Polo Players Edition

NOV 2011

Polo Players' Edition is the official publication of the U.S. Polo Association. Dedicated to the sport of polo, it features player profiles, game strategy, horse care, playing tips, polo club news and tournament results.

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rider, with and without tack, watching how the horse moves," he says. "Radiographs of the back, with today's new digital x-ray equipment, have made it so most equine veterinarians can get good radiographs of the dorsal spinous processes of withers and back. "Ultrasound examination can also help experienced veterinarians evaluate problems of including the back, issues with dorsal longitudinal ligaments, etc. The facet joints can also be evaluated with ultrasound. The supraspinous ligament (large ligament that runs down the top of the back and keeps all the spinous processes in line with one another) can become swollen and irritated, and can easily be evaluated with ultrasound. The veterinarian can radiograph the spinous processes and examine them for impingement ("kissing spines") or evidence of possible fractures," he explains. "For sacroiliac problems we still do rectal ultrasound examinations to assess the lumbosacral joint and L4, 5 and 6 lumbar spaces, and the sacroiliac joint. This requires some experience, but examining these areas via rectal ultrasound can be very valuable." He looks at nerve roots in the lumbosacral and sacral areas that combine to form the sciatic nerve to see if there are bony changes. "We used to do some local anesthesia in the back, but results are very non-specific. anesthesia between spinous processes might Local the dorsal relieve symptoms but is not necessarily identifying where the problem is, and is not without risk. This can affect the sciatic nerve and the horse might have problem standing, so we rarely do this anymore," says Mitchell. Nuclear scintigraphy (bone scan) useful in chronic and is identifying chronic arthritis, bone problems, chronic sacroiliac inflammation in the back. "This can help elucidate what's going on, if other methods have failed to do so. It can let us know we need to radiograph or ultrasound a 26 POLO PLAYERS EDITION which the horse is changes. "With a back problem in functioning poorly, our goal is to make the horse comfortable enough to work and get fit again. It's the same with people who have a bad back. If you can get the patient rehabilitated well enough to be relatively pain free, then the patient can function enough to exercise and become stronger— thereby supporting the otherwise impaired back," says Mitchell. "We try to relieve pain and increase motion and mobility. If we can get these horses comfortable and working again they may be able to maintain mobility of these joints. We may inject the neck or lumbar facet joints with corticosteroids, under ultrasonic guidance to put the medication directly into the joint. This will relieve the inflammation and then we try to get the horse on a program of exercise to encourage better carriage of the body," he says. "Sacroiliac strains sometimes require time off. It depends on severity; if a horse is quite lame with a recent sacroiliac injury we may treat it with an intra- articular injection in the sacroilic joint, but there may be so much trauma and inflammation in the surrounding ligaments that horse needs rest, the to let these structures heal a little. You may be looking at 30 to 90 days in which the horse needs a break from work," he says. In some instances, injections also given are certain area—perhaps the withers or neck if the scan shows a hot cervical facet joint," says Mitchell. TREATMENTS The type of treatment used for a back problem will depend on the injury. Muscle or ligament strain would be treated differently than an arthritic condition with bony proliferative changes or erosive between the spinous processes when there is impingement and bony proliferative change between the vertebrae. "We can inject locally between the affected vertebrae to relieve inflammation and soreness, to try to improve the horse's mobility and get him to raise his back, if he can. Until you relieve the pain, it feels like he has a knife in his back all the time," says Mitchell. Many horses continue to work, in spite of sacroiliac problems. They periodically need

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