Joints & Mobility

Content

1. Some would say that the horse is the greatest athlete in the world
2. The Glucosamine/Chondroitin story
3. Cue collagen
4. Summer joints
5. Clicky joints? Don't panic ...
6. Natural plant support
7. Video - THE 24 BEHAVIORS OF THE RIDDEN HORSE IN PAIN: SHIFTING THE PARADIGM OF HOW WE SEE LAMENESS

Sub-Chapters

1. PSSM
2. Tendons & Ligaments

Some would say that the horse is the greatest athlete in the world

Certainly to see a healthy horse in motion is a joy to watch. The skeleton, connective tissue, muscles and joints all hold the body together, enabling it to stand, move and display the form. Yet this brilliantly engineered mobility system is used and misused by physical wear and tear, and in the blink of an eye, problems can occur.

To quote Dr Eleanor Kellon ...

"Lameness makes most people think about bones and joints but it's much more complicated. Any good body worker can tell you the bones and joints only create the form. It is the soft tissues of fascia, tendon, ligament and muscle that do the work of movement and maintaining stability."

And ... joint health and comfortable mobility also depends not only on what use our horses are put to, but also their diet, lifestyle and metabolic state.

If the biochemical and metabolic processes are undernourished and out of balance, the body as a whole will be under greater strain to eliminate toxins, which can build up in the connective tissue and trigger the development of arthritis, which will eventually lead to the progressive destruction of the joint itself, aka DJD - degenerative joint disease. Once a limb or joint is damaged, patience is needed for the time it needs to take to heal. Rehabilitating limb injuries can be expensive and time-consuming, and unfortunately usually associated with variable success rates, mainly due to the tendency for injury to reoccur.

There are many therapies for limb injuries, ranging from box rest to cold therapy, magnetic field application to shock wave therapy, non-steroidal anti-inflammatory drugs (NSAIDs) to major surgical procedures. However, few of these therapies are proven to be fully successful with many being of questionable value, and worse still, some being potentially harmful. None appear any more or less effective than another for returning horses to full athletic function without re-injury.

Long and short, the most common injuries we see here at EquiNatural are when the supporting connective structure around the joints, specifically cartilage and muscle, breaks down, causing misalignment and inflammation. A vital part of the therapy is ensuring a toxin-free, healthy bloodflow to the depleted tissues to maintain the body's own natural detoxing of the cellular debris from the affected area.

Keeping the joint tissue healthy is the first step to maintaining healthy limbs; however, no amount of joint supplements will keep your horse's joints healthy if you're not feeding a species-appropriate, quality diet packed with micronutrients and antioxidants.

Working horses need access to plenty of naturally occurring antioxidants to neutralise the free radicals being produced from heavy exercise. Good antioxidant properties can be found in blue-green algae such as spirulina, and omega-3 fatty acids courtesy of micronised linseed, which comes in at the same omega-3 profile as fresh, growing grass, which means horses not on fresh grass will have a dietary deficiency of omega-3. Also, certain nutrients such as sulphur is really valuable for connective tissue, filling out the protein make-up to achieve optimal healthy and functioning musculature and overall build.

The Glucosamine/Chondroitin story

For years, glucosamine and chondroitin have been the go-to support for joint care, but do they work? Studies on glucosamine and chondroitin reveal disappointing results - there's glucosamine that works - glucosamine sulphate, and there's naff glucosamine which doesn't, such as L-Glucosamine/Glucosamine HCL which is synthetic glucosamine. As for chondroitin, forget it.

Here’s a quick snapshot at what these (human) studies revealed:

• A two-year National Institutes of Health (NIH) study, the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), compared glucosamine HCL (synthetic) and chondroitin, both separately and together, with a prescription drug or inactive placebo for mild knee pain. Overall, there was no significant improvement in those with mild pain and limited improvement in those with moderate to severe pain with the supplements.
• A 2010 Meta-Analysis of 3,800 people with knee and hip issues found that treatment with glucosamine, chondroitin or both combined was no better than a placebo.
• A 2016 study of 164 patients with symptomatic knee concerns found that combined treatment with chondroitin and glucosamine HCL showed no superiority over a placebo for joint pain or functional use.
• More than 20 studies looking at the effect of chondroitin on knee and hip pain have found no consistent evidence that it lessens pain.
• Several studies have also looked at whether glucosamine and chondroitin can benefit joint structure. Any improvements seen were too small to make a difference to the patients.

Then there's green lipped mussels (GLM)

I’m not a fan of feeding GLM supplements to horses – while the active ingredient is good (glucosamine sulphate) there’s only around 8-10% of said active ingredient. The rest is mussel meat, which is dried and ground and fed to horses, with many horses not liking the taste. And lest we forget, a horse and their gut system isn't evolved to eat fishy …

There are a couple of other issues here - mussels filter sea water so they’re ingesting and accumulating both microscopic plastic particles and heavy metals, i.e. mercury/radioactive waste (remember Fukushima?).

