Welcome And Inflammation Basics

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Hello everyone, welcome back. Today's podcast is about inflammation, and I am Leslie and I will be presenting that to you today. So, first we're going to go back and we're going to look at inflammation and its characteristics. So, redness is one thing that we may see. So, this is due to the increased blood supply to the injured area. Heat is another thing that we may feel. So, due to the increased blood supply and chemical activity in the area. And of course, there is the inflammation itself, which is the swelling aspect. This is due to the increased permeability of the cell. Damaged leaking cells, an extra blood supply results in an excessive buildup of fluid in the area. Pain results from increased pressure on the nerves from the buildup of fluid. So they're irritating the nerves. So this is where we need to perhaps get an understanding of like how did the inflammation occur? Was it an injury? What sort of an injury? Are we looking at something like the overuse and muscle fatigue aspect of the body? Overstretch, which turns into then an overstrain? Have we got a strain on a joint mechanism? Is the ligaments affected? Are the ligaments affected? Muscle tendon strain. So muscles attach onto a tendon that or turn into a tendon, the tendon attaches onto the bone. Or is there inflammation and heat in just a particular aspect of one muscle? Are several muscles involved? If we're looking at those muscles, what are their, what's their job? You know, how do how are they flexing what bone from one aspect to another? Because every muscle has a job. Its action is its job. Are we looking at something that's age-related? Could it be that it's the early onset of arthritis? And that could have been due to past joint dysfunction, tight fatigued muscles, muscle atrophy, leading then to a joint injury. Are we looking at something that's congenital? So we could have elbow or hip dysplasia. Let's look at the word chronic. So this means the condition

Causes And Why Diagnosis Matters

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is persisting over a long time and the condition is constantly reoccurring. Therefore, you need to have a veterinary's diagnosis so that the owner of the animal can understand the extent of the injury and accommodate the healing and rehabilitation processes. For example, the healing of joint-related strains requires a lot of time and it requires some good thought and the effort that you're going to put into that. The consideration of x-rays and perhaps ultrasounds also will help confirm these things, as the exact injury, then we will know more about, and any um, you know, the probable outcomes of that, which then clarifies the best way to manage certain conditions with or without medications, but for how long? You know, there's always that initial aspect where anti-inflammatories are usually required. But, you know, how long should the animal be on those? You know, what is the realistic um aspect of the outcome when we look at this injury? So the condition of it, the pain management, this is paramount for an animal's well-being. But how long could this possibly go on for? So this is where we've got to have realistic um expectations of the healing processes and what we may be left with. Not we, the the animal, the dog, or perhaps the horse is going to be left with. So let's understand a little bit more about the healing aspects of soft tissue injuries, as they are divided into three phases. Number one is we see the inflammation. We see it, we can feel

The Three Healing Phases

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the heat and the inflammatory inflammation aspects of that when we touch it. Number two is proliferation, and number three is remodeling. So the initial inflammation is the body's natural response. It brings in all the emergency tools to the area and helps to break down and remove damaged tissue. However, the enzymes which help break down the damaged tissue will also break down healthy tissue if inflammation is allowed to continue for too long and if it extends beyond the area of the injury. So this is very common in serious injuries, especially those where a wound is present and the risk of infection is higher. The role of inflammation is trying to help the body's response to fight infection. The most important feature of inflammation is the accumulation of white blood cells at the site of the injury. Most of these cells are forms of phagocytes. So your phagocytes are cell-eating leukocytes that ingest bacteria and other foreign particles and clean up cellular debris caused by the injury. The main phagocytes involved in acute inflammation are the neutrophils. They are a type of white blood cell that contains granules of cell destroying enzymes and proteins. When tissue damage is slight, an adequate supply of these cells can be obtained from those already circulating in the blood. But when damage is extensive, stores of the neutrophils, some in the immature form, will be released from the bone marrow where they are generated. Large numbers of neutrophils reach the site of injury first,

