EC August Select, 2010

A new method to help promote bone strength and density in horses utilizes whole body vibration, with the horse standing with all four feet on a frequency-controlled vibration platform. This type of therapy (bio-mechanical stimulation of body tissues) is new to horses, but has been in use for human medicine for more than 40 years. Currently it is used for human athletes, stroke victims, patients suffering from multiple sclerosis, arthritis, rheumatism, cerebral palsy, Parkinson’s disease and numerous other problems. It has proven helpful in elderly people to prevent osteoporosis.

In the 1960s vibration therapy was utilized by the Russian space program to offset bone loss in space, and NASA has continued to use it. In the United States, Dr. Clinton Rubin (Director of the Center for Biotechnology, State University of New York, Stony Brook) has been the main researcher in human applications of this technology. He also used it on the hind legs of sheep for a year, and found that they developed more density in the treated leg bones.

Bill Casner (co-owner of WinStar Farm, Versailles, Kentucky, owners of Super Saver, who won the 2010 Kentucky Derby and Drosselmeyer who won the 2010 Belmont Stakes) learned about Rubin’s studies 10 years ago and thought this type of therapy might be beneficial to horses in athletic training. “Rubin was the pioneer of these studies in the U.S. and much of his research has been funded by NASA,” says Casner.

RESEARCH ON THE EFFECTS OF WHOLE BODY VIBRATION

“Rubin’s first clinical trial showed that vibration therapy could produce a 34 percent increase in trabecular bone–the honey-comb interior in the ends of the long bones. In this trial they put the hind legs of the sheep on the vibration plate for 20 minutes a day, at a vibration frequency of 30 hertz. It increased the density of the bone without increasing the bone diameter,” explains Casner.

“To me, that was incredible. Even 10 percent increase would have been huge, but to get 34 percent was amazing. This could be very significant for horses. I spoke with Dr. Kawcak at the University of Colorado about doing a clinical trial with horses, but we realized it would involve too many horses and be too expensive to do a full-blown clinical trial at a university level,” he says.

“At that time I thought about developing a plate to use on horses, but I wondered about the effect it would have on growth plates in young horses. I put the idea on the back burner, but during the past 7 years continued to monitor the human research being done. A couple of recent studies showed that the vibration therapy was actually very positive for the adolescent human. One trial summarized that if employed in adolescence this therapy would give a very positive carry-over into adulthood to prevent osteoporosis,” says Casner. The vibration stimulates the skeleton, which responds by forming more bone and tissue to resist this force.

TRYING IT OUT HIMSELF

The more he read about it, the more he realized it had tremendous implications, especially for elderly people. “Bone loss is always a challenge. We have one of the human plates, and my wife and I both use it. These human models were developed in the 1990s.  Vibration technology is being explored in trying to limit bone loss and maintain muscle strength. The vibration causes stimulation of the muscle fibers, and this has been well-documented,” he says.

The human plate is very simple, but really helps your knees, back and any other joints that might be bothering you. If you do stretches on it, this can make you a lot more flexible. You can do sit-ups or push-ups, as well as just standing on it. I stand on it, on one leg, for instance, and switch legs, and it helps my balance. The plate is about 14 to 15 inches wide and 3 to 3.5 feet long. Everyone I know who has one just swears by it, because it makes them feel better. It’s wonderful for someone with diabetes because it enhances circulation to the extremities.” Casner says he always tries any new therapy on himself before he tries it on his horses.

His quip regarding people’s reactions to innovations like this: “There are three stages. The first is ridicule, second is strong opposition, and third is universal acceptance as being self-evident.” He also wants people to know that he has no financial interest in the marketing of this technology. His sole interest is the benefit and promise that it holds for helping horses maintain soundness during their athletic careers.

