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Equine Anatomy in Perspective

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This slide show is from a presentation given by holistic veterinarian, Dr. Chris King, at the 3rd International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine, which was held in Raleigh NC in 2004. It presents an integrative view of musculoskeletal anatomy in the horse. Please enjoy, and move through the slide show at your own pace.

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Equine Anatomy in Perspective

  1. 1. Equine Anatomy in Perspective an integrative view of musculoskeletal anatomy Christine King BVSc, MACVSc, MVetClinStud 3rd International Symposium on Rehabilitation and Physical Therapy in Veterinary Medicine Raleigh, NC 2004
  2. 2. Equine Anatomy in Perspective the way we’re taught anatomy limits our understanding of how the body functions as an integrated whole
  3. 3. Equine Anatomy in Perspective the way we’re taught anatomy limits our understanding of how the body functions as an integrated whole teaches us to view the body as a collection of separate parts
  4. 4. Equine Anatomy in Perspective the way we’re taught anatomy limits our understanding of how the body functions as an integrated whole teaches us to view the body as a collection of separate parts we approach illness, injury, and other dysfunction as a failure of the offending part…
  5. 5. Equine Anatomy in Perspective the way we’re taught anatomy limits our understanding of how the body functions as an integrated whole teaches us to view the body as a collection of separate parts we approach illness, injury, and other dysfunction as a failure of the offending part… rather than the system failure that it so often is
  6. 6. Equine Anatomy in Perspective it’s useful to start out by learning anatomy in readily ‘digestible’ pieces…
  7. 7. Equine Anatomy in Perspective it’s useful to start out by learning anatomy in readily ‘digestible’ pieces… but we must then assimilate it - put it all together in a way that serves us…
  8. 8. Equine Anatomy in Perspective it’s useful to start out by learning anatomy in readily ‘digestible’ pieces… but we must then assimilate it - put it all together in a way that serves us… otherwise, we miss the big picture!
  9. 9. Equine Anatomy in Perspective an integrative or wholistic view of anatomy better describes how the living horse functions
  10. 10. Equine Anatomy in Perspective an integrative or wholistic view of anatomy better describes how the living horse functions it better explains and helps us to predict the scope of illness, injury, and other dysfunction…
  11. 11. Equine Anatomy in Perspective an integrative or wholistic view of anatomy better describes how the living horse functions it better explains and helps us to predict the scope of illness, injury, and other dysfunction… because it emphasizes relationships
  12. 12. Equine Anatomy in Perspective an integrative or wholistic view of anatomy better describes how the living horse functions this relational approach has more clinical value diagnosis treatment rehabilitation prevention
  13. 13. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy:
  14. 14. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: bones as passive struts and support columns
  15. 15. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: bones as passive struts and support columns muscles as activators
  16. 16. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: bones as passive struts and support columns muscles as activators tendons & ligaments as cables & guy wires
  17. 17. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: this mechanistic paradigm has the system functioning like a crane
  18. 18. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: this mechanistic paradigm has the system functioning like a crane (fascia as an inert outer covering or binding material)
  19. 19. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: a muscle exerts its effect on a bone (or bones) either directly or via its immediate extension (a tendon)
  20. 20. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: a muscle exerts its effect on a bone (or bones) either directly or via its immediate extension (a tendon) this effect is essentially limited to the bones and joint(s) with which the muscle (+ tendon) is directly associated
  21. 21. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: a muscle exerts its effect on a bone (or bones) either directly or via its immediate extension (a tendon) this effect is essentially limited to the bones and joint(s) with which the muscle (+ tendon) is directly associated i.e. the effect is LOCAL
  22. 22. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: the foundation for most forms of therapy in sports medicine
  23. 23. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: the foundation for most forms of therapy in sports medicine if a part is injured, it is because localised forces have overcome local tissue strength
  24. 24. Equine Anatomy in Perspective conventional view of musculoskeletal anatomy: the foundation for most forms of therapy in sports medicine if a part is injured, it is because localised forces have overcome local tissue strength thus, local remedies are needed
  25. 25. Equine Anatomy in Perspective integrative view of musculoskeletal anatomy:
  26. 26. Equine Anatomy in Perspective integrative view of musculoskeletal anatomy: still uses elements of the mechanistic model
  27. 27. Equine Anatomy in Perspective integrative view of musculoskeletal anatomy: still uses elements of the mechanistic model also recognises that everything in the body is interconnected
