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June 2017

Saddle fitter or physiotherapist?

How about both, says Faith Fisher–Atack. Saddle fitters who read the feature and submit correct answers to the quiz will receive CPD recognition from the Society of Master Saddlers (SMS).

Never has there been a more appropriate time to discuss the interaction of the horse, rider and saddle.

At the 2017 National Equine Forum, Dr Sue Dyson presented several studies addressing the impact that saddle fit plays on both the horse and rider and not least the negative implications and welfare issues that may arise in the presence of poorly fitted tack. In a recent article in Horse and Hound, Hazel Morley of the Society of Master Saddlers (SMS) suggested that “getting the whole industry working together” would improve standards and education on the subject.

As saddle fitters and physiotherapists, we are two groups of industry professionals that serve to improve this interaction, with the common interest being the welfare of horse and rider and placing them at the centre of all decisions and interventions. As professionals in our respective fields, we are aware of the importance of multidisciplinary team working. It may seem like a simple principle that we all believe we are employing. However, do we really understand why we need to work together?

Defining our roles

Defining the roles of both key parties is important. Physiotherapy is an established health care profession with protection of title issued by Royal Charter. The Chartered Society of Physiotherapy (CSP) governs physiotherapy provision within the UK to service users in both the NHS and private sector.

The application of physiotherapy to animals is recognised by the CSP as a specialist interest group titled The Association of Chartered Physiotherapists in Animal Therapy (ACPAT) which requires formal education routes following the acquisition of chartered status in human practice. Chartered physiotherapists that specialise in animal practice are therefore uniquely placed to work with both riders and horses.

Application of clinical practice serves across all levels of performance, with the British Equestrian Federation (BEF) employing chartered physiotherapists to serve at Olympic and international competition across the equestrian disciplines.

Members of the SMS are trained to deliver high quality workmanship to deliver a professional and quantified service with the first saddle fitting qualification launched in 1995. The society continues its work to carry these standards through build, repair and fit, and to work towards the complete comfort and safety of horse and rider, ensuring that its members meet continual professional development standards. Recently, the SMS joined a cross-industry steering group to improve industry led education and training.

The two groups of professionals are therefore perfectly placed and armed with the knowledge, tools and qualification to deliver both quantifiable and clinically reasoned approaches to improving the interaction of the horse, rider and saddle.

A review of the literature

There is growing evidence that justifies the need for increased frequency of saddle fit and in doing so also highlights the need for chartered and veterinary physiotherapy intervention. Within the literature, variables associated with saddle fit include the effect of and on rider position, equine performance, lameness and equine back pain.

At an international workshop hosted by the Animal Health Trust in Newmarket in 2012, the effect of the rider was addressed by Dr Narelle Stubbs, a human and equine physiotherapist from the McPhail Equine Performance Centre at Michigan State University, USA. Dr Stubbs highlighted common biomechanical patterns that riders adopt often as a result of over activity and dominance of one side of the body. Also that rider asymmetries are common and can be a causative or contributory factor in the horse, saddle and rider interrelationship.

Adding to this conundrum, Guire et al (2015) objectively evaluated riders’ hip position with both a correctly fitted saddle and a saddle that rolled. A significant asymmetrical increase of rider hip flexion was measured with the poorly fitted saddle, showing that saddle position and therefore fit affected rider biomechanics and capabilities to maintain balance.

Conversely, a saddle that may fit the horse may not fit the rider. In a recent review, Dr Sue Dyson noted the presence of equine back pain was prevalent in cases where the saddle did not fit the rider. In this instance, a physiotherapist would be uniquely placed to address both equine and rider abnormalities. Methods such as taping and balance exercises that target the riders’ weaknesses and promote a more balanced seat could be utilised as well as employing treatment for the equine patient.

There is additional evidence to suggest that even correctly fitted saddles can still lead to equine movement and performance adaptation. In one recent study, fore limb and hind limb range of movement and thoracolumbar widths were compared in horses ridden in correctly fitted saddles that met industry standards against a saddle designed to reduce peak pressure on the mid-section of the spine.

