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Sacroiliac Rehabilitation Protocol?

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  • Sacroiliac Rehabilitation Protocol?

    I just got my horse's sacroiliac treated via four ultrasound guided injections around the joint. The vet says to give him 7-10 days off, but I am not sure what to do next. Can anyone share their successful program for rehabbing a horse with SI issues? I hope to gradually reintroduce dressage work but I do not want to stress him. He was doing fourth level work.

  • #2
    My previous horse had 10 different diagnostics until I called the Miracle Vet, who found out all the different lameness issues came from his sacroiliac. He treated him and recommended 10 days off, followed by 10 days with the lunge with the Pessoa System.

    It worked, and meanwhile I sold the horse. The new owner reports no lameness issues whatsoever.


    • #3
      My eventing mare had her SI injected as well as as her L3 and L4 (one side of each) and then the rest of the injection fluid was put into the muscles to act like mesotherapy sort of (it made all of the muscles relax since the majority of the soreness was muscle tightness). Because it made all of her muscles relax I basically treated her like she had zero muscling. We started back with about ten minutes of walk without asking her to come into any sort of frame, and did about two weeks of this gradually increasing the time of walking. Then I started adding in some long and low work to it, just a few minutes at a time before coming back to the walking on a loose rein. This all increased over time and eventually as she got stronger I would pick her up more until we were in a working frame. This helped her build muscling back up since her back was now feeling healthy, so all the muscling she had was 'healthy muscle' not muscle built from protecting the sore parts of her back.

      I'm not sure if you need to be that careful if you didn't do much to the muscle, but I would say that it certainly can't hurt to try to build muscle really slowly now that your horse is feeling good with his injections!


      • #4
        Once you get to that point, my vet has SI horses canter before they trot. Both in the rehab process (so you introduce canter and do that for a few weeks before introducing trot) and in their daily work.

        She also advises working the horse so it's round through its topline, as opposed to hollow.
        The Evil Chem Prof


        • #5
          Assuming this wasn't in response to an acute injury...

          -3-5 days off
          -tack walk 2-3 days, picking up contact, and marching along round- using the hind legs
          -return to normal work, incorporating as much correct stretching/long/low work as possible. If the horse/rider are not capable of correct stretching work, with the back lifted and the hind legs engaged, it shouldn't be done. If the rider can't work the horse correctly over the back at all, use a different rider, or a competent lunger and side reins.
          -incorporate cavaletti and light hill work as soon as possible to strengthen the hind end and back


          • #6
            Long, long LONG story for us, but SI injections have worked a miracle for my horse--and we haven't had to inject a hock or stifle since we injected the SI back in August.

            We have topline and a butt... And a canter in both directions... And lateral work... And throughness... I could go on.

            What I would caution is that you bring it back really very slowly. Your horse is going to feel like a million dollars and will want to do all his stuff. This will make him stiff and sore and miserable if you let him. You will then spend a bunch of money on a vet visit and your horse will be sound as a pound when the vet arrives.

            I hope it works as well for you as it has for us. We got our mojo back big time... I wish we had done it two years ago.


            • Original Poster

              Thank you all for the great suggestions. Sounds like the take home message is: take it slow!

              ATR- Thanks for sharing your success story. I am trying not to get too excited about the prospect of my boy getting back to his original fabulous self, but it is fun to think about.

              SCMSL - I had heard of the Pessoa rig for rehabbing horses. I have always been leary of headsetting rigs, but I have to say I was impressed when I watched the youtube videos of the pessoa rig in action. The horses seem to move freely in them. They are pricey though and it sounds like they are sized for medium-build horses. My guy is a very long 16-3 hands. Also, there is some criticism that the rigging that goes around the haunches puts rhythmic pressure on the bit. Having use the rig, do you think this a valid concern?

              Peggy - Did your vet say why canter before trot?


              • #8
                Canter before trot. It had to do with the horse's spine being rounder more naturally at the canter, IIRC. Or it being easier to achieve that at the canter. Part of my horses issues were in the spine, mostly the neck but also a bit under the saddle. The same vet gave the same protocol of cantering first for a different horse with SI issues and no diagnosed neck or other spine issues.

                I still canter first unless I have a really good reason not to, like we've had a number of days off due to rain and it's cold, and I feel like my life could be in danger. But today, when he hadn't been out of the walk for over a week due to a gastroscopy and a slipped shoe (good thing I like this horse, huh?) I cantered first. But our "cold snap" had ended. I ride my trainer's lesson horse in some lessons and he has some sort of hind end issue and I've found he's more comfortable cantering first as well.
                The Evil Chem Prof


                • #9
                  I had mine made by the same person who fixes all my leather stuff. However, the ones you buy are perfectly adaptable to any size of horse (I've seen it used in tiny Arabians).

                  I don't think it has any adverse effect on the horses mouth, If you use it correctly.

                  It was recommended to my by my vet for the horse I mentioned earlier, but I have since started using it once a week on my other horses and all I can say is there have been far less injuries lately. There was an article in eurodressage about it released last month, might be worth taking a look.

                  It is expensive, but I couldn't recommend it more.


                  • #10
                    Interesting... here's the article:


                    Schneiders sells something similar to the Pessoa:


                    I'm also concerned with the action this system has on the bit. It pulls on the bit with every stride.
                    Boyle Heights Kid 1998 16.1h OTTB Dark Bay Gelding
                    Tinner's Way x Sculpture by Hail to Reason
                    "Once you go off track, you never go back!"


                    • #11
                      You can get the lines pretty cheap on ebay: http://www.ebay.com/itm/EQUESTRIAN-H...70911789372%26