  28. 28. Equine Anatomy in Perspective integrative view of musculoskeletal anatomy: still uses elements of the mechanistic model also recognises that everything in the body is interconnected so, any action (whether positive or negative in outcome)…
  29. 29. Equine Anatomy in Perspective integrative view of musculoskeletal anatomy: still uses elements of the mechanistic model also recognises that everything in the body is interconnected so, any action (whether positive or negative in outcome)… has LOCAL, REGIONAL, and GLOBAL effects
  30. 30. Equine Anatomy in Perspective the concept of interconnectedness is central to understanding how injury occurs
  31. 31. Equine Anatomy in Perspective the concept of interconnectedness is central to understanding how injury occurs and how seemingly unrelated dysfunction…
  32. 32. Equine Anatomy in Perspective the concept of interconnectedness is central to understanding how injury occurs and how seemingly unrelated dysfunction… at often distant and apparently separate locations…
  33. 33. Equine Anatomy in Perspective the concept of interconnectedness is central to understanding how injury occurs and how seemingly unrelated dysfunction… at often distant and apparently separate locations… can be either a cause or a consequence of that injury
  34. 34. Equine Anatomy in Perspective No injury occurs in isolation!
  35. 35. Equine Anatomy in Perspective the concept of interconnectedness: expands our diagnostic abilities
  36. 36. Equine Anatomy in Perspective the concept of interconnectedness: expands our diagnostic abilities allows us to customise and thus optimise Tx and rehab
  37. 37. Equine Anatomy in Perspective the concept of interconnectedness: expands our diagnostic abilities allows us to customise and thus optimise Tx and rehab enhances our ability to prevent injury/reinjury
  38. 38. Equine Anatomy in Perspective the concept of interconnectedness: expands our diagnostic abilities allows us to customise and thus optimise Tx and rehab enhances our ability to prevent injury/reinjury may even help us to optimise performance
  39. 39. The Connective Tissue Link all structures in the body are connected to one another
  40. 40. The Connective Tissue Link all structures in the body are connected to one another no matter how distinct or distant the parts may seem
  41. 41. The Connective Tissue Link there are three bodywide connecting systems… (physical systems that, if illustrated in isolation, would accurately depict the structure of the entire body)
  42. 42. Human circulatory system (Vesalius, circa 1548)
  43. 43. The Connective Tissue Link three bodywide connecting systems… circulatory (vascular and lymphatic systems)
  44. 44. Human nervous system (Vesalius, circa 1548)
  45. 45. The Connective Tissue Link three bodywide connecting systems… circulatory (vascular and lymphatic systems) neural (central and peripheral nervous systems)
  46. 46. The Connective Tissue Link three bodywide connecting systems… circulatory (vascular and lymphatic systems) neural (central and peripheral nervous system) fascial (connective tissue network)
  47. 47. The Connective Tissue Link connective tissue literally forms (and informs) the body
  48. 48. The Connective Tissue Link connective tissue literally forms (and informs) the body one can follow the connective tissue trail from subcellular organelle to whole organism…
  49. 49. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… cell infrastructure: highly organised, 3-D cytoskeleton of microtubules & microfilaments
  50. 50. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… cell infrastructure: highly organised, 3-D cytoskeleton of microtubules & microfilaments links the nucleus, cytoplasmic organelles, and cell membrane
  51. 51. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… cell infrastructure: highly organised, 3-D cytoskeleton of microtubules & microfilaments cell membrane: network of filaments (integrins)
  52. 52. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… cell infrastructure: highly organised, 3-D cytoskeleton of microtubules & microfilaments cell membrane: network of filaments (integrins) links the intracellular structures with the extracellular matrix
  53. 53. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… cell infrastructure: highly organised, 3-D cytoskeleton of microtubules & microfilaments cell membrane: network of filaments (integrins) extracellular matrix: network of structural molecules
  54. 54. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… cell infrastructure: highly organised, 3-D cytoskeleton of microtubules & microfilaments cell membrane: network of filaments (integrins) extracellular matrix: network of structural molecules (collagens, laminins, fibronectins, proteoglycans)
  55. 55. Conventional view of the cell and the extracellular matrix
  56. 56. More accurate view of the cell and the extracellular matrix
  57. 57. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… fibrils of one sort or another mechanically link cells and extracellular matrix to form tissues…
  58. 58. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… fibrils of one sort or another mechanically link cells and extracellular matrix to form tissues… tissues to form body parts…
  59. 59. The Connective Tissue Link one can follow the connective tissue trail from subcellular organelle to whole organism… fibrils of one sort or another mechanically link cells and extracellular matrix to form tissues… tissues to form body parts… and body parts to form…
  60. 60. a whole body
  61. 61. The Connective Tissue Link information sent along these mechanical connections…
  62. 62. The Connective Tissue Link information sent along these mechanical connections… influences cell structure and function!
