Immersion 4

November 18th,19th & 20th

Kissing Spine

Jean Luc Cornille 2011

Kissing spine is unfortunately a relatively frequent problem with very few medical solutions. One is invasive surgery, with all the risks related to surgery. The other is injections which might provide transient relief but do not cure the problem nor teach the horse to live with the abnormality.

The problem of kissing spine often combines genetic anomaly and protective posture. The dorsal spines are inherently too close and the horse adopts a protective posture providing short-term relief but long-term problems. In a 1980, Leo Jeffcot summarized the results of 443 cases of horses having back issues. The British scientist categorized the severity of dorsal spine impingements into five levels.

Interestingly, there were a high percentage of affected horses showing a higher level of severity, (42%). In the eighties, back soreness was thought only to be a compensation for hock pain or other musculoskeletal disorders. Commonly, kissing spine issues induce discomfort in the hind legs. The symptoms vary from reluctance to pick up the hind legs to lameness. One can imagine that with the mind set on the thought that back problems were the outcome of hock issues, hocks and other limb joints were investigated and injected again and again before looking higher into the horse’s vertebral column. When finally the focus was directed on the horse’s back, the problem had already evolved to the higher severity level.

With technology improving the quality of the pictures and a greater willingness to investigate the horse’s vertebral column, horses can be diagnosed even when the dorsal spine only touches intermittently. These horses are easier to reeducate. The concept of therapy in motion is pertinent especially in a world where training techniques are the main cause of equine injuries. In 1994, Mikael Holmström wrote, “Most dressage manuals describe the training of passage and piaff, but very few explain how the horses perform them.” Indeed, the science of motion focuses precisely on the body coordination allowing a horse to perform soundly and efficiently.

In many instances, the genetic predisposition, which places the dorsal spine too close, does not alter the horse’s activities until the intensity of the demand increases or the horse is submitted to inappropriate training techniques. Very little can be done about this genetic predisposition, which places the dorsal spines a little too close, but a horse can learn to work and function efficiently with this genetic abnormality. The key is to identify the posture and working attitude causing intermittent contact of the dorsal spines. The horses that we have reeducated presented a combination of stiffening or arching of the thoracolumbar spine, associated with a problem of lateral bending and/or transversal rotation. 

Once the source of the kinematic abnormality has been identified, the reeducation is in fact an education. The therapy for kissing spine can be summarized as educating the horse to live with his problem. The horse learns to function efficiently adopting a vertebral coordination avoiding closing of the dorsal spines.

Adequate gymnastics is in fact the horse’s sole hope. The reeducation is precise, demands great consistency, but is not outrageously difficult. In fact, the difficulty is more in turning back to old habits.

“A man should look for what is, and not for what he thinks should be.” (Albert Einstein)  The horse’s thoracolumbar spine can be reeducated addressing the horse’s thoracolumbar column as it really works and not how conventional equitation thinks it should work. The same can be said about dressage movements. For instance, shoulder in has been abundantly used in the reeducation of horses presenting impingements of the dorsal spines. However, the shoulder in rewarded in the show ring is not by any means the gymnastic exercise used for the reeducation of affected horses. Judges reward a shoulder in executed with a lateral bending of the neck exceeding the lateral bending of the thoracic spine. Practiced this way, the shoulder in does not have the educative effects that were the pride of its inventor. “This lesson produces so many good results at once that I regard it as the first and the last of all those which are given to the horse in order to make him develop complete suppleness and perfect freedom in all part of his body.” (Francois Robichon de la Gueriniere, Ecole de cavalerie, 1731).

Lateral bending of the neck that exceedes lateral bending of the thoracic spine is likely to induce inverted rotation of the thoracic vertebrae. Such inverted rotation is placing the pelvis in the wrong inclination. The inside hip joint is then higher than the outside hip joint rendering it difficult for the horse to lower the inside haunch, which is the main value of the shoulder in. 

Lateral bending of the horse’s vertebral column is always coupled with a movement of transversal rotation. The proper combination, which is illustrated on the right side of this picture, (correct rotation), predisposes the horse’s physique for the right shoulder in.  “The shoulder-in prepares a horse for placing his weight on his haunches because, with each step that he takes in this posture, he brings the inside hind leg forward under the belly and places it over the outside hind leg, which he cannot do without lowering the haunch.”  By contrast, the incorrect combination, which is illustrated on the left side of this picture (inverted rotation), places the dorsal spines and the pelvis in a postural alignment inappropriate for the movement.

