Knowing what we now know about posture from Posture Part I, lets go through the first part of your horse’s chiropractic exam….. When starting the chiropractic exam, I always start with the “static” or non-motion exam. I am systematic about this and do it in the same order each time so it becomes automatic and I don’t miss a step or forget to consider an important detail (the details are SO important and can clue you in to something very impactful for your horse!).
Step 1: Posture
I evaluate your horse’s posture. You, as the owner, have the best opportunity to evaluate your animal’s posture, as this is best done when watching them standing at liberty or when eating . Bringing a horse into the barn for an exam or to be ridden/etc. can alter their behavior and thus their posture. To account for this, I let them settle in for several minutes before beginning the evaluation and use this time to chat with my client, fill out paperwork, and get updated on how my patient has been doing since I saw them last. Periodically I will check on how the horse is standing and pay attention to how fidgety they are and how they end up standing after a period of motion. Usually, this is enough information for me to feel confident about how my patient feels comfortable positioning themselves when standing, but, if I am still unsure, I can have a handler calmly walk them on a flat surface stopping several times and noting how they end up in their eventual halts.
In this portion, I look at them from the sides, and evaluate how their limbs are in relation to their body and the ground. Does the horse stand camped out (forelimbs out in front of the horse, or hind limbs out behind the horse)? Does the horse stand camped under (forelimbs behind the vertical, or hindlimbs forward underneath the abdomen)? Or some combination of both? Is one hoof/leg always resting (hind limb) or pointed out in front (forelimb)?
This horse is pointing his left front leg to unload it, and as a result is standing "camped under" with his right forelimb and right hind limb to help stabalize his body weight on his remaining three limbs.
Step 2: evaluating symmetry
I ask the owner/handler to square the horse up (if they aren’t already). It is best to evaluate muscle symmetry and other elements of posture when the horse is square. I walk around the horse and look at them from the front. Does the horse carry their head high or low or neutral? Are their eyes and ears level?
Looking at your horse head-on can highlight asymmetries of the head, face, and neck. Note how this horse is holding its head slightly tilted to its right (note the right ear lower than the left), it has marked muscle atrophy over the right eye, and its muzzle is deviated to the left.
I walk to one side and evaluate conformation: does the horse seem to have equal proportions in thirds (head/neck; torso/back; pelvis/hindlimbs?) or is one segment particularly long or short? What is the shape of the topline? The angle of the joints of the front and hind limbs? How does the low back tie into the pelvis (i.e. is the horse “rough coupled” with a prominent angle at the tuber sacrale?) what is the angle of the croup?
If you looked at your horse from the side and divided him into three segments (front end, torso, hindend), would the segments be equal thirds?
Then I walk behind the horse to evaluate the gluteal and hamstring muscle symmetry and (from a slightly elevated vantage point) the straightness of the neck, thoracic and lumbar spine, and pelvis; and symmetry of the shoulders.
Looking at your horse from behind (and slightly above- becareful!) is a great way to evaluate spinal, neck, and shoulder symmetry. Notice the bulge over this horses right scapula.
Step 3: palpation:
I get my hands on my patient! Starting on one side, I palpate the TMJ, palpate neck symmetry by running my hands along both sides of the cervical spine at the same time (so mild asymmetries are more easily detected), palpate along the scapula and down the forelimb- noting any areas of swelling including effusion of any joint capsules, lightly run my hands over the spine from shoulder to pelvis looking for “spinal heat” (warm and/or swollen areas), then back to palpate over the dorsal spinous processes (these are the bony tops of each vertebrae. Is there any asymmetry or pain response?) from withers to pelvis, then back one more time to palpate the muscles that run alongside the spine (any asymmetry or pain response?), I palpate the gluteal and hamstring muscles (asymmetry? pain response? Sensing a theme?....), and finally, down the hind limb as previously with the forelimb.
Step 4: Feet & Teeth
Lastly, I take a moment to note impressions about hoof balance, especially comparing front feet to each other and hind feet to each other. I pick up the feet and note any asymmetry to the sole, hoof wall, bars, frog, etc. Both the frog and the hoof capsule structures respond to weight-bearing. The hoof capsule undergoes a similar response to loading (weight-bearing) that bony tissue will….bony tissue remodels according to wolff’s law, which states that bone in a healthy person or animal will adapt to the loads under which it is placed. If loading of a particular bone in a particular area is increased, the bone will remodel over time to resist that loading force. When translating this phenomena to the hoof wall, you may, for example, see flaring of the lateral hoof wall if the horse is bearing more weight on the outside of the foot.
These are the hind feet on an older gelding I worked on last week (left hind on the left and right hing on the right). According to his owner, this horse spends most of his time standing "close behind" or even, sometimes, with his hind feet crossed! This is reflected in his feet, look at the outside part of the hoof, heel bulb, and frog....notice how they are over developed in response to the extra load.
The frog also reflects loading forces in its shape and size. The frog relies on the pumping action of alternating weight-bearing and non-weight bearing to bring nutrients to the tissue and remove waste products. So…. hooves that allow for appropriate weight-bearing on the frog will should be plump and spongy with all four frogs relatively the same size or the frogs on the front feet slightly larger than that of the hind feet (because they bear more weight!).
Look at the difference in these two frogs? Which looks healthier? Can you tell which one bears more weight?
This is also when I will take a peek at the horse’s teeth to try and determine a bit about their dental occlusion/balance. Do the incisors look appropriate for the age of the horse? Are they particularly worn? Any missing or diseased looking teeth? Are they evenly balanced, or is there a slant or some other type of abnormal wear pattern? Are there any hooks or ramps that would alter the rostral-caudal (front to back) excursion of the jaw? Are there severe sharp enamel points or an abnormal wear pattern to the surfaces of the premolars and molars that would prevent normal lateral-medial (side to side) excursion of the jaw? Imbalances in dental occlusion can have profound effects on the movement of the TMJ (temporo-mandibular joint). The TMJ has more nerve endings associated with it than just about any other joint in the body! This means that is provides a TON of input to the central nervous system, and thus is SUPER important for balance and proprioception……AND, interestingly, is not JUST related to the head/neck/front-end balance, BUT also is closely linked to the balance of the hind end- in particular: the sacrum.
This is an example of a marked incisor slant.
In the last two blog posts all about posture, we have talked about what posture is, what good posture is, what abnormal posture is, practical ways to evaluate posture, specific asymmetries to look for in your horse that can clue you into abnormal posture, and a detailed description of all the things your horse’s chiropractor is noticing before they even get to treatment! Hopefully, now you have the tools to get started evaluating your horses’ posture with educated eyes, such that you can recognize pain before it becomes a lameness—or better yet—asymmetries before they become painful!
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