Appendix 4 - Osteopathy

An interview with Dustie Houchin.

Dustie Houchin qualified from the British School of Osteopathy in 1998; graduating as an Animal Osteopath in 2001. She is the founder of three Osteopathic practices in the South East of England , including one in Harley Street . She also works in conjunction with three Veterinary Practices covering a broad geographical area with her equine and canine work. Her animal patients range from pets to professional Show Horses and she also works voluntarily to help animals in need.

In 2006 Dustie studied an Advanced Management Programme at Ashridge, followed by an MBA at Warwick Business School & SDA Bocconi. Today she mixes Clinical practice with Business Consulting, helping existing practitioners and graduates to build strong successful practices and networks by designing personalized businesses packages which allow them to do what they love most; treating patients.

Q:What is osteopathy?

A:Osteopathy is a complete and well established healthcare system, which teaches the following philosophy. The body is a unit in and of itself, which has its own self regulating and protecting mechanisms and its structure and function are mutually interrelated. The system of Osteopathic examination and treatment is therefore built upon these principles and one of the main aims is to allow the body to heal itself.

Osteopaths use many of the standard clinical and orthopaedic assessments which allow clarity of diagnosis. They are interested in each individual as an individual and every case history is viewed as unique. They assess the mechanical, functional and posture aspects of the patient’s body and intertwine that information with what is known of the patient’s social and working environment, thus assessing the whole picture and not just a snapshot in time.

Q: Who can benefit from it?

A: Anyone can benefit from Osteopathy. It is a system which can be used either for people with specific problems or for those who wish to maintain a balanced and healthy body. Many of us walk around with minor aches and pains, and do not exercise or stretch as much as we should. We push ourselves both physically and mentally and do not rest adequately. All this leads to an imbalance in our structure and the function of our body, which generally results in pain and stiffness. So whether you are an athlete or a house-wife; twenty years old or sixty, Osteopathy can help you keep your body performing to the best of its ability.

Q: What problems do riders (horses) come to you with?

A: I treat a wide variety of muscular-skeletal problems, ranging from injuries caused by day to day activities associated with owning a horse, and others which stem from a simple lack of fitness and readiness for the sport. People wouldn’t try to run a marathon without training and they shouldn’t take up riding and/or a new discipline expecting their body to adapt instantly. I see so many riders who become stiff and sore and yet continue to ride without adequate physical training. Eventually these imbalances are transferred to the horse during riding, and the horse has to compensate for the rider’s discrepancy. This can cause problems with the horse’s own biomechanics and a cycle begins.

Many of the problems I see are caused because the rider is unfit for the sport, lacking general muscular tone and internal muscular strength. Many riders mount their horse and switch off physically, expecting the horse to provide all the energy and enthusiasm. When I say this I am of course referring to the amateur rider, not the professional (although I have seen my fair share of unfit professionals too).

Riders need to be pro-active when they ride, using their posture correctly and maintaining a soft neutral spinal position, with abdominal tone engaged at all times. Legs should have a firm, gentle enveloping contact and arms and shoulders should be relaxed, as tension in this area leads to all sorts of problems in the upper back and neck region. Riders should also be balanced in their seat bones when riding, as imbalances in the seat can have a huge impact on the horse’s own balance.

As I see it, all riders need a good teacher to assess their position and alignment when riding, and someone to encourage the correct use of the body. Riding requires a degree of physical tone and one should be both generally fit and riding fit. Working on the strength of the legs, back and abdominals can really help to improve overall control and also the intensity of movement required thus making the overall experience of riding much more enjoyable; both for the rider and the horse.

Q: Have you noticed any patterns?

A: Only really those I mention above which relate to poor physical condition.

Otherwise I study each individual as they present in my surgery, with their own set of social, physical and mental issues. Some may present with a direct injury from a fall or a blow, whereas others may be suffering merely from the aches and pains associated with the hard labour of horse ownership.

Of course the back and neck are always going to be target areas for riders because of the nature of the sport, but because levels of fitness and skill can be so varied, it is almost impossible to group people together. For example, professionals suffer very differently from say a total beginner and those who study dressage will have different probable injuries to those who ride cross country courses.

Q: What do you believe causes these problems?

A: A lack of readiness for the sport and/or chosen discipline, with those who simply own a horse for the purpose of hacking out being at most risk, because they generally don’t have lessons, so bad habits escalate very quickly.

As far as I can see, many of the problems that arise for riders are as a result of limited technical information and training along with a body that is less than appropriately ready for the tasks demanded of it.

Q: What body factors do you believe influence a rider's capability to ride well?

