The fourth and final aspect of an initial assessment is RANGE OF MOTION. This is all about assessing the articulations (or joints) of the body.
Brucey boy demonstrating beautiful hip protraction range of motion.
Range of Motion can be assessed both passively and actively. During dynamic assessment (see Dynamic assessment blog), I will have already assessed the animal’s active range of motion- the movement of the joint during movement, with active muscle contraction. Passive range of motion assessment is where I will step in to passively move the animal’s joints for them- taking the joint through its normal range of motion (flexion and extension) without the animal having to use their muscles.
What do I feel?
After palpation (see last week’s blog on palpation) I will asses the range of motion of the head and jaw, the neck, joints of the limb such as the fetlock, or toes and wrists of a dog, carpus (forelimb knee), hock (heel), elbow, shoulder, hip and stifle (hindlimb knee). I will also asses the back and the tail because the tail is just an extension of the spine- often giving clues to subtle problem areas of the spine and back.
Diagram presenting articulations of the horse along with other bones.
Diagram presenting the main joints in the dog. Notice how the difference between the bones of the feet of the horse and dog- the difference between toes and a single hoof!
What do I feel for?
When gently taking these joints through their range of motion, I will always have a hand on the joint that I am assessing so I can feel for any heat, restriction, swelling, enlargement, crepitus (clicking) or a pain response from the animal. These signs may be indicators of underlying pathologies. And, just as I do with palpation, I will always compare the joint to the opposite joint (e.g left elbow vs. right elbow) to check what feels normal or abnormal.
The hindlimb of the horse is an incredibly interesting system of anatomy. In order for the horse to save energy whilst running long distances or stand for long periods of time (for example, entering a light sleep whilst still standing), the muscles, tendons and joints of the stifle and hock are able to ‘lock in’. This is the passive stay and reciprocal apparatus.
This means that the stifle and hock joints can only be taken through their range of motion together. You cannot flex and extend these joints separately. Therefore, when assessing the hindlimb of the horse, I tend to pick up the entire leg from the fetlock and flex the joints altogether (see diagram below).
So there we have it! All four steps of our initial assessment.
As a recap, these include:
4) Range of Motion
You can read through my last three blogs on these topics if you haven’t already.
These four steps are what will take place on your animal’s first appointment- followed by their first treatment of course!
In the next few weeks I will go through the different types of treatment I will often use- the first, and most commonly used, is massage.
If you would like to find out more or have any queries on whether your animal may benefit from veterinary physiotherapy, contact me on the contact page of my website, by phoning me on 07545 251 008 or email email@example.com .