Motion Microscope Therapy
Jean Luc Cornille
Equine locomotion combines the subtle orchestration of large movements, such as flexion and extension of the hocks, synchronized with microscopic movements such as the displacement of the tarsal bones. Soundness as well as the beauty of performances depends as much on the subtle orchestration of microscopic movements than large movements. The problem is that large movements can be seen even with a moderately educated eye while mocroscopic movements demands that the rider’s feeling is coupled in the rider’s mind with a sound understanding of proper kinematics. A naked eye cannot see the minute movements of T4 and consequent separation of the lateral splint bone Mt4. However, such minute movement can cause, according to James Rooney, suspensory damage. As the load on the hind legs does not increases as much as the load on the forelegs, hind legs suspensory damages result from minute kinematics abnormalities.
This exploded view of the right hind legs shows a large diversity of bones having all specific functions. Paraphrasing James Rooney, the elegance of the performance, as well as the horse soundness, depend on the precise synchronization of the movement of each part on every other part and in relation to be body as a whole. The gait abnormality is there first and it is the repetition of aberrant kinematics that causes injuries. “The gait abnormality created by a specific lesion, is the gait abnormality that causes the lesion.” (Biomechanics of lameness in horses, 1976) While treatments and therapies focus on the lesion, the Motion Microscope therapy concentrates on the source of the kinematics abnormality causing the lesion. Motion microscope therapy is a department of the science of motion, which trade mark is identifying and correcting the source of the kinematics abnormality causing the lesion. Conventional thinking injects the hocks; Motion Microscope Therapy corrects the vertebral column dysfunction inducing abnormal stresses on the hocks.
The thought that limbs kinematics abnormalities originate, for a large part from thoracolumbar dysfunction is pertinent. Conventional thinking rather believe that back problems are only a compensation for hock pain or other musculoskeletal disorders. In 1999, Kevin Haussler DVM, DC, PhD, suggested that primary back problems existed, “Limb disorders are often treated exclusively, without investigating possible structural and functional interactions between the spine, upper limb and lower limb. Even if back soreness is thought to be only a compensation for hock pain or other musculoskeletal disorders, practitioners still have an obligation to evaluate and manage the back problem concurrently. As a profession, our task is to acknowledge that primary back problems do exist in horses.” (Kevin Hausler DVM, DC, PhD, 1999 Preface, Veterinary Clinics of North America) However, traditional thinking still interpret data protecting the thought that back issue are only a compensation for hock pain. A recent statistic study concluded that out of about 600 cases of limb lameness, only 27% were related to back problem. The kinematics abnormality is there first and if the source of the kinematics abnormality is not identified and corrected, the kinematics abnormality induces pathological damages, lesions. At this stage of the evolution, the lameness is a limb lameness and is statically registered as a limb lameness. The first point is that if instead waiting for the kinematics abnormality to became a lesion and therefore being a limb lameness, the thoracolumbar dysfunction causing the kinematics abnormality have been addressed, lameness would not have handicapped the horse. The second point is that injecting the hocks without correcting the kinematics abnormality inducing abnormal stress on the hocks, is just the beginning of a long and armful series of hock injections.
According to Leo Jeffcott, the biomechanics of the vertebral column are very complex; “The biomechanics of the vertebral column, although very complex, are of vital importance because they form the basis of all body’s movements,” (Natural rigidity of the horse’s backbone – 1980) It was the époque where, training superior equine athletes for high level performances, I realized that concepts such as the back acting as a bow kept under tension by the “string”, pectoral, abdominal muscles and linea alba, (Slijper’s bow and string concept, 1946) was elementary and antiquated. The thoracolumbar spine does not flex or extend as a whole but is indeed capable of very minute but diversified adjustments. The concept proposed in 1964 by Richard Tucker needed to be upgraded to actual knowledge but was more in tune with reality. “An initial thrust on the column is translated into a series of predominantly vertical and horizontal forces which diminish progressively as they pass from one vertebrae to the next”. (Richard Tucker-1964). Through subtle education of the main back muscles, not only the translation of the thrust generated by the hind legs into horizontal forces, forward movement, and upward forces, balance control, can be refined, but also the precise correlation between lateral bending and transversal rotation and consequent limbs kinematics.
