When you say “there's a knot in the muscle” you’re speaking about Myofascial Trigger Points.
Myofascial Pain Syndrome, a general definition that refers to all muscle pain and a specific definition that refers to pain caused by Myofascial Trigger Points. Myofascial Pain Syndrome can be a very painful, debilitating condition affecting the muscles and fascia (an interconnecting web formed by connective tissue throughout the entire body that plays an important role in the locomotory system and the influence it has on the biomechanics and posture.)
A Myofascial Trigger Point is a hyper-irritable patch of muscle tissue associated with a tight band within the muscle belly that elicits referred pain or a painful reaction with digital pressure or muscle contraction. Some fibers within the tight band are “stuck” in contraction, therefore, reducing the overall effectiveness of that muscle and its function.
Myofascial Pain is more prevalent in horses and is often the reason behind many poor performance and behavioural issues in a horse. It is also known to affect a horse’s biomechanics or way of moving.
Signs and Symptoms of Myofascial Pain within the Horse
Any or all gaits can be affected and become irregular and show uneven strides. The Horse might appear to move stiffly with a reduced tendency to track up in the walk. Incorrect paces in the walk, trot or canter may develop, any one of these gait changes need to be taken as a sign that something is wrong.
Sometimes the gaits are normal but the horse is unwilling to transition or even want to pick up a transition from the start. One example is a jumping horse which is reluctant to land on a lead leg, another is a dressage horse which has problems with its flying changes. Lower level horses may show difficulty in striking off on a particular lead or may continually break or disunite while in the canter.
If particular muscles have tight taut palpable bands within them and preventing other muscles from being engaged and also working incorrectly then the horse might not be capable of answering the training request of them. Not every horse will react the same, the level of pain the horse experiences depends on the particular muscles affected, the level and demands of training within the discipline, i.e. eventing, showjumping, racing, polo, games etc and the chronicity of which the muscles have been affected.
Causes of Myofascial Pain in Horses
When I’m taking a case history I always try to determine when the decrease in performance or change in behaviour was first noticed. A golden rule to live by is “listen to your gut” NEVER ignore your initial instinct or the advice of a rider when you/they feel your horse is off form. What might start off small and insignificant could quickly escalate to something more serious. Injury, overuse, inactivity, for example, box rest after an injury, incorrect training, inadequate warm-up and cool down, ill-fitting tack, poor dental, inadequate hoof or nutritional care can all contribute to myofascial pain. Fortunately, myofascial pain is treatable however a thorough investigation to determine contributing causes should always be undertaken to avoid any recurrence.
Dry Needling - Treatment & Management of Myofascial Trigger Points
Myofascial Trigger Points can be mechanically de-activated by Dry Needling. Depending on the area of the body that needs treating, varying different lengths of very fine, solid needles are inserted into the trigger point which then causes a localised twitch response. The muscle relaxes allowing the muscle fibers to lengthen, increases more blood flow, promoting healing and restoring normal function. Horses accept dry needling rather well with most just being held in a head collar. An important benefit of Dry Needling is the horse can continue the work with minimal time off.
In conclusion, Myofascial pain can be treated successfully if the complexities of horse, rider, and training and management interactions are addressed within the treatment protocol.