Often a GLM supplement has other ingredients, i.e. hyaluronic acid and chondroitin sulphate. Hyaluronic Acid is apparently degraded in the equine gut so never reaches the joint – it can be injected into the joint but only lasts around 24hrs, so a regular daily jab into an already painful joint is, in my humble opinion, never a good idea. Chondroitin sulphate reaches the joints but is often derived from pigs so, er, it’s a no from me.

So what to do?

Well, it's back to glucosamine, blended with MSM for the sulphur.

• Always look for glucosamine sulphate - this is recognised by the liver as it's the natural version of glucosamine (HCL being synthetic) and gets into the joints with positive improvement; L-Glucosamine/glucosamine HCL doesn’t because try as it might, the liver simply can’t convert the HCL to a sulphate.
• MSM (organic sulphur) basically offers the body a bit more sulphur to produce glucosamine sulphate in the cells; the body normally produces enough sulphur to feed its cartilage cells, so by feeding MSM the body can produce more glucosamine sulphate, and yes, you’ll see improvement - not major, but combined with glucosamine sulphate, along with a natural anti-inflammatory, it's said to be beneficial. As per our JointReflexa which has positive reviews.

Cue collagen

Probably the most important factor in joint health is maintaining healthy levels of collagen; collagen is the cellular glue that helps hold together all the connective tissue in the body. It provides the structure for bones, muscles, tendons, joint cartilage, blood vessels and organs, including the entire digestive system, and, would you believe, it makes up a whopping 70% percent of the skin’s protein. Collagen truly plays a crucial role in how well the body functions.

Collagen is also the most abundant protein – and the most abundant substance – in cartilage, second only to water. There are nearly two dozen types of collagen, but three types make up 80-90& of the collagen in the body, specifically Types I, II, and III. Types I and III are found mainly in skin, bones, ligaments and tendons; joint cartilage is mostly Type II collagen.

Age also plays a huge part. During the growing years, the body makes enough collagen to keep tissues pliable and youthful, but certainly in human terms, you can tell when this changes, usually from the mid-20's onwards. By the time us humans reach 40, the body’s ability to produce its own collagen drops around 25%, and by the time we've hit the big 6-Oh, our production is half our youthful levels - cue the visible signs in facial wrinkles and creases (welcome to my world!). 80-years plus, and we've around four times less collagen, which is why our skin now sags more, typically noticeable on the face, neck and arms.

It's less easy to equate the aging process to equines, although you can usually see distinct sagging of face and neck skin in late 20/30-yo horses. However, from a joint health and comfort perspective, collagen is hugely important because it covers and cushions the surfaces of opposing bones, and because most domestic horses are typically in reasonable to high work levels, wear and tear also plays a major part in collagen levels deteriorating. Also why I personally keep our two ancients, Murphy and Carmen, permanently on our JointReflexa.

Maintaining collagen levels

Several nutrients can help boost collagen level. Antioxidants such as vitamin E, sulphur (MSM), silica (found in many herbs, i.e. Calendula, Nettle and Horsetail) and the omega EFAs (cue micronised linseed) are all important for collagen production. Vitamin C is also renowned for supporting the formation of collagen but there's no need to supplement it to horses as the equine liver produces plentiful vitamin C (although chucking in a handful of rosehip shells won't hurt). For us humans though, we definitely need to add it to our diet.

Collagen fibres are somewhat unusual in having large amounts of two amino acids, hydroxylysine and hydroxyproline, both of which can be found in micronised linseed, which is (in my humble opinion) invaluable for joint comfort. These two amino acids are important for formation of all three types of collagen and are also needed to provide the different collagen types with their appropriate amount of strength and flexibility. Several studies have shown that linseed supports connective joint tissue, and also reduces pain, inflammation and swelling of compomised and/or injured joints.

Summer Joints

Dehydration in the summer is a common cause of joint pain as the body’s need for fluids becomes greater as we sweat more in the heat. I know it’s stating the obvious, but water really is a key ingredient in allowing the body to function properly, especially joints.

Why? Water makes up the majority of the lubricant and cushioning in the body’s joints, particularly joint cartilage and synovial fluid, which is produced in the spaces between joints to help reduce friction and facilitate movement. Water also helps flush toxins out of the body which consequently helps to fight inflammation.

All this means that when the body becomes dehydrated, joint comfort suffers. Twin this with rock-hard, dried-out summer-drought turnout and you’ve got concussive impact as well.

So, the take-home message here is to always encourage hydration. Add electrolytes or extra salt to the feedbowl, and also offer drinking buckets with diluted salt – you may find horses prefer this over regular water.

