We’ve been using KER ClockIt Sport to objectively measure and track Mr P’s rehab walk sessions.
The app can be downloaded for free, all you need to do is create an account with KER.
It allows us to track speed, distance and time spent in each gait. It evens records altitude and weather, including temperature, humidity, pressure and sky conditions!
And best of all it can connect with a heart rate monitor so you can measure the cardiovascular intensity of your sessions.
It’s a great tool in regular training, but also really useful in rehab as it provides us with a measure of progress. For example, if we see that speed and distance are increasing for the same time period, this suggests that Mr P is coping well with the exercise and we can look at progressing his program. Equally if we see a pattern emerging of decreased speed or distance over time it may suggest we need to drop back a little on the intensity of our sessions. The weather conditions are super helpful too, as that can provide us with valuable information as to how he is coping in different conditions, and allow us to adjust sessions accordingly.
Measuring cardiovascular fitness is often seen as important in disciplines such as Eventing or Racing, but it can play a really important role in rehabilitation as well.
We’ve been measuring Mr P’s heart rate during his walk sessions and are about to start assessing how the addition of different elements into his training affects his heart rate. While we can’t obviously use faster gaits like trot and canter just yet to get his heart rate up, we can try different low load exercises to see if we can start to get him working a little harder in an effort to increase his cardiovascular fitness.
It’s time to start some rehab!
For us exercise is absolutely the main focus of our rehab plan. In this video we will chat about why, what happens when we exercise and why getting the right amount of load is crucial.
Is Mr P going to be happy about starting to train again? Take a look to find out....
You may remember that a few weeks ago we did the IMU (inertial motion units) gait analysis with Mr P, which showed he was moving evenly in front but had a right hindlimb asymmetry. There was video in which that right hind lameness was quite apparent.
We repeat this analysis every 2 weeks, and this next one was done after he had his shoes put on. It was quite different...
What we are seeing now fits a little more with his clinical diagnosis. He is moving largely symmetrically behind (anything under 8mm is considered within “normal” range in the pelvis - data on the right), and we’re now seeing a significant right forelimb asymmetry, worse in the push off or propulsion phase (data on the left).
So why were we seeing a right hindlimb but not a right forelimb lameness before?
The likely explanation relates to his feet. He was incredibly foot sore before he had shoes on, so the “evenness” in front was likely due to him being “equally sore” in both front feet, not giving us a true reading of his soundness relating to the tendon injury. Now that we’ve technically taken away the foot soreness, what we are seeing is an asymmetry purely related to the tendon injury.
Now we can hopefully more accurately monitor his response to treatment!
In part 2 of our second physiotherapy assessment with Mr P we’ve found that although there is some improvement in his weight bearing through the right forelimb, it’s still not equal to the left. So we looked at incorporating some new exercises to help improve this, in the form of dynamic mobilisation exercises (often know as 🥕 stretches).
Take a look to see what we did.
Side note - yes we’re fully aware of Mr P and his ahem 🍆... what can we say, he really likes licorice 🤷♀️
This is a great example of assess the horse, not the tendon.
This is Mr P's first gait assessment with the inertial motion sensors. If you don't know much about gait analysis, you can check out more info here.
You would expect that we would have measured an asymmetry in the right forelimb, however we actually measured an asymmetry in the right hindlimb during the propulsion phase. Surprisingly he was actually measuring pretty well symmetrically in the forelimbs. Look at the video closely, it's subtle but you can see that he kind of hops and doesn't really push off as well on that right hindlimb.
While we don’t currently know if the hindlimb asymmetry is due to his feet, a compensation that has developed or is its own issue entirely, we’ll continue to assess and objectively measure, with our primary focus on improving whole horse movement, symmetry and function.
Our next step in objective gait analysis will be to perform a proper high-speed video and 2D kinematic analysis to delve deeper into measuring how he’s loading and using each limb.
We weren’t involved in the early stages of Mr P’s rehab, only taking over his care a couple of weeks ago. We were informed that he had sustained the injury to his right forelimb SDFT during a race. There were initial concerns that he may have ruptured the tendon but the scan was performed soon after the injury and it can be difficult to determine exactly what is going on when there is a lot of swelling in the early days.
Ramon Perez from Southern Highlands Equine and Randwick Equine Centre has known Mr P for several years. This is the first time he has seen him since he sustained the injury. At this initial assessment he watched him trot up and performed an ultrasound of the tendon.
This was the moment of truth. Was the tendon healing the way we hoped? What was the prognosis? And just what had we got ourselves into....?
Watch through to see what Ramon found on the ultrasound.
Ramon Perez - DVM
Ramon grew up along the East coast and Mid-West of the United States, and was raised into the horse racing industry.
Ramon’s father was a jockey and his stepfather the assistant trainer to Hall of Fame trainer Bill Mott. Growing up around the racetrack Ramon was able to work with some of the best racehorses, such as Theatrical, Cigar and Hussonet.
In 1994 at the age of 16, Ramon dropped out of high school to pursue a career as a jockey.
In 1995, Ramon received the ‘Eclipse Award’ as the champion apprentice jockey in North America. Ramon was fortunate to ride horses such as Elusive Quality, Escena, Northern Emerald and Lite The Fuse.
His career was cut short due to weight issues but he managed to ride over 400 winners in just 2.5 years, including two Group 1 victories.
Following his retirement Ramon worked for the Sheik Mohammed’s Goldolphin stable in the UK and Dubai before going back to the USA to begin his studies. Ramon graduated in May 2010 in Veterinary Medicine.
In August 2010, he took up an internship at Randwick Equine Centre (REC), and on completion joined Illawarra Equine Centre. In 2014, Ramon returned to the Randwick Equine Centre’s racetrack practice at Warwick Farm, and can be seen most mornings at the Rosehill racecourse. Ramon recently relocated to the Southern Highlands, and although still servicing Rosehill most mornings he is now out and about in the Southern Highlands area most afternoons, including a trip to Goulburn weekly. We are fortunate that Ramon has made a special allowance to come up to North-West Sydney to review Mr P!
Watch the full appointment session with Erin Stevens, showing how he trimmed and then cast the front feet, his reasoning behind why he has chosen this method initially and explaining his management plan for the first 4 weeks.
ERIN STEVENS - MASTER FARRIER
Starting his career as a farrier in 1999, Erin was awarded apprentice of the year before going on to build his own successful farrier business in the Hills & Hawkesbury region of NSW. A dedicated family man, raising four young boys with his wife Courtney on a 170-acre farm in rural NSW. Erin still runs his professional farrier business and writes regular horse owner education articles on hoof care in an equine magazine.
Erin has a strong focus on continued education both as a farrier and business owner. This has led him to opportunities of working with Equine Veterinarians using the latest technology and products to provide solutions to therapeutic shoeing cases.
He believes in a team approach with the owner, vet and farrier on board to reach the best outcome for the horse and the ongoing management of the case. He also values and encourages client feedback to streamline his business practices and to maintain long-term soundness for the horses he works on.
Erin’s latest contribution to the farrier industry in Australia is embarking on the journey to create an annual conference for farriers known as The Australian Farriers’ Conference. The inaugural conference held in Wisemans Ferry NSW in 2018, and then on the Gold Coast in 2019.
At Mr P's first consultation today Erin was incredible, providing sound clinical reasoning and a long term plan to get his feet in the best condition possible, along with taking into consideration how to best help in the rehab of his tendon injury. We have some great content from him to share very soon!
In the meantime head over to his website to learn more about Erin