Oaklands Physiotherapy

Oaklands Physiotherapy human musculoskeletal & sports physiotherapy, lymphatic drainage, Reiki, Bowen therapy, horse/rider assessments and treatments, My name is Freddy von Rabenau.

I qualified in Germany as a human physiotherapist in 1986 and followed this up with a qualification as a lymph therapist in 1988. Always committed to continuous personal development I obtained my BSc in Physiotherapy with the University of Portsmouth in 1993 and my MSc in Sports Physiotherapy with the University of Queensland in Brisbane in 1998 and got a qualification in the Bowen Therapy in 2005. Living and working abroad for many years my work was exclusively with humans but following my return to the UK in 2008 I branched out into the world of veterinary treatments when I studied Equine Bowen Therapy with Beth Darrall in Gloucestershire. I found this form of treatment highly effective and the course coincided with my decision to take my TB mare off her shoes. As my farrier was concerned that the horse would go lame and refused to take the step I was referred to Trevor Jones, an equine podiatrist, who took her shoes off in November 2008. Interestingly my mare's main problems were tightness in her lumbar- and hamstring musculature but with her being my first Bowen case study she got over her problems much quicker than anyone had anticipated and we never looked back. I subsequently also took my show pony, who had muscular back problems that I was unable to clear, off his shoes and he immediately got better. His lumbar tension cleared with minimal help within a short period of time after the shoes were removed. As Equine Bowen Therapy was not widely known and accepted I felt at a disadvantage compared to other practitioners such as veterinary physiotherapists, which made me decide to study veterinary physiotherapy as well. I completed my post graduate diploma in veterinary physiotherapy and became ACPAT CAT A registered in 2013 and used to integrate the Bowen Therapy into my veterinary physiotherapy practice as I have been doing with my human treatments since 2005. As the Bowen Therapy is a holistic and gentle treatment even animals with strong pain responses and fear of pain are able to tolerate the treatment or part thereof as a frontline approach. Due to work political rasons around veterinary consent and pet insurance issues (coupled with increasing numbers of therapists with inferior training [such as from the school of 'all you need to know about physiotherapy in 50 hours'] flooding the market) I have given up treating animals except my own and have reverted back to just treating human patients from my clinic in Selesy. A special interest of mine were rider biomechanics according to the 'Ride With Your Mind' concept developed by Mary Wanless, which I used for evaluation during ridden assessments as I felt that rider posture and errors can contribute to health and performance problems in horses to an equal degree as physical problems of riders. The treatment of the horse rider team was another special interest of mine as problems can be transferred from rider to horse and vice versa. In addition to ACPAT I used to be a member of RAMP, the register of animal musculoskeletal practitioners, which became active in late 2016/early 2017 and serves the purpose to regulate animal practitioners in order to make the expected quality of care more transparent to vets and animal owners. I have recently located to Mid Devon and hope that I will be able to help the residents in my new area as I did the ones in West Sussex.

11/02/2022

“Bridle Lameness”

“Bridle lameness” was a word that I had never been confronted with in my youth, maybe because I grew up in Germany, maybe because none of the horses where I rode had cause for it (even though I doubt that). In any case, the word suddenly appeared in my vocabulary when in 2008 I bought my first horse here in the UK but no one was able to explain to me in a coherent way what it actually was.

That is, until one day in December 2009 it was explained to me by my horse.
My riding instructor at the time decided to try a different bit on my mare halfway through a session in which she rode her. My mare was used to a snaffle and the bit my instructor introduced consisted of a very thin straight rod with some lever action. I could see my mare immediately going tight in the neck and left shoulder to avoid contact with the bit and within a minute or so she showed left forelimb lameness. At the time I didn’t have the wherewithal to tell my instructor to swap the bit back and she rode the other half hour on a slightly limpy horse with the (forced) head carriage that she had intended to achieve by changing the bit.

This was an eye opener for me and I suddenly realised that I had just been shown a live demonstration of bridle lameness.

The next day I rode my mare in her usual bit on the beach and I suppose I must have been unlucky as she ended up with a tendon injury. And yes, in her left forelimb. Coincidence? I’m not so sure. My suspicion is that the tightness she had developed in her left neck/ shoulder/ forelimb the previous day had left her predisposed for a significant flexor tendon injury.

Why am I bringing this story from 2009 up again now? Because an incident from 2015 came up in conversation with a friend recently and some information that I did not have until a few days ago made me feel that I want to mention this subject.