  63. 63. The Connective Tissue Link connective tissue truly connects everything in the body
  64. 64. The Connective Tissue Link connective tissue truly connects everything in the body it doesn’t begin or end anywhere
  65. 65. The Connective Tissue Link connective tissue truly connects everything in the body it doesn’t begin or end anywhere there are no real origins and insertions
  66. 66. The Connective Tissue Link connective tissue doesn’t just arise from or cover muscle…
  67. 67. The Connective Tissue Link connective tissue doesn’t just arise from or cover muscle… it arises within and comprises muscle
  68. 68. The Connective Tissue Link it arises within and comprises muscle connective tissue is not confined to the tendonous extension or the fascial covering of muscle
  69. 69. The Connective Tissue Link it arises within and comprises muscle connective tissue is not confined to the tendonous extension or the fascial covering of muscle it originates at the subcellular level and forms muscle…
  70. 70. The Connective Tissue Link it arises within and comprises muscle connective tissue is not confined to the tendonous extension or the fascial covering of muscle it originates at the subcellular level and forms muscle… and then keeps on going!
  71. 71. The Connective Tissue Link connective tissue doesn’t just run to bone…
  72. 72. The Connective Tissue Link connective tissue doesn’t just run to bone… it runs through bone
  73. 73. The Connective Tissue Link it runs through bone connective tissue is an integral part of bone’s structure
  74. 74. The Connective Tissue Link it runs through bone connective tissue is an integral part of bone’s structure not only does collagen form a major component of the bone’s outer covering (the periosteum)…
  75. 75. The Connective Tissue Link it runs through bone connective tissue is an integral part of bone’s structure not only does collagen form a major component of the bone’s outer covering (the periosteum)… collagen and other structural molecules create a matrix on which mineral is laid down to form bone throughout life
  76. 76. The Connective Tissue Link seeing the body as a continuous, 3-D network of connective tissue…
  77. 77. The Connective Tissue Link seeing the body as a continuous, 3-D network of connective tissue… makes it easier to understand how the body functions as an integrated whole
  78. 78. The Connective Tissue Link seeing the body as a continuous, 3-D network of connective tissue… makes it easier to understand how the body functions as an integrated whole switches us on to whole-body patterns of strain distribution and compensation
  79. 79. The Connective Tissue Link seeing the body as a continuous, 3-D network of connective tissue… helps us appreciate how a painful problem in one part…
  80. 80. The Connective Tissue Link seeing the body as a continuous, 3-D network of connective tissue… helps us appreciate how a painful problem in one part… can be linked to a ‘silent’ problem in some distant part
  81. 81. The Connective Tissue Link seeing the body as a continuous, 3-D network of connective tissue… helps us appreciate how a painful problem in one part… can be linked to a ‘silent’ problem in some distant part reminds us to think GLOBALLY
  82. 82. A Living Tensegrity Model Tensegrity = tension + integrity
  83. 83. A Living Tensegrity Model Tensegrity = tension + integrity refers to structures that maintain their integrity…
  84. 84. A Living Tensegrity Model Tensegrity = tension + integrity refers to structures that maintain their integrity… primarily via a balance of continuous tensile forces throughout the structure
  85. 85. A Living Tensegrity Model Tensegrity = tension + integrity refers to structures that maintain their integrity… primarily via a balance of continuous tensile forces throughout the structure e.g. suspension bridge (tensegrity) vs. stacked-stone bridge (compression)
  86. 86. A Living Tensegrity Model tensegrity structures comprise:
  87. 87. A Living Tensegrity Model tensegrity structures comprise: individual compression-resistant members (rigid struts)…
  88. 88. A Living Tensegrity Model tensegrity structures comprise: individual compression-resistant members (rigid struts)… balanced and ‘poised’, separate from one another, in a…
  89. 89. A Living Tensegrity Model tensegrity structures comprise: individual compression-resistant members (rigid struts)… balanced and ‘poised’, separate from one another, in a… continuous network of tension members (flexible cables)
