SI Soreness and Treatment - The Horse Forum
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post #1 of 23 Old 12-19-2017, 11:50 PM Thread Starter
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SI Soreness and Treatment

Hi everyone!

Hopefully somebody can help me with this issue. My mare has a confirmed SI injury from her past (but no, if very small, hunters bump). This leads to her struggling to pick the back leg up for the farrier, along with a shortened stride and some reluctance jumping when the pain becomes too great. I've gone two cycles with this issue and her being turnout/stall-bound without riding while it heals. It's manageable, but right now our management strategies are strength exercises under saddle and chiropractic/massage.

I'd like to be proactive in helping my mare. I have an excellent massage therapist who comes as-needed to see her, and we are planning on putting her on the monthly schedule (there's a sweet discount). The last time she saw her, aka yesterday, she noticed she was about 3/10 sore in the SI. She was able to help relax the area but only to maybe a 1.5/10. And this massage therapist is really good! My mare loved her appointment, and today she rode GREAT, but her back and SI are two areas that must constantly be checked on.

We ride dressage and she does jump. She's required to use her hind end quite a bit, and the therapist hypothesized this is where the pain may come from (as she only jumps once a week, and very lightly). She also does a 2 hour trail once a week, but the therapist thought this was going to help more than hinder.

She didn't give us too much at-home homework, mostly because the sensitivity and discomfort was so minor. At the same time, anything above a 1, to me, is too much for my mare. I promised her when I bought her I would do everything in my power to keep her pain-free, so here I am asking for advice. My internet search has come up with almost nothing. Vet recommends SI injections when the pain becomes a 5-6. But that would require her to be hauled down to the clinic, which I'd like to not have to do (it's about an hour drive). She did say that injections can be prolonged as long as we keep that area strong and healthy.

Besides her massage appointments and injections, are there any at-home exercises I can do to help her?
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post #2 of 23 Old 12-20-2017, 12:01 AM Thread Starter
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Hm. as I read this article, I realize she shows none of these symptoms. The therapist asked about her hocks, if I have been noticing anything strange? Could her SI soreness be related to hocks, and how would I know? I'm not sure how to test for hock lameness.
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post #3 of 23 Old 12-20-2017, 09:01 AM
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SI problems are a crapshoot, they never seem to heal 100% and almost always cause issues down the track. My TB gelding has SI issues (probably from racing but who knows) and the only thing that made him truly comfortable was reducing his workload. We'd begun playing with some upper level dressage stuff and he was getting ready to step up to the 90-100cm SJ class but it just made him sore and it just wasn't worth it. He hadn't had too many issues before this point so we believe he redid an old injury in his SI when he was out in the paddock, but even after injections and rehab it was still painful and caused issues when trying to bump up to that next level. So, easiest solution was to reduce the work load, stop jumping regularly and he is happy as larry. I'd imagine massage/physio and injections would be the best management plan, perhaps a joint supplement too?

As for whether its hocks or SI, you'd need to get a full lameness exam for that including nerve blocks I'd imagine. Hind end lameness can be really difficult to pinpoint exactly where its coming from and flexions are often not helpful- Its very difficult to isolate and flex one single joint in the hind leg. X-rays might also be useful to see if there are any arthritic changes in the hocks. Either way, you would most likely need a vet to give you a definite answer.
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post #4 of 23 Old 12-20-2017, 10:30 AM
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Quote:
Originally Posted by cbako01 View Post
SI problems are a crapshoot, they never seem to heal 100% and almost always cause issues down the track. My TB gelding has SI issues (probably from racing but who knows) and the only thing that made him truly comfortable was reducing his workload. We'd begun playing with some upper level dressage stuff and he was getting ready to step up to the 90-100cm SJ class but it just made him sore and it just wasn't worth it. He hadn't had too many issues before this point so we believe he redid an old injury in his SI when he was out in the paddock, but even after injections and rehab it was still painful and caused issues when trying to bump up to that next level. So, easiest solution was to reduce the work load, stop jumping regularly and he is happy as larry. I'd imagine massage/physio and injections would be the best management plan, perhaps a joint supplement too?

