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Exercise and Rehab Plan for PSSM Horse Muscle Issues

Originally posted 10/2/17

PSSM Horse Muscle Issues: Is it possible to bring them back once symptoms have started?

PSSM Horse Muscle Issues: Just after a colic episode, during his most severely symptomatic months.  Note the wasted and tense muscles around his flanks, lumbar, and stifles.

Before answering this question, let’s look at everything I’ve done to help bring Jax back to his former glory.  Keep in mind that he went severely symptomatic, and due to misdiagnosis was laid off for 6 months which made things much worse.  If you’re seeing subtle signs and have time to work with your horse daily (or at least 4-5 days/week) then you may not have a journey as difficult as we’ve had.

PSSM Horse Muscle Issues: Exercise & Rehab Plan

Note: injury, illness, and time off can set your horse back.  In these cases, lower the mileage and intensity of workouts for a few days to keep from setting off an episode.

The first few months of our PSSM horse muscle rehab (before diagnosis and moving Jax to a new barn) I worked on fixing his feet and lunging about 4-5 days/week.  This helped him to build up strength, but wasn’t quite enough to get him rideable.  After diagnosis (about 4 months into rehab) I moved him to a place with trails and an indoor arena.  I started riding him for about 10-15 minutes at a walk doing suppling exercises:  walking over poles, bending around cones, backing, etc.  We started venturing out onto the trail for slow, one mile rides just before winter 2016.

For the really cold months (and while he was on alfalfa) his muscles were very stiff so we rode inside most of the time.  We started adding short trot sessions (maybe 2 minutes total) and worked up to 25-30 minutes total ride time, again using lots of suppling exercises.  Just before spring 2017, I was able to add some canter (1-2 very short bursts per session) and we were up to 2 miles on the trail, walk only.  We kept building through spring and into summer, and by mid-summer we actually had enough canter to do a playday with a few friends (some barrels, pole bending, and a few games).  As the summer progressed, we made it up to 6 miles on the trail with lots of trot and canter.  

At the time of writing this, we’re at almost 18 months of rehab (edit to add: this is with PSSM1 diagnosis only – we had not yet tested for PSSM2 variants, and he was not yet being managed for PSSM2/RER).  He’s not 100% yet, but he’s probably about 95% most days.  He’s got his canter back, though it’s still rough some days and he’s much better cantering straight than he is in circles (the trot started out the same, and I think we’ll get a more collected and refined canter in a couple more months so that we can add circles) (edit to add: we did get more refined canter and small circles with the addition of PSSM2/RER management!).  On his bad days, we do a maintenance day (see below) with either a lunging session for exercise or a short arena day with suppling exercises.  Sometimes a light day may be about 2.5 miles of walking on the trail.  It’s been a long, slow process but he is getting stronger and is almost back to the horse he was at his pique (around the middle of his 7th year, about 3 years ago).

Here are a few ridden exercises that I use to work both his mind and his body.

PSSM Horse Muscle Issues: Maintenance Days

Occasionally, (about twice per month, more if needed) Jax will start to get a little slower, a little more tender in his muscles, and over all just a little “down” compared to his normal self.   There are also times that he’s been working hard for a week or so and I feel like he should get an easier day to help keep him going well.  These are times that I’ll throw a “maintenance day” into our PSSM horse muscle rehab plan.  Maintenance days usually look something like this:

  • (everyday) Check his back for soreness after assessing how he walks in from the pasture
  • (everyday) Feed 1/2 of his “grain” mix
  • Full trim on all four hooves if needed (usually do touch-ups in between these days)
  • Myofascial grooming work about 1-2 hours over his whole body, focusing on major muscle groups and sore spots (I groom him this way everyday, but usually for only about 10-15 minutes before tacking up)
  • Percussive massage (see below) – about 1-2 hours, focusing on major muscle groups of the neck, back, hindquarters, and sore spots
  • Light lunging with walk/trot/canter, some walking or backing over poles/up hills, and other light groundwork to loosen his muscles
  • On occasion, transdermal magnesium soak for sore muscles
  • (everyday) Feed other 1/2 of his “grain” mix
  • (everyday) Put him back out to pasture

These days are necessary to keep him going.  The next day is usually an easy walk trail ride (maybe 3-4 miles) to loosen him up more without asking for too much work, then we can start back where we left off the next day.

PSSM Horse Muscle Issues:

A sleek, loose-muscled Jax after a maintenance day, during a leisurely hand walk.  So relaxed he’s practically asleep!

