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Animal Chiropractic

Technique Manual

Equine

Extremity Adjustments

Version 2

Ian Bidstrup, Heidi Douglas, Kate Haines, Wendi Housiaux, Kim Lim, Susan Telepis

©AVCA 2007

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Animal Chiropractic

Technique Manual

FORELIMB TECHNIQUES

Equine

©ABPA

2015 revised 2006, 2007, 2008, 2015

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CONTENTS EQUINE TECHNIQUES - PAGE

Forelimb

1. Extension restriction of the Glenohumeral joint 6

2. Internal Rotation/External Rotation Restriction of the Glenohumeral joint 7

3. Ventro-dorsal glide restriction of the Scapula 8

4. Dorso-ventral glide restriction of the Scapula 9

5. Caudal Scapula glide Restriction 10

6. Cranial Scapula Glide Restriction (ref. Dorsal Scapula cartilage), Distal Scapula

11

7. Elbow Extension Restriction 12

7a. Radial Head Extension/Rotation Restriction 13

8. Elbow Flexion Restriction 13

9. Accessory Carpal Glide 14

10. Carpal Extension Restriction 15

11. Carpal Flexion Restriction 16

12. Fetlock P1-P2-P3 Motion Restriction 17

13. Sesamoid Glide Restriction 18

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KEY TO TECHNIQUE CHARTS

Motion Star

SPATIAL TERMS

ANIMAL HUMAN

(D)Dorsal Posterior

(V)Ventral Anterior

(Cr)Cranial Superior

(Cd)Caudal Inferior

(L)Lateral Lateral

(M)Medial Medial

Depicts left or right sacroiliac joint motion restrictions. Eg. Right Sacroiliac extension restriction shown. Can be used also for coxofemoral joint restrictions (left & right rotation bars not shown here).

Depicts motion restrictions at Occiput-Cervical-Thoracic-Lumbar-Lumbosacral joints. Accordingly, the specific motor unit displaying the restriction is identified, eg L2/3, C3/4 etc. Throughout this manual, photographs depicting body positioning and contact points are used. The white arrows correspond to the direction of the Line of Correction.

flexion

extension

rightlateralflexion

leftlateralflexion

leftrotation

rightrotation

restriction

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KEY TO TABLES

Joint Motion segment where motion restriction is detected. All positions are relative to the side of the joint restriction.

Motion restriction Direction of motion restriction

Doctor position Ipsilateral/contralateral used in reference to the side of restriction. Fencer’s stance - with legs balanced to give maximal stability and balance. The doctor’s centre of gravity, gluteals and shoulder of adjusting hand should be behind the adjusting hand. Body Drop - uses the weight of the doctor's body to provide force for the downward thrust through the L.O.C. The doctor's arms and shoulders are locked and the drop is performed by flexing at the knees and/or ankles.

Handler position At the patient's head and always the same side as the doctor in horses unless otherwise indicated

Animal position Animal posture to maximize stability for adjustments. Stabilization is often inherent in the standing horse.

S.C.P Segmental Contact Point - anatomical landmark through which thrust vector is applied

1o C.P. Primary Contact Point - Doctor’s primary anatomical structure through which thrust force is applied to the patient. Eg. Pisiform, calcaneal

2o C.P Secondary Contact Point - Location of supporting arm/hand during adjustment procedure. This may be to

1. 1. Stabilize adjacent joints to the adjustment 2. 2. To support and protect the doctor’s own adjusting hand if stabilization

is already inherent in the animal 3. eg. Toggle Position - the pisiform of the indifferent hand is placed in

the snuff box of the primary hand. There should be an imaginary line running from the doctor’s sternal notch, through the primary contact point, continuing through segment being adjusted in the LOC. Supported Wrist Position - the indifferent hand grasps the wrist of the thrusting hand to prevent hyperextension of the primary wrist. This is primarily used with the Body Drop.

L.O.C. Line Of Correction - direction through which the thrust’s force vector is applied usually along line/s of joint planes.

Thrust Style of adjustment thrust (high velocity, low amplitude thrusts) 1.High Velocity, Low Amplitude Thrust (HVLA)- hands stay at end-point position after adjustment, the segment maintains its position, there is no recoil. 2.Recoil - hands are quickly removed from vertebra following the adjustment. This allows the segment to recoil and find its own level.

Notes Additional comments

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Extremity techniques – note - many extremity motion restrictions will resolve once the spine and pelvic joints are functioning correctly. Treat these first. Local scar or myotherapy may also be indicated before attempting limb adjustment.

