Engage Physiotherapy Blog
Carrot stretches, baited stretches, neck stretches – whatever you may call them they amount to the same thing – getting your horse (or dog) to follow a tasty treat in directions to bend, flex or extend their neck. They are frequently given as homework for owners between therapy sessions. But what are they actually doing? How can they help in the rehabilitation of other areas other than the neck?
Well…. I will digress into the realm of human physiotherapy research and some key principles regarding back pain (don’t worry, all will become clear!).
Humans, canines, and Equines and all have a spinal stabilising muscle called Multifidus. Rather than one single muscle, multifidus is a group of smaller muscles which run all the way from the pelvis to the top of the neck and attach one vertebra to another vertebra two/three levels above it, interlocking the sections.
Human research into back pain has highlighted this small, multi-level spinal stabiliser as being critical in a) spinal stability and healthy function, and b) being frequently dysfunctional or atrophied (wasted) in patients with back pain. Evidence shows that multifidus is so key in spinal and whole body stability that, say for example you want to reach your arm up to grab something or throw a ball, the multifidus switches on (to stabilise the spine) before any of your upper limb muscles do. Our limbs have to work from a stable base and the multifidus is at the very core – literally.
Further evidence from human practice has shown that in patients with low back pain the multifidus muscle becomes atrophied (wasted) at the spinal level where the pathology/issue originates – and even once the pain has resolved, the muscle atrophy does not just spontaneously recover – meaning there is a continued weakness in the spinal stabilisers at that level with the continued risk of recurrence of the pain and further problems.
How do we fix this? ……….. Exercise! The correct type of exercise.
Back to baited stretches……
So, following on from the human research the same issues have been found in horses; muscle atrophy of multifidus – and therefore weakness and continued pain/dysfunction. Using diagnostic ultrasound (like used during pregnancy) to assess the cross sectional area (thickness) of multifidus researchers found that multifidus atrophy corresponded to spinal levels where there was pathology and this did not spontaneously recover once the pain was gone. Just like humans.
So, how do we fix this in horses?
Exercise! Just the same as human patients …… and the exercise they used in the study …… baited stretches! Hurrah!
So baited stretches of the neck can help in the rehabilitation of back pain in horses – but why is this? Why would moving the neck help increase muscle bulk of a muscle deep in the back (and it is VERY deep)?
A horse is a quadruped (walks on all 4 legs – obviously!), when it moves the neck, it has to stabilise through the rest of the body – the length and weight of the horse’s head and neck is pretty heavy! As you encourage the horse to move to the end of its range of movement you will see that it has to recruit its abdominal muscles and the horse has to stabilise itself against the increased “axial rotation” of the spine and against the altered weight distribution. This increases recruitment/activity of multifidus, and therefore, rehabilitation of the muscle’s strength and increased thickness happen over time with repeated sessions, along with increased spinal stability – which is great considering we then sit on horses and ask them to perform extremely athletic tasks!
Frequent use of baited stretches consisting of a programme of: 5 to each direction, 5 times a week has been shown to have a profound effect on the rehabilitation of multifidus – and therefore spinal stability in the horse.
So, carrot stretches really DO have a point. Along with the obvious benefits of baited stretches in horses with pain, tightness, weakness or decreased range of movement in the neck, these very simple exercises are great for horses with back pain or as part of maintaining a healthy spine in your horse!
N.B: If you are unsure of whether these exercises are suitable or if your horse has specific issues (diagnosed or not), it is advisable to discuss any programme of exercise rehabilitation with your veterinary surgeon and/or ACPAT Chartered veterinary physiotherapist prior to commencement.
Baited stretches should be used with caution in animals which may be food aggressive or have an increased risk of adverse behaviours. Baited stretches form a part of wider comprehensive physiotherapeutic assessment, treatment and management of pain and dysfunction.