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Acupuncture in Equine Sports Medicine

Acupuncture in Equine Sports Medicine

by Marilyn Maler, DVM, Dipl, ACVSMR, Alachua, FL

Author: Chi Institute/Wednesday, January 14, 2015/Categories: TCVM Newsletter, 2014 Winter Issue

The use of acupuncture in equine sports medicine is very common today, and it is used by performance horse veterinarians to a varied spectrum of depth. Many practitioners, myself included, are fully integrative and use many modalities including traditional diagnostics and medicines as well as TCVM to approach cases. I also observed, when reconnecting with past Chi Institute students, that some practitioners have done a complete paradigm shift after their education at the Chi Institute and practice using only TVCM principles. There are also some practitioners who do not practice acupuncture on a daily basis but frequently use the Jing-Luo diagnostic scan to help localize an issue.    

While acupuncture can treat a wide variety of musculoskeletal performance issues, I find there are two situations in which the use of acupuncture has demonstrated particularly impressive results. The first is for lameness which a traditional lameness blocks up to the stifles or shoulders cannot improve. In this case, a diagnostic acupuncture scan can be used to pinpoint the Qi-Blood Stagnation in the neck, back, shoulders, scapular, or pelvic region. Then, electro-acupuncture and/or aqua-acupuncture at the local, master and influential points combined with dry needles at the associated Ting points will often clear the Stagnation after only a few treatments. 

The second situation in which TCVM shines is when there is no obvious lameness but the rider reports that the horse is just not able to perform as well anymore. There is no single limb lame enough to recommend a diagnostic block, radiographs, or diagnostic ultrasound. Like the first situation, the issue may root in the back, neck, thorax or pelvis, or it could be a multiple limb lameness for which the horse is compensating very well and thus does not show an overt lameness. Bilateral forelimb or hindlimb lameness can be difficult for both owners and veterinarians to recognize, but a diagnostic acupuncture scan will often be able to sort out areas of Qi-Blood Stagnation in this situation. These cases often require more treatments to resolve, since they are usually chronic in nature as the horse has managed to compensate and continue in work, although at a reduced level of performance. Acupuncture is able to improve this type of lameness given enough time and treatments, however, to return the horse to soundness in a time frame that is acceptable to the owner/rider, additional modalities might often be necessary.

There are several common TCVM patterns that are seen in musculoskeletal complaints of performance horses. Local Qi-Blood Stagnation is often the source of simple local painful conditions, such as sore hocks or sore feet.  Liver Blood-Yin Deficiency often causes Weakness, failure of tendons and ligaments and subsequent lameness. In older show horses or Jing Deficient horses, Kidney Deficiency and/or Bony Bi syndrome usually is the source of joint pain.  Horses on the show circuit for long periods often have an underlying Deficiency pattern, many times associated with their constitution. To help these horses cope with the stresses of travel and showing, appropriate tonifying herbal formulas usually can be very beneficial.

One must also take constitution into account in diagnosis, treatment and prognosis.  Wood and Fire horses usually show their pain much sooner and are more difficult to acupuncture than other constitutions, but they usually have a quicker and more complete resolution of lameness. Before any obvious lameness presents, a Wood horse often will buck or exhibit other aggressive behavioral changes, while a Fire horse may spook or bolt in reaction to the pain.

Case 1

Lovebug, a 6-year-old warm-blood Gelding, presented with a one-year history of violent bucking undersaddle. He had Wood constitution. His tongue was purple and pulses were strong. His lameness examinations with flexions done over the previous year yielded no significant findings. Observation on a longeline revealed a reduced swing phase of both front limbs, with the right worse than the left. Motioning of the scapula dorsally elicited a pain response. Diagnostic acupuncture scan revealed significant reactions at points LI-15, LI-16, LI-17, TH-15, SI-9, SI-10, GB-21 on the right.

Electro-acupuncture was performed with 4 in. needles directed at points underneath the scapula wherever possible, including GB-21, LI-16, BL-11, BL-12, Fei-men, Fei-pan  SI-9, LI-15 and local Ah-shi  points, together with manual therapy techniques including Tui-na. Improvement was noticed after the first treatment, but full resolution was not achieved until five treatments were completed at 1-2 week intervals.  Initially he was very difficult to treat and required significant restraint to place needles. But by the last treatment, restraint was no longer needed.  Liver Happy was used for 2 months.  The purple tongue and violent bucking revealed that this was not just a local Stagnation, but had progressed to general Liver Qi Stagnation. When the Qi stagnation had resolved, his temperament improved immensely. 

Case 2

Mona was a 3-year-old TB racehorse mare.  She was a Wood constitution horse. Her tongue was pink and her pulses were strong. Mona had a history of placing in many races, but not breaking her maiden. The trainer also commented that she always traveled with her pelvis cocked to the inside.  She had IA injections to both her hocks and stifles 3 months ago, after which there was some improvement in training times, but she still traveled crooked.

Her diagnostic acupuncture scan was quiet except for the local hip points including Huan-tiao, Huan-zhong, Huan-hou, Da-kua, BL-53, BL-54, GB-29, and GB-30, which were extremely reactive on both sides. 

Treatment included electro-acupuncture using 4 in. needles followed by aqua-acupuncture at the reactive points and dry needling at BL-67 and LIV-3. The first morning after the treatment, she traveled straight during her workout on the track,  and  went on to break her maiden two weeks later. Normal tongue color and pulses indicates that her Stagnation was limited to the local reactive area, which is likely why it could be resolved after only one treatment.

Case 3

Buddy is a 12-year-old children’s low level jumper Gelding, with Earth constitution. His tongue was pale purple and wet, and his pulses were weak.

Buddy had been consistently lame for 6 months on the right front with a head nod at the trot. He had several lameness workups with regional and intra-articular anesthesia up to the shoulder and radiographs of all joints of the limbs.  None of the blocks improved the lameness. Radiographs and flexion tests were unremarkable. Diagnostic acupuncture scan revealed very reactive neck points at Jing-jia-ji, TH-15, LI-16, LI-17, GB-21, with the right worse than the left.  He also had poor neck muscling with hypertrophy at the cervical facet region of C3-C6.

Treatment involved electro-acupuncture using 3” and 4” needles at the reactive diagnostic points, along with dry needling LI-1, TH-1 and LU-7. Aqua-acupuncture with vitamin B12 at BL-20, BL-21, BL-24 and ST-36 was performed for his Qi Deficiency.  Buddy was also treated with manual therapy before and after each acupuncture treatment, and dispensed with the Cervical Formula.  There was minimal improvement after the first treatment, but considerable improvement was observed after the second session.  After the fifth treatment he was sound to resume flat work.  Since Buddy was an Earth constitution and would work through pain without complaint as long as he could, his lameness was not obvious until it was very advanced.  It was recommended that Buddy not return to jumping and be worked on the flat only in order to maintain his soundness, and have treatment several times a year to remain sound. 

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