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TMJ

 Another issue I have seen in many dressage horses, mine included, are problems with the TMJ.  Signs that your horse could be having problems are numerous.  They may include being heavy in your hand, pulling the reins out of your hand, stiffness in it's neck and/or back, having difficulty in half-passes, flying changes, and/or pirouettes, refusing to collect especially in the piaffe and passage work.  The main cause of TMJ problems start with dental work.  Your horse MUST have it's teeth floated by a veterinarian.  The natural wear and tear and growth of teeth, makes this necessary.  However, having the jaw placed in the spectrum can cause the TMJ to become sore and get out of it's natural alignment.  Dressage work demands that our horses go "on the bit."  This places additional stress on the TMJ.

    What is the TMJ?  This is the Temporal Mandible Joint.  "The mandible (lower jaw bone) of the horse is the largest bone in the face.  When seen from the side, it is shaped like a boomerang, one end at the mouth, the other in the area of the cranium.  Here it articulates with the temporal bone, at a joint formed by the temporal fossa and the coranoid process." (The illustrated Veterinary Encyclopedia for Horsemen, p. 319)  It is located behind and just above the eye on both sides of the face.  

    How do I know if my horse's TMJ is sore?  Besides the symptoms I mentioned above, there is a very easy way to check the TMJ.   It is easier to find when the horse's bridle is on.  If you look where the brow band meets the cheek piece, you will find two bumps.  These are the two bones of the TMJ.   Just below these two bones, as you run your fingers toward the mouth, you can feel two nerves that run down the side of the horse's face.  This is where you can check if your horse has a sore TMJ.  If you press on these two nerves, just below the two bumps, there should not be any reaction.  This would mean the TMJ is normal.  However if you press here and your horse slowly moves away or tilts it's poll away from the pressure, your horse does have a sore TMJ.  Be careful, some horses are so sore, they will move away very quickly and violently.

    What do you do if your horse has a sore TMJ?  The first thing is to find a veterinarian chiropractor who is familiar with this joint.  Some of them are and some are not.  If you cannot find one who is, but is willing to learn about this problem, I would be happy to put them in touch with a vet or explain to them how to adjust the TMJ.  It is relatively easy once you know where to place your hands.  If however, your horse's chiropractor does adjust the TMJ and it is still sore, your veterinarian may need to inject the joint.  This is usually a one time injection of Legend and cortisone.   Again, my vet would be happy to share with your vet the dosage and placement of the injection.  Simply contact me, and I will give you Dr. Lenhart's phone number.  Your vet can call him and he will be happy to share the exact dose, type, and location of the injection.  This procedure takes about ten minutes and is usually a one time treatment.  It could make a world of difference in your riding and your horse's comfort and ability to perform dressage movements.

    The correct alignment of the TMJ is extremely important for all horses.  But it is critical if we expect our dressage horses to perform in a correct manner.  I cannot express enough how this small joint can cause many horses extreme pain.

 

    Hocks and Joints

    Another problem for performance horses are sore hocks.  It is very hard for a rider to feel a hind end lameness.  It is also hard to see a hind end lameness unless you have developed an eye for it.  Usually, the rider feels that the horse is not pushing from behind like it used to or it's just hard to get the horse to go forward on it's own.  The easiest way is to do a flex test on the hocks.  This is a two person job.  One to be at the head of the horse ready to trot him off immediately after the second person flexes the hocks tightly for at least 60 seconds.  If the horse take even one bad step, you could have hock problems starting.  There are various treatments available to help.

    At that point you need to have a vet inject the horse's hocks.  "Corticosteroids are the most potent anti-inflammatories."  (USDF Connection, Feb. 2004, pg. 41.) Many people feel this should be avoided and with the use of old cortisones, this was a concern.  However, the newer generation cortisones are safe to use every 4 months with little side affects.  In fact, some have been proven to produce healthier cartilage. The use of hyaluronic acid (HA) in conjunction with steroid treatment has been well-applied in the veterinary world for years. HA is no longer thought to have a primary function as a joint lubricant, since its anti-inflammatory effects are more important.