The study highlighted a 13% and 22% increase in fore and hind limb protraction respectively as well as increased size of spinal muscles following a prolonged time of exercise associated with a saddle that reduced peak pressure (Guire et al, 2016).

This study not only highlights the potential performance limitations associated with pressure upon the spine but also the fact that peak pressure can be present under what would otherwise be identified as a correctly fitted saddle. The need for both improvement in fit and saddle design is raised. Additionally, regular physiotherapy assessment would identify pain associated with peak pressure, identify changes to muscle size and symmetry and, if necessary, use treatment modalities to reduce pain and inflammation.

The importance of using both a qualified saddle fitter and physiotherapist in the management of ridden horses is highlighted in one study that found that horses who received regular physiotherapy management of back pain increased the likelihood of also having regular saddle fittings (Dyson et al, 2015).

These findings were reversed for horses that didn’t receive a combined professional approach. 51% of these horses were significantly more likely to have both a poor saddle fit and abnormal findings at the thoracic spine. In addition, 62% of riders interviewed noted that they had suffered back pain themselves and horses ridden by these individuals presented with thoracic abnormalities and muscular asymmetries when assessed.

Dr Dyson’s research distinctly shows that a combined management approach and increased frequency of skills delivery in view of fit and pain management improves not only the welfare of the horse but also the comfort for the rider. Interestingly, 48% of riders interviewed for the study noted that they would only consult a professional if they felt there was a problem albeit with the saddle and/ or their horse. This shows there is a need for both saddle fitters and physiotherapists to encourage a proactive, preventative approach to management as opposed to waiting for a problem to develop.

Understanding the literature is key to understanding why both professions should work together and promote one another. As research continues to deepen our understanding of biomechanics, anatomy, physiology and clinical application, there is a distinct interrelationship evolving between our respective areas of expertise, most notably the correlation between equine back pain, lameness, rider position and saddle fit.

This not only justifies the importance and relevance of our roles individually but also highlights the need for multidisciplinary interaction between us. The rotation of both physiotherapy assessment and saddle assessment should be promoted along with other services acquired on rotation such as farriery and dentistry. This can be achieved through both industry led initiatives and individual education to our clients.

What will a physiotherapist do?

Calling up on a physiotherapist to assess your horse or client’s horse will include a thorough assessment and treatment regimen.

Assessment

• Observe the horse’s natural posture
• Assess the horse’s movement at different gaits
• Palpate muscle tissue for irregular tone and pain
• Mobilise joints to assess range of movement and quality of movement
• Perform special tests for pain reaction

Treatments

• Soft tissue mobilisation techniques that reduce spasm and increase circulation
• Electrotherapy modalities will often be used to mobilise tissue or to reduce pain
• Joint mobilisation will increase range at specified joints
• Dynamic taping
• Exercise prescriptions to strengthen and/ or mobilise target areas.

A saddle fitter’s view…

Kim Gordon-Holt of Krugar Saddlery, West Yorkshire agrees there must be interaction between the physiotherapist and saddle fitter to truly benefit the horse.

“Horse owners require continued education from professionals to realise the importance of correctly fitted tack and how to identify underlying reasons why a horse may not perform as it should. Saddle fitters and physiotherapists are key to this education.

“In most cases, I would recommend the saddle fitter visits the horse prior to the physiotherapist. It makes more sense to get the saddle correctly fitted first and then have the physiotherapist treat the horse for secondary muscle spasm. That way, the work of the physiotherapist is not undone when an ill-fitting saddle is placed back on following treatment.

“I can’t stress enough how important it is that the saddle fitters and physios work together. A horse cannot verbalise pain, it is our job to identify a problem and resolve it professionally and further educate to minimise the risk of further problems.”



