EXPANDING HUMAN TO VETERINARY BIOMECHANICS APPLICATIONS

By Stephen M. Apatow,  Director of Research and Development, Sports Medicine & Science Institute.

Introduction

Analysis, correction and retraining to optimize the biomechanics of the elite dancer in classical ballet training has provided tools that are applicable to both human orthopedic and veterinary applications.  The differentiation between functional vs. pathological limitation, is a crucial aspect for integration.  The Humanitarian University Consortium: Graduate Studies Center for Veterinary Medicine was developed as a supportive resource for use in conjunction with the  the SMSI Veterinary Sportscience Center that provides access to reference materials from the Merck Veterinary Manual (for disorders that include Lameness In Horses, Disorders of the Foot, Fetlock and Pastern, Carpus, Shoulder and Elbow, Tarsus, Stifle, Hip,  Back, and developmental orthopedic disease).  

Development

During the 1980's, a specialized analysis, correction and retraining program was developed to enhance the joint flexibility and technical performance of competitive international level dancers in Soviet ballet training.  The program incorporated the analysis of a dancers postural alignment to the classical ballet mechanical ideal, isolation of muscle-tendon-articular restrictions and correction via a specialized procedure to increase the elasticity of structures limiting potential joint range of motion. The method yields an immediate change in spinal and extremity flexibility, providing the dancer with the capacity to optimize classical ballet alignment, which is then integrated into the overall development program. Biomechanical changes include increased hip turnout, functional flexibility (strength) of the legs and upper extremities in all classical positions.  Technical progress of 2-3 turns on pointe to 7-8 turns on pointe has been demonstrated in a one month concentrated program prior to an international competition.

In the mid 90's, Dr. Keith Forbes, a veterinarian and blackbelt in Tae Kwon Do, learned about the scope of this work in conjunction with a program I was conducting at a martial arts training center in Northern Nevada. Discussion associated with this specialized work, included my reference to a cervical entrapment neuropathy case on female client (Yale Case), and presentation of my interest in veterinary applications.

The dialogue led to his request for me to review a case, including X-rays, associated with a disk prolapse on a Basset Hound, approximately 8 years old, presented with paraparesis, unable to stand on his hind legs, but still presenting some limited motility.  The physical exam revealed some mild pain along the back of the thoracic-lumbar junction, on the neurological exam indicated that conscious propioception was absent in the hind legs, the withdrawal reflex was decreased, and the patellar reflex was increased. The owner declined surgery, so drug treatment was started with prednisolone at the dosage of 0.5 mg./lb. for one week and then decreased to 0.25 mg/lb. for the 2nd week. At the end of two weeks of medical treatment the dog was re-evaluated with no improvement clinically or neurologically.  Alternative treatment was started at this time.

Dr. Forbes and assistants helped while the problem was assessed and small muscle tendon restrictions in the thoracic, lumbar and sacral spine, pelvis and hind legs were isolated with corrective procedures utilized to increase the elasticity of abnormal tension relations.  As demonstrated in human cases, the approach yielded an immediate increase in joint range of motion of the affected spine and extremities, correction of compensatory changes that resulted in the functional capacity of the dog to support its weight on its hind legs with progressive loading when the hind end was lifted and released from approximately 6 inches above the ground.  One week later, after only one session, the owner brought the pet in for an examination, and the dog stood up and walked out of the exam room. 

After observing the effective cross-application of the biomechanical analysis and corrective procedure in a quadruped, I was interested in exploring applications relating to both musculo-skeletal conditions and performance in high level sporthorses.  Our first case was a Hanovarian jumper at the Franktown Meadows Equestrian Facility in Northern Nevada.  The horse was flexibility restricted, requiring over a one hour warm up period prior to lessons or competition.  The assessment of muscle-tendon relations of the spine and extremities resulted in our isolation of restrictions and hypersensitivity that contributed to numerous compensatory patterns.  The same procedure was used to increase the elasticity of the affected structures, a number of which exhibited hardening or fibrosis due to trauma or a chronic condition in which compensatory changes resulted in stabilization.  As with the Basset Hound, we were able to immediately increase the elasticity of these structures, decrease the hypersensitivity and observe an immediate increase in functional joint range of motion.

After the assessment and procedure, we proceeded to saddle and have the trainer assess the functional capacity of the horse.  To our surprise, the horse walked out relaxed and with the same level function that was experienced after a prolonged warm up period. During the session the horse improved progressively and the training objective was to work with movements that could be executed correctly, avoiding any destabilizing compensatory pattern. If a problem was observed in a movement, the instruction was to back off, and only work in a range that the horse could function correctly and below a threshold of discomfort.  Our capacity to increase the joint flexibility to accommodate integrity, combined with efforts to control inflammation,  led to the continued progress in the horse's performance.

Conclusion

The success with the animal applications demonstrated that once the animal was provided the functional capacity to work without pain, they would automatically adjust their mechanics into a stable pattern, a scenario that doesn't happen quite as easily with humans.  To date, doors have opened to adapt this work on numerous small animal cases with conditions ranging from herniations to arthritis and hip dysplasia as well as hundreds of sporthorses in dressage,hunter-jumper and western training programs.