). Physical therapy can best be described as “medical treatment of orthopaedic and neurological disorders, where exclusive use is made of natural forces such as light, water, electricity, heat, cold, massage and movement”. This definition is, in fact, very broad and covers almost everything that does not fall into the category of pharmaceutical or surgical medicine(2). Within physical therapy, three main disciplines can be distinguished: massage, movement therapy and the application of physical techniques. Of the three, massage is by far the oldest and most well known method, but movement therapy is now seen as the most important and effective discipline, and the one that offers the best veterinary possibilities, especially in the horse.

Massage
Massage was already being used in classical times, and still is a part of daily life in many cultures. Massage has a direct mechanical effect, but works also reflexively via the autonomic nervous system. Effects of massage can include: alleviation of pain, improved circulation, relaxation or otherwise activating the musculature and stimulating oedema resorption. In its general form, massage stimulates metabolism. On the basis of this effect, contraindications are easy to imagine: presence of fever, tumours, inflammation, and open wounds. There is a variety of massage techniques (variations in pressure direction, movement direction and intensity of pressure and movement, as well as frequency) with various indications. In humans, massage is still used, but is one of the least important components of physical therapy. In the horse it is not used very frequently, but it is common enough that clear guidelines have been published (3). Apart from the metabolic effects mentioned above, massage also has a relatively strong sedative effect in the horse. [...]