The association between lateral bending and transversal rotation was comprehensively explained in 1999, which is more than two and half centuries after Monsieur de la Gueriniere (1688-1751). The findings underline the fact that only a horse associating lateral bending and correct rotation is physically coordinated for the real shoulder in. At the contrary, the shoulder in executed with a bending of the neck exceeding the bending of the thoracic spine is creating inverted rotation downgrading the movement into a useless contortion. No need to say that the shoulder in used for the reeducation of horses affected with impingement of the dorsal spines is the real shoulder in.

“I dream my painting and then I paint my dream.” (Vincent van Gogh, 1853-1890) As well, the horse’s education and never the less the horse’s reeducation, demands a sound vision of the horse’s locomotor apparatus (I dream my painting) and an equitation refined to the subtlety of the horse’s biological mechanism, (and then I paint my dream). Everyone wants a gymnastic exercise or postural alignment that would fix the problem. There are event pretenders selling miraculous postures or rein effects. The reality is that there is not any movement having any specific effect as long as the rider does not have a sound understanding of the horse’s biological mechanism. For example, lateral bending of the horse’s thoracolumbar spine demands knowledge and sound understanding of the interactions between lateral bending and transversal rotations. 

Four cases of kissing spine were presented on the second day of the third Immersion Program. All four horses regained soundness and propensity to perform. However, one of the four horses, which was a powerful mare, did not return to performances. This was not because her physique was impaired but because her memory was badly bruised by previous experiences. The powerful mare was sound and performing well on the flat but the sole presence of jumps in the ring triggered frantic panic. Before being diagnosed with kissing spine the mare’s reluctance to perform had been interpreted as bad behavior and she was aggressively ridden on jumping courses.

The reeducation of Cocoa, which was one of the four horses suffering impingement of the dorsal spines, has been documented with almost daily video recording. The document demonstrates that while dressage movements are an intricate part of the horse’s reeducation, success does not rely on a specific gymnastic exercise but rather on daily analysis of the horse’s evolution.  Living mostly in the moment, the horse does not develop protective reflex mechanisms for a better future but instead for instant relief. Sometimes the horse’s mind is following a logic that does not fit human thinking. Success demands an understanding and respect of the horse’s thought process; guiding the horse’s brain toward more appropriate body coordination.

While the combination of back rigidity and spastic scoliosis kept the thoracic spine chronically bent to the left, which was the postural alignment causing impingement of the dorsal spine, the problem that initiated Cocoa’s wariness was his incapacity to properly use the propulsive activity of the forelegs. The horse was controlling balance by opposing the braking activity of the forelegs to the propulsive activity of the hind legs. It is in fact very probable that this opposition of force was the root cause of the postural misalignment causing the kissing spine issue. Cocoa becomes sound in about two weeks, but exhibited very short movement of the forelegs. It took 40 days for him to figure out how to properly coordinate the propulsive activity of both, the hind and front legs.

Several approaches have been used to guide his mind toward the right coordination. Once Coca figured out how to properly coordinate the propulsive activity of the hind and front legs, the progress went very fast. Coca was fully reeducated and ready to go home in three months.

Kissing spine often sounds like a death sentence. In fact, in most instances, the problem is not even difficult to resolve. The reason for somber prognosis is that standing therapies are powerless. The solution is to create new and adequate locomotor patterns, which can only be done with the horse in motion. Basically, competent equitation is the horse’s best therapy. James Crook wrote, “A man who wants to lead the orchestra must turn his back on the crowed.” The form of equitation that is crippling the horse perpetuates the heretical beliefs that the horse’s vertebral column can be stretched and that its range of motion can be increased. By contrast, an equitation upgraded to actual knowledge of the equine physiology regards the mechanism of the equine vertebral column as a large orchestra where multiple instruments tune up their part with great subtlety to every other instrument creating an overall harmony.