  90. 90. A Living Tensegrity Model tensegrity structures: the struts resist the inward pull of the tension members
  91. 91. A Living Tensegrity Model tensegrity structures: the struts resist the inward pull of the tension members the tension members restrain & support the struts
  92. 92. A Living Tensegrity Model tensegrity structures: the struts resist the inward pull of the tension members the tension members restrain & support the struts as long as these forces are balanced, the structure remains in dynamic balance
  93. 93. A Living Tensegrity Model this balance and synergy of compression and tension makes the structure maximally efficient
  94. 94. A Living Tensegrity Model tensegrity structures are:
  95. 95. A Living Tensegrity Model tensegrity structures are: very strong stronger than predicted by the sum of their parts
  96. 96. A Living Tensegrity Model tensegrity structures are: very strong very stable despite initial appearances (insubstantial and unsteady)
  97. 97. A Living Tensegrity Model tensegrity structures are: very strong very stable very resilient
  98. 98. A Living Tensegrity Model tensegrity structures are very resilient: continuous network of flexible tension members…
  99. 99. A Living Tensegrity Model tensegrity structures are very resilient: continuous network of flexible tension members… allows the structure to be very accommodating
  100. 100. A Living Tensegrity Model tensegrity structures are very resilient: continuous network of flexible tension members… allows the structure to be very accommodating in response to local stress, all of the interconnected elements rearrange themselves a little
  101. 101. A Living Tensegrity Model tensegrity structures are very resilient: continuous network of flexible tension members… allows the structure to be very accommodating in response to local stress, all of the interconnected elements rearrange themselves a little the whole system accommodates to attenuate local stress
  102. 102. A Living Tensegrity Model whole system accommodates to attenuate local stress: load one part and the whole structure will ‘give’ a little
  103. 103. A Living Tensegrity Model whole system accommodates to attenuate local stress: load one part and the whole structure will ‘give’ a little load it too much, however, and ultimately the structure will ‘give way’…
  104. 104. A Living Tensegrity Model whole system accommodates to attenuate local stress: load one part and the whole structure will ‘give’ a little load it too much, however, and ultimately the structure will ‘give way’… but not necessarily anywhere near where the excessive load was placed
  105. 105. A Living Tensegrity Model whole system accommodates to attenuate local stress: because it distributes strain throughout, along the lines of tension…
  106. 106. A Living Tensegrity Model whole system accommodates to attenuate local stress: because it distributes strain throughout, along the lines of tension… the structure is most likely to break at some weak point…
  107. 107. A Living Tensegrity Model whole system accommodates to attenuate local stress: because it distributes strain throughout, along the lines of tension… the structure is most likely to break at some weak point… which may be some distance from the area of applied strain
  108. 108. A Living Tensegrity Model by virtue of its continuous network of connective tissue…
  109. 109. A Living Tensegrity Model by virtue of its continuous network of connective tissue… the horse’s body acts like a living tensegrity structure
  110. 110. a living tensegrity structure
  111. 111. conventional view
  112. 112. tensegrity view
  113. 113. A Living Tensegrity Model the horse’s body as a living tensegrity model: conformation, tone, balance, and resilience (or vulnerability) of the entire system are determined by…
  114. 114. A Living Tensegrity Model the horse’s body as a living tensegrity model: conformation, tone, balance, and resilience (or vulnerability) of the entire system are determined by… myofascial tension
  115. 115. A Living Tensegrity Model the horse’s body as a living tensegrity model: it then becomes clear how an injury can result from abnormal load or tension in another part…
  116. 116. A Living Tensegrity Model the horse’s body as a living tensegrity model: it then becomes clear how an injury can result from abnormal load or tension in another part… that may be some distance away
