The
Role of the Physical Therapist
© 2006 Cherry Hill www.horsekeeping.com
Physical therapists play an essential role in the rehabilitation
of equestrian accident victims. Originally doctor's technicians, today's licensed
therapists usually have a M.S. degree. Unless employed by a hospital, therapists
operate a separate business, often associated with a sports medicine practice.
However, about half of the states in the U.S. still require the patient to be
referred to a physical therapist by a doctor. The majority
of a therapist's time is spent designing and implementing individual exercise
programs. Commonly, this involves sessions on specialized equipment, which is
located at a rehabilitation clinic. In addition, therapists teach the proper techniques
for the exercises that the patient will later do at home. Some
clinics follow a proprioceptive program. The therapist responds positively when
the patient has, for example, neutralized the pelvis, thus straightening the lower
back. Biofeedback equipment works on similar principles. When the target muscle
group is contracted or relaxed (whatever is the goal in the particular circumstance),
a pleasant tone sounds. In both of these situations, the patient learns when he
has activated or deactivated a target muscle group. Riding
instructors operate in a similar fashion - you get praise when you settle weight
in your heels by lengthening your calf muscles. Therapists
also deal with painful, acute injuries. Ice is one of the first treatments for
bruises and swelling. With the injured area elevated, ice is applied with compression
on and off for several days. (A helpful acronym: RICE = Rest + Ice + Compression
+ Elevation) Ice is also useful during rehabilitation. When
it is applied for about 10 minutes immediately following a workout of the injured
part it will greatly discourage the return of swelling. Prior
to exercise, therapists use heat in varying forms to limber the body and increase
circulation. Superficial injuries respond well to ultraviolet rays. Ultra-sound,
a sound wave categorized as deep heat, encounters little resistance from the skin.
Whirlpools, hot packs, saunas and hot baths achieve various heating effects.
Liquid paraffin has been found to be a safe and effective heating agent. An injured
extremity is dipped repeatedly in melted paraffin which is held at 52-58 degrees
Centigrade (125.6 - 136.4 Fahrenheit). Sometimes an injury
will involve muscle spasms. Heat, followed by massage, is often effective in breaking
the spasm cycle. Another alternative is Transcutaneous Electronic Muscle Stimulation.
A TEMS unit is programmed and installed by your physical therapist to send electrical
stimulation to the desired area. The small battery operated appliance can be carried
in the pocket or worn on the belt. There are two types of units, one that affects
nerves (TENS), for chronic pain, and one that targets muscles (TEMS).
The latter one, utilizing galvanic stimulation, helps speed the healing process
by increasing circulation within the muscle and decreasing swelling. It can also
be programmed to fatigue a muscle spasm so that the muscle will cease to fire
or contract. Anti-inflammatory drugs and pain relievers are
frequently prescribed by doctors during the course of a rehabilitation. Although
drugs can make life bearable when an injury is acute, they can bring anguish later
if the user is not aware of their masking properties. Drugs give the athlete a
false sense of well being; worse injuries can result from over exuberance. And
some drugs are habit-forming. Many injuries require support
for an extended time after the accident. Besides a cast, a patient might be prescribed
a variety of reinforced cloth braces. Some allow partial participation in activities.
Taping, wrapping and splinting the joint or affected area can add protection while
riding and can actually teach the rider better posture. When
you first begin riding again, you may need to modify the way you do some things,
such as mounting or posting. You may need to lengthen or shorten your stirrups
or not use them at all. There are few standard exercises to
recommend for rehabilitation. Each case involves specific damaged areas. There
are, however, some good pieces of general advice for prevention of injury. Be
in shape for your particular event. Do stretching and warm up exercises regularly
and before strenuous efforts. Know proper techniques for your specialized area
of riding. Have the appropriate strength for your event. Use a time at the end
of your riding for a cool down. Be aware of your breathing patterns. Locate your
tension and learn to control it. Don't begin riding until
your healing is complete. A setback early in your reconditioning program could
mean extended time out of the saddle. As in all forms of exercise, stop immediately
if you experience pain. Try to locate what is causing the pain and deal with it
through stretching and relaxation. Rest periodically while riding and quit before
you are physically or mentally exhausted. Continue your out-of-the-saddle exercises,
even after you have resumed your riding schedule. Take care
of yourself as well as you do your favorite equine athlete. 
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