EQUINE FORELIMB TECHNIQUES

1. Extension restriction of the Glenohumeral joint

Joint Glenohumeral joint

Motion restriction Extension

Doctor position Standing at front of horse facing caudally, slightly to ipsilateral side

Animal position Standing square, Ipsilateral pastern or cannon held between Dr’s knees, forelimb in extension.

S.C.P Over Glenohumeral joint & proximal humerus

1o C.P Pisiform/Calcaneal of medial hand (arm closest to horse)

2o C.P Stabilising over primary contact. If small horse may use indifferent hand to hold forelimb

L.O.C Cr>Cd, slight D>V (through the bisection of the joint), angle may vary depending on the limb position, the aim is to distract the joint slightly during the thrust

Thrust Traction leg. Could also use assistant to hold leg fwd

Notes If using assistant, be aware of their posture/spine. Beware of Hyperextension of carpus in older animals. Check the status of any associated musculature – Triceps, Deltoid etc and treat associated spinal restrictions and muscular problems first.

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2. Internal Rotation/External Rotation Restriction of the Glenohumeral joint

Joint Glenohumeral

Motion restriction lnternal or External Rotation

Doctor position Ipsilateral at level of shoulder facing across. Horses forelimb flexed off ground with fetlock supported behind Dr’s calf *

Animal position Standing square with ipsilateral leg off the ground, not wt bearing

S.C.P a)Olecranon & b)Proximal Humerus

1o C.P Calcaneal/Thenar & Fingertips

2o C.P Calcaneal/Thenar & Fingertips

L.O.C Int Rotation: Pull olecranon M>L whilst drawing GH joint medially or Ext Rot: Push olecranon L>M whilst pulling GH joint M>L

Thrust Thrust should be through the GH joint with the proximal hand, any pull through the olecranon should be secondary

Notes *Preferences vary as to the use of Dr’s Cr or Cd to support the horses forelimb. Cr leg ie : On left side forelimb supported behind Dr’s left calf or the Cd leg. Alternatively using the Dr’s Cd leg may cause less ‘twist’ in the Dr’s spine, but there is the possibility of the Dr overbalancing if the horse pulls its forelimb forward.

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3. Ventro-dorsal glide restriction of the Scapula

Joint Scapulothoracic

Motion restriction Ventro-dorsal glide restriction

Doctor position Ipsilateral side facing across at level of shoulder

Animal position Standing square with ipsilateral forelimb flexed

S.C.P Indirect technique

1o C.P Forearm of contact hand behind carpus and holding cannon

2o C.P Support under fetlock, can use Dr hip to help with movement in LOC

L.O.C V>D along line of spine of scapula

Thrust Horse’s leg fully flexed. Can thrust using knees & keeping Dr back straight

Notes Protect carpus by having forearm resting on palmar surface

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4. Dorso-ventral glide restriction of the Scapula

Joint Scapulothoracic

Motion restriction Dorso-ventral glide restriction

Doctor position Elevated above horse on contralateral side at the level of the shoulder, facing across

Animal position

S.C.P Dorsal Scapula cartilage, ipsilateral side

1o C.P Calcaneal

2o C.P Supporting wrist

L.O.C D>V, slight Cd>Cr along the line of the scapula spine

Thrust

Notes Assistant lifts and holds ipsilateral leg flexed *Spinal and muscle work pertaining to the Upper Trapezius and Rhomboids should be done before attempting this adjustment

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5. Caudal Scapula glide Restriction, Proximal Scapula (Ref: Dorsal Scapula cartilage)

Joint Scapulothoracic

Motion restriction Caudal scapula glide, proximal scapula

Doctor position Set up as in technique 1 with leg between Docs knees and toggle position

Animal position

S.C.P Cranial aspect of proximal portion of scapula

1o C.P Pisiform of lower hand

2o C.P Knees and inside leg

L.O.C 1o Cranial to caudal, 2o Cd-Cr, V-D by straightening knees

Thrust

Notes As leg pulled forwards GH joint comes forward and proximal scapula moves backwards taking cranio-dorsal scapula muscles to tension

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6. Cranial Scapula glide Restriction (ref. Dorsal Scapula cartilage), Distal Scapula

Joint Scapulothoracic

Motion restriction Caudal scapula glide, distal scapula

Doctor position Cranial to ipsilateral foreleg

Animal position

S.C.P a) Cranial aspect of glenohumoral joint b) ipsilateral cannon

1o C.P a) Palmar aspect of upper hand

2o C.P b) hand grip

L.O.C 1o Cranial to caudal,

Thrust Should thrust

Notes 2o hand supporting leg in flexion

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7. Elbow Extension Restriction

Joint Humeroulnar and humeroradial

Motion restriction Extension

Doctor position Standing in front of horse slightly to ipsilateral side, facing Cd . Dr’s medial shoulder braced against ipsilateral horse’s GH joint

Animal position Pastern held between Dr’s knees, leg in extension

S.C.P Caudal surface of the Olecranon

1o C.P Looped Fingers @ Olecranon

2o C.P

L.O.C Cd>Cr, slight V-D towards the head

Thrust

Notes NB: Radius & Ulna are fused in equines - Radial head lateral aspect forearm. Looped Fingers @ Olecranon using thenar pad over Radial head. Cd>Cr, D>V, also slight L>M. See 7a !