PSSM Horse Muscle Issues: Massage and Bodywork

  • Starting out light – Beyond Horse Massage by Jim Masterson – This method is wonderful for when Jax can’t handle other types of muscle work.  Many owners on the PSSM Forum (Facebook) use it as well.  Look up his book on Amazon (link provided) and his videos on YouTube for more information.
  • Stress Points – Beating Muscle Injury for Horses by Jack Meagher – this book is amazing and can show you where your horse is really hurting and how to fix it.  The Masterson method was a great start when Jax was really bad, and this was a great complimentary method once we got to a point that he could handle it.  You can find it on Amazon.
  • Percussive Massager and Myofascial Release – Jax gets percussive massage (from a $30 hand-held massager I bought on Amazon) as often as needed, but at least once every 2-3 weeks.  The first couple of months of rehab he was getting daily massage due to severe muscle tightness.  He now gets daily grooming with a jelly groomer to loosen his fascia (see Gentle Myofascial Release for PSSM Horses), which has reduced his need for daily massage dramatically.  Update July 2020: Jax rarely gets massage with the percussive massager as he doesn’t seem to need it anymore (hasn’t had a massage in well over a year!).  We still touch up areas with Masterson and stress point work, and still do jelly grooming sessions on occasion, which aren’t essential daily any more.  Moving him home and getting his diet managed for all 3 genes has him healing his own muscles from the inside, and he needs far less support from body work now.
  • Stretching – many PSSM horses are helped by stretching.  Jax can handle that some days, but not very often.  I usually just rely on a slow, walking warmup and a Back On Track blanket (in cooler weather) rather than stretching him.  On days that he’s really bad and we can only do groundwork, I might stretch him as much as he can tolerate since he won’t get a lot of exercise on those days.  I should note here that Jax is extremely flexible!  It seems he’s better choosing when to stretch himself rather than having it chosen for him, though I’m not 100% sure why since stretching does help so many of these horses.

PSSM Horse Muscle Issues: Hoof Health

One of the most important things to remember about PSSM horse muscles – they can’t compensate for hoof pain.  So, if anything – and I mean ANYTHING – is wrong with their feet, you will find problems in their muscles.  Anything from a bad trim, to Low Grade Laminitis (which seems to be a problem for some PSSM horses, including Jax), can be detrimental to your rehab plan.  Before you can fix the muscles, you have to fix the feet (or at least start the hoof rehab process, and rehab the hooves as you rehab the body like I did with Jax).  Jax had issues with “long toe low heel” and it’s taking a while for his feet to get back in shape (especially since he is prone to low grade laminitis every spring), but I can feel that as his feet get better his muscles get better.

If you are rehabbing feet, you may have trouble with abscesses.  Jax never had an abscess until he went symptomatic and his feet fell apart.  The longest episode he’s had to date was a two week span with mild shoulder spasms caused by abscess pain.  Here’s a pic of the culprit:

PSSM Horse Muscle and Hoof Issues: The entire bar and part of the heel would later detach from this hoof.  It grew back stronger than ever, but took awhile to do so.

As soon as this blew, he started to do really well (even though he’d been off work for two weeks).  Don’t underestimate how important healthy hooves are, especially to a PSSM horse.

PSSM Horse Muscle Issues: Start a Daily Journal of Symptoms, Issues (Including Hooves), Breakthroughs, Tack Used, etc.

One of the things that really helped me figure out what my horse needs is a daily journal.  Every day I put notes on what tack I used, what feed/supplements I gave, the type of work we did, when his feet were trimmed, pics of feet after trim, who did the trim, notes on sore muscles, days he was massaged, and anything else I could think to put down.  I included pics and videos to monitor changes in specific muscles and posture.

For an example of PSSM journaling, see my journey to a sane horse and keeping a PSSM journal post.

PSSM Horse Muscle Issues: Environment

Cold, wet weather sets Jax back for days.  If it’s going to be cool and wet (70*F and below) or  just cold (50*F and below) he gets blanketed.  Before symptoms, he grew a coat like a bear and stayed warm all year.  Since symptoms, his muscles can’t handle the stress of shivering to stay warm – it leads to spasms every time.

PSSM Horse Muscle Issues: Special Equipment for a Horse with a Muscle Myopathy

If you’ve looked through my tack reviews, you’ve seen that everything I review is either treeless, bitless, or barefoot.  Believe it or not, I’m not a hippy lol. However, my boy has specific needs, and these are the types of tack that he does best with.  When he’s back sore but needs exercise, a bareback pad works best (preferably one with spinal clearance and mild rigidity to distribute weight).  Even on his good days, the rigidity of a tree is too much but a well-fitting treeless works great.  Since he rope walks when his shoulders are sore, he can’t have metal shoes or he’ll give himself splints (he got 6 splints in the 6 months he wore shoes!).  His jaw used to get very sore with a bit, even though I have fairly light hands – but he does great bitless.

Back on Track blankets and pads are also very helpful.  I use one under his saddle every day that’s below 80*F (some people won’t use them over 70*F, but Jax has a harder time warming up than cooling down so he has no problem with it in slightly warmer temps).  

This doesn’t mean that every PSSM horse needs exactly what Jax gets, they’re all different so you’ll need to find what works for yours.  

PSSM Horse Muscle Issues: So, can a horse come back after major symptoms set in?

My answer to this question is a hopeful YES.  It’s a lot of stress and hard work from both horse and owner, and not everyone is in a position to do everything that I’ve listed above (fortunately, not every horse needs this much help!).  These horses have a lot of heart, give them a chance and they may surprise you!

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