2017 was the year of the Big Ouch. I started the year off by crippling myself during a personal training session. That was not my intention. I had been training at the gym for a year attempting to cajole my aging body into a better fitness level. I went to a serious gym, worked with a respected personal trainer, owned and read 5 books on rider fitness, and I still injured my knee. Two weeks of RICE (rest, ice, compression, elevation) and I was ready to get back to riding. Then, a fast moving cold front caused feelings of gaiety in my elderly FEI horse. He leaped and cavorted in his pasture. “Wow,” I thought, “he looks good!” When he came in for dinner, there it was, a swollen scrape that ran from the fetlock up for several inches. Oh, boy. Now it was Victors’ turn for RICE. I just could not coax him to elevate his leg (ha ha). So it was RIC (no elevation) for Vic. Just when I was ready to get back in the game Victor was on the injured reserve list. Sigh.
Another couple weeks go by, Vic and I are moving along pretty well, when my beloved hubby shared his cold with me. Colds are usually just an irritating thing for most people but I have asthma. The cold kicks my asthma into crisis mode. I spend the next three weeks sitting in the house (I cannot breath lying down) and sucking albuterol from my home nebulizer unit hourly. This has happened twice before so I know how to be patient and wait for the prednisone and albuterol to bring me out of the crisis. Beloved hubby has to do my barn work. Serves him right.
The straw that broke the riders’ knee. Well, all I did was pivot around to get something when my knee “Pops”. My girlfriend, who was standing next to me at that time, jumps back and says, “What was that?”
“My knee,” I report. “I’m screwed,” I think.
I start the rounds of sports medicine doctors, radiographs, MRI, physical therapy, more RICE and anti-inflammatory medicines, and the coup de gras arthroscopic surgery (the doc scoped my knee to take a peek and see why it was getting worse, not better). Interestingly the MRI showed nothing wrong. The scoping showed a torn medial meniscus so the surgeon “fixed it” by removing the torn part. A month after arthroscopic surgery, instead of improving, the knee felt like I was driving a dagger into it every time I put weight on the knee.
2017 was 10 months of me being lamer than my elderly FEI horse, Victor.I had Total Knee Replacement on October 25, 2017.
Neither Victor nor I will pass a vet exam now. However we are both serviceably sound.
January 2018, one year after the initial strain injury, I am in my 3rd month of rehabbing my total knee replacement. If you have not heard, the rehab for “TKR” is brutal. (More painful than hip replacement and worse than the pain from the two abdominal surgeries I had 15 years ago. I am still questioning the reasoning behind the total brutality of bending a knee that is swollen like a grapefruit. I would never do this to a horse.) I was told it was necessary to “get ahead of the adhesions”. Be a wimp and you might wind up with a “frozen knee” without the ability to bend and straighten the knee normally.
I am now able to ride Victor at a gentle walk and trot plus do my barn work. I still have trouble with heat and swelling after a busy day, but I have a plan to get us both back in the game. Both Victor and I saunter stiffly around for a while (20 minuets) loosening up our aging, out of shape muscles and joints before doing anything we can call athletic. We are both patient with one another while we both prompt these muscles, tendons and ligaments to move the way we remember that they used to move. I know I’ll never regain my youthful athletic body. I have already mourned that loss. What I am doing is maximizing the body that I have right now while staying sound. I am working on acceptance of what is, right now.
I look back on the arrogant, youthful perspective that I once had about aging horses and I am ashamed. Where was my empathy? Where was my knowledgeable and patient planning skills? I was invincible and so was any horse I was riding. This was foolish, narrow-minded thinking for the training an older horse.
In the hopes of passing on the wisdom of experience and age, here are a few thoughts about Respecting the Older (or recovering) Horse.
- Respect the fact that your horse is limping. If you can feel and see the limp there is a problem. It’s not your horse “playing possum” there is something wrong. Stop bullying him into working through the pain. (Two of my doctor visits I reported to the doctor that the pain felt like a dagger in the knee when walking but bearable if I elevated the knee and iced it. The doctor wrote in his medical record that ‘patient reports mild to moderate pain’. Really? Is that what “dagger in my knee” means? P.S. always get your medical records and see what the doctor is hearing, it might not be what you said.)
- Rehab your horse slowly with the idea that long walks will be pleasant and give the underlying muscles and structures time to develop a tolerance for basic work. Most horses will offer more work when they are ready. Horses were born to run. Believe them when they say, “That’s enough”! You can ask again tomorrow and see how they respond then. (When I was rehabbing my knee I could over ride the pain and walk almost normally. That did not mean it was time to go run on the treadmill.)
- Overdo the intensity (or duration) then be prepared for a reinjury that could set you back three months in your rehab process. (I pulled this idiocy attempting to rehab a horse’s suspensory injury when I was young and dumb.)
- Start the rehab process with a mild intensity and ramp up the duration slowly as you monitor the horse’s comfort level. Remember, you will be able to feel the “hesitant to work” feeling from your horse long before your feel the limp.
- Never use HIIT (high intensity interval training) at the beginning of rehab. HIIT workouts are for horses (and people) that already have a high tolerance for intense workouts.
- Stretching is only done when the body is warm, unless you want to injure cold muscles by forcing a cold muscle to stretch. This is why walking is safe to start rehabbing your horse. After 20 minutes of walking you’re safe to work on stretch down for the topline development.
- Every injury is different. Every horse rehabs at different rates. This is why you need to be very tuned into the horse you are riding and not compare him to another horse of your acquaintance. To successfully rehab a horse riders must almost be clairvoyant!
- Bodies do not rehab in a straight line on the rehab graph. There will be backslides while the body adjusts to new levels of work. The trick is to know if this backslide is because you or your horse injured or reinjured something or if the horse is “adapting during a small breather”. Riders need to be clairvoyant. During my TKR rehab the force with which they bent (and straightened) my swollen knee strained the top of the calf muscle and caused a bulge in my low back (L4-L5) resulting in a whopping case of sciatica. I am still dealing with rehabbing these rehab injuries. (Acupuncture and chiropractic care are mitigating the pain while I keep stretching and strengthening my body. P.S. Not one doctor or physical therapist suggested these modalities. I knew from rehabbing my horses that they work)
- Keep a rehab journal (for you and/or your horse). You will get depressed. You will get anxious. You will lose patience. Reviewing the progress reported in your journal will keep you from straying into an emotional pit of despair instead of a staying with a well thought out training/rehab plan. One day I was whining about wanting to get on the horse again SOOM but how badly swollen my knee was STILL. Cue violins. My friend looked at me and deadpanned “Carol, you are only a month out of having your knee sawed off and replaced. You give horses with only strained tendons 3 – 6 months off. Have a little more patience with your healing body.” Thank God for friends. She talked me off a big ledge.
- Always choose people smarter than you are for your advice givers/support people. They need to know you well plus have knowledge about whatever you are asking advice. During the first week of rehab my friend told me “Carol, you have a high pain tolerance, you need to tell these physical therapist your working with to back off. They are pushing you too far because they can’t see how much pain your in. They are used to working with 82 year old couch potato patients.” Oops. Being stoic got me into a bad place rehab wise. Some horses are also very stoic. It is too late by the time you notice that something is wrong.
These observations are fluid guidelines. Every rider and every horse and every circumstance has its own flavor and timeline. The clever person has a structure to work from that is basic and correct theory. Then the clever person adjusts the timeline to suit the horse (or person). There are no written in stone, black and white answers. But then, life is hardly ever black and white. Is it?