IMPORTANCE OF BONE STRENGTH

The main advantage horse owners hope to gain by this type of therapy is to increase bone strength, to better prepare their horses for the stresses and rigors of athletic training. “I attended the 2009 AAEP meeting in Las Vegas, where they had lectures on lameness and looked at many of the challenges these horses face, regarding bone. One of the things that Dr. McIlwraith and Dr. Bramlage both spoke about is the fact that in most cases where there’s bone failure (whether it’s a condylar fracture—at the end of the bone—fracture of the cannon bone, etc.) there is always a predisposing pathology,” says Casner. Stress has already weakened the bone.

“It’s a cumulative process. Excessive stresses to the bone put it at risk. The trainer walks a fine line. You must stress the horse enough to build more bone, but not so much that it’s damaging to that bone. Shin buck is a case in point—this is a reaction to excessive stress. When we start creating overload, it accelerates the remodeling process,” he says.

“Remodeling is a good description of what happens in bone. There are bone cells called osteoclasts that remove the damaged bone. Then another type of bone cells (osteoblasts) start replacing bone and building it up. But at first the bone starts to weaken,” says Casner.

“About 13 years ago Texas A&M did studies on what happens when we put horses in training. They did bone density measurements and showed that these horses start to lose bone from the very first day we put them into training—putting weight on their backs and adding any type of stress. The horses lose bone for the first 65 days in that process. At about the 65th day these horses are at the lowest bone density they will ever have. After that, it starts to reverse and it takes about another 65 days for the bone to return to the density it had at the beginning of training. So it’s at least 4 months before the horse gets back to even—and during that time he’s incredibly vulnerable to injury. This can also occur after an injury lay-off,” he says.

“Many people rush the training process. With a racehorse, they may start breezing in 60 to 90 days. That’s too soon, and the horse may shin buck or get a saucer fracture because the bone has not had a chance yet to strengthen,” he says.

“In our program we generally accept the fact that if we can get a horse to the races in a year from the time we start breaking him, that’s the best case scenario. If we start breaking him in August of his yearling year, we can run him in August as a 2 year-old. We still see a few problems and injuries in young horses. Our hope is to start putting these horses on the vibration plate in April of their yearling year, before we ever start breaking them—to start adapting the bone,” says Casner.

Any young horse going into a strenuous athletic career—cutting, reining, barrel racing, jumping, etc.—might have fewer injuries if vibration therapy could be utilized before their early training.

STIMULATING SWIFTER BONE REMODELING

“The clinical trials in humans show there is stimulation to the trabecular bone, cortical bone and periosteal (outer layer) bone. In a trial finished in September 2009, Dr. Rubin showed there was an actual increase in cartilage thickness over a six week period. That’s also very exciting. What we are seeing is total adaptation of the bone; it’s not just one component responding. The entire bone, along with the cartilage, is adapting due to the mechanical stimulus,” he says.

The stimulus mimics muscle contractions. “Muscles vibrate when they contract. It’s a tiny vibration we can’t feel, but it can be measured. That vibration in humans is generally in the 27 to 35 hertz range. The muscles of all mammals are very similar in their cellular makeup. The stimulation effect seems to occur anywhere from 20 hertz up to about 55 hertz. This seems to be the range in which we see a response in bone cells and muscle cells,” he says.

One trial showed that the vibrations slow down the osteoclastic activity and stimulate the osteoblastic activity. “It really enhanced the remodeling process. This offers a lot of promise for young horses being prepared for training, and also for use in conjunction with training. It will help a horse in training stay ahead of the pathology due to stress. Dr. McIlwraith, Dr. Bramlage and others have talked about how there’s about a 3-month lag from the time stress and strain occurs until the time the bone remodels, and it may take even longer. So there is continual vulnerability during that time. When horses are training, we want to keep ahead of that. This therapy can help them remodel bone much more rapidly and effectively to stay ahead of damage. If they have stronger bone to begin with, and keep strengthening it during training, we may avoid common injuries,” says Casner.

