Lately, I have been really focused on creating a new bedroom for both of my boys. They are 4 and 2, so we are trying to create just the right environment to meet both of their needs. I have business plans for the room my youngest has been occupying, but I haven't been focused on new content for my website. Then, I remembered this article I had written for another publication. I hope you enjoy it!
The end of 2019 found me catching up on continuing education credits that I had neglected, and although it always seems like a hassle, I enjoy spending time returning to my athletic training days. The world of medicine, and especially it seems, orthopedics is ever changing. Every continuing education cycle I learn something new, and I’m always encouraged by the evolution of thought in practictioners. One of my favorite presenters is a man from South Africa, Adriaan Louw, who has centered his studies around pain. One of this theories is that the medical world has spent too much time on tissue damage and not enough time on the study of pain. Not all tissue damage causes pain, and not all pain is caused by tissue damage. This wasn’t revolutionary for me, but it did get me thinking about how we, and the veterinary world treat our horses.
Traditionally, if your horse is lame, you call the vet. The vet does a battery of tests, and he/she will diagnose the lameness issue. I think we’ve all had that horse, or maybe more than one, that just didn’t seem sound, and no vet could find a good reason. Sometimes the vets give you a list of reasons, but as Louw states, tissues heal. Sometimes our horses do not. Why is this? I certainly don’t know the answer, but Louw’s lecture resonated with me. He stated that, “pain is one hundred percent produced by the brain when it perceives a threat” and that “pain is a decision made by the brain based on the perception of a threat”.
Louw began this lecture by reviewing some physiology, particularly that the tissues do not actually have pain receptors. They have receptors that transmit information to the brain and the brain decides, is this pain or is it something else. One comparison he used was spraining your ankle while crossing a busy street, you look up and see a speeding bus coming. What do you do? Run, of course! In that moment your brain does not perceive that tissue damage as pain. The bus is perceived as a greater threat. Rodeo clowns and cowboys were also used as an example (and that made me think of equestrians), they often have lots of tissue damage throughout the years and continue on being happy and functional. Whereas, you may have someone who leads a basically sedentary lifestyle who is riddled with pain on a daily basis, and they have no tissue damage. How does this happen? Louw suggests that environment and patient education (in the matter of pain and tissue healing) are the biggest factors.
If this is true, should we be looking at treating our horse’s differently? I’ve never had a vet tell me, maybe this horse is unhappy in his environment. I have seen horses with health and soundness issues get remarkably better with just a change in environment. Maybe it was coincidence. Maybe not. Many sport horses are housed in environments that are not horse friendly. We, think that they are horse heavens; with big box stalls, beautiful center aisles, automatic waterers, heaters, and fluffy pine shavings. Meanwhile, our horse would prefer lying in the grass in an open field amongst his closest friends and standing with his butt against the wind in a torrential downpour. The horse is designed to be outside, he is designed to move. Are our human preferences causing him pain?
I don’t know how you educate horses about pain (if that’s even possible), but I have seen horses change their attitude towards pain with a change in their environment. I have also seen horses change their feeling with a change in training. I believe any time there is a soundness or behavior issue with a horse, I always look at more than a veterinary diagnostic.