ACCREDITED BY

amtra







It makes more sense to get the saddle correctly fitted first and then have the physiotherapist treat the horse for secondary muscle spasm





Author Faith Fisher-Atack


About the author

Faith Fisher-Atack is a category A member of the Association of Chartered Physiotherapists in Animal Therapy (ACPAT) and a chartered human physiotherapist.

As an undergraduate, Faith studied physiotherapy at the University of Huddersfield following a gap year riding for British Showjumping team trainer Alan Fazakerley.

After graduating in 2009 in human practice, Faith spent five years working for Leeds United Football Club. She graduated as a veterinary physiotherapist from the Royal Veterinary College in 2012 and founded Equine Physio Services, a company providing physiotherapy treatment, rehabilitation, advice and education to both horses and riders across all disciplines of the equestrian industry. Faith can be contacted by email: faith@equinephysioservices.com



December 2016

The saddle fitter as educator

In ETN’s latest CPD feature for saddle fitters, Anne Bondi BHSI looks at the relationship between the horse, saddle and rider. Saddle fitters who read the feature and submit correct answers to the quiz will receive CPD recognition from the Saddle Research Trust.

Today, considerably fewer people grow up with the horse as part of their daily lives and many of today’s horse owners do not have a family tradition of handed down wisdom.

This lack of natural horsemanship training has led to an increase in the number of horses that are managed by inexperienced owners. Welfare problems generally occur due to horse owner mismanagement as a result of ignorance rather than intentional abuse. However, ignorance of good practice is as just as likely to create welfare concerns as deliberate malpractice.

It is therefore important that professional equine industry practitioners should identify opportunities to educate their clientele as part of their service. Saddle fitters are uniquely positioned to play a pivotal role as key educators.

Problems due to poor saddle fit, associated back problems and loss of performance in the horse are unfortunately widely documented. Although saddle fit problems have long been recognised as an important clinical performance-impairing problem in the equine athlete, methods for the objective evaluation of saddle fit and investigations of the influences of ill-fitting saddles are lacking.

A great deal of money is spent trying to define poor equine performance, but the effects of the saddle are frequently overlooked. The vast majority of saddles are not optimally adjusted for the horse on which they are used; the frequent use of saddles unsuitable for a given animal seems to indicate the rider’s lack of attention to this crucial area. The saddle fitter can help to improve this situation by raising awareness of the issues and discussing the current principles of good practice with their clients.

Horse, saddle and rider interaction

The effects of movements of the saddle and of the rider are undoubtedly of great importance to the way in which the horse moves and performs, but remain poorly understood.

Saddles do not “move with the horse” when ridden, but instead create complex torque patterns that are instigated by the movements of both horse and rider. Although a saddle may have a relatively small weight or mass, the combined torque applied to it by both rider and horse can create a very large effect, which has yet to be measured.

An ill-fitting saddle disturbs horse/rider communication, which impairs the ability of the horse to move in a regular, consistent pattern. In forcing the horse to search for a more comfortable movement pattern, motion instability is further increased. An ill-fitting saddle therefore has the potential to make even a skilled rider appear uncoordinated, presenting a further challenge to the saddle fitter.

Effects of loading

The weight ratio between horse and rider is an important consideration, but currently there are no reliable, evidence-based guidelines to assist the saddle fitter in assessment of appropriate loading.

Increased rider weight increases the risks associated with poor saddle fit. Rider weight compresses the saddle onto the back, which may alter the saddle balance. The same saddle may be used by different riders with a wide range of weights, so the saddle fitter should always check the circumstances under which the saddle is to be used.

Saddle fit under different weight ratios should be reviewed and temporary balance pads may be required to support the saddle and provide sufficient lift. Communication between the saddle fitter and the horse owner is of particular importance in these circumstances.

Asymmetry

Recent studies have shown that a disturbingly high proportion (75%) of horses that were in normal work and believed to be sound by their owners were, in fact, lame.