In 2015 I had a riding lesson on Vienna with someone who advertised himself as a grand prix rider. I rode her in the first half hour of the lesson and he decided that I was riding Vienna too incompetently and that he could do it better, so I was asked to hop off and he hopped on. The first issue was that he must have weighed about 20 kg more than I did and Vienna had never carried anyone heavier than me before. In fact, she had never been ridden by anyone else than me up to that point. I could see she was struggling the moment he got on her. As she was not going forward as he thought she should, he spent half an hour whipping her. She took the beating without going forward significantly more than with me because she couldn’t.

What I learned recently is that there was another person present who had told him that she thought that Vienna was lame, to which he had apparently replied that he thought that she was bridle lame. And presumably in his opinion bridle lameness was not a legitimate reason for a horse to not go forward or to limp, hence the half hour whipping to overcome the lameness imagined by the horse. *

I propose here to change the term “bridle lameness” to “tack lameness” with an addition of maybe even “rider lameness” as in my opinion based on my observation anything that is causing a horse discomfort or hinders its free movement can cause resistance, tension and will lead to an irregular gait that can’t be beaten out of the horse. (Maybe if you beat hard enough the horse will eventually decide that the pain from the whipping is worse than the pain that is causing the lameness and it will choose the path of the least resistance and the rider has “won”, but at what cost??)

My other horse Heidi used to suffer from “tack lameness” because her saddle used to bang against the caudal edges of her shoulder blades with each forward movement of the forelimbs in the swing phase (at that point the scapula rotates backwards). So she shortened her strides in order to reduce the caudal rotation of her scapulae that led to the banging and as a result she looked and felt lame in both front limbs under saddle while she strode out freely riderless on the lunge.
This scenario in my opinion occurred because of her slightly strange conformation but this “tack lameness” was overcome by using a saddle that has a carbon tree which twists in itself in concert with her strides. A treeless saddle may have done the trick as well but as she always seemed to throw saddles to the right, I didn’t think that treeless was a suitable option for this horse.
However, after a jumping lesson she was “saddle lame” again the next day, I think because the tree banged against her very rotated scapulae during landing with my added weight behind it. Subsequently me riding her ba****ck to remove the offending saddle tree/ scapula interface allowed us to continue with the ridden work without any problems and I’ve been mostly riding her with a ba****ck pad since then.

I would like to urge everyone to treat “bridle lameness” with the respect and consideration it deserves as horses generally don’t make up pain and lameness. While they may learn certain behaviours by association I think it is unlikely that they attempt to predict human responses to their lameness behaviour. Try to be aware which piece of tack the lameness may come from and eliminate through trial and error by changing potential causative factors.

*Just to complete the story of the riding lesson: I was unable to ride her for 3 days after that session due to back related lameness that I treated. 2 months later Vienna ended up having bilateral plantar nerve neurectomies. Her Suspensory ligaments in both her hindlimbs had neurogenic pain without the tissues being significantly damaged. Because both hindlimbs were affected she lacked impulsion without visibly limping. She was also diagnosed with kissing spines and her surgery was performed the following year, after she had recovered from the leg surgeries.

30/01/2022

This is Vienna today, two days after her left fore mediolateral imbalance was corrected. Her willingness to get into canter alone already shows me that she is a lot more comfortable. She also seemed a lot happier during and after the session. After the discussion following the previous post I did check her back (neck and shoulders excluded for the moment as I did not want to interfere with what I thought might be going on in the front limbs) but did not find any major muscular problems. I will keep an eye on things and may do a bit more soft tissue work in the neck/shoulder area over the next few days.

29/01/2022

Two opinions about a performance
What prompted me to write this ditty was my recent experience with my own horse who (amongst other issues) has been having a lifelong problem with mostly mediolateral imbalance in her left front hoof, which, when insufficiently addressed, can lead to lameness due to torsion in her hoof and in the worst case 2 years ago, had caused her, who is normally very surefooted, to stumble and fall in the arena twice in one session (doing ground poles in trot, unridden on the lunge, which she usually does very well). Over the past two weeks I have noticed an increasing reluctance in her to canter on the left rein and I asked the farrier to come and check out the problem. I texted him that my horse was getting increasingly lame and he came out early in the trimming cycle (less than a month since last trim) to have a look. What looked like a considerable lameness issue to me looked like a reluctance or unwillingness to canter to him. While he said he could see her reluctance he would not call it lameness. The next question then must be: why is the horse reluctant to do what I’m asking, especially if the horse knows that the correct answer earns a reward? And when does reluctance become lameness? Or is one an expression of the other rather than two different levels of (dis)ability on the same spectrum? To me reluctance lies in the realm of behaviour, lameness implies pathological biomechanics; so can they even be escalating points along the same spectrum?