As for whether its hocks or SI, you'd need to get a full lameness exam for that including nerve blocks I'd imagine. Hind end lameness can be really difficult to pinpoint exactly where its coming from and flexions are often not helpful- Its very difficult to isolate and flex one single joint in the hind leg. X-rays might also be useful to see if there are any arthritic changes in the hocks. Either way, you would most likely need a vet to give you a definite answer.
Oh well sh** that doesnt make me happy... My horse is dealing with an inflammated SI ligament and is on stallrest for 2 months, with injections... I was told he'd be 100% after :( ****, looks like that might not be the case then.

OP, my horse has arthritis in the hocks (very light, it doesnt really bother him, but he has a shorter stride behind and he takes a bit longer to warm up at the start of a ride) and he did something to his SI ligament a few weeks back so he's currently on stall rest. He did get the injection. My vet also said physiotherapy was an option, which would be 20 sessions, 10 continuous and then 10 'separate' ones. That was out of my budget and not really justified given the age/workload of my pony. My vet said he would heal fine with 2 months stallrest and injections alone. Physiotherapy might be worth looking into for you. My guy is getting massages every other day as well.

If it flares up again after he's done healing and back into work I will look into semi-retiring him to a barn where he can be out in the pasture, and where I will maybe play with liberty training, and hack him out on the trails on weekends. Maybe the occasional tiny jump. He was/is in work where he jumped twice a week (80-90cm) and was ridden almost daily. At any rate, my guy is around 20 years old, so 'early' retirement makes sense for him, I dont know how old your mare is.

We think he hurt himself when he was spooking at everything on a windy day, he probably made a weird movement when shying to the side and bolting at some point. According to the sonogram he has a fairly thinned ligament anyway, which makes him more prone to injury.
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post #5 of 23 Old 12-20-2017, 11:07 AM
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I've had 4 direct experiences with SI injuries and they all had different outcomes
A very talented young horse I had never recovered, the discomfort made him so irritable he became difficult to handle and the pain meds gave him ulcers so I eventually gave up and had him euthanized
A horse boarded with us had a rotational fall, recovered well enough to live a long life and competed in Endurance riding but was never able to jump again
Another horse boarded with us had a fall in the field, recovered well enough to jump again at lower level but developed some stiffness problems as he got older and spent the rest of his long life as a 'happy hacker'
A close friend had a horse who had a rotational fall eventually had him euthanized as he became too difficult to ride due to discomfort.


I personally wouldn't jump a horse at all if it was showing significant stiffness because these things are usually 'wear and tear' related so the more wear you put on them the worse they get.
You can use pain meds which help the horse to use himself more correctly which in turn reduces the domino effect that a pain in one place causes on other places and also keep them comfortable but they're not competition legal so better to settle for giving the horse an easier life

Just winging it is not a plan
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post #6 of 23 Old 12-20-2017, 03:28 PM
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The thing with any SI injury is that to compensate the horse will generall misalign through the diagonal shoulder. If this is not corrected then the SI will misalign again.

It could well be that the SI injury was caused from a shoulder misalignment in the first place and that either could be caused from a neck misalignment.

Swings and roundabouts.

One big hunter I had kept misaligning behind, he was square in front and we couldn't fathom why he kept going 'wrong' though he was always sound.

My human chiropractor working with my equine chiropractor, found it all very interesting and offered the advice that it was happening because of muscle memory that kept pulling him out. He could only liken it to humans and with a human often pelvic injuries needed neck muscles to be 'reminded' of their correct positioning. He felt in Skips neck, worked on the muscle and thatnhorse never went wrong again.

Treatment as in adjustment, for SI depends on which way the horse is misaligned, one requires lifting the hind leg, the other on crossing it under the horse. Takes experience in knowing which is correct.
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post #7 of 23 Old 12-20-2017, 03:28 PM Thread Starter
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The SI issues seem to have come from racing. I believe this is what landed her in retirement in the first place.