  117. 117. A Living Tensegrity Model the horse’s body as a living tensegrity model: it then becomes clear how an injury can result from abnormal load or tension in another part… that may be some distance away e.g. flexor tendonitis in a forelimb, arising from a problem in the contralateral hindlimb
  118. 118. A Living Tensegrity Model the horse’s body as a living tensegrity model: injury may occur where it does because of…
  119. 119. A Living Tensegrity Model the horse’s body as a living tensegrity model: injury may occur where it does because of… inherent weakness or previous damage at that site…
  120. 120. A Living Tensegrity Model the horse’s body as a living tensegrity model: injury may occur where it does because of… inherent weakness or previous damage at that site… not necessarily because of excessive local strain
  121. 121. A Living Tensegrity Model seeing the body as a living tensegrity model:
  122. 122. A Living Tensegrity Model seeing the body as a living tensegrity model: enables us to get a more complete picture of the problem
  123. 123. A Living Tensegrity Model seeing the body as a living tensegrity model: enables us to get a more complete picture of the problem provides a basis for which structural interventions can improve movement and facilitate tissue repair
  124. 124. A Living Tensegrity Model seeing the body as a living tensegrity model: enables us to get a more complete picture of the problem provides a basis for which structural interventions can improve movement and facilitate tissue repair e.g. various manual and movement therapies
  125. 125. A Living Tensegrity Model seeing the body as a living tensegrity model: enables us to get a more complete picture of the problem provides a basis for which structural interventions can improve movement and facilitate tissue repair e.g. various manual and movement therapies or simply restoring balance and comfort to the feet!
  126. 126. A Living Tensegrity Model seeing the body as a living tensegrity model: and, by identifying areas of local strain or lines of chronic tension/strain before they lead to structural damage…
  127. 127. A Living Tensegrity Model seeing the body as a living tensegrity model: and, by identifying areas of local strain or lines of chronic tension/strain before they lead to structural damage… and restoring the balance of myofascial tone in the system, …
  128. 128. A Living Tensegrity Model seeing the body as a living tensegrity model: and, by identifying areas of local strain or lines of chronic tension/strain before they lead to structural damage… and restoring the balance of myofascial tone in the system, … many athletic injuries may be prevented
  129. 129. ‘Anatomy Trains’ a metaphorical approach to functional anatomy
  130. 130. ‘Anatomy Trains’ a metaphorical approach to functional anatomy takes the concept of interconnection and lines of strain a step further…
  131. 131. ‘Anatomy Trains’ a metaphorical approach to functional anatomy takes the concept of interconnection and lines of strain a step further… by identifying clinically important myofascial pathways
  132. 132. ‘Anatomy Trains’ The premise:
  133. 133. ‘Anatomy Trains’ The premise: “whatever else they may be doing individually…
  134. 134. ‘Anatomy Trains’ The premise: “whatever else they may be doing individually… muscles also operate across functionally integrated body-wide continuities within the fascial webbing
  135. 135. ‘Anatomy Trains’ “these sheets and lines follow the warp and weft of the body’s connective tissue fabric…
  136. 136. ‘Anatomy Trains’ “these sheets and lines follow the warp and weft of the body’s connective tissue fabric… forming traceable ‘meridians’ of myofascia
  137. 137. ‘Anatomy Trains’ “these sheets and lines follow the warp and weft of the body’s connective tissue fabric… forming traceable ‘meridians’ of myofascia strain, tension, fixation, and compensations are all distributed along these lines”
  138. 138. ‘Anatomy Trains’ 11 “myofascial continuities commonly employed around the human frame”
  139. 139. ‘Anatomy Trains’ 11 “myofascial continuities commonly employed around the human frame” individuals may develop other functional lines that are unique to them
  140. 140. ‘Anatomy Trains’ 11 “myofascial continuities commonly employed around the human frame” individuals may develop other functional lines that are unique to them set up by patterns of use or injury
  141. 141. Superficial Back Line
  142. 142. Superficial Front Line
  143. 143. The two lines work together for postural support Superficial Back Line (SBL) Superficial Front Line (SFL)
  144. 144. Back Functional Line
  145. 145. Back Functional Line in the horse?
