Little Man: Pre-hab Before and Rehab After Kissing Spine Surgery

Little Man is a 9-year-old Hanoverian who had had life long challenges staying sound and comfortable under saddle. He was eventually diagnosed with back pain caused by kissing spines. He had presented to us for rehab previously and had gained strength, stability and improvement in comfort, but when he returned to under saddle work, he became painful again. With his degree of discomfort and the severity of his radiographic changes, surgery was recommended.   

A horse with kissing spines has decreased movement between the affected vertebra.  As a result, the surrounding musculature tends to atrophy. During surgery, the interspinous ligaments are transected to restore movement between each of the vertebral spinous processes, which essentially abruptly de-stabilizes a weak back.  These horses can become very painful after surgery and are challenging to get back into work. Rehabilitation to strengthen the stabilizing musculature is mandatory for these horses to succeed.   

There is now significant evidence that physical therapy to strengthen stabilizing musculature prior to surgery can decrease pain after surgery, decrease surgical healing time, and decrease the time spent in rehabilitation after surgery.

For four weeks prior to surgery, Little Man stayed at VRSVA in a PRE-habilitation program.

During this pre-hab period, Little Man received the following therapies:

• Aquapacer 3 times per week

• Pole exercises in hand daily

• Exercises in the Equicore Band 3 times per week

• Core strengthening exercises 5 times per week

• Vibration plate therapy 5 times per week

He gained significant strength through the stabilizing muscles of his back and his comfort level improved. His surgery was successful and he returned to VRSVA for recovery and rehabilitation. He spent two weeks off work receiving Class IV laser therapy, vibration plate therapy and hand-walking. His comfort improved quickly and, while he lost a small amount of strength during this short recovery, he did much better than horses we’ve seen without a pre-hab program. As soon as his sutures were removed, Little Man was ready to jump back into a full rehabilitation program incorporating the Aquapacer, lunging in the Equicore Band, core strengthening and vibration plate therapy.  He is back under saddle now and is staying comfortable!