As well as upping hydration, there are also effective herbs such as Willow and Arnica, a renowned herb for bruising, to help support general summer joint pain. Our Carmen always finds the hard summer ground challenging because of her twisted hoof from birth – it doesn’t take long before she’s head-bobbing on three legs. I keep her on a daily measure of our DuoBute in the feedbowl which effectively takes the edge off discomfort and inflammation.

Clicky joints? Don't panic ...

How many times have we heard clicky joints in our horses and panicked? June 2020 we had a friend's horse rehab with us - the very gorgeous William - to help come sound following kissing spine surgery and various peripheral lamesness. I've not ever heard joints click like William's - you could literally hear him from the other side of the field! Plus husband's joints click like mad too; he's frequently seen deliberately flicking his knee or elbow joints to undo the click. It doesn't hurt him, but he says his joints can ache depending on the weather. Then again, probably like most of us 😉.

Back to that click, and it's all about the joint cartilages and it's protective 'synovial' fluid, the natural, slippery body fluid that cushions the ends of the bones to reduce friction between the articular cartilage of synovial joints during movement. A synovial joint is the type of joint found between bones that move against each other, i.e. shoulder, hip, elbow and knee.

A joint's synovial membrane produces substances called albumin and our old friend hyaluronic acid that give the synovial fluid its viscosity and slickness. When a joint is at rest, cartilage absorbs some of the synovial fluid, then when the joint's moving the synovial fluid is squeezed out of the cartilage, like water being squeezed out from a sponge. When my Connie, Murphy, was younger, he developed a soft, squishy cyst-like bubble on his RF knee - synovial fluid leak.

This is all very common - what we're hearing is air bubbles in the synovial fluid and the snapping of tightly stretched ligaments as they slide off one bony surface onto another.

Overall joint clicking is usually harmless, but it does imply that we should perhaps do some stretching exercises as soft-tissue tightness in itself can be a cause for injuries. When stretching we might hear a loud pop - this is what husband does when he senses air-pressure in his joints, followed by a sense of relief in the area - when you hear the click the stretching has done its job.

Can we prevent it? There’s only one solution - get moving. "Motion is lotion," as the saying goes. That said, it won't hurt to keep an eye on it as general joint stiffness can lead to arthritic-y symptoms in the future.

Natural plant support

Joint health is an area that can be well supported with an excellent range of nourishing herbs that can help support peripheral mobility, joint health, collagen production and alleviation of discomfort. First up it's important to alleviate the discomfort with natural anti-inflammatories such as Willow and Meadowsweet (see our DuoBute), both of which are effective analgesics as well, with Meadowsweet being particularly useful as it's also a diuretic and hepatic which helps to clean and eliminate toxins.

Next up it's our JSTTonic (stands for Joints & Soft Tissue) which starts with alteratives, aka blood cleansers, which gradually clean and rebalance the blood; Burdock and Nettle are excellent alteratives for joints, with nettle being super-nutritious as well as a renowned promotor of collagen formation. It's also an ancient mineraliser, helping to build the body's own natural production of collagen with high levels of collagen co-nutrients such as calcium, silica and sulphur, making them an excellent source to help boost collagen receptors. According to some sources, one cup of infused nettles contains 300-500mg of calcium, as well as carotene, magnesium, vitamin A, B + K, potassium, and protein.

Then there are diuretics such as Dandelion Leaf, which support the kidneys to eliminate the metabolic waste, and we also use Viburnum as a really effective antispasmodic for arthritic muscle cramping.

Rosehips are one of the highest sources of vitamin C, with a reported 60 times more than citrus fruit. Horses love them too - pick them fresh from hedgerows and feed them as a treat - my now-retired Murphy used to love nothing more than burying his nose deep into a wild rambling rose hedge and nibbling on rosehips while we're out on a trail. Veggies high in vitamin C include broccoli and green leafy vegetables so you can always add these into the feedbowl or onto their turnout as a treat.

Then there's Calendula (marigolds) and garlic (best fed as a crushed fresh clove), both high in sulphur, with garlic also high in lipoic acid and taurine which help rebuild damaged collagen fibres. 

Avena sativa is also a significant source of silica, rich in body-building components, and helps to maximise absorption of calcium into the body.

THE 24 BEHAVIORS OF THE RIDDEN HORSE IN PAIN: SHIFTING THE PARADIGM OF HOW WE SEE LAMENESS

Meanwhile, here's a 2022 video that's truly eye-opening - if you have an unsound or confirmed-lame horse, this may be the best spent 35-minutes of your life to watch. Here's the link for you - https://www.youtube.com/watch?v=hrZgtrqbMVI

It features Dr Sue Dyson, one of the top Equine Orthopaedic Specialists in the world of equine lameness, helping a really touching real-life case study of a beautiful horse named Galina, and her deeply empathetic owner who absolutely realises that her horse is in pain.

PS - Nerve blocking alert at 17:50, so if you're a bit needle-squeamish, beware! (Made me twitch a bit ...)