  146. 146. ‘Anatomy Trains’ underlying principle:
  147. 147. ‘Anatomy Trains’ underlying principle: continuity of fascial fibres from one piece of track to the next
  148. 148. ‘Anatomy Trains’ underlying principle: continuity of fascial fibres from one piece of track to the next either direct or indirect (via intervening bony connection)
  149. 149. Superficial Front Line
  150. 150. ‘Anatomy Trains’ underlying principle: continuity of fascial fibres from one piece of track to the next thus, continuity of tensile transmission along the entire track
  151. 151. ‘Anatomy Trains’ underlying principle: continuity of fascial fibres from one piece of track to the next thus, continuity of tensile transmission along the entire track functional integration of the structurally integrated elements
  152. 152. ‘Anatomy Trains’ Anatomy Trains and the horse:
  153. 153. ‘Anatomy Trains’ Anatomy Trains and the horse: provides much food for thought in reinterpreting equine functional anatomy, but…
  154. 154. ‘Anatomy Trains’ Anatomy Trains and the horse: provides much food for thought in reinterpreting equine functional anatomy, but… it is an exercise in frustration to attempt to transfer myofascial lines directly from human to equine frame
  155. 155. ‘Anatomy Trains’ Anatomy Trains and the horse: horses have much more substantial fascial connections and interconnections…
  156. 156. ‘Anatomy Trains’ Anatomy Trains and the horse: horses have much more substantial fascial connections and interconnections… which reflects the functional priorities of this species
  157. 157. The Horse speed & economy of locomotion are priorities for horses
  158. 158. The Horse speed & economy of locomotion are priorities for horses flexibility & dexterity may be higher priorities in humans
  159. 159. The Horse speed & economy of locomotion are priorities for horses several structural and functional features reflect these priorities…
  160. 160. The Horse long, slender limbs
  161. 161. The Horse long, slender limbs strong enough to support the body, yet…
  162. 162. The Horse long, slender limbs strong enough to support the body, yet… lightweight enough to move with minimal effort at speed
  163. 163. The Horse the bulk of the muscle mass is located on the upper limb and attachment of the limb to the trunk…
  164. 164. The Horse the power for gross limb movements (i.e. locomotion) is generated at the top of the limb
  165. 165. The Horse the power for gross limb movements (i.e. locomotion) is generated at the top of the limb forelimb kinematics - jointed pendulum
  166. 166. The Horse the power for gross limb movements (i.e. locomotion) is generated at the top of the limb forelimb kinematics - jointed pendulum hindlimb kinematics - jointed lever
  167. 167. The Horse joint conformation below shoulder and hip limits gross movement to flexion-extension in the sagittal plane
  168. 168. Left forelimb, lateral view Left hindlimb, lateral view
  169. 169. The Horse joint conformation below shoulder and hip limits gross movement to flexion-extension in the sagittal plane shape of the articular surfaces
  170. 170. The Horse joint conformation below shoulder and hip limits gross movement to flexion-extension in the sagittal plane shape of the articular surfaces e.g. sagittal ridges and corresponding grooves in facing surfaces
  171. 171. Left forelimb, cranial view Left hindlimb, cranial view
  172. 172. The Horse joint conformation below shoulder and hip limits gross movement to flexion-extension in the sagittal plane shape of the articular surfaces position and orientation of supporting soft tissues
  173. 173. The Horse joint conformation below shoulder and hip limits gross movement to flexion-extension in the sagittal plane shape of the articular surfaces position and orientation of supporting soft tissues collateral ligaments, palmar ligaments, flexors, extensors, etc.