A: I think there is little doubt that those who perform well have a greater degree of general fitness and muscular tone than those who take their riding a little less seriously. Good abdominal tone and a strong back help tremendously with riding technique and balance, and strong leg muscles aid in the control and precision of movements, and help to avoid excessive use of the upper back.

Riding is a very physical sport when performed well. It uses every aspect of the body, from the pelvic floor to the base of the neck. A good rider uses muscular tone rather than brute force to attain the required movement in the horse. Movements should be subtle and gentle both for the rider and the horse. This way the horse does not become confused by the bombardment of signals and is able to listen to the riders aids easily and effectively.

Riding from a physical point of view is about balance, tone, fitness and breath. All of which are required to achieve the maximum physical relationship between horse and rider. If a rider bounces around, unable to control their own centre of balance, unable to maintain a good seat, incapable of using abdominal tone to drive their horse forward and breathing frantically due to a lack of fitness, what hope has the poor horse got of doing anything well.

A horse ideally needs to be supported by a rider with a firm but gentle leg, a good seat, balanced posture, calm breathing and an energised level of tone that tells the horse that he can perform to the best of his ability without losing his rider. I often think of riding as I do Osteopathy, it is about balance of structure and function and about acting as a single unit not as disengaged parts of a whole.

Q: What exercises/therapies would you recommend for riders? Is there anything you would specifically recommend immediately before or after a riding session?

A: Core stability exercises on a fit ball are excellent for correcting a rider’s seat and improving the internal abdominal and spinal stabilizers. These exercises can be taught by a therapist or at a gym under the guidance of an instructor. They are very subtle exercises but have tremendous end results.

Also, as I have mentioned, a general fitness regime of cardio-vascular training and strength training is helpful for any level of rider because it makes the whole process of riding more enjoyable.

Stretching is also an important component of any exercise regime and whilst stretching is often confused with fitness, it is a completely separate entity. Good flexibility allows the body to move more fluidly and with less risk of injury. Basic yoga is also an option for those who have the time to attend a class, but it is really important to find a class to suit the individual’s needs. Yoga encompasses exercises of balance, breathing, strength and flexibility, all of which would benefit a rider.

Pre-riding – I would always suggest that a rider stretches before riding. Simply working through the back, quadriceps, hamstrings and calf muscles and once mounted, stretching the inside leg away, in order to lengthen the leg before placing it in the stirrup. This frees up the body and creates a sense of length.

Of course, in an ideal world, proper warm ups and spinal exercises would be of benefit; but as most riders are pushed for time and do not have any private space at the yards for such activity, it is mostly unsuitable to even suggest it.

Q: There is a lot of heavy work involved in caring for horses. Are there any guidelines you would give for this?

A: The stronger the person is, the less likely they are to become injured. So follow all the rules above.

Always lift correctly using the strength of the legs and bending one’s knees whilst maintaining a straight back is the safest position for moving heavy objects.

Q: Can regular osteopathy help a rider? How? How often?

A: Osteopathy can help maintain the fluidity of movement within a rider’s body, helping to avoid restrictions that might otherwise become problematic.

Q: How does osteopathy fit with - Pilates; Alexander technique; Physiotherapy; sports massage; Yoga; Tai Chi; Gym; aerobics/step; jogging; swimming; racket sports.

A: I have been in practice for some 15 years as a Sports Therapist and Osteopath, and I treat both humans and horses. Over the years I have come to realise that each patient has their own set of needs. Some need to focus on flexibility and thus Yoga is ideal, others need a fitness overhaul and would gain from going to the gym two or three times a week. From a treatment perspective, again it is somewhat individual and also about cost. In an ideal world I would work with an Alexander technique teacher and a sports masseuse/masseur, but many people struggle to afford one treatment, let alone three; so I tend to refer patients on, as and when appropriate, and this seems to work quite well.

Q: Are there any supports (back; sacroiliac etc) you would recommend for riders?

A: Not ideally. The answer is….get fitter.

Q: Are there any machines e.g. massage, TENs or lotions/potions you would recommend for riders?

A: There are a multitude of lotions and potions on the market but ultimately it is the massage that is required to apply them that does the most good, so if you have sore muscles have a good soak in a warm bath and ask someone to give you a gentle massage. If something is swollen or painful however, a therapist or doctor should be visited in order for a proper diagnosis to be made.

Ice is a helpful tool for acute injury but the pack should always be covered with a tea-towel or something similar and applied for a maximum of ten minutes (five on less fleshy areas).

Machines such as TENS are available but should be used under the guidance of a therapist.