When Inflammation Becomes A Problem

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sometimes within an hour after an injury or the first sign of infection. Once acute inflammation has begun, a number of outcomes may follow. These include healing and repair and chronic inflammation. The outcome depends on the type of damaged tissue involved and the amount of tissue destruction that has occurred, which are in turn relating to the cause of the injury in the first place. The prolonged or excessive inflammation attracts more fluid and encourages more migration of cells, which causes further irritation and activity drawn to the damaged area. This results in an engorged area, which in turn inhibits venous return, adding to the problem. The immobilization of the animal can also add to the scenario of the inflammation buildup. This is because the lymphatic system surveillance of the body relies on pulsating blood vessels. That means muscle movement to aid in a better flow of the lymphatic system to effectively do its job. So when we're not moving as much, there is a stagnant body and therefore a stagnant lymphatic system. In soft tissue-related injuries, this stagnant buildup of fluids and cells results in tissues adhering to one another and deposits of fibrous tissue causing an adhesive feel of the muscle fibers, or we can say muscle cells, to protect the area. These can often be referred to as something like an adhesion. It's restricting movement of the muscle fibers, inhibiting normal function. Worse still, if the muscle fibers are stretched and irritated too soon within the healing processes, the fibrous nature of the soft tissue will lay down more inflammation as a protective measure. This can inhibit restoration of the muscle tissue to normal function. This often occurs if the injury is stressed too soon or if the rehabilitation process is too aggressive. The breakdown of adhesions via good myotherapy techniques can cause pain, displaying a bit of a rigid spasming effect, or muscle tremors, and you can call them stress points, or what some people would like to call them as a trigger point. This kind of reaction within the muscles' neuroreceptors are communicating that the area is in a heightened state of distress. Therefore, muscles in distress will have inhibited blood supply, and if left untreated, muscle atrophy can be observed and at times also seen as atrophy or it can be hypertrophy, which means then overuse of a muscle in areas as a secondary problem to the initial injury due to the build-up of compensation patterns in the body. So we end up with muscular compensation patterns. And we would know this for ourselves as humans. You know, if you've hurt yourself, you've

Adhesions Compensation And Repeat Strain

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done an ACL, you've done a shoulder, you know, the way in which you are then coping with your body, you're not as balanced as you are. Left and right side, um, legs, the upper body, whatever it might be, you are not a hundred percent balanced. You have an injury, you have compensation happening in your body. No different to our animals, even though they've got four legs on the ground, we've only got two, um, four legs on the ground. This is where their compensation patterns can go undetected for months or years until some ugly injury comes along and alerts everybody. Oh my god, look at how crooked my dog is. Look at the muscular tree. I've got atrophy here, hypertrophy here. I've got tense, stringy muscles, I've got nice big bulbous muscles. What in the world has happened? And I shouldn't say it's just dogs, this is horses as well. This is horses in abundance. So no different. Soft tissue is soft tissue. So, again, I'm gonna say this. One can apply this to a scenario which might seem like a bit of a less obvious situation, but let's just say, after heavy exercise, with some excessive exertion here and there, some micromuscle cell damage can occur. This results in inflammation within lymph, fibroblasts, and enzymes clogging up the circulation. The traffic jam causes a buildup of lactic acid, and the feelings of being stiff or sore is what comes about from that. The animal becomes reluctant to move freely with the clogged-up, locked-up feeling, increasing pressure on the nerve endings, which causes more pain. If the animal is being asked to move, exercise, perform, the need to stimulate the sympathetic nervous system and trigger a dumping of adrenaline is what they will do to help as a pain-coping mechanism. This in turn may create a vicious circle known as repeat strain injury due to a trigger of adrenalized state of mind each time that they are asked to do this particular thing to cope with the discomfort. You see this a lot in horses. It is there in dogs, but dogs have that way of wanting to adrenalise themselves because they are a predator. It is easy for them to go like, yep, we're onto it. We're gonna please our family. Our human pack is our family. We're going for a walk, we're going to the agility, we're gonna go do whatever it is. So dogs can kick in that adrenalized state really easily. A horse as a prey animal generally only has to be in that state when there is a predator, when there is a sign of a reason to run for fear. So that's their flight instinct, isn't it? Fear, fight, flight instinct. But horses generally would want to flight rather than fight. So under saddle though, a horse is controlled by a bridle and a bit in its mouth and what the rider is doing. So their flight response may want to kick in, but because they can't flight because of the bit in their mouth and they're in an arena and whatever might be happening, then they might show some fight little aspects, do some bucking and pig rooting, shying and careering around the arena. So you can see how a dumping from the sympathetic nervous system to help an animal cope can be common practice. But this whole sort of injury inflammation scenario, which could be coming and going continually, it will start over again and again and again each time these scenarios come up if the body has not gone through its full rehabilitation in the first place. It's nothing for an animal to have one initial injury in, say, left shoulder. Okay, that's going to transfer through to perhaps the right hind initially, but then it could transfer across, transfer across to the other shoulder and then back again to the other hind quarter. And then we might have those issues then that are just far too much dysfunction and coping mechanisms that we could see a whole heap of stuff then starting to um really come through the rest of the body. So you'll see it in the lower back and then finally up through, you know, the bulk of the rib cage and so forth. It goes on. I'll move on. So now let's look at stage um the next stages of healing and what are they, what are the processes? So we've got uh proliferation. This is a repair process. So when blood vessels mend,