I would be willing to do hock x rays, but the reason I haven't considered it is because the mare is 8. Her workload is about 5 hours a week, but she is ridden every day. We had almost 3 months in between the last massage/chiro appointments and the pain only got to a 3. So that's hopeful. I know SI Injections are quite a crap-shoot which is why I am reluctant to travel down that road.

The question is, is the SI a symptom of some other lameness? She shows none of the traditional SI issues: no bunnyhop, no hunters bump, she only has issues holding her hind leg and using her hind end at times. She has bunny-hopped in the past, during our 8 month rehab. So I believe a lot of the bucking problems we had were SI related.

I try to keep her as unmedicated as possible. I'm not down for treating pain whenever it crops up. I'd rather her be able to tell me when it's too much. We have a height-limit on this horse. She's not to go above 100cm (3'3). That is as high as she needs to jump to be competitive in our discipline. Any higher and we risk permanent injury. Her jump amount is significantly smaller. She jumps once a week for about 10 repetitions at most. My trainer knows of her lameness/soreness/body issues and trains appropriately. After the last massage appointment she felt AMAZING.

If it's just a matter of bodywork, that can be added into her program though I can't promise I can commit to a routine schedule. I could try joint supplements - anyone have recommendations? I've also considered legend/adequan but we aren't necessarily there. Right now she schools first level. We probably won't push her past third if we even get there. DEFINITELY not jumping higher than 3'3 ever. 2'6-3'3 is all she needs to do to stay in the A circuit.

This horse is not extremely sound in the traditional sense. She takes a lot of maintenance.
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post #8 of 23 Old 12-20-2017, 05:16 PM
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Honestly, if she isn’t tradionally sound and requires significant maintenance and she is only 8... I would question whether or not jumping her is fair. Or if you are jumping her into the ground- is that something you are ok with?

X-rays of her hocks and feet would be the best place to start. Know what you are actually dealing with.

Inject earlier rather than later so that you are staying ahead of the damage rather than chasing your tail with destroyed tissue and just trying to mask the problems.

Joint supplement to encourage healthy cartilage.

A GOOD VET/Chiro, saddle fit and massage are all pieces of the puzzle.

There are exercises to help strengthen the backend and hocks but you need to know what is hurting first.
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post #9 of 23 Old 12-21-2017, 12:52 PM Thread Starter
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Dehda, not jumping her into the ground. I think I was pretty clear that she jumps irregularly. Like I said she has none of the symptoms of SI disease which makes me think SI pain is related to something below. We will do X rays. Joint injections for the SI simply too risky right now. They are not to do with a faint heart.

Joint supplements you recommend that are proven to be effective?

When the SI ligaments are injured and heal it creates what is called a hunters bump which is not what she has. The SI can also be stressed through work that requires hind end engagement, which we have been doing with dressage, so I am not sure I would jump to jumping being the source of the problem.

Horses get sore like people get sore and she has a lot of pathologies we are battling. My question was related to how to help what we have right now, not how to make her perfect. She will never be perfect but she can be managed.

I'd prefer some homeopathic remedies rather than surgical and/or invasive. She's going to keep up with her massage, saddle fits per saddle fitter.
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post #10 of 23 Old 12-21-2017, 01:52 PM
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Originally Posted by thecolorcoal View Post

The question is, is the SI a symptom of some other lameness?
None of us can tell you that.

Without getting into the drama of the other closed thread, you need to pick a vet and take your horse for a full lameness evaluation. Based on what the vet finds, they will make recommendations on which tests might be best to run and if she seems to be sore anywhere else.

It is not uncommon for a horse to also have other hind end issues if they have SI issues, because often they try to compensate for it. But we cannot diagnose your horse over the internet. She needs to be evaluated in person by a professional.

Quote:
Originally Posted by thecolorcoal View Post

Joint supplements you recommend that are proven to be effective?
Since you don't actually *know* what is wrong with your horse, it would be a [email protected] to recommend any types of supplements, whether feed through or injectable.

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