By Carole McClelland
When owners and riders think about the horses back, the sacroiliac region is an area that is often overlooked or not considered significant. However injury in this area can cause the horse to be in a lot of pain or discomfort and can cause problems without there being any visible abnormality.
A study by the University of Minnesota reported that over half of the 124 horses presented to the clinic with suspected back pain had a sacroiliac problem. This suggests that the sacroiliac should be given some serious consideration when looking at back problems.
The sacroiliac junction connects the horses spine at the sacrum and the ilium of the pelvis. The joint is capable of very little movement and contains little or no joint fluid. It is supported by the ventral sacroiliac ligaments. In the area are also dorsal sacroiliac ligaments although these do not have anything to do with the joint structure.
Causes of pain in the sacroiliac region include:
Ligament injuries of the ventral sacroiliac ligaments or the dorsal ligaments running from the tubersacrale to the sacrum.The significance of this injury depends on the severity ie, if the ligament it torn or just strained.
Misalignments of the tubersacrale can cause discomfort in this area as joints may not be functioning within their normal range of movement (ROM). A McTimoney practitioner will often treat this area to support optimal joint function.
Fractures, predominantly stress fractures of the iliac wing have been found in racehorses. These are often too small to be seen on x-rays and are so found post mortem, this means they may well be present in horses of other disciplines but due to the lower incidence of post mortem examination they may not be picked up.
In certain equestrian disciplines the SI region can be put under extreme strain. Extremes of engagement, hind limb action or speed can over stress the joint. This means showjumpers, racehorses, eventers and dressage horses are at risk. Conformation of the horse is a consideration and whether the horse has conformation which is suitable for the job they are doing.
Sacroiliac injury can also be a result of falling, slipping and rearing particularly those that have gone over backwards.
Signs which may suggest that your horse has SI pain include:
- Lacking topline and in consistent muscle development across the back and hind quarters
- Lack of impulsion, reluctance to engage the hindlinmbs when ridden and reluctance to go forward
- Bucking or kicking out whilst ridden
- Hind limb lameness where other conditions have been ruled out
Definitive diagnosis is difficult unless there is an obvious injury as the joint is deep and therefore cannot be examined by usual methods such as x-ray. The vet may suspect SI injury when the pain cannot be localised by nerve blocks right up to the stifle. Sacroiliac pain may be suspected by the McTimoney practitioner if the horse is sensitive to palpation over the tubersacrale.
Prognosis is generally good although this depends on the nature and severity of the injury. Ample time off work must be given to allow for ligament repair, it is thought that when recovery has been poor it can be due to not allowing enough time off work. Treatment options address the symptoms rather than the cause of the problem and can include: acupuncture, manipulation and corticosteroids.
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