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7.a Radial Head Extension/Rotation Restriction

Joint Radiohumeral

Motion restriction *Rotation component

Doctor position Standing in front of horse slightly to ipsilateral side, facing Cd . Dr’s medial shoulder braced against ipsilateral horse’s GH joint

Animal position Pastern held between Dr’s knees, leg in extension

S.C.P Radial head lateral aspect forearm

1o C.P Looped Fingers @ Olecranon using thenar pad over Radial head

2o C.P

L.O.C Cd>Cr, D>V, also slight L>M

Thrust

Notes Use knees to provide some traction to forelimb

8. Elbow Flexion Restriction

Joint Humero ulnar

Motion restriction Flexion

Doctor position Ipsilateral side at shoulder level facing across with knees bent feet apart

Animal position

S.C.P Dorsal Elbow joint

1o C.P Cr forearm against dorsal elbow joint

2o C.P Cd hand supporting cannon & fetlock

L.O.C

Thrust More of a gentle stretch. Gentle repeated traction, more of a gentle stretch

Notes Can use Dr’s hip/thigh to assist - Thrust not indicated

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9. Accessory Carpal Glide restriction

Joint Accessory Carpal

Motion restriction Medial or Lateral glide

Doctor position Ipsilateral side at shoulder level facing across with knees bent feet apart

Animal position Standing square with ipsilateral forelimb flexed off the ground

S.C.P Medial or Lateral Accessory bone

1o C.P Medial: Fingertips of contact hand Lateral : Thumb/ Pisiform of contact hand

2o C.P Lift forelimb to partially flex forelimb

L.O.C Medial: push L>M or Lateral : pull M>L

Thrust

Notes Loop 2: Can also use Activator

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10. Carpal Extension Restriction

Joint Carpals

Motion restriction Extension

Doctor position Standing at front of horse facing Cd; horse’s cannon held between Dr’s knees.

Animal position

S.C.P Dorsum of relevant carpal bones

1o C.P Bilateral thumb pads

2o C.P Fingers wrapped around Carpus

L.O.C Dorsal > Palmar

Thrust HVLA

Notes Thrust with leg in extension, using knees to traction forelimb. Should not be in full extension before thrust – will damage joint Row 1: R,I,U,A ; Row 2 : 1*,2,3,4 Be gentle. May be arthritis

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11. Carpal Flexion Restriction

Joint Carpus

Motion restriction Flexion

Doctor position Ipsilateral side at shoulder level facing across with knees bent, feet apart

Animal position

S.C.P Palmar aspect of Carpus

1o C.P Forearm of contact arm

2o C.P Supporting fetlock

L.O.C Lift fetlock gently

Thrust Traction type movement. Can thrust at point of tension

Notes

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12. Fetlock P1-P2-P3 Motion Restriction

Joint Coffin, Pastern or Fetlock joint

Motion restriction Flexion, Extension, Rotation

Doctor position In front of horse facing Cd, with Indifferent arm supported on thigh

Animal position

S.C.P Over P1, P2 or P3

1o C.P Palm over hoof

2o C.P Holding under fetlock to stabilize the relevant joint

L.O.C According to restriction

Thrust Basically Flexion & Extension and Rotation against motion restriction

Notes Distract as free up. Foot Roll or Figure 8 are of benefit. Strong Collateral ligaments *Note each individual joint P1/P2 & P2-P3 – have different contact points & stabilization. P1-P2: stabilise P1, contact P2, F/E primarily, possibly a little LF. P2-P3: stabilize p2, contact hoof capsule, Flexion/Extension and rotatory components, traction also useful.

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13. Sesamoid Glide Restriction

Joint Sesamoids

Motion restriction Distal-proximal glide

Doctor position Beside horse facing Cr, with Indifferent arm supported on thigh

Animal position

S.C.P Palmar surface of the base of the sesamoids

1o C.P Bilateral thumb pads

2o C.P Fingers wrapped around dorsal surface of P1

L.O.C D>P

Thrust Thrust at end of movement while flexing fetlock joint

Notes