Different gaits, different amounts of force
In straight walk to the naked eye my horse is not lame (walk = 4 beat gait, always three feet on the ground, low impact and ground reaction forces), in trot on a circle to me she looks like she is holding back (trot = two beat gait, higher impact and ground reaction forces that are shared between the legs of each diagonal pair), while in canter (canter = 3 beat gait with full weight bearing on the lead alone at one point of each gait cycle) on the left rein it is getting increasingly difficult to get her to transition into as well as keep the gait.

Defining the issue
While the Cambridge online dictionary describes lameness as the inability to walk correctly because of physical injury to or weakness specifically in the legs or feet, Wikipedia does not limit its definition to the limbs per se but describes lameness as an abnormal gait or stance of an animal that is the result of dysfunction of the locomotor system. This invites us to think about which parts of the body make up the locomotor system and if one wants to be picky one also needs to define “dysfunction”. Beside the limbs, as part of the locomotor system I personally would include the axial skeleton (back and neck) with the pelvis and the sacroiliac joint (transfer of forces) and the relevant muscles and their attachments.
Where dysfunction is concerned we may need to look at what may be causing the abnormal gait pattern. Is it pain, stiffness, weakness (disuse or neurological?) or a neurological cause?

The conundrum
What is equine lameness? And at what point can an impaired performance level be called lameness?
•Does apparent unwillingness to perform always/ever imply pain?
•Is pain always an integral part of lameness?
•Can a gait dysfunction caused by stiffness be called lameness?
•Should an abnormal gait at the beginning of a ridden (or lunged) session that is caused by stiffness but resolves with movement be classed as lameness, or not?
•Would a pain free unlevel (limping) gait that is caused by limb length discrepancy be classed as lameness?
•Is only limb impairment classed as lameness or should poor performance due to other factors like internal (such as ovarian, urinary, gut) or back problems or maybe even restricted gait due to adhesions in the gelding scar be classed as lameness as well?
•Should the terms “sound/unsound” be used rather than “lame”?

An added complication is that according to research vet Sue Dyson it also needs to be considered that in many cases lameness only shows up when the horse is ridden. We then have to ask if it is the competence level of the rider that is making it impossible for the horse to move better or whether the rider's weight imposes extra strain on subtly damaged structures. For example, doubtlessly in kissing spines even a competent rider who does not negatively influence the horse’s biomechanics to a massive degree will have a negative impact on the horse’s soundness, behaviour and performance.

My own thinking is along the lines of a performance spectrum which is an expression of disability:
•Subtle performance changes (such as responsiveness to aids or requests, other small signs of discomfort)
•reduced performance
•unwillingness to perform
•overt inability to perform
•crippled (that’s a Freddy expression, not necessarily politically correct but it gets to the point)
How does that tie in with your experience of the 1-5/5 or 1-10/10 lameness scales?

Certain physiological and behavioural signs indicate that horses are in discomfort
This little list is by no means exhaustive but serves as a check list when you watch the video that I’ve put out.
• dilated nostrils
• head tossing
• ears back
• gnashing teeth
• tail swishing
• strained look on face
• excessive sweating at low level exertion
• limping
• Conflict behaviour
• rushing
• bucking
• rearing
• spooking
• refusing jumps
• not going forward (possibly even under threat of punishment)

The horse in the video is asked to canter. All this ditty is really about is for you to decide whether the horse in the video is: badly trained, lazy, unwilling, an arse, trying to make my life difficult, in pain, unsound, lame, stiff, weak, something else? Which behaviours (listed or unlisted) do you see in the video? Why would those behaviours confirm your decision regarding what is going on with the horse? I’m looking forward to the discussion.

12/01/2022

How much hay should I feed my to horses at night?