Proliferation Remodelling And Contraindications

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usually within one week of injury, new blood is brought into the area. This fresh supply of blood brings in the repair materials, lays down collagen and a clotting protein known as fibrin, and takes away the damaged cells and fluid deposits. Granulation tissue forms until the broken ends and recreating structure of the injured area starts to happen. In an open wound, epithelial tissues must grow over granulation tissue before skin can completely heal. So this is if you've got an open wound. Sometimes the granulation tissue grows over the edges of the wound, restricting the growth of the epithelial tissue and the healing. Remodeling is the third and final stage of healing. It's a long process involving cellular activity to restore previous structure and function. It is a stage which is which is often overlooked and underestimated in a rehabilitation plan. So following the regional and caution aspects of a contraindication. So contraindications means that you know it is required that a vet gives guidance and clearance for therapies to start, particularly that would be massage or any sort of exercise therapy. But other aspects of a contraindication can be in stages. So we've got past stage one, so we can start with this, and then finally there will be nothing that will contraindicate the original injury, and you can keep proceeding. So the question is: how do we treat chronic pain and inflammation? The original and initial consultation that you may be having

Practical Rehab Rest Movement And Diet

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as a myotherapy massage practitioner or um going off to see the vet and so forth. Initially, what everyone is trying to do is to form a plan, but don't forget about the common sense aspect of rest and cold compress, depending on what has happened and the situation, may or may not be warranted, um, may or may not be able to do. Um, but then there's also the aspects of compression bandaging as well. So that again, this will all come down to what is the injury, why have we got it to this stage, or in and how bad is that? And obviously in the human world, if you look at the rice, which is um rest, um ice or cold compress, compression bandages, but there's also E4 elevation, it's too hard to elevate a dog or a horse's limb or whatever it might be. But you're looking at the common sense um factors first. So, from a practitioner's point of view, we always have the critical critical thinking cap on. So we look at it from this point of view that if the animal has confined rest, quite easy for a dog, may not be um uh good for the human to see that their dog has to be crater. A horse may need to be stabled, but if a stable is going to stress a horse out, then a smaller yard so that they can see their other horse friends. But maybe in that situation you need to bring a horse's friends closer to them so that everyone is then a bit calmer. And especially in the first three to five days, you know, that first initial couple of days after the vet has seen what it's needed to see, and the dog has come home or the horse is back home or whatever it might be, you know, you've got that first, it's really the first week, isn't it? But then there's the dietary considerations, you know, what they're eating, how how biologically healthy is that to support the internal environment of the animal and bring them to the most healthiest that they can possibly be. Uh, as we start the um the rehabilitation physical aspect of things, we need to think about slow, controlled, passive exercise. So for a dog, of course, that's going to be on a lead. For a horse, obviously, they're in a halter and lead rope, and again, it's a walk situation. But what sort of walk whereabouts is the horse going to get upset about something? Um, is the walk machine applicable at this point? Will the walk machine be too much? There's lots of things to think about. I think allowing for a slow rehabilitative recovery to avoid compensation patterns in their musculature and improve body balance, you've really got to look at the animal from a whole perspective of how to bring this back, but how to bring the body back so that it's got a better chance of longevity and not re-injuring again too quickly. So, this is where good old fashioned physiotherapeutic pole exercises done slowly are very beneficial to balance up the body. You know, um, and also maybe you have to look at the exercise but also the lifestyle changes to avoid. Any further injury. Complimentary supplements, uh, they need investigating. They can be a hit or miss. Obviously, you know, this is a part of our naturopathic um medicine that we work with, but there's a place for them. And long-term use of these need to be um managed and thought about in that way. And we will talk about those sorts of things in other podcasts. But you know, at the end of the day, we can't prevent injury if it's going to happen. Sometimes it does. But sometimes you can prevent it. You know, your your lack of awareness of what is you're actually seeing or is habitually happening with that horse or with that dog on a daily basis, these are the things you need to you need to curb them. You need to come back and go, well, hang on, what am I really doing? Um but also it's always nice to think about prevention, it is always going to be better than the cure. So if you have an animal that is doing lots of different sports, or um is an ha is an animal that is not happy in its environment and it's got erratic behavior, then we've got to look at ways in which we can balance that within their body and their mind. Okay, it's an emotional state too for some. So we're looking at the body as a whole. And always, you know, anything

