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A different kind of horse sense: Physical therapists provide much-needed treatments for equine and human athletes

Kirk Peck, Ph.D., an associate professor of physical therapy at Creighton, demonstrates a neck stretch for horses using a carrot.How do you get a 1,200-pound horse to tell you about the range of motion in his neck?

Give him a carrot, of course.

At The International Omaha horse jumping and dressage competition held May 5 through 7, Kirk Peck, Ph.D., Creighton University associate professor and chair of the Department of Physical Therapy, along with fellow physical therapist Sharon Classen, saw several dozen hoofed patients as they continue to spread the word about the benefits of physical therapy for athletes of both the four-legged and two-legged variety.

“Equine physical therapy has really exploded in the last few years,” said Classen, who is herself an equestrian and earned a certification to perform physical therapy on horses a little over a year ago. “And there’s a huge need for it. This sport doesn’t have physical therapists or regular access to physical therapy for humans or horses. But we knew it was effective and could make a difference in performance for the athletes, both human and horse.”

In short order, Classen convinced Peck, who already holds certification for practicing physical therapy on dogs, and is the state’s leading advocate for animal physical therapists, to go after his certification to work on horses. Classen and Peck comprise Serenity Physical Therapy, based out of Classen’s farm near Bennington.

Peck is in the final stages of completing his equine certification. When available, he will join Classen as she travels the horse show-jumping circuit, providing fresh insights on enhancing performance, helping horses and riders recover faster, preventing injuries, and conducting ground-breaking research.

Sharon Classen and Kirk Peck at work on one of Classen's show-jumping horses.That’s where the first weekend in May found the PT pair as the CenturyLink Center Omaha played host to The International, an event widely seen as a dress-rehearsal for next year’s 2017 Longines Fédération Equestre Internationale World Cup Jumping and Dressage Finals, March 29 through April 2. At the May event, Peck and Classen worked with 28 horses and 20 riders and expect they’ll see equal or greater numbers at next year’s competition.

“One of my goals is to encourage more PTs to look at this as a niche market,” said Peck, who advised the Nebraska Board of Veterinary Medicine and Surgery on policymaking for animal rehabilitation and wrote the regulations for practicing on animals for physical therapists. “Never give up your human skills, certainly, but work with humans and maybe think about a specialty in something like this. It’s a great skill to have.”

Since the inception of the sport of show jumping, the horse has often been seen as the athlete and the rider simply a guide. But as Classen and Peck have demonstrated, each is reliant upon the other — the horse acting as an extension of the human and the human as an extension of the horse.

The tiny collisions occurring repeatedly in a sport like horse jumping — riders jouncing in saddles, horses jostling up and down over the fences — add up, just like the pitches on the arm of a Major League Baseball player. And just as when a pitcher leaves a game and packs his arm in ice, one of the first things Peck and Classen do at the conclusion of a horse’s jumping circuit is ice the animal’s legs.

Sharon Classen uses a carrot to help a horse perform its pre-competition stretching.Lower back problems can plague horse and rider, given the weight each is negotiating during jumping and landing. Manual therapy, laser technology, and other physical agent modalities help speed recovery. In addition, increasing joint range-of-motion and stretching exercises for horses and riders help in the preparation for competition. The physical therapists have employed slow-motion video to determine how horse and rider are working or not working together. There’s also a host of core-strengthening exercises Peck and Classen perform with the animals.

Working in consultation with veterinarians, most of whom are just now coming to an understanding of PT for animals, Peck and Classen have been able to educate the equine community on the value of having physical therapists involved with the sport of show jumping. It’s the same as the interaction of a physical therapist with an orthopedic surgeon after a human starts the path to rehabilitation, Classen said.

“We’re in the unique position to treat humans and horses and to appreciate the biomechanical interplay at work in that relationship,” Classen said. “We fix the rider, the horse moves better. We fix the horse, the rider moves better. We have to be creative in our treatments. A horse is much different from a human, so we have different approaches that we are always trying to examine and improve upon. PTs, as a general rule, are pretty creative in their practice, so when you get into the multifaceted world of research on PT for the equine athlete, you quickly learn there is very little evidence to support various treatment techniques. ”

That’s when the carrots come in handy.

In addition to practicing PT on horses and riders, Classen and Peck are also in the midst of collecting normative data to help foster their burgeoning avocation to study the interaction of horse and rider and style new interventions for preparation and recovery. The duo would like to know what the most common injuries are for horse and rider and begin devising exercise solutions for prevention.

“We have all the data for the exercise demands for cross-country runners, cyclists, marathoners, but not for horses and equestrians.” Peck said.

Kirk Peck, Ph.D., works on stretching the rib muscles in a horse.And as the sports world becomes increasingly cognizant of concussion and traumatic brain injury, Peck and Classen are also keenly aware of the dangers inherent to a fast-paced sport involving two bodies, one of them an immense being on four legs.

“Show jumping is probably the most dangerous sport out there,” Classen said. “When you add a 1,200-pound animal into the competition, you’re just at a higher risk.”

Eventually, Classen and Peck hope to see physical therapy practice make its way into more corners of the sport and at its highest levels. As they pointed out, physical therapists are highly visible at other Olympic sports, working on human athletes.

Last year at a jumping competition in Colorado, Peck hit what he called the “trifecta of PT,” as he found himself helping treat horses and humans when a dog with a cruciate tear also wandered into one of the stalls where he was providing treatment.

“It was human, horse, dog, all inside the span of 60 minutes,” Peck remembered. “But that’s kind of what we want the epitome of PT to be. This is a new adventure for PTs, but one I’ve seen a lot of students start to embrace. How can you help people and animals where they need to be, pain-free, drug-free, and feeling their best? If the end goal is peak performance, it makes sense to treat both athletes.”

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