     There is another option available that utilizes the horse's own cells to aid in the healing process.  This process is known as IRAP or interleukin-1 receptor antagonist proteins.  IRAP was developed in Europe as a treatment for osteoarthritis.  The vet draws the horse's blood in a special tube.  The blood is processed to produce regenerative and anti-inflammatory proteins, which are injected back into the horse's joints.  This process can be extremely useful with less complications of corticosteroids.

     Another useful tool new to the vet world is extracorporeal shock wave therapy or ESW.  This can very effective when used on bone changes and tendons and ligaments where they connect to the bones.  A specific sound wave is used to penetrate the body and release energy.  This energy stimulates the body's own healing process. ESW can significantly reduce lameness and synovial fluid in the lower joints of the hock and in the rear third of the heel associated with soft tissue trauma.

    Of course, maintenance of the joints is extremely important.  Adding Glucosamine to your horses maintenance program is very important.  "Glycosaminoglycans inhibit the enzymes that damage cartilage."  (USDF Connection, Feb. 2004, pg. 41.)  Studies have proven that the use of intramuscular injections do help to maintain healthy joints.  There are three on the market; Adequan, ChondroProtec, Acetyl-D-Glucosamine. You can obtain these from your vet or have your vet write you a prescription.  They should be given every four days.  There are several companies that you can purchase your glucosamine, I have found Precision Pharmacy a reliable source for Acetyl-D-Glucosamine 20%.  Their contact information is listed on the Ulcer page of this web site.

    The use of feed through glucosamines have become very popular, but there is little scientific proof that most of them work.  Many believe that the horse's digestive system destroys most of the glucosamine before it can get to the joints.  There are only two products on the market that have done studies to show that they are digested and can work.  One is Cosequin and the other is Corta-Flx.  I use and believe the Corta-Flx has been effective in my horse. 

    Another product that should be used regularly for maintenance is Hyaluronic Acid.  It "binds to proteoglycans and prevents the leakage of cartilage components.  It stabilizes cell membranes." (USDF Connection, Feb. 2004, pg. 41.)  This is extremely important to maintain healthy joints.  You can make sure your horse keeps this very important chemical in it's body in two ways.  One is a monthly injection of Legend.  Since it is given IV, it is advised that it is given by your vet.  The other way is by feed through products.  I have found the most inexpensive way to add this is to buy Hyaluronic Acid capsules.  I give 100 -200 mg per day.  I simply take the capsules apart and sprinkle in the grain.  A new study in Great Britain has shown that feed through Hyaluronic Acid DOES get absorbed by the horse and DOES enter the joints.  You can get them at www.puritan.com 

     Some research has proven efficacy of the use of omega-3 fatty acids to inhibit enzymes that break down the cartilage matrix. In a three- to four-month period, horses supplemented with omega-3 fatty acids seemed to have less stiffness and pain related to osteoarthritis. You can add Omega- 3 to your horses system, by adding Rice Bran and/or Flax Seeds (ground or soaked).

  There new research on using a supplement with unsaponified avocado and soy, which is thought to somewhat decrease interleukin-1 levels and cartilage disease scores. This might be a useful product to add to a nutraceutical supplement.  I have not found it as yet, so I add soy bean pellets/meal or freshly sprouted soy beans and 1/2 of an avocado to my horse's daily meal.

   A great healing food are pumpkin seeds.  They are high in nitric oxide which will heal anything that needs it.  You can buy them in  powder from www.glenbrookfarms.com  and add a tablespoon once or twice a day.  You can also use whole pumpkin seeds from www.bulkfoods.com  Soak a 1/2 cup in water for 1 - 4 hours, drain, then the following day add water and pour everything into the blender.  The advantage is this brings the seed alive and they are much more productive.  I have seen all my horses do better in 1 - 6 months.

     It is important for the soundness of the horse to do everything that we can to help them perform.  Most "horse" products on the market are expensive with a 200 - 500 % mark up and recent studies have shown that many do not even contain the amounts of additives they claim.  I have found it less expensive to use the ingredients above. With the use of these things, I believe I can help my horses have less damage in their joints while performing, thus staying more comfortable and have a longer career.