Horse owners were found to be able to recognise lameness in only 11% of cases and sore backs in only 4% of cases, thus providing further evidence that horse owners and riders need expert assistance with the early detection of musculoskeletal injury. A saddle fitter who trains to recognise gait irregularities could contribute greatly to the prevention of the vicious cycle of lameness, back pain and saddle fit issues.

Rider asymmetries are common; several studies have recorded asymmetric posture in 100% of the riders that they evaluated. Rider asymmetry may be caused by gait asymmetry or a crooked saddle – or it can be a contributory factor to the asymmetry conundrum. Therefore it is important that the saddle fitter should also have analytical skills in rider performance.

When saddles move asymmetrically, the rider tends to ‘collapse’ to the opposite side, e.g. when viewed from behind, if the saddle moves to the right, the rider’s seat slides to the right and the spine flexes to the left.

It has been shown that asymmetric saddle movement is often an indication of hind limb lameness, occurs most commonly towards the lame side, increases in circles compared with straight lines but is not related to the degree of lameness. In some cases, the saddle moves one way on one rein and the opposite way on the opposite rein as the lameness alters in severity with the changes of direction.

The rider can also affect the extent of lameness according to which diagonal they select in rising trot. This highlights the importance of viewing the horse, saddle and rider from behind, from both directions and at all gaits during saddle fitting evaluations.

Riders are often unaware of the presence of asymmetry in the saddle or how to carry out simple, routine checks for this, providing another valuable opportunity for the saddle fitter to teach basic principles of good practice.

A study of saddle asymmetry showed that 45% had asymmetric panels and that all of those were in use on horses that were assessed as lame.

Although there is anecdotal evidence of its occurrence, further work is necessary in order to ascertain how repeated asymmetric movement of the horse may create asymmetry in the saddle by ‘self-moulding’ it to accommodate the shape and movement of the individual horse and whether or not interventions should be carried out to resolve this.

An asymmetric ‘self-moulded’ panel may be more comfortable for the individual horse and changing the status quo could result in a less comfortable fit for the horse. However, the potential deleterious effect on the back health of the rider caused by an asymmetric saddle must also be taken into consideration by the saddle fitter.

Back shape

Changes in back dimensions occur throughout the year. Recent studies have shown that the presence of gait or back asymmetry can reduce back dimensions. Improved saddle fit, similar or increased work intensity, season (summer versus winter) and increased bodyweight can all increase back dimensions. Saddle fit should therefore be professionally reviewed several times a year, ideally at least every three months, but especially if there has been a change in work intensity.

The back dimensions of horses working correctly increase transiently with work. However, back width only increases with good saddle fit; if a saddle does not fit properly before exercise, this increase in size does not occur. It is important therefore that saddle fit should be assessed both before and after exercise to ensure correct fit.

Force measurements

The use of an electronic force sensor placed beneath the saddle is a popular technique for measuring force applied to the horse’s back. However, used in isolation, it is insufficient to accurately assess saddle performance and may lead to false conclusions.

Force sensors register only force that is applied perpendicular to their surface, therefore the shear component escapes detection, resulting in under-estimation, particularly where saddles exhibit considerable movement or where horses have steeply contoured back shapes.

If the sensor indicates asymmetric loading, it cannot identify whether the source of the asymmetry lies in the crookedness of the rider, poor saddle fit or lameness of the horse.

Translating research into practice

Although dissemination of research is critical to the raising of industry standards, there is a gap where key messages are not always translated into practice. An additional problem is that industry standards do not yet exist in many crucial areas, making it difficult to offer advice on many aspects of current practice.

The saddle fitter therefore has a crucial role to play in communicating with other professional practitioners, thereby creating a feedback loop that will help educate their valuable clients – the horses and riders who rely on them.



