Animal Rehabilitation: A Specific Skill Set

by Kevin Haussler, DVM, DC, PhD

Rehabilitation plays a crucial role in restoring health, functionality, and performance following surgery, injury, or illness. Just like in human medicine, animal rehabilitation encompasses a spectrum of interventions aimed at promoting recovery and optimizing outcomes. In this blog, we will delve into what rehabilitation entails, the qualifications required for practitioners, the importance of proper training, and what practitioners and owners can reasonably expect from this vital aspect of equine and canine care.

Animal rehabilitation

Historically, equine “rehabilitation” typically consisted of either prolonged stall confinement or pasture turnout for 6-12 months, with the expectation that the horse would somehow self-heal and be ready for reinitiating training or ridden exercise. Similarly, prolonged cage rest has been routinely prescribed for dogs with intervertebral disk disease and other chronic medical or surgical conditions. Unfortunately, these practices continue today for some patients with challenging behavioral or lameness issues and chronic medical issues.

An example at the other end of the spectrum, from the human world, is the team of coaches, athletic trainers, sports psychologists, physiatrists, nutritionists and dietitians, massage therapists/bodyworkers, acupuncturists, chiropractors, strength and conditioning coaches, sports scientists, exercise physiologists, sports medicine physicians, orthopedic surgeons, and physical therapists who provide comprehensive care and support to elite human athletes to help optimize their performance and recovery from injuries.

While it is wonderful to have all these professionals to provide care for our human athletes, unfortunately, we often cannot provide these same services to our equine and canine patients. Limiting factors include the lack of available professionals who could offer these services and the obvious associated costs, time and organization that would be required.

Veterinary medicine unfortunately often lags behind human medicine in the development and services that can be provided to their patients. The field of veterinary sports medicine and rehabilitation had its early start when human physical therapists who had interest in working with dogs or horses began applying human physical therapy principles and modalities to animals. Since then, numerous certification programs in animal rehabilitation have been developed and formal board specialties in veterinary sports medicine and rehabilitation have been approved in the United States and Europe.

What is rehabilitation?

Rehabilitation is defined as the process of restoring function to a prior or optimal level of health or performance. It involves a comprehensive approach to manage pain and inflammation, facilitate healing, restore function, and enhance performance. It encompasses a range of techniques and modalities designed to address musculoskeletal injuries, neurological conditions, and other health issues that may affect an animal’s well-being.

However, there seems to exist a wide range of purported definitions of rehabilitation, therapeutic intentions, and practitioner qualifications. Some practitioners may define equine rehabilitation narrowly, focusing primarily on physical therapy techniques such as exercise programs, manual therapies, and modalities like ultrasound or laser therapy. Others may adopt a broader definition, incorporating complementary modalities such as acupuncture, chiropractic, massage therapy, or behavioral modification and training techniques.

Prehabilitation, often referred to as “prehab,” is a proactive approach with the goal of optimizing a patient’s health and function prior to undergoing surgery or other medical interventions. Prehabilitation consists of assessing the patient’s current physical condition, identifying areas of weakness or potential risk, and implementing targeted interventions such as weight loss, exercise programs, or nutritional support to improve strength, flexibility, and overall health. By addressing potential issues preemptively, prehabilitation aims to enhance a patient’s ability to tolerate surgery or other treatments, reduce the risk of complications, and facilitate a faster recovery process. Ultimately, prehabilitation plays a crucial role in promoting the well-being and resilience of animal patients, setting the stage for successful outcomes and improved quality of life.

Different kinds of rehabilitation

Physical rehabilitation focuses on restoring and enhancing physical function through exercises, manual therapies, and modalities like ultrasound, laser therapy, and electrical stimulation. It aims to improve flexibility, strength, coordination, and range of motion.

Neurological rehabilitation specifically targets conditions affecting the nervous system, such as spinal cord injuries or neurological disorders like equine protozoal myeloencephalitis (EPM) or cervical vertebral compressive myelopathy (Wobblers). Techniques may include proprioceptive exercises, balance training, and therapeutic elastic bands or taping.

Post-surgical rehabilitation includes tailored programs to aid recovery following orthopedic or soft tissue surgery. It involves controlled exercise, wound management, and monitoring to ensure proper healing and prevent complications.

Cardiorespiratory rehabilitation addresses conditions affecting the cardiovascular or respiratory systems. Exercise programs may be designed to improve cardiovascular fitness, lung function, and overall stamina.

Behavioral rehabilitation addresses problematic behaviors, often stemming from chronic pain, prolonged confinement, trauma, neglect, or inadequate socialization. Key components of behavioral rehabilitation include behavior modification techniques, environmental enrichment, socialization, and building trust and confidence through positive reinforcement and deconditioning techniques.

Mental health and fitness

Mental health and fitness is not only an important aspect of everyday life but is a critical component to consider in physical rehabilitation programs. Prolonged stall confinement is often very difficult for both horses and their owners and grooms. Enforced cage rest or kennel confinement can have similar mental, as well as physical, detrimental effects in small animal patients. Even brief periods of confinement or immobilization can have profound negative effects on muscle development, bone density, motor control, and cardiovascular fitness.