The practical application of advanced research studies that is the foundation of the science of motion, aimed originally at enhancing gaits and athletic achievements of performance horses. It is the genuine observation of a successful and highly respected retired equine vet, that introduced the adaptation to therapy. Dr. Jean Delsalle DVM, commented one day, “You change the hind and front limbs kinematics of your horses turning descent movers into superior movers. Using the same technique, you should be capable to correct limbs kinematics abnormalities causing injuries.” Delsalle asked how I modified the kinematics of my horses’ hind and front legs. I told him, “Through precise coordination of the thoracolumbar spine muscular system.” He commented shaking his head, “This is not going to be an easy concept to sell; we are not trained to think this way.”
Indeed, it was not easy to sell, but even more difficult was waking up horse owners, riders and trainers to the fact that muscles, tendons, fascia, do not work under the principle of release, stretching and relaxation. Muscles tendons, ligaments and fascia manage forces through nuances in tone. It is for a great part, about storage and reuse of elastic strain energy. “The muscular work of galloping in horses is halved by storing and returning elastic strain energy in spring-like muscle-tendon units.” (Alan M. Wilson, M. Polly McGulgan, Anne Su & Anton J. van den Bogertt, Department of Biomedical Engineering, Cleveland Clinic Foundation - 2001) The range of motion does not increase releasing, stretching or elongating muscles. The range of motion is the outcome of elastic strain energy stored in the tendons, muscles, aponeurosis, fascia and ligaments during the stance and reuse for the swing. Muscles ensure optimum tension of the tendons and aponeurosis. Optimum tension of the tendon allows optimum storage and reuse of elastic strain energy. Instead, releasing the muscles alters the capacity of storage and reuse of elastic strain energy. The range of motion is related to the mass, power and spring properties of the muscles.
Spring properties are due in large part to the large cytoskeletal protein known as ligament titine. “Titine functions as serially linked spring that develop tension when stretched. There are multiple titin isoforms that vary in size and stiffness. Which explain the elastic-stiffness diversity across vertebrate muscles. Titin has multiple roles in striated muscles ranging from sarcomere assembly to mechanical roles such as providing the forces needed to maintain proper sarcomere integrity during contraction.” (Paul C. LaStayo, PT, PhD. John M. Woolf, PT, MS, ATC. Michael D. Lewek, PT. Lynn Snyde-Mackler, PT, ScD. Trugo Relch, BS. Stan L. Lindstedt, PhD. Eccentric Muscle Contractions: Their contribution to injury, prevention, rehabilitation, and sport. Journal of Orthopaedic & sports physical therapy. 557-571. Volume 33, NUMBER 10, October 2003)
Titin most significant role appears to be muscle spring; a muscle-stiffening spring. Efficiency in locomotion and performances occurs at microscopic level. Under the microscope, a muscle gains elasticity through adaptation of its internal structure and the motion microscope therapy concentrates the rider as well as the horse mind on elements, such as proper frequency, influencing sound work of these internal structures. “If titine is functioning as a locomotor spring, then it should be tuned to the frequency of muscle use.” (Lastayo and all) Understanding and respecting the horse natural cadence for instance, further the chances of recovery much more efficiently than manipulating the limbs.
Motion microscope therapy is the subtle orchestration of the microscopic and numerous movements that are the foundation of soundness and athletic performances. Microscopic movements are there, either we accept it or not. Their education demands an equitation as well as an in-hand work updated to actual understanding of equine biomechanics. Microscopic movements demand an advanced participation and an education of the horse intelligence. Riders as well as horses are capable of such education as long as riders, as well as horses are given a chance. The equitation of formulas, such as inside leg outside rein, dumbs down the equestrian education. We constantly observe than talking intelligently to adults and even more to children, opened skill, sharpness, perception and also ethic and kindness that were previously burrowed under loads of simplistic formulas.
Soundness and elegance demands the subtle orchestration of microscopic and numerous movements. It is like orchestrating the notes of each instrument of a large orchestra. It is both complex and fascinating. Most horses and riders have the capacity to learn and create and preserve soundness. Learning, creating and preserving soundness demands a refinement of the body orchestration that is the recipe for superior performances. This includes turning the back to strongly established beliefs. But, paraphrasing James crook, “A man who wants to lead the orchestra must turn his back on the crowed.” Jean Luc Cornille 2017