Massage Grooming And Long Term Prevention

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in a remedial sense. So if you're looking at remedial myotherapy, it's because you're trying to reset the body. The stimulation will activate an increase of the body's own anti-inflammatory agents as well. So you can never go wrong with that, triggering the body to complete the healing processes when the body has been stagnant for too long with these sorts of injuries. So anything to do with traditional massage, which you know we can call that as traditional massage, it's whole body massage, it's using your hands and it is working hard. Um, it's it's a hard job if you're working massaging horses from head to toe, but it's an enjoyable job, isn't it? Um dogs are a lot easier, but then they can be very wibbly-wobbly. So again, it there's a there's a way to go about it, and there's a purpose for it where you are stimulating the healing processes from within because you're working with the whole muscle, the whole body, and that will affect that in many um positive physiological effects. So, yeah, again, if we're coming back to looking at massage, it can facilitate and um working in the dilution and removal of excess fluid irritants and help the lymphatic system. We can support the parasympathetic function of the nervous system, so a calmer body and a calmer mind is enabling an improved healing process. We can also look at how our treatments can slow down formation of fibrous scar tissue, um, but also enable the scar tissue to remain pliable as it's forming. Yeah. Um, so there are some variables, obviously. If we're looking at the variables of a horse, for example, what is your warm-up and warm-down procedures? I mean, this has been said for years, I know. But there's another aspect is bring back good old-fashioned grooming with a brush. There are a lot of clients over the years and students that have come through where they've gone, oh, we just forgot to brush, you know, because it was so much easier to just do a warm hose down, scrape the horse off, put a cotton on and whatever rug else that might go on or not. Um, and that's it. You know, but grooming with a brush, grooming with several brushes, stimulates a lot of the physiological effects that is going to be um promoted through the body via the nervous system. So the skin itself has nerve receptors coming into the layers of fascia, coming into the muscles themselves as you're you're almost palpating with your brush. So I'm gonna say it, bring back the grooming. Um, horses' saddle fit checks always. Don't don't um ever dismiss um looking at your horse from say, like stand up on something. Uh it could be a um a mounting block that you can stand up and look down your horse's back. You know, if you can stand up safely behind the horse, whether that's a couple of meters behind it or up close to your horse, look down your horse's back, look at the imbalances that your horse may have. One shoulder's bigger than the other, one shoulder set forward more than the other. Look at your hind quarter, look at the point of hip. Are they even? Um, look at your horse's hooves. How unbalanced are they? Are they all even? Sometimes they don't have to be perfectly even because that's a way in which the body has been formed through the skeletal form and then built with that muscle around it. There's so much. Um, but yeah, look at muscle atrophy. Then look at what muscles are working a little bit too much because of the atrophy. So quite often when we have muscle atrophy, we'll have hypertrophy because it's an over-use, because it's over having to do this work that the atrophy muscles can't do. Um, and think about stabling. I know stabling can be convenient and it feels like the horse is in