Physiotherapy for animals - What, why and how?

Most people know the benefits of physiotherapy. Whether it is on or off the sports field, acute or chronic injury, rehabilitation and conditioning plays a major role in all aspects of sports and daily living. Just as important is the management of pre- and post-operative hospital patients, chronic pain sufferers and your average Joe who has an unexplained pain that needs to be sorted out.

The same goes for your animals: Your top-performance horse that started knocking down poles or your happy-hacker who 'just doesn't feel right'; your best friend, Buddy, who suffers from painful hips; or your champion agility dog that seems 'off his game'.

Animals, like humans, are prone to many types of injuries. Just like athletes, performance animals need conditioning to reach and maintain their fullest potential. This is where animal physiotherapy can help.

What is physiotherapy?

Physiotherapy is a healthcare profession that involves assessing, treating and preventing movement dysfunction, pain and physical impairment. Physiotherapy also involves improving performance in the sporting realm by addressing stiffness, altered coordination and muscle imbalance through specific therapeutic exercise prescription and treatment techniques.

Physiotherapists are skilled in analysing musculoskeletal movement and function and are able to pick up subtle problems that need to be addressed. Animal physiotherapists are capable of applying the skills learned from a broad scope of human practice to animal patients, and do so in close consultation with the veterinary surgeons.
Techniques and modalities used in assessment and treatment include manual joint mobilisation and manipulation, specific soft-tissue techniques, neural-tissue techniques, therapeutic taping or strapping, hydrotherapy as well as a variety of electrotherapy and specific exercise prescription. The success of the professional physiotherapeutic management of a patient, whether human or animal, lies in the ability to apply the process of clinical reasoning. Clinical reasoning refers to the process of deducing what the best type of treatment is for each patient.

What the physio will do

The physiotherapist will gather information (the history) about the patient and add this to what he/she finds on the physical examination. By using their thorough knowledge of the body's musculoskeletal and neural systems, they can plan treatment and choose the most appropriate techniques and modalities for that patient. This is why a physiotherapist's education is so vital. Without an in-depth understanding of anatomy, physiology, biomechanics, normal and dysfunctional movement, there will be little hope of a successful treatment outcome.

Apart from treating horses and dogs, a wide range of other animal species can also be treated by physiotherapists. Physiotherapists belonging to the APGSA have been involved in treating cheetahs, lions, snakes, birds, camels, zebra and even elephants. Animals are living, moving creatures and as such are subject to the same manner of injuries and illnesses that may be addressed by the skilled hands of a physiotherapist.

Some examples of conditions that are treated in animals include:
• Back pain.
• Tendon injuries.
• Ligament and muscular injuries.
• Nerve injuries.
• Poor performance in equestrian and canine sports.
• Respiratory conditions.
• Prolapsed spinal discs.
• Orthopaedic post-operative rehabilitation.
• Neurological rehabilitation.

Essentially, physiotherapists are professionals with the expertise to assess and treat neuro-musculo-skeletal conditions in both human and animal patients.

Becoming a qualified physio

Animal physiotherapy is classified as an area of special interest for qualified physiotherapists. In order for a person to apply these skills in treating animals he/she must first have a degree in human physiotherapy and then have further specialised training in animal physiotherapy. Only persons so qualified are eligible to call themselves animal physiotherapists and to use the title 'physiotherapist', 'physio' or the words 'physical' and 'therapist' together in a title.

The terminology differs from country to country, and in some countries it appears to be acceptable to call oneself a 'physio' with no training in physiotherapy at all. It is very misleading for individuals to present themselves as qualified professionals when they have merely done a short course in a few arbitrary techniques taught by non-qualified individuals, and works to the detriment of the physiotherapy profession and the general public.

Fortunately, in South Africa it is against the law to misrepresent oneself in this manner. Persons misrepresenting themselves in this manner, may be reported to the South African Society of Physiotherapy (SASP) or the Animal Physiotherapy Group of South Africa (APGSA).