  174. 174. Left carpus, lateral view
  175. 175. The Horse and tying it all together (literally):
  176. 176. The Horse and tying it all together (literally): the long, polyarticular flexors/extensors and the many shorter but functionally inseparable fascial structures…
  177. 177. The Horse and tying it all together (literally): the long, polyarticular flexors/extensors and the many shorter but functionally inseparable fascial structures… “tie” the bones together such that…
  178. 178. The Horse and tying it all together (literally): the long, polyarticular flexors/extensors and the many shorter but functionally inseparable fascial structures… “tie” the bones together such that… flexion/extension of the limb during locomotion is a single, fluid, coordinated action, in which…
  179. 179. The Horse and tying it all together (literally): the long, polyarticular flexors/extensors and the many shorter but functionally inseparable fascial structures… “tie” the bones together such that… flexion/extension of the limb during locomotion is a single, fluid, coordinated action, in which… the entire limb folds up or straightens as a unit
  180. 180. during locomotion, flexion/extension of the limb is a single, coordinated action
  181. 181. The Horse flexors/extensors below the elbow or stifle don’t really do what we were taught they do…
  182. 182. The Horse flexors/extensors below the elbow or stifle don’t really do what we were taught they do… individually, they primarily act as shock absorbers or energy stores
  183. 183. The Horse flexors/extensors below the elbow or stifle don’t really do what we were taught they do… individually, they primarily act as shock absorbers or energy stores another important contributor to economy of locomotion
  184. 184. The Horse flexors/extensors below the elbow or stifle don’t really do what we were taught they do… individually, they primarily act as shock absorbers or energy stores they flex/extend in concert with, and under the influence of, the more proximal muscles
  185. 185. The Horse flexors/extensors below the elbow or stifle don’t really do what we were taught they do… individually, they primarily act as shock absorbers or energy stores they flex/extend in concert with, and under the influence of, the more proximal muscles in other words, they flex/extend both actively and passively…
  186. 186. The Horse flexors/extensors below the elbow or stifle don’t really do what we were taught they do… individually, they primarily act as shock absorbers or energy stores they flex/extend in concert with, and under the influence of, the more proximal muscles they serve an equally important role in supporting and stabilising the joints they cross
  187. 187. The Horse example: deep digital flexor (DDF) in the forelimb
  188. 188. The Horse example: deep digital flexor (DDF) in the forelimb connects distal humerus and proximal radius & ulna…
  189. 189. The Horse example: deep digital flexor (DDF) in the forelimb connects distal humerus and proximal radius & ulna… to third phalanx along the caudal/palmar aspect of the limb
  190. 190. The Horse example: deep digital flexor (DDF) in the forelimb connects distal humerus and proximal radius & ulna… to third phalanx along the caudal/palmar aspect of the limb when considered in its entirety, it is mostly connective tissue
  191. 191. Deep digital flexor tendon
  192. 192. The Horse example: deep digital flexor (DDF) in the forelimb when considered in its entirety, it is mostly connective tissue there are three fleshy muscle bellies in the forearm
  193. 193. The Horse example: deep digital flexor (DDF) in the forelimb when considered in its entirety, it is mostly connective tissue there are three fleshy muscle bellies in the forearm but these muscle bellies have extensive fascial connections both within and without
  194. 194. deep digital flexor (humeral head) Left forelimb, medial view (deep dissection)
  195. 195. Left antebrachium, cross-section
  196. 196. The Horse example: deep digital flexor (DDF) in the forelimb its primary action can be replicated in a dead horse…
  197. 197. The Horse example: deep digital flexor (DDF) in the forelimb its primary action can be replicated in a dead horse… simply by reproducing the action of the long head of m. triceps brachii
  198. 198. The Horse example: deep digital flexor (DDF) in the forelimb its primary action can be replicated in a dead horse… simply by reproducing the action of the long head of m. triceps brachii i.e. drawing up on the olecranon
  199. 199. The Horse example: deep digital flexor (DDF) in the forelimb thus, an important component of its primary role as a digital flexor is accomplished passively
  200. 200. The Horse example: deep digital flexor (DDF) in the forelimb thus, an important component of its primary role as a digital flexor is accomplished passively when the olecranon is raised by another muscle (or muscles)
  201. 201. The Horse this structural & functional relationship between P3 and triceps is part of an ‘Anatomy Trains’ line…
  202. 202. deep digital flexor triceps (long head) rhomboid (nuchal ligament)
  203. 203. The Horse this integrative approach to anatomy suggests a new way of interpreting musculoskeletal disorders
  204. 204. The Horse this integrative approach to anatomy suggests a new way of interpreting musculoskeletal disorders consider the implications of the DDF-triceps-rhomboid connection in relation to the club-footed horse…
  205. 205. The Horse DDF-triceps-rhomboid & the club-footed horse… flexor contracture of the coffin joint is assumed to be caused by excessive tension in the DDF
  206. 206. The Horse DDF-triceps-rhomboid & the club-footed horse… flexor contracture of the coffin joint is assumed to be caused by excessive tension in the DDF WHY excessive tension develops and persists in this structure is never addressed
  207. 207. The Horse DDF-triceps-rhomboid & the club-footed horse… flexor contracture of the coffin joint is assumed to be caused by excessive tension in the DDF WHY excessive tension develops and persists in this structure is never addressed what if the DDF is merely a passive participant in an event that originates further up the line?