Usually I write about things related to the human condition, less frequently I write about animal observations. However, this one is about feeding my horses. Since we have moved and I have unlimited access to my horses at any time of the day or night, I have taken to checking on them between 22:00 and 23:30 at night. I skip them out, make sure they have enough water, they get their small treat that I call "Betthupferl" and last but not least I check their hay nets. While I'm not a fan of hay nets they do help to reduce waste and therefore one has a better idea of how much the horses are actually eating at night. I have the combination of 'biggest nets with smallest holes' I could find and the nets are never weighed, they are just stuffed very generously, often to the hilt, I'd say. In the previous livery yards where I kept my horses with more limited access during the night, frequently in the mornings there was a ball of moderately compacted hay roughly 2/3 the size of a football left in their nets. Somewhere, I think in an online article about feeding horses, the author postulated that leaving this amount of hay indicated that the horses had had sufficient hay for the night - and left what was found in the mornings because they didn't need it. I challenge this as my observation over the past two months has been totally different. Frequently by the time I see them very late in the evening their haynets are practically empty (yes, even the generously stuffed ones) with only the aforementioned ball sized amount left in them. Also one of my horses often has the empty net with this leftover ball hanging outside her stable while every last bit of hay that has dropped to the floor inside her stable has been hoovered up. At that point they are getting their new haynets, very stuffed again, to see them through the rest of the night and they greedily help themselves to the new food. So what's it with the leftover hay? If they are so hungrily devouring the new hay, why are they leaving the hay in the previous net? And why is the net with the hay ball often hanging outside the stable? Some mornings one of my horses has both nets with the hay ball hanging out of her stable. My theory based on my observation is that there comes the point where the horse has to use undue effort to get the next bit of hay out of the mostly deflated net and this is associated with excessive head tossing to free the hay from the now floppy and freely moving net. This is the force that tosses the net out of the stable. This repetitive forceful head tossing with the hay net hanging from its mouth may be uncomfortable for the horse or maybe just expends more energy than the hay brings in, so it is left as a bad job. Atm, during this wet and unpleasant time of year my horses are eating a lot more hay than is commonly advised to feed and they are not getting fat, even though exercising is rather sketchy for us right now. There is not much to eat left in their paddocks and night time is when they get most of what they need. I'm writing this because not everyone has the chance to make observations like these (until recently I never did) and particularly with view to gastric ulcers in horses maybe this scenario should be considered in prevention and/or treatment of these ulcers.

Merry Christmas to all Pretzels and former Pretzels
23/12/2021

Merry Christmas to all Pretzels and former Pretzels

This may be of interest to some of you who have horses or horses with breathing disorders in particular.
04/12/2021

This may be of interest to some of you who have horses or horses with breathing disorders in particular.

Learn about the steps you can take to reduce the number of asthma-causing airborne particulates in your horse’s barn.

22/11/2021

Hello to everyone who follows my physio ramblings. I just need to inform you that I will change the name of my Physiotherapy practice to OAKLANDS PHYSIOTHERAPY, probably sooner rather than later.

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Oaklands, Lower Reeve, Wembworthy
Chulmleigh
EX187SH

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Freddy’s Story

My name is Freddy von Rabenau. I qualified in Germany as a human physiotherapist in 1986 and followed this up with a qualification as a lymph therapist in 1988. Always committed to continuous personal development I obtained my BSc in Physiotherapy with the University of Portsmouth in 1993 and my MSc in Sports Physiotherapy with the University of Queensland in Brisbane in 1998 and got a qualification in the Bowen Therapy in 2005. Living and working abroad for many years my work was exclusively with humans but following my return to the UK in 2008 I branched out into the world of veterinary treatments when I studied Equine Bowen Therapy with Beth Darrall in Gloucestershire. I found this form of treatment highly effective and the course coincided with my decision to take my TB mare off her shoes. As my farrier was concerned that the horse would go lame and refused to take the step I was referred to Trevor Jones, an equine podiatrist, who took her shoes off in November 2008. Interestingly my mare's main problems were tightness in her lumbar- and hamstring musculature but with her being my first Bowen case study she got over her problems much quicker than anyone had anticipated and we never looked back. I subsequently also took my show pony, who had muscular back problems that I was unable to clear, off his shoes and he immediately got better. His lumbar tension cleared with minimal help within a short period of time after the shoes were removed. As Equine Bowen Therapy was not widely known and accepted I felt at a disadvantage compared to other practitioners such as veterinary physiotherapists, which made me decide to study veterinary physiotherapy as well. I completed my post graduate diploma in veterinary physiotherapy and became ACPAT CAT A registered in 2013 and used to integrate the Bowen Therapy into my veterinary physiotherapy practice as I have been doing with my human treatments since 2005. As the Bowen Therapy is a holistic and gentle treatment even animals with strong pain responses and fear of pain are able to tolerate the treatment or part thereof as a frontline approach. In addition to animals I continued to treat human patients from my clinic in Selesy. A special interest of mine were rider biomechanics according to the 'Ride With Your Mind' concept developed by Mary Wanless, which I used to evaluate during ridden assessments as I felt that rider posture and errors can contribute to health and performance problems in horses to as great a degree as physical problems of riders. The treatment of the horse rider team used to be another special interest of mine as problems can be transferred from rider to horse and vice versa. In addition to ACPAT I was also a registrant of RAMP, the voluntary register of animal musculoskeletal practitioners.

Due to numerous misgivings that I have outlined in detail in a post on this page dated 10.11.18 I decided not to renew my RAMP registration and became a non-practising ACPAT member in November 2018. I am currently practising human physiotherapy from my clinic in Selsey and also do home visits to clients who are unable to leave their homes easily.