(Disclaimer) Equine Hanna Somatics (EHS) is not 'bodywork.'

EHS is a natural method of movement re-education, in which the horse is a willing participant who moves his/her body voluntarily and cooperates with the practitioner. EHS is neither diagnostic nor is it “bodywork” but gentle neuromuscular training and education. EHS is based on the successful work of Thomas Hanna and Eleanor Criswell Hanna in utilizing Hanna Somatics, and specifically the technique of Voluntary Pandiculation (which is unique to Hanna Somatics), to help thousands of clients (human, canine and equine) regain comfort, mobility, athletic ability, performance potential, well-being and over-all improved quality of life.

Equine Hanna Somatics Educators are often called in to help in cases of “last resort,” undiagnose-able lameness, or failure to thrive. However it has been observed that horses in all stages of health, development and training can and do benefit from EHS. As Eleanor Criswell has said: “If a horse’s issues – mental or physical – have to do with sensory-motor amnesia or chronically contracted muscles, we can potentially help (with EHS).”

Case Study by Alissa Mayer BSc(Equine) EHSE-C

Mustang "M" with Mysterious Chronic Pain and an Odd Mouthing Behavior participated in 3 Equine Hanna Somatics Sessions (over the course of one week) with Certified Equine Hanna Somatics Educator Alissa Mayer.

Presenting Complaint:

“M” an approximately 7-year-old mustang gelding presented with difficulty moving, “pain and/or restriction” all the time in movement and an odd mouthing behavior.

When moving at the trot and canter, he balked rather than being willing to move freely forward, appeared lame on at least one fore and one hind limb, had developed an upside-down posture rather than his usual correct posture, and had consistent sheath/gut sounds.

Frequently he presented an unusual stereotypical behavior in which he mouthed the air, ground his teeth and sucked his tongue, bobbed his head and neck upward, occasionally dropped his penis and grunted. This had continued for up to several minutes at a time. He appeared to present this behavior when both stressed and relaxed, and it was difficult to interrupt this behavior once it had started.

Horse History:

This problem began after M suffered an accident in March of 2016 (2 years prior to these EHS sessions) in which he came to a sudden sliding halt from moving at speed, which caused his rider to come off and fly over his head. His momentum then broke the arena gate he had slid into, and he escaped by jumping over his rider who was lying on the ground. Contained by the property perimeter fence, he ran around for a short while before being caught. After this accident, M did present some swelling of the neck in the poll area that was sensitive at the time but had resolved, and he did not present as lame at that time, although his owner began to note his difficulty moving forward after the incident.

These behaviors seem to be aggravated by riding and/or training, although not as much when the horse is being worked at Liberty in large spaces. He has not been ridden much since the accident, and time off has not been effective at reducing these behaviors or improving his movement or willingness.

In addition, one year after the accident he suffered a large chemical burn on his back over his withers/thoracic area from a topical fly control product. No scarring or lasting sensitivity from this is apparent.

M had a dental exam 3/16/18 with nothing abnormal reported.

He was not sensitive to full mouth palpation by the vet, and has no problems eating or chewing.

On 3/4/18 a full lameness exam was performed by his vet.

To summarize the vet’s report: In addition to being mildly lame in both front feet, there was some head and neck tossing and oral grimacing when he moved to the right at the trot and canter, which was less apparent when he moved to the left. M showed these “aversive” behaviors as well as presented his mouthing behavior when ridden both with a saddle and bareback, but appeared more comfortable with the rider bareback. M was painful on palpation of his thoracic, lumbar and SI area, and sensitive to sternal palpation. Gastric ulcers were suspected, as well as saddle fit a concern.

Additional History:

I have had the privilege of knowing this horse and owner team since they met when M was still a young wild mustang, so to this current (since March 2016) history I can add the following from my own observations.

As a young horse, M had exceptionally correct natural posture and movement, with natural rhythm, cadence and collection present in his way of going. He was always willing to move forward, either on his own or when asked to by his owner, with whom he has always had a positive relationship and strong bond.

Since being started under saddle, M was less willing to move freely forward and would occasionally balk or pop upward instead of pushing off with his hind end when asked to go forward. At that time, he was also started in a bridle with a snaffle bit, and since has presented occasional mouthing and bothered behaviors with or without a bitted bridle.