ACCREDITED BY

amtra



The same saddle may be used by different riders with a wide range of weights



Asymmetric saddle movement is often an indication of hind limb lameness



Riders are often unaware of the presence of asymmetry in the saddle (Photo: Animal Health Trust)





Author Anne Bondi BHSI


About the author

A successful rider and trainer who has competed at advanced level in eventing and dressage, Anne Bondi has been placed in international three-day events including Windsor, Blair and Blenheim. As a trainer, she has prepared pupils for competition careers and professional exams and was a senior examiner of the British Horse Society (BHS). Specialising in the production of young competition horses and in the education of problem horses, she has also produced a dynasty of homebred horses.

In 2009, Anne founded The Saddle Research Trust (SRT) to promote the welfare of the ridden horse and to raise awareness of the widely underestimated issues surrounding saddles, welfare and performance. The SRT is now internationally recognised for its ground-breaking work.
Anne is currently finishing a PhD researching horse, saddle and rider interaction.



June 2016

The future of saddle fitting

In ETN’s latest CPD feature for saddle fitters, Dr Gerry van Oossanen looks at the future of saddle fitting and checking horse/rider interaction. Members of the Master Saddle Fitting Consultants (MSFC) Society who read the feature and submit correct answers to the quiz will receive CPD recognition.

Back pain is a significant cause of altered gait, poor performance and misbehaviour in the horse.

There are many similarities between animals and humans in anatomical and chemical ways of nociception (recognising pain). Therefore conditions which are painful in humans should be assumed to be painful in animals until behaviour such as aggression, kicking, grinding teeth and flattening the ears, or clinical/physiological signs eg. heart rate, respiration rate or abnormal locomotion, prove otherwise.

Modern techniques like gait analysis and thermographic imaging, as well as observing behaviour, are proven to be important tools in recognising and diagnosing pain and discomfort in animals. As a saddle fitter, you need to be aware of this to be able to recognise a problem promptly because saddle fit is well recognised as an important factor in the welfare and performance of riding horses.

However, evaluation of saddle fit is subjective - and therefore depends on the knowledge, experience and preferences of the saddle fitter.

The ridden horse must endure not only the static weight of the rider, but also the dynamic load when moving. Therefore the quality of the saddle fit, the pressure peaks under the saddle and how a rider sits and distributes their weight on the saddle are important aspects in developing or avoiding back problems and lameness.

Recent studies show that there is a high prevalence of ill-fitting saddles, mainly due to lack of using a professional saddle fitter on a regular basis (minimum twice a year). Ideally saddle fit should be evaluated before, during and after exercise because we know that back dimensions can change during work, with some horses more than others.

Repeated measurements of the horse and the saddle with the same rider can be very useful in order to maintain a good fit. Correct tree fit is necessary of course, but will only work when other equally important aspects such as gullet width, panel shape, thickness and especially the type of flocking, and the placement of the girth straps, are correct too.

The saddle should follow the movements of the horse’s mid-thoracic back. Besides the vertical movement of the rider, the components of the saddle force could mainly be associated with the movement of the forelimbs, the lateral flexion and unilateral contraction of the horse’s back muscles as well as with the rotation of the horse’s pelvis.

Discussion about what defines a well fitting saddle remains controversial. However, there’s general consensus that a saddle should neither traumatise nor injure the horse.

Since it became possible to measure saddle pressure, several studies have tried to define the upper limit of tolerated pressure. Earlier investigations related saddle pressure to the occurrence of back pain or to the fit of a saddle. These studies gave a good overview of what was to be expected when dealing with badly fitting saddles and demonstrated how diverse saddle problems and their potentially negative influence on the horse’s back can be.

The most frequently encountered problems are bridging, ill-fitting headplates and incorrect stuffing of the panels. Therefore, a good saddle fitter is also capable of rebalancing a saddle with flocking him/herself.

In horses, back muscle soreness is often accompanied by dry spots in the saddle area. Sweat glands are embedded in a dense network of capillaries. Due to high pressure, local ischaemia [restriction of blood supply to tissues] results in reduction of sweat production. Therefore, the associated symptom of dry spots can be used together with the more obvious signs like a saddle sore as an estimate of too high pressure load.

