When I began studying animal physiotherapy all those years ago, it became clear early on that one particular aspect of my training was my most favourite: massage. I really enjoy treating horses with massage, I find it wonderfully therapeutic to perform and it helps me focus my mind on the tissues and structures beneath my hands. Clients will often watch what I do and say "Ooo, can you do humans, too?"
Massage is an incredibly versatile tool within the role of physiotherapy, and its benefits have been acknowledged for centuries. When tense or injured, the body will naturally strive to heal itself; but by mobilising and manipulating the soft tissues of the body, it is possible to provide and support the best environment possible to facilitate faster, more effective recovery. No matter what sort of massage, or what purpose/goal it is being used for, the patient is left with a sense of 'well-ness' after treatment - If you’ve ever had one yourself, you’ll know what I mean!
Massage is a holistic therapy, meaning that in order to restore and maintaining health and well-being, the patient is considered in their entirety, not as separate issues or parts. When massaging a horse I am primarily treating the muscles and other soft tissues, but this in turn will influence everything supporting, supported by, and connected to them. This is why it’s important to understand the effects that massage can have, and to recognise when and where it may be most effectively applied – and when it most certainly should not be used.
Muscle Injury
Muscles require a vast supply of fresh blood, bringing with it nutrients and fresh oxygen from the lungs, and removing any waste products. This demand increases relative to exercise, but any disruption to the supply can cause injury to the muscles.
Such causes include:
Falls, kicks, collisions.
Fatigue – poor fitness, irregular or excessive exercise (which can also cause repetitive strain).
Inadequate warming up and cooling down, not enough stretching or rest.
Poor nutrition and metabolic disturbances.
Infection.
Neurological disorders or trauma.
Compensatory posture.
Tension, anxiety, emotional stresses.
Any or all of the above can lead to a build up of lactic acid, adhesions and scar tissue, which creates tension in tissues and fascia, and subsequent trigger/stress points and muscle tension/spasm. If left untreated, these problems can lead to a pain cycle, which considering the interconnectivity of the horse’s body, we know does not necessarily remain localised.
Benefits of Massage
Massage can stimulate as well as relax and has long-term benefits when performed regularly for maintenance. Hands give a masseur accurate feedback on the body throughout a treatment, and the most effective massage is obtained by maintaining good contact, even pressure and consistent rhythm. Gentle rhythm soothes and relaxes, but also allows for deeper work, whilst a faster rhythm stimulates the tissues and nervous system.
The primary benefits are:
Massage indirectly assists in the oxygenation of tissues by increasing circulation throughout the body.
Relaxes the nervous system, allowing for deeper, steadier breathing and, therefore, better gas exchange (fresh oxygen replacing waste carbon dioxide, etc.).
Assists with circulation of blood and lymph, allowing more nutrients and oxygen to reach associated tissues. It also relaxes the central nervous system, so it subsequently contributes to improved overall function of the endocrine (glands), digestive, urinary and reproductive systems.
Reduces the amount of scar tissue.
Loosens tight muscles.
Stretches connective tissue.
Relives cramps and stresses.
Decreases muscle fatigue.
Loosens joints and improves their range of movement.
Increases muscle strength.
Calms the nervous system.
Stimulates circulation and lymphatic drainage.
Firms up muscle and skin tone - similar to the use of strapping/stropping.
This is the 'Ooooooommm' part: massage relaxes the mind, relives stress, anxiety and depression – creates an overall feeling of well-being. During a relaxing routine or maintenance treatment, the horse will lower their head, breath deeper and slower, sigh, lick and chew, and also pass gas and droppings.
Movements involved in Massage
Stroking: light and soothing, allows for a purely nervous reflex effect.
Effleurage: a slow, continuous stroke with the flat of the hands. A steady speed and constant pressure and rhythm facilitates cleansing, promotes blood circulation and lymph flow, and warms up the tissues. This is used throughout the treatment to prepare muscles for deeper work and to enhance drainage.
Petrissage: from the French verb 'pétrir', meaning 'to knead' and this does what it says on the tin! With techniques including lifting, kneading, wringing, and skin and muscle rolling, petrissage is all about constricting and releasing the blood vessels in an area to encourage fresh blood flow rich in oxygen and nutrients.
Tapotment: a percussive technique used to stimulate tissues (also originating from French: 'tapoter' - 'to tap/pat') by making them contract and relax in quick succession. The rapid, rhythmic movements help to stimulate nerve endings and maintain muscle tone, whilst also encouraging more blood flow to an area. Techniques involved include tapping, cupping, pummeling (see below) and hacking.
Friction: this is a precise technique used on smaller areas, and essentially aims to irritate a tissue into initiating a healing response. Once again, this technique promotes better blood circulation, but also breaks down fatty deposits and adhesions.
Stress/Trigger Point Therapy: stress/trigger points are areas of built-up lactic acid, which can have negative effects on surrounding tissues, disproportionate to their size. Similar to friction, this type of therapy aims to kickstart the body's natural healing process.
Myofascial Release: another technique which focuses sustained pressure on the knots at the centre of restrictions, triggering a healing process within the fascia. This releases the pressure in that area and drains the build up of toxins. The release of tense fascia also releases endorphins and seratonin into the body.
It is important that soft tissues are sufficiently warmed up before any deeper, more taxing work or stretching is performed. To make sure that a horse is fully prepared, I like to use my Photizo red light phototherapy device alongside effleurage: this is a really handy, non-invasive tool which - among other benefits - helps to increase blood circulation in an area by emitting pre-programmed doses of red and infared light.
Contraindications - when NOT to massage
In general, massage needs to be avoided whereby any condition where an increase in circulation would prove a disadvantage is present. This is really important. Should any contraindications be present, massage will not only be highly uncomfortable – even painful – it can also make things much, much worse. This is why a full history of a horse from owner and vet (in addition to veterinary permission) must be obtained prior to any physiotherapy appointment.
Such contraindications include:
Inflammation – this needs addressing appropriately first!
Hemorrhage immediately after an injury.
Dehydration.
Infection.
Raised temperature.
Skin irritations, fungal infections, bacterial infections.
Open wounds and burns.
In areas of active bone growth – this could be over unfused growth plates or over areas of bone breaks/fractures which will be healing.
Colic or azoturia – these conditions naturally create high levels of toxins, which can linger in the body for days after recovery. Any horse showing symptoms will need to be left well alone for at least 10 days following recovery.
Cancerous tumours and cysts.
Bleeding disorders.
Pregnancy.
Because you're never too old for homework...
So that was just a brief introduction to massage and how it can do more for physical health than just a strong feeling of well-being. For any further reading, I thoroughly recommend ‘Massage: a practical guide’ by Jean-Pierre Hourdebaight. This was my go-to text throughout my studies, whatever the topic. A wonderfully thorough and comprehensive book on absolutely everything you could wish to know about massage, stretching, the locomotor system and the anatomy and physiology of the horse. Naturally, after all that reading you'll be worn out, so why not immerse yourself in the experience and book yourself a massage? Just for research purposes, of course... so you will really understand how your horse feels... Oooooommm...
All diagrams are originals drawn by the author.
All photographs are originals taken by the author, V. Hollingdale, or D. Eyres.
Jess Eyres
J. Eyres Equine Physiotherapy
November 2020
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