I had the opportunity to ride M in November 2017, at which time he was already presenting the above-described complaints. My assessment at that time was that his balking and stereotypical mouthing behaviors were not related to musculoskeletal pain, because he did them with and without a saddle or rider, while being worked both online and at liberty, but also when standing still and left to himself. Instead, I felt that his behavior was related to compensations for difficulty moving due to his body alignment being out of symmetry, which restricted his range of motion overall. 

As a result of his “crookedness,” which was really only apparent once I sat on him and felt his movement, his barrel was rotating laterally to the left with every stride, which caused the saddle to feel as if it was going to toss me off to the right. This was very disruptive to his balance and rhythm. Unable to move with relaxation and proper biomechanics, he was tossing his head and neck excessively and using momentum to propel his body through space as best he could when asked. The mouthing behavior appeared and disappeared several times, sometimes when asked to work, other times when he was otherwise relaxed, which is what leads me to categorize it as stereotypical (habitual/abnormal) behavior, rather than a current pain response or a specific complaint about working. I do not deny that he may have had some pain, but my feeling is that it was due to soreness from his distorted posture and inability to move correctly, and the compensations he had developed to deal with this inability and the stress it can cause.

I did not address saddle fit in any of my sessions thus far.

Pre-Assessment Examination Notes, Session 1 - 3/24/18:

Mentation: The horse was bright and alert, friendly and happy to see me

Gait: M’s movement was not freely forward, the walk was base narrow, looked effortful, with consistent flexion to the right, and he was unable to track up in any gait.

To the right – at the trot, there was inside flexion but irregular rhythm. M tried stretching his neck out and down but it would pop back up again after 1-2 strides, with occasional head-bobs in time with his right front and right hind limbs bearing weight. Departure into the canter was difficult for M, with his head and neck being thrown up every stride, with more up-and-down movement rather than forward movement.

To the left – at the trot, M braced and shortened his neck, and held his nose to the outside, repeatedly offered to change direction, preferring to go to the right. At the canter, M showed more difficult departs with his neck high and tight continuously, very short strides in front, and he was reactive, kicking out at light pressure or movement from the longe whip/stick. Sheath/gut sounds present.

Posture Assessment

Mild Red Light reflex, base narrow and Trauma/Asymmetry Reflex evident in his spinal c-curve to the right

Palpation: 

Head - tension in the masseter muscles, especially apparent on the left, and both his temporalis muscles were so flat and underdeveloped as to appear not present.

Neck – tension in splenius muscle and around poll, he was reactive to touch near poll/ears on the left side. There were audible pops and cracks as he flexed his neck around to watch me palpate, and he began yawning and his habitual mouthing behavior as I palpated down his cervical spine, shoulder and barrel area. Brachiocephalic, upper trapezius and scalene muscles were very tight on both sides of his neck, as well as the sternomandibular muscle. I suspected he had chronic tension in his omohyoid and sternothyroid muscles as well (tongue retracting muscles) because of his tendency to suck his tongue back while doing his mouthing behavior).

Barrel – his whole barrel and abdomen looked and felt “drum tight.” Descending pectorals were overdeveloped and M was very reactive to palpation at his girth area over his ascending pectoral muscle and external abdominal oblique muscle on the right side. M’s breathing was consistently shallow, and he held his breath often.

Hindquarters – M was very reactive to touch in area of the left semitendinosus muscle, flinching and lifting his hoof as if to kick, but interestingly not overly tight in this area. He had bilateral tension and over development in both his hind adductors, slightly less apparent on the left hind limb.

Management & Outcome: 

I recommended three EHS sessions to begin helping this horse address any motor sensory amnesia and chronic involuntary muscle contractions that were distorting his posture and disrupting his natural way of going.

Session 1 Notes – March 24, 2018 – Ideal EHS Protocol

In EHS, we always begin working with the horse’s more contracted side, so I began his first session by asking him to pick up and slowly lower his right forelimb back to the ground. At first, with both forelimbs, M had difficulty moving the limbs smoothly on the slow returns to the ground, and seemed unsure of where to place his hooves, readjusting his weight and moving his hoof a few times before relaxing. With his hind limbs, M was clearly skeptical and in some discomfort as I asked him to lift and lower his limbs – the discomfort apparent by his quick/reflexive movements, pedaling the hoof in the air instead of holding it up quietly, and stomping the hoof to the ground.

