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Tom,
It sounds like you could have used this last night. Hope it will still
help. I have heard of chiropractic manipulations of knees (not to
mention backs, necks, even the pelvis!) But never actually witnessed
one. With specific reference to the knee problem you described, there
are certainly many horses out there who have less than perfectly aligned
knees/cannon bones. A "shift" of the carpal bones to the lateral side,
resulting in improper alignment is a fairly common conformation defect
although I am not aware of any cases where this configuration has
developed after birth (which is what is sounds like was being suggested
here). The most commonly seen problem with this conformation is inside
splints - which should give everyone some idea of exactly how common a
defect it is!. If the work is heavy enough, degenerative arthritic
changes can be expected to develop along the medial and anterior surface
of the carpus and synovitis, especially in the lower joint, is extremely
common. Some horses even go on to develop what would be the equine
equivalent of carpal tunnel syndrome - that is, a lameness that is only
alleviated by blocking the median nerve just above the point where it
enters the dense connective tissue sheath surrounding the carpus.
Having said that, yes, there may very well be a lameness associated with
the conformational defect of the carpal bones not being properly
situation over the cannon bone (or, more accurately, under the radius),
it is a pretty big jump to suggesting it is anything that can be
corrected by a simple manipulation (assuming it is even possible to do
such a thing).
The tendon of the ulnaris lateralis fans out over a fairly broad area on
the lateral surface of the carpus. It covers and attaches to the
accessory carpal bone, blends into the joint capsule of the carpus and
even sends a branch down to the upper portion of the lateral splint
bone. I have trouble picturing how, even in a "hypertonic" state, this
muscle alone could cause a shift of all the bones of the carpus. Any
pull of the ulnaris lateralis would be countered by activity in the
flexor carpi ulnaris. There would also be the sizeable stabilizing
force of the joint capsule and all the ligamentous attachments between
the rows of carpal bones themselves to overcome to actually achieve a
shift of the carpal bones. It seems to me that would cause an awful lot
of damage that would remain painful even if you could "realign" the
bones. The situation would be even worse if the condition was, as
suggested, chronic. Chronic to me means plenty of time to develop all
the nasty end effects of inflammation - synovial proliferation and
thickening, osteophyte formation, decline in quality of joint fluid,
etc., etc.. They would all still be there even if you shifted the bones
back into a more anatomically correct position.
I also have to question
the diagnosis of "hypertonicity" of the ulnaris lateralis. This is an
EMG diagnosis, unless the muscle is so spasmed it is rock hard and
bulging to the point it is obvious from across the room. Every muscle
has an antagonist to balance its action, both during movement and when
at resting tone.
Any muscle that is active to the point it can override the balance of
antagonist groups would be obvious to anyone that worked around the
horse.
Hope this helps.
E.
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