  208. 208. The Horse DDF-triceps-rhomboid & the club-footed horse… what if the DDF is merely a passive participant in an event that originates further up the line? if so, then it suggests some less invasive alternatives to inferior check desmotomy and other surgical solutions
  209. 209. a living tensegrity structure
  210. 210. Putting it all Together every part of the musculoskeletal system is inter- connected, so any action has system-wide impact
  211. 211. Putting it all Together every part of the musculoskeletal system is inter- connected, so any action has system-wide impact introducing tension into the system at one location…
  212. 212. Putting it all Together every part of the musculoskeletal system is inter- connected, so any action has system-wide impact introducing tension into the system at one location… e.g. uncomfortable saddle, rider hauling on the reins
  213. 213. Putting it all Together every part of the musculoskeletal system is inter- connected, so any action has system-wide impact introducing tension into the system at one location… e.g. uncomfortable saddle, rider hauling on the reins e.g. postural adjustments made to avoid further foot pain
  214. 214. Putting it all Together every part of the musculoskeletal system is inter- connected, so any action has system-wide impact introducing tension into the system at one location… inevitably results in bodywide compensations that limit optimal function…
  215. 215. Putting it all Together every part of the musculoskeletal system is inter- connected, so any action has system-wide impact introducing tension into the system at one location… inevitably results in bodywide compensations that limit optimal function… and may ultimately overload a vulnerable structure
  216. 216. Putting it all Together fortunately, the converse is also true:
  217. 217. Putting it all Together fortunately, the converse is also true: a sensitive and skilled therapist or rider can positively impact the situation…
  218. 218. Putting it all Together fortunately, the converse is also true: a sensitive and skilled therapist or rider can positively impact the situation… by relieving or redistributing abnormal myofascial tone…
  219. 219. Putting it all Together fortunately, the converse is also true: a sensitive and skilled therapist or rider can positively impact the situation… by relieving or redistributing abnormal myofascial tone… thus shifting the system back towards balance, resilience…
  220. 220. Putting it all Together fortunately, the converse is also true: a sensitive and skilled therapist or rider can positively impact the situation… by relieving or redistributing abnormal myofascial tone… thus shifting the system back towards balance, resilience… and optimal function
  221. 221. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best
  222. 222. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best no injury occurs in isolation!
  223. 223. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best no injury occurs in isolation! there will always be other areas of disorder elsewhere
  224. 224. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best no injury occurs in isolation! there will always be other areas of disorder elsewhere secondary/compensatory…
  225. 225. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best no injury occurs in isolation! there will always be other areas of disorder elsewhere secondary/compensatory… or actually the ‘silent’ instigator of the clinical problem
  226. 226. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best if not identified and addressed, these other problem areas can delay or limit full recovery…
  227. 227. Putting it all Together diagnosis and treatment that is confined to just the injured part is incomplete, at best if not identified and addressed, these other problem areas can delay or limit full recovery… and increase the potential for reinjury to occur
  228. 228. Putting it all Together when evaluating a horse with a structural or functional abnormality:
  229. 229. Putting it all Together when evaluating a horse with a structural or functional abnormality: ask “WHERE and WHAT?”
  230. 230. Putting it all Together when evaluating a horse with a structural or functional abnormality: ask “WHERE and WHAT?” ask “HOW and WHY?”
  231. 231. Putting it all Together when evaluating a horse with a structural or functional abnormality: ask “WHERE and WHAT?” ask “HOW and WHY?” and then ask “WHERE ELSE?”
  232. 232. Tailor treatment & rehab accordingly.

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