I decided to offer him some Kinetic Mirroring (KM - inviting the origin and the insertion of various muscles to come closer together, triggering a spinal cord level relaxation response in the involved muscles) of the muscles of the left hind limb, as he was threatening to kick and clearly not comfortable picking it up when I asked the first time. I discovered that his left semitendinosus muscle was in spasm, which explained some of his discomfort and behavior. When I asked him to tuck his pelvis, he lifted his left hind leg in time with my request, and began licking and chewing, as well as to breathe more deeply. After several minutes of KM, I repeated my request for M to lift and slowly lower his left hind, and he was able to do so with relaxation, although the limb was still jerky at times while in the air.

We proceeded through the protocol, M lifting his own limbs as I asked him to perform protraction and retraction with each one. He again had some difficulty with his left hind on the first request, but was able to cooperate and release some tension in subsequent requests, even extending his hoof beyond the range I was asking for, and sighing deeply several times.

Palpation at this point in the session revealed that the spasm in M’s left semitendinosus muscle had resolved and returned to a comfortable resting tonus.

M had no difficulty performing adduction with all four limbs (stiffer with the left hind), but was less able to move in the direction of abduction at first, especially with his hind limbs. Interestingly, he repeatedly reached around to bite and scratch at his rib cage on the right between our abduction attempts, beginning just behind his right elbow and working his way caudally a few inches at a time.

Kinetic Mirroring of M’s right rib cage, as well as vertebral highlighting his right (concave) side was uneventful but seemed to be pleasant for M, after which he reached around to his left side to scratch his barrel, for the first time during this session. It’s possible that as more and more of the chronic tension left the muscles of M’s right side, that he was then more willing and able to lengthen those muscles to reach/flex to the left.

M had consistent loud gurgling gut sounds every few minutes during the whole hour long session.

After we concluded the session M decided to roll, after which he had close to zero reactivity to being touched or palpated around his right ear and poll.

Session 2 – March 25, 2018 - EHS Head and Neck ProtocoL

Pre-Assessment:

M’s movement was still short and choppy at the walk, especially to the right, but at the trot he was only flipping/bobbing his head and neck when tracking to the right, and he had improved “tracking up.” He offered to canter to the left before we asked him to, and he moved smoothly into the transition with zero tossing of his head and neck. He was still preferring to stop or break gait from the canter to the trot, and from the trot to the walk.

On palpation, I noted no flinching in the barrel or hindquarters at all. M’s right side back and neck were tighter than on his left, and he did flinch when I palpated his right splenius muscle. I again noted that his masseter muscles both right and left were large and had higher tone than is ideal, and that his temporalis muscles were so small and flat as to appear non-existent. M yawned and chewed repeatedly throughout the palpation.

Session Notes

Every EHS session begins with the Initial Pick-ups of all four limbs, beginning with the most contracted side, and on this day M had more difficulty lifting and controlling the limbs on the right.

M began his “mouthing behavior” when he was asked to flex his poll to the right, which included severe tongue sucking, in which he retracted his tongue far back while chewing, bobbing his head and curling his muzzle. I used a “tongue release” which is a request for him to relax and lengthen his tongue out between his incisors (this horse happens to have already have learned this cue, which is not part of the EHS protocols, and if he hadn’t I would have taught him at this point – it is not a manipulation of the tongue but a training cue given from the side of the horse’s mouth). This request for M to release his tongue proved useful to occasionally interrupt his mouthing behavior so we could move on with the session. I only corrected his head-flipping behavior when it became dangerous for me in my position close to his head, and I found that I could distract him by offering him an equally energetic movement of his halter or scratching applied with my fingers to his face, forehead and neck – which again, I only did when it became a safety issue – as I continued with the protocol, asking M to do various small movements with his jaw, ears, head and neck.

Asking M to perform lateral flexion of the neck, and especially diagonal lateral flexion to the left, was very effective in helping him stop his mouthing behavior and soften all the muscles of his face and mouth. This movement asks the horse to contract and slowly de-contract the braciocephalic (and other) muscles. The brachiocephalic muscle was previously noted as one M holds with high resting tonus.

After doing several neck extensions and head rotations to both the right and left (M especially enjoyed these to the left) he became very relaxed and yawned several times, opening his jaws wider than we had previously observed him doing.

Kinetic Mirroring of M’s masseter muscles was successful in returning both the right and left sides to a more normal resting tonus, and after KM his temporalis muscles, which at first he objected to, but quickly cooperated with, these muscles too seemed to “pop” into presence and show some muscle tone.