Another metaphor distinguishing equitation that cripples the horse from equitation that reeducates the horse comes from Albert Einstein, “As our circle of knowledge expands, so does the circumference of darkness surrounding it.” The circumference of darkness emphasizes a rigid order to which the equestrian education is submitting the horse, forward before balance, balance before straightness and so on. These training principles are both archaic and ineffective. Any living creature is composed of systems within systems within systems. All systems have to work in harmony. Any action executed at one level will not have the expected effect if the deeper systems are not properly coordinated. Lateral bending for instance will not have the expected effect if not associated with the correct rotation.

One just has to place, in parallel, a commonly accepted principle of conventional equitation; correct aids equal correct movement with a basic understanding of the horse’s neurological system, to measure the thickness of the darkness. “Various networks at different levels of the nervous system coordinate different motor patterns, be they the eye or hand movements or those that underlie respiration, locomotion and posture. Together, these networks provide a motor infrastructure that can be used by the nervous system to generate the elegant movements of a ballet dancer or the demanding postural control of a tight-rope walker. Some networks are present at birth, whereas, others mature during development to be modified and perfected through learning.” (Sten Grillner, The motor infrastructure: from ion channels to neuronal networks. Nature reviews/ neuroscience. Volume 4, July 2003). This motor infrastructure permits the whole to learn new patterns of coordination. However the components of this infrastructure, which are referred to as central pattern generators, have their own capacity of learning. Applying the so-called correct aids, the rider stimulates a series of complex networks. The quality of the performance relies on the proper orchestration of these many networks instead of the accuracy of the rider’s aids.

Whatever the correctness of the rider’s aids, the shoulder in will never be a real shoulder in as long as the rider does not have knowledge, understanding and feeling of the difference between proper and inverted rotation. In fact, the multiplicity of the many layers involved, clearly expose that the rider only influences the visible part of the iceberg. What we can consider as the body of the performance is the sound coordination of the whole network. Since a great part is not under direct control of the horse’s cortical decision, the whole concept of submission and obedience is in the surrounding darkness.

If not submitted to a system, the horse’s nature is the rider’s best help. From superficial to macroscopic level, the horse’s biological system is designed and functions in search of efficiency, which for the horse is about minimum muscular work and maximum force production. Through subtle body language, the rider’s job is guiding the horse’s brain toward the most efficient coordination. Given a chance, the horse willingly participates to the research. Equine athlete efficiency coordinate is performing easily. Ease is the rider’s best information. If the horse performs easily, his physique is adequately coordinated for the effort. At the contrary, if the horse struggles, his physique is improperly coordinated. When one comes back from a training session feeling pain in the back and shoulders from having pushed the horse intensively and supported heavy weight on the hands, one needs to reflect on the training technique. A horse efficiently coordinated performs easily.

Out of their talent, dysfunctional athletes might win in the show ring but only until the hocks collapse or the dorsal spine inherently too close starts to contact intermittently. The reeducation of kissing spine, like the reeducation of navicular syndrome and other injuries, is about creating a functional athlete. In fact the morning of the second day, which was focusing on the kissing spine issue, a horse was brought to the center for navicular syndrome. The participants of Immersion III were invited into the ring and assited and even participated in the analysis. Unfortunately, the horse was brought to the Science of Motion too late. The horse had already been nerved twice. The gait abnormality was not the one that caused navicular syndrome in the first place. Instead, the forelegs’ kinematics was adapted to the discomfort created by the advanced stage of the disease. However, even at this advanced level, it was possible to create a locomotor pattern providing some relief. The work was done in hand. The horse was very willing and obviously quite intelligent. Working on the biomechanics of the vertebral column it was possible to reduce the weight loading of the forelegs and the horse showed noticeable difference in his walk. In spite of being new in the work in hand, the horse’s owner was capable in improving the horse’s balance providing greater comfort in the alighting and support phase of the forelegs.

The Science of Motion is a new approach to therapy, which, instead of treating the pathological changes and subsequent damage is, instead, addressing the kinematics abnormalities causing the pathological changes. It would seem at first that the approach would be essentially preventive, but the successes of the therapeutic approach into fields where other therapies were ineffective underline the capacity of the horse’s physique to heal efficiently or, as is the case with kissing spine, to live with the problem, as long as the source of the abnormal stress has been corrected.