its most warmest and comfy stable. But stabling for however many hours quite often leads to a very stagnant digestive system, circulatory system. So that's both blood and lymphatic. It leads to less muscle activity. So when a horse is in a paddock, if it does get a little bit cold, it will start walking and eating because that's how it will fuel its body. Things like um uh you know, the over-rugging. Sometimes you're creating too much warmth in a horse. And so then it doesn't feel the need to want to move around. Yet moving around keeps the body and the all the internal systems acting as a complete homeostasis of all working together as one, it keeps it healthier than being stagnant. You know, horses haven't been on this planet for how many years to not know their body, to not know what they need. We just stick them in a paddock and they get a little bit blocked by that paddock because they can only roam so far. But if they can move about and roam and pick and choose when they need to eat and when they need to drink and move and all the rest of it, that's a good thing. Yeah. But you know, obviously there is times for stabling, there's no doubt about it. But think about if that is something that your horse is doing a lot of, and yet you are having some of these other issues as well, because again, what we've just been talking about, think about it. And there's nothing worse coming out to your horse in the morning and you know, you've their legs are swollen. You know, we've got a lymphatic stagnant system there which has caused some inflammation in the body because they couldn't move. Don't forget their beautiful hooves act as an auxiliary pump. The frog in that hoof is an auxiliary pump. Same sort of scenarios can be happening with dogs too. Dogs are the ultimate willingness to please their pack. Every family that owns a dog, you are the dog's pack, and dogs love pleasing their pack. But when they are pleasing their pack in their little carnivore predator way, they are so good at zipping up that nervous system, triggering that um sympathetic, crazy state of mind, getting excited, getting in there and joining in with the family. But sometimes then they already have done their warm-up. But their warm down is just straight in on their bed and go to sleep. So warm-up and warm-down procedures for a dog, depending on what you've got your dog doing, is something to think about. And there's going to be other talks where we talk about dogs and how they are exercised and how much exercise a dog should actually do. Because hereditary ancestry, if we go back and we look at dogs and how much they didn't exercise for a reason, it'll also trigger those memories or those thought processes, I should say, for you to think about that about your dog. Dogs live half the life of perhaps, you know, of a horse. If we look at the average age of a dog that will pass away compared to the average age of a horse, and yet a horse is carrying a human which it was never designed to carry. So if we look at how what a short life a dog has, and a lot of the illnesses and injuries that they suffer in that short life, it's quite often human-driven. Um, so it's another thing that we'll talk about. So, yes, um, always lots to talk about. Uh, I hope today just did give you some different insight into aspects of inflammation and an animal's body and things to think about in the healing stages or phases as well, but other

Final Takeaways And Sign Off

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things that can come towards um, you know, bringing your dog to be the best it can be in its healthiness and its function, um, and your horse as well. So, all right, I'll sign off and I thank you for listening, and I'll catch you next time. Bye for now.