As we finished this session, M offered to do lateral flexion of his torso on his own several times to each side, moving slowly and in a controlled manner. He then yawned repeatedly, licked and chewed, appeared drowsy and happy – the typical picture of a horse post-EHS session.

Session 3 – March 26, 2018 - EHS Barrel Protocol

Pre-Assessment:

On this day M was moving with greater freedom in all three gaits - walk, trot and canter - in both directions. He was tracking up much more, his hind hooves stepping into the back edge of the fore hoof prints. Additionally, M was able to circle smaller with inside flexion when tracking to the left, which he has been previously only able to do when tracking right. He had minimal sheath/gut sounds in movement.

On palpation, I noted that M’s right brachiocephalic muscle and left side back and barrel were tighter than ideal. M licked his handlers hands, sleeves, and the lead rope constantly during the pre-assessment and palpation, a behavior none of us have observed in him before today.

Session 3 Notes:

After the initial pick ups, which were difficult for M initially, with some kicking and stomping until after I Kinetic Mirrored his scapula and pelvis, I took a few minutes to complete a few jaw and ear movements that I had been unable to ask M to do the day before due to his head-flipping behavior. He seemed to really enjoy the jaw movements, and was mildly reactive to touch on his left ear at first, then relaxed and allowed me to touch his ears and face all over calmly.

The first part of the barrel protocol was uneventful, asking M to shift his barrel forward and back, and to flex laterally to the right and left.

It was interesting that when asked to lift his barrel on the right side, he swished his tail under his abdomen and then performed a spontaneous pandiculation of his neck. On the third repetition of asking him to lift this barrel on the left, M dropped his penis and kicked up at his abdomen/sheath area several times. Then he began his mouthing behavior, which continued for 2 seconds before he offered his own tongue release and then started more normal licking and chewing.

Lateral flexion of his whole torso, including the neck, was uneventful to the left, but to the right seemed to trigger his mouthing behavior – again for just a few seconds before he released his tongue and changed to normal licking and chewing.

When I offered KM to the internal abdominal oblique and transverse abdominal muscles in the right flank area, M was very reactive. He began stomping his feet, lifted his head and neck high into the air and held it there while pawing with his left fore limb. This is a pattern his owner recognized as one he has done in the past only when under saddle and seemed to be objecting to something the rider had done or requested. With repetition of the KM, this behavior became milder, and it was also present but very mild on the left side. While he was reactive, he did not appear particularly stressed or agitated, and quickly relaxed again.

At the close of this third session, M appeared very sleepy and relaxed, moving slowly around the round-pen at liberty with a “somatic glide” – a loose, more integrated quality to his movement that we often observe in horses who have experienced EHS.

Post-EHS Assessment by the Owner

April 12, 2018

“Mateo seems to not be doing the mouth thing. He seems more cheerful too.”

Recommendations for continued progress:

1. Weekly EHS sessions if possible with a certified EHS Educator

2. Saddle-fit assessment to address any pain or restrictions being caused by tack and fit

3. Begin light work online/liberty and riding (after saddle fit is addressed) as is comfortable, keeping sessions short, fun, and working equally to the right and left, with a long (10-15 minutes) cool-down after each session.

Conclusions:

Before EHS, M had a progressively worsening condition of discomfort, restriction and/or pain associated with forward movement with a poor prognosis due to lack of specific diagnosis or treatment options. 

After the three EHS sessions following specific protocols designed to relieve the chronically contracted muscles that can and often do distort a horse’s posture and movement, M has improved dramatically.

After Session 1, the Ideal Protocol, M was moving more easily and was able to trot and canter to the left without any resistance or head/neck tossing. After Session 2, the Head and Neck Protocol, M was moving more freely in both directions at the walk, trot, and canter, was tracking up better, and was able to make smaller circles to the left with correct flexion, which he was unable to do before Session 1. After Session 3, the Barrel Protocol, M as stopped doing his odd mouthing behavior, and appears happier and more relaxed.

While EHS work is not diagnostic nor a “treatment,” we can conclude that at least some of what was causing M to have difficulty moving and also causing him to do his mouthing behavior had to do with chronic involuntary muscle contractions and motor sensory amnesia, the conditions that EHS is effective at alleviating.

REFERENCES

Chasteen, Barbara. Fragile Fulcrum: The Hyoid. Natural Horse Magazine volume 11, issue 6 2009: 8-11.