Development in the field

The field of animal physiotherapy is rapidly advancing worldwide. Australia, the United Kingdom and the United States are actively involved in continued research and development of this exciting field. In Australia and the UK, collaboration between veterinary science and physiotherapy faculties at university level has seen the establishment of two masters-level qualifications for qualified physiotherapists. Currently, only the UK version of this masters-level qualification is active.

Locally, qualified physiotherapists are offered post-graduate education in animal physiotherapy that covers both companion animals and equines respectively. This training is built on the foundation of the four-year education that all qualified physiotherapists attain at university during their bachelor degree in physiotherapy, spans one year and covers all aspects of theoretical and practical knowledge necessary to equip qualified physiotherapists with the relevant skills and background to treat animals.

All prospective physiotherapists who enrol must have at least two years' practical working experience in human physiotherapy. This allows them to establish and consolidate what they have learned at university before pursuing a career in treating animal patients. Training is offered by the APGSA and is endorsed by the SASP. The curriculum is structured and taught by South African physiotherapists who have a masters-level education in animal physiotherapy.

International standards

Veterinarians, farriers, dentists, nutritionists, behaviourists, trainers and saddle fitters also lecture certain components to facilitate better understanding of their fields. This gives animal physiotherapists the background to work in collaboration with others involved with the care of the animal. To ensure that an international standard is maintained and that the candidates are exposed to international trends in the latest evidence-based practice, at least one module of the course is presented by an international physiotherapist.

Apart from actively educating physiotherapists in South Africa, the APGSA also encourages members to attend international congresses and courses. In November 2010, South Africa hosted a physiotherapy congress, attended by some of the world's most respected physiotherapists and veterinarians, presenting their latest research in the field of equine physiotherapy. This formed part of the International Congress of Equine Exercise Physiology (ICEEP).

Prominent physiotherapists

Physiotherapy is fast becoming an important part of the animal competition circuit. Internationally, many equestrian teams send a dedicated team of physiotherapists to events such as the World Equestrian Games and the Olympic Games. Narelle Stubbs, co-author of Animal Physiotherapy and Activate Your Horse's Core, is the official Australian equestrian-team physiotherapist.

Amanda Sutton, author of The Injury-Free Horse and The Injured Horse, has been team physiotherapist to the British Olympic eventing team. Local physiotherapist, Milyn Brazier, accompanied the South African Endurance team to the World Equestrian Games in Aachen as well as Malaysia, as the official team physiotherapist for both the horses and riders.

On the home front, many show jumpers, dressage riders, eventers, endurance riders and racing trainers are seeing the benefits of using a physiotherapist as part of their routine. The benefits range from having a qualified person on hand who can treat injuries in consultation with the veterinarian, to maintaining the equine athlete's physical comfort in ensuring optimum performance.

Better safe than sorry

Often the physiotherapist will pick up an abnormal pattern of soft tissue discomfort in a horse, which may indicate trouble brewing elsewhere. In some cases, this functions as an early warning system, drawing attention to where it is needed.

Often a postural fault of the rider can manifest as a problem with the horse. By having a physiotherapist assess the horse and the rider as individuals and as a unit, these problems may be addressed to ensure optimised performance. It is useful to remember that both rider and horse are participating in athletic pursuits during equestrian sport. If we think of riding as a team sport, it helps to maintain a mind-set that both rider and horse need to be fit and suitably conditioned to achieve their goals and to prevent injuries.

While some injuries occur accidentally, many injuries are actually the result of fatigue, poor preparation for the level of competition, and inadequate warming up or cooling down. A careless approach to equestrian sport can gradually cause the horse to develop joint stiffness and muscular tightness, which may predispose it to injury or poor performance.

Get hold of a physio

If you are concerned about your animal's physical wellbeing or suspect that he/she may benefit from physiotherapy, ask your veterinarian to recommend a qualified physiotherapist or visit www.physiosa.org.za to find a qualified physiotherapist in your area.

For further information, please feel free to visit the APGSA website at www.animalphysiogroup.co.za.