Physio for riders

25/04/2021

Sport-specific movement therapy adapted for riders

It's less well known here in Hungary is what not so far from us, in Germany, the Netherlands or even Denmark it is very common among those who practice equestrian sports: the sport-specific movement therapy for riders. Numerous successful foreign riders, whether dressage riders or show jumpers, regularly visit a physiotherapist, movement therapist or masseur to correct the soft tissue abnormalities in their bodies, strengthen the muscle groups needed for the sport through specific training, or develop further training to succeed in the sport. 

Many research results show that professional, high-level equestrians, who spend most of their day in saddle, have a higher percentage of chances of developing degenerative spinal disorders, low back pain, intervertebral cartilage degeneration due to fluid loss or even discus herniation. This is even more true for dressage riders who do most of their trainings in sitting trot.

However, these disorders can be prevented effectively or treated by specialized, indivualized professional therapeutic technics and interventions.

It's quite common to meet a dressage horse with very tense back muscles, and examining the rider of that horse at the lumbosacral area - that is, where the spine meets the sacrum - we oftenly find something different from physiological. In such cases, - tense back muscle of the horse and pelvic imbalance of the rider - the whole pelvico-lumbar rhythm, ie the pelvis and the whole waist region of the rider should be examined in one function. In particular, it is worth observe which structure, i.e., which joint, moves relative to what and to what extent in sport-specific movements (whether it is a shoulder in or a canter pirouette). This is the basis of kinematics. Then both sides are compared and we draw conclusions based on what we see.

However, working with the veterinarian, the trainer, and the rider together as a team, we can easily and effectively correct each rider's soft tissue problems. It often makes difficulties to determine whether a horse's tight back muscle made the rider's pelvic assymetry and stiffness or whether the rider's inadequate functionality has led to a horse's back problem. As I experienced, if there is no effective therapeutic interaction in these cases, the problems can be dragged on indefinitely, not to mention the amount of money spent on treatments, which, however, in the absence of causal, customized and evidance based therapy, brings only temporary - if any - relief.

In the absence of the proper warm-up of professional riders, regular, effective stretching technics of the muscles used during the sport, and strengthening of specific muscles and muscle groups, it is not possible to do equestrian sports, more precisely none of the sports, in the long term. I can not emphasize enough that equestrian's physio is much more than yoga, cardio or exercise therapy only. Equestrian's physio is a specific, evidance based professional program, which is individual, particular, personalized and led by a specialist. Of course there is a part in my program that contains cardio and self-stretching exercises, but the only way to offer specific and individualized treatment is to spend time observing, evaluating and examining each rider's whole body. Only this makes us any chance to offer effective treatment. 


Although equestrian sports, such as dressage, are fundamentally symmetrical sports (unlike fencing or canoeing), however, like neither human, neither horse uses both sides in the same way. Every rider is aware of from which hand he/she will enter the dressage arena when he/she starts the dressage test, as every rider knows exactly which side of their horse is easier to control, or straighter, on which hand is the horse more relaxed or shows higher ability for self-carriage. As these are some of the essential conditions for dressage and the judges observe these factors among others while evaluate the production. All in all, success lies in the details and as a physiotherapist offering equestrians individualized sessions, it's my responsibility to properly assess all my clients' posture and body asymmetry. Many riders come to me with concrete pain or discomfort. In this cases I have to establish if the pain has to do anything with the sport or no and treat accordingly. Manual therapy is always a big part of the treatment.


During my 20 years in amateur competition dressage and during my professional study trips and scholarship programs abroad, I observed the small factors that we tend to skip over, even though they greatly influence the success of our riders. Based on human anatomy, movement theory and kinematic I have been able to develop a preventive sport-specific method that not only reduces the number of injuries typical for equestrian sports, but also develops skills that are essential for riders. I adapted some of the exercises that develop concentration to the equestrian athletes from the trainings that were also applied to Formula 1 drivers. I had chance to work with the turkish national dressage riders and we achieved remarkable results. This gave me a boost to work hard on my prgram to be able to offer an even more precise treatment to the riders. 


All riders who come to me take part in a long and detailed but very important thorough medical history and static posture analysis, after which we start to analyze the videos of the trainings and competitions, where the possible shortcomings and problems are already outlined. We can get the best evaluation if I can see the horse-rider pair live while training. After what I've seen, I usually already have a picture in my head of what I'm going to experience on the special tests, i.e. the functional status assessment. Only then we can start working together effectively, which, in addition to the specific treatment, includes patient education as well. I do believe that as a physiotherapist, it is also my job to explain to my patient the exercises and trainings clearly as I also want he/she to be able to help himself/herself and their horse without me later on. 


In case of certain difficulties and problems, it may also be necessary for me to go to the riding school and observe how my patient rides in the first minute of the training and over time. I can draw important conclusions from this, because I can observe in which part of the training, when and what kind of problems arise or just disappear. I take into account the factors of sports physiology, the response of the muscles to the increase in circulation during warming up, the adequacy and correct responses of the body in the actual function. In such cases, I almost always have to treat my patient, after which he/she sits back on the horse and continues training and as an immediate feedback reaction he/she understands how he/she can better perform the exercise right after my manual treatment. In this case, not only the joint or muscle, but the entire central nervous system is stimulated, as a new pattern of movement begins to be stored in the cerebral cortex which is exactly the way how we learn and improve. Here we are no longer talking about correcting a posture only, but about learning automation that exploits the plasticity of the brain. The ability of the brain that makes us able to respond to the stimuli that affect us at all times. This amazing function of the brain makes us able to learn at any age. 

In some cases for the long-term success it is also needed to examine the horse and as an enthusiastic physiotherapist I feel personally responsible to see everything in its entirety. This includes the horse as well. It's useful to work together with a vet and exclude some conditions or diseases in order to offer safe and effective exercises for the horse as well, including balance or coordination training and also soft tissue mobilisation. 

Just as it is clear to all sports enthusiasts today that it is important to spend some time for warm up in order to prevent injury, I hope that soon the importance and benefits of sport-specific trainings will be at least as widespread among riders, as it is still untapped. There are more opportunities in it that many may not have heard of...