Many modern measuring techniques are now available to the public; some are useful, others are not and a waste of money. It also depends on how much you like gadgets and how much money you want to spend on them.

The cheapest and still a very reliable tool to measure a horse is the simple flexicurve. A more advanced version, which provides a similar but more objective picture, is the 3D-scanning device from Horseshape. However, it’s not immediately visible to your client on site.

Thermography is, my opinion and experience, the best tool for the modern – and future - saddle fitter. It’s a non-invasive, heat detecting technology that translates skin surface temperature information into colour images.

A thermal imaging camera is used to convert infrared radiation emitted from the skin surface into electrical impulses that are visualized in color on a video screen. Heat generated by inflammation is transmitted to the overlying skin via increased capillary blood flow and is dissipated as infrared energy.

By using an infrared camera, also known as a thermal imager, and a specially developed analyzing software program, the infrared energy can be measured.

The first advantage of using thermal imaging is that it’s an easy and small device to take with you. But most importantly, it gives you and your customer an immediate picture of what’s going on. It shows what the saddle does to the horse’s body. Of course, as with every tool, you need proper training to interpret the pictures correctly. The MSFC is to provide additional training for this in near future.

Studies have shown that measurement of pressure between the saddle and the horse’s back offers another alternative for assessment of saddle fit and horse/rider interaction. However, it’s only proven in a standardized set-up on a standing horse - and when calibrated every day! The repeatability was very poor when used in practical saddle fitting situations, and it’s therefore not advised as a reliable, useful tool.

According to a new study by equitation scientists, horses prefer to avoid rein tension rather than just get used to it. And beyond a certain force threshold, rein tension can cause conflict behavior. So when a horse owner comes to you thinking he or she has a saddle problem, look further.

Also look at the rider, look at the bridle and bit fitting. Many riders, including professionals, have no idea how much pressure they have in their hands – including big differences between their left and right hands. From studies, we know that too much and/or uneven rein pressure says something about the asymmetry of the rider and/or horse.

As a saddle fitter, you need to find the main cause of the problem and if the saddle and bridle fit correctly. A handy new tool in this respect is a rein tension device. Already widely used in The Netherlands by vets, trainers and Olympic competitors, when a rider sits more to one side, it can be seen in the graphs.

The device is small enough to take with you; you only need a laptop. It’s also easy to show and explain to customers and is especially useful combined with video of the rider. It works well with another new tool, the Visualise System from Centaur Biomechanics, too.

Examining saddle fit is perhaps the most important aspect of examining a horse with a suspected back problem. If the back problem is corrected but an ill-fitting saddle continues to be used, the problems will return. An ill-fitting saddle also contributes to lower leg lameness, making correction even more imperative.

Riders, trainers and other professionals involved in equine care and performance need better education to recognise ill-fitting saddles, lameness, saddle slip and rider crookedness, said Dr Sue Dyson during the SRT’s (Saddle Research Trust) latest conference. And I fully agree with that.



ACCREDITED BY

amtra



The simple flexicurve is cheap and reliable.



Thermography gives you and your customer an immediate picture of what’s going on.



Author - DR Gerry van Oossanen


About the author

DR Gerry van Oossanen studied at Antwerp University and Utrecht University. She graduated in equine movement science (research subject: the triangle horse-saddle-rider) and has a Masters degree in Equine Physical Therapy Science. She is also a chartered animal physical therapist, certified acupuncturist and certified equine thermographer (Ohio State University).

Dr van Oossanen is the Director of the Academy for Master Saddle Fitting Consultants (MSFC) which runs complete training programmes for saddle fitting and saddle making. She is specialises in back and neck disorders (especially in relation to saddles and bridles), and has developed a special back-friendly horse and rider rehabilitation training programme. She also teaches saddle fitting in relation to back problems to veterinary students at Utrecht University.



 

 

 

 

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