ADAPTING THE VIBRATION PLATES FOR HORSES

Casner looked into possibilities of having plates made for horses but never found a company that was interested. “Mary Knight called me one day and told me she’d found a company that made a plate for her horses. Her husband had Parkinson’s disease and she got one of the human plates for him, and decided to try it on her horses. Since then we’ve been working together on this technology,” says Casner.

The company now makes plates for humans and horses. “I had one made for use with stocks, here on our farm. They also make a larger plate that works well at the track. It’s placed next to a wall, you lead the horse up on it and a person stands there and holds the horse,” explains Casner.

“All we do is put the horse on the vibration plate for 20 minutes per day. The horses seem to love it; it’s very easy to train them to stand on it. I have one on my ranch in Texas and also at our farm in Kentucky. Eoin Harty also has one at his barn at Santa Anita.”

The typical therapy is about 20 minutes per day. “The changes start immediately, but according to clinical trials, you start to see significant changes within 4 to 6 weeks. It may take as long as a year”.

“The amazing thing is that it’s so simple, and the machines are so easy to use. I bought one of the human models for myself, but it took me 2 years to be persuaded to do it because I couldn’t believe that anything so simple could do so much good. I’ve only been using it on my horses since October 2009. Science continues to support it, however, and reports have been published in some of the most prestigious science and medical journals that have very stiff peer review. They intensely review these trials,” he says.

“To me, this is one of the most exciting things that’s come along in a long time. Implications for use are tremendous for preserving and improving bone density or preventing bone failure in horses. It also has a good chance of helping horses with OCD. We know these horses have defects in the subchondral bone, and vibration therapy could be very instrumental in helping deal with this. One of the trials showed what it does for cartilage. If it can enhance cartilage growth it might help clear up the defects in subchondral bone. More research can help us figure this out,” he says.

“Sesamoiditis might also be helped. Another problem is a high suspensory injury—inflammation of the attachment of the suspensory ligament to the bone. The attachment area becomes inflamed and remodels in reaction to strain and stress. I think we’ll find that vibration therapy will help with this,” he says.

“I used to have chronic shoulder and elbow pain. When I started using the plate and started doing pushups on it, it relieved my shoulder and elbow pain and these haven’t bothered me for more than 4 years now. I rope a lot, and I’m swinging and throwing a rope nearly every day. I’m 62 years old and used to have a sore elbow and shoulders all the time,” says Casner.

PROMOTING FASTER HOOF GROWTH

“One of the things I noticed immediately is how much new hoof growth horses get. I had one horse, Well Armed (who won the Dubai Cup in 2009) that I put on the vibration plate. He had a chip removed off his sesamoid and a very small tear in the attached suspensory. I used vibration therapy as part of his rehab process. In late November I had ultrasounds done after 2 ½ months, and it showed healing was complete. But one of my first observations was new hoof growth. The first day I put him on the plate I put a mark on his coronet band and measured the hoof 6½ weeks later; the foot had grown a full inch—which is about twice the rate of normal growth. I’ve never had a horse grow an inch of hoof in 6½ weeks! About the best you can hope for is a half inch.”

Clinical trials have shown that vibration therapy stimulates nitric oxide and MMP, which are both vasodilators. “Thus it would be reasonable to believe you’d get increased hoof growth. There are strong indications that vibration plates could be very helpful in management of chronic laminitis, under-run heels or thin soles. Blood circulation in the feet is always a challenge.

“If vibration therapy could help alleviate these problems, that would be a tremendous benefit,” says Casner. Thin soles, lack of blood flow to the digital cushion, etc. are all problems in racehorses and can be a factor in other equine athletes as well.

Some of the major rehab centers around the country and in Canada are using it as part of a multi-faceted approach to helping horses heal, recover from injuries or regain fitness, along with use of cold saltwater leg spas, swimming pools, underwater treadmills, hyperbaric chamber, etc.

