Obviously I’m a little biased, being a Physio who’s trained in Pilates. There are of course many other therapy options available, but as this is a blog about Physio and Pilates, that is what I will focus on!
In case you have never been to see a Physio and so don’t know what we do, we assess and treat pretty much all of the body. I have specialised as a Musculoskeletal (MSK) physio for many years, although this should perhaps be described as ‘Neuromusculoskeletal’ as in this field we work on nerve tissue (neuro), soft tissue (musculo) and bone/joint (skeletal) conditions. There are lots of other areas of Physio – respiratory, neuro rehab, orthopaedics, paediatrics to name but a few. If you are a rider, you are most likely to need an MSK Physio like me, but Para riders, for example, often need the input from a Neuro rehab specialist.
Seeing a Physio can be helpful even if you don’t have any major physical problems, just as many of you will get your horses checked over for ‘maintenance’. Professional – or even serious amateur sports people in all fields routinely see a Physio to keep themselves fit for purpose. Not only can it be helpful to prevent small niggles becoming big problems, but it can also help identify ‘problems’ that you may not have been aware of. When striving to improve your physical performance this can be crucial.
For long term issues – whether it’s managing old injuries, naturally occurring asymmetries or work related repetitive loading as examples – keeping these under control can make the difference between riding to the best of your ability and being constantly hampered. Looking after horses is also a physically demanding pastime, hence the high incidence of low back pain in the population. Considering the importance of good back mobility and stability in riding (as well as day to day life), managing back pain is very important.
As an aside, when I was training I can remember a discussion in a woman’s health session that raised the issue that horse riders had a high incidence of urinary incontinence. The only theory put forward was that is was due to the ‘bouncing around in the saddle’!!! I’m not one to think of the right thing to say on the spot, so despite my background couldn’t think of a suitable response as I didn’t think that many of us bounce round that much….since then though, I have thought about this often, and I suspect that the high incidence of incontinence is actually due to the high incidence of low back pain and the subsequent poor pelvic floor function. This is due to something called pain inhibition – a topic for another day I think though to explore it properly.
The main role of an MSK Physio very simply is to stretch the tight bits and strengthen the weak bits. This way, imbalances, asymmetries and pain can be resolved or at least managed. A combination of manual therapy – mobilising joints and soft tissues – exercises, and some electrotherapy, form the key treatments. For me – and for many of my colleagues – self-management to some degree is absolutely key, and this is where exercises come in. I personally get frustrated when I talk to clients who see a therapist who only ever treats the symptoms on the day, and never provide any means for the client to improve themselves between treatments. If you are someone who sees a therapist who doesn’t give you ‘homework’, consider it this way: If you have ingrained movement or postural habits, just having 30 minutes of manual treatment is a drop in the ocean when it comes to correction. Hours of work are needed to establish new ways for your body to move. So when you choose someone to treat you, make sure they are going to work with you, not just on you. It helps even more if you find someone who is prepared to help you work with postures and movements specific to your riding, especially if you have specific areas that you struggle with. This may sound obvious but it often isn’t the case. And whatever you do, make sure you choose someone who is well qualified.
Lots of Physios, like me, use Acupuncture as part of a treatment plan.
Acupuncture is a HUGE topic that I cannot possibly do justice to here, and I know that not everyone is prepared to consider it as a treatment option. It is however, excellent for treating pain, and fantastic for trigger points. Trigger points are the ‘knots’ that you can feel in your muscles when they are tight/overactive. I have dodgy thumbs and really struggle to treat trigger points manually, but a needle into the centre is pain free for me and much more efficient too. Trigger points are major culprits of pain, weakness and movement asymmetry due to their ability to prevent a muscle from contracting effectively, so any treatment that resolves them is worth a try. Of course, you need to follow that up with exercises to then restore correct movement patterns afterwards….
For me, Pilates naturally fits in to this. I teach Modified Pilates, which is rather less extreme and ballistic than the original method taught by Joseph Pilates! The aim of Pilates is to restore and maintain symmetry of posture, movement and muscle activity through controlled exercise. It focusses on improving core muscle activity to support the skeleton and enable the body to function optimally. For a rider, that is almost exactly what you are trying to achieve on the horse, so really the two go hand in hand.
In summary then –
Physio and Pilates can both help keep you straighter and stronger, and help you manage ongoing problems. You definitely need to do your bit and not just rely on a therapist ‘putting things back’ (another topic for another day), and in case you didn’t get the idea from the multitasking post….pelvic floor muscles are rather important, especially if you have/have had low back pain. All of which is essential if you want to be Ready to Ride.
Keep up the good work,