Confinement can lead to various psychological issues such as boredom, frustration, anxiety, and depression. Lack of mental stimulation and limited social interaction in horses can result in stereotypic behaviors like cribbing, weaving, or pacing, which are indicators of distress and poor welfare. Similarly, dogs subjected to prolonged cage confinement may experience heightened levels of stress, anxiety, and an increased risk of developing behavioral problems such as excessive barking, chewing, or aggression. To mitigate these issues, environmental enrichment strategies tailored to each species should be implemented, incorporating mental stimulation, physical activity within the confines of the space, and social interaction where possible.

The need for proper training

In the world of animal rehabilitation, there exists a vast array of practitioners, facilities, and individuals who advertise themselves as specialists in the field. While many of these professionals may indeed possess valuable skills and expertise, the reality is that not all may have undergone specific training or possess the necessary qualifications to provide optimal care.

Rehabilitation is a specialized field that requires a comprehensive understanding and working knowledge of anatomy, biomechanics, and pathology, as well as proficiency in the application of various rehabilitation techniques and modalities. Additional skills include a proficiency in collecting information and assessing contributing factors to chronic pain mechanisms, altered function, and reduced performance. Some level of training or expertise is also required in the recognition of pain, assessment of tack fit and use, the proper application of training aids, development of effective fitness and conditioning programs, evaluation of trainer or rider-related issues, and the ability to identify and recommend correction of dental malocclusion and podiatry issues.

The dangers of inadequate training

Without proper training, practitioners may lack the knowledge and skills necessary to accurately assess, diagnose, and manage horses or dogs with musculoskeletal or neurological issues. This can lead to suboptimal outcomes, exacerbation of injuries, or even harm to the patient.

Misdiagnosis and mistreatment: Without a thorough understanding of anatomy and pathology, practitioners may misdiagnose conditions or prescribe inappropriate treatments, delaying proper care, and potentially causing further harm.

Contributing factors: Awareness of the complex interactions that may exist between riders, rein tension, bits, bridles, dental occlusion, head and neck positions, and performance is essential. The ability to identify and manage interactions between ground surfaces, shoeing, hoof care, limb lameness, and compensatory gait mechanisms is also needed.

Risk of injury: Improper application of rehabilitation techniques can increase the risk of injury, particularly if they are performed without proper supervision or oversight.

Legal and ethical concerns: In many jurisdictions, practicing equine or canine rehabilitation without proper training or licensure may constitute a violation of veterinary regulations or professional standards, leading to legal and ethical ramifications.

Directing individuals to proper training resources

For individuals interested in pursuing a career or a specialization in equine or canine rehabilitation, it is essential to seek out reputable training programs and educational resources. Several established organizations provide certification programs to veterinarians, technicians and human physical therapists. Other educational programs are also open to osteopaths, chiropractors, nurses, massage therapists/bodyworkers, and animal owners. These courses cover a range of topics related to animal rehabilitation techniques and practices.

In closing…

Animal rehabilitation is a specialized discipline that requires proper training, knowledge, and expertise to ensure the optimal care and well-being of the animals treated. By understanding the different types of rehabilitation, the qualifications required for practitioners, available training avenues, and realistic expectations, both practitioners and owners can make informed decisions to support animal well-being and optimize their recovery and performance.

Resources

Organizations, in alphabetical order, involved in educational efforts related to animal rehabilitation:

  • Academy of Animal Sport Science – Animal Sports Therapy and Rehabilitation
  • American College of Veterinary Sports Medicine and Rehabilitation
  • Animal Rehabilitation Institute – Certified Equine Rehabilitation Therapist or Assistant
  • Canadian Physiotherapy Association / Animal Rehab Division
  • Canine Rehabilitation Institute – Certified Canine Rehabilitation Therapist
  • Chi University – Equine Rehabilitation and Performance Medicine Certification
  • Chi University – Certified Canine Rehabilitation Veterinarian
  • College of Integrative Veterinary Therapies – Clinical Integrative Canine Rehabilitation
  • Curacore – Integrative Rehabilitation & Physical Medicine
  • European College of Veterinary Sports Medicine and Rehabilitation
  • Healing Oasis Wellness Center – Veterinary Massage & Rehabilitation Therapy
  • North Carolina State University – Certified Companion Animal Therapist
  • University of California Davis – Certified Canine Rehabilitation Veterinarian
  • University of Tennessee – Certificate Program in Equine Physical Rehabilitation
  • University of Tennessee – Canine Rehabilitation Certificate Program

Were you aware that animal rehabilitation involves specific skills and requires specific training?

If you are not certified in rehabilitation but offer rehabilitation as one of your services, do you inform your clients of this fact?

If you are an owner, do you ask your rehab practitioner if they have received specific training?

Join Dr. Haussler and his guests on April 25th to discuss all things rehabilitation – Arlene White, PT M. ANIMST (Physiotherapy), founder Animal Rehab Institute (ARI); Carrie Schlachter, VMD, DACVSMR, co-founder Academy of Animal Sport Science (AASS); and Becky Tenges, MMCP, CERA (ARI).

Registration at vetspine.org/community-gatherings/

Interested in learning more?