The Sanctuary in Ocala, Florida has a vibration plate. Call (352) 369-HEAL (4325), or check the website: www.sanctuaryequinerehab.com for more information on this exciting new therapy.

THE FIRST VIBRATION PLATES FOR HORSES

Mary Knight was the first person to have a vibration plate built for horses. “My husband has Parkinson’s disease and was basically immobile, having a problems with muscle cramps, poor circulation, etc. I went online to see what I could find that might help resolve these problems. The VibePlate looked like it could work, and I thought it might also work for horses. Many horses are standing in stalls much of the day, and some are injured and can’t exercise—and their circulation is seriously compromised when they are idle,” says Knight.

She felt that if she could stand a horse on this vibration plate, it might be helpful in many ways. “I tried it myself, after I got one for my husband. I galloped horses for 30 years, had a dislocated hip, a reconstructed knee, a double compound fracture of an ankle—all those old injuries that made it hard for me to sleep. After getting on the plate a lot of those aches and pains were relieved. People who use them during a workout at a gym while doing weight-lifting say it enhances their workout by about 35 percent.”

She looked online to see who made vibration plates. “I found a company and talked them into making me a plate 40 inches by 80 inches. I work with Winner Circle ranch in Bradbury, California. Don Shields, the veterinarian who owns that ranch, was very supportive of my putting a plate up there,” says Knight.

“The first horse I put on it was Super Strut. He really enjoyed it. His feet were rough so I put new shoes on him about the time we started him on the plate, and his feet grew 1.34 centimeters in 30 days, in the dead of winter. I was very impressed with this. For foot problems, we thought this therapy could be really good, because it stimulates circulation to the foot.”

At first she wasn’t sure she should put horses on the plate that had shin buck or fractures, but recent studies in humans showed this therapy is very effective in promoting bone development and healing. “I’ve only been using it in horses for 2 years and we are currently developing protocols for use in horses,” says Knight.

“Carl O’Calahan, who trains for one of my clients, bought the prototype plate from me because they wanted to try it. They took it to Santa Anita, where Carl gallops his own horses. He has some old claiming horses that took forever to warm up, and he put them on this machine for 15 minutes before taking them to the track. He says the difference in these horses is like night and day. They are already warmed up after standing on the plate,” she says.

One of the immediate effects of vibration therapy is improved blood circulation, due to the rapid, involuntary contraction/relaxation of muscles (30 to 50 contractions per second). The improved blood flow enhances oxygenation of tissues, removal of toxins and metabolic waste, and enhances the body’s ability to heal itself. As Knight points out, 5 to 10 minutes of vibration can help prepare a horse for athletic activity without using up energy through the activity and excitement of a conventional warm-up exercise.

She feels it will have a lot of positive applications. Young horses starting in training always lose bone density before the bones begin to remodel and build back. Horses standing in stalls recovering from injuries also lose bone strength and density. “Even horses that are able to be hand walked 15 to 20 minutes per day are likely to experience some loss of mineral from their bones as this amount of exercise doesn’t provide enough stimulation to the bones to signal a need to retain these minerals. Whole body vibration provides significant stimulus and helps prevent this loss of bone density during prolonged periods of inactivity,” says Knight.

“It’s really simple and very easy to use. Once the horses get used to standing on it, they like it because it seems to relax them. Very few horses have resisted. I start them out with a very low vibration frequency and gradually move it up,” she says. Research in humans has indicated an increase in levels of certain hormones including Human Growth Hormone, Testosterone and Intrinsic Growth Factor 1 after the vibration therapy. People who use the vibration plates experience a feeling of general well-being. Horses adapt to it quickly and after 3 or 4 days of use they look forward to standing on the platform and stand quietly for the vibration session.

A growing number of horse people are now using the plates including Dr. Doug Herthel (Alamo Pintado Equine Hospital), and Todd Pletcher, who trained this year’s Kentucky Derby winner Super Saver.