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What does Equilibre mean?Equilibre is the French word for balance and originates from the Latin prefix equi-, meaning equal or equally and the Latin word libre meaning free or unrestricted. All of these words underpin the principles of the work that we do and drive our physiotherapeutic aims and techniques. At Equilibre we believe that correct movement can only be achieved through freedom from pain and balance within the musculoskeletal system. Promoting movement through freedom and balance
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What is equine physiotherapy?Equine veterinary physiotherapy is a physical therapy that aims to restore, maintain or maximise movement and physical function. It involves a thorough assessment of your horse: at rest, moving dynamically and clinically through palpation and physical assessment. Appropriate therapeutics are performed according to each horse’s unique requirements. These may include manual therapies including joint mobilisations, dynamic mobilisations, stretches, passive range of motion exercises, targeted massage, myofascial release, trigger point therapy and cryotherapy. Electrotherapies are sometimes used if clinically indicated including LLLT (low level laser therapy), PEMT (pulsed electromagnetic therapy), NMES (neuromuscular electrostimulation) and TENS (transcutaneous electrical nerve stimulation). Read more about our services here.
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What are the benefits of equine physiotherapy?Equine veterinary physiotherapy is used in rehabilitation, maintenance and performance cases to restore, maintain and maximise physical function and movement. At Equilibre we believe that correct movement can only be achieved through freedom from pain and balance within the musculoskeletal system. Effective physiotherapy can help restore musculoskeletal weaknesses and compensations to promote strength, stability and suppleness. Horses will be more comfortable and relaxed – at rest and at work, show improved performance and function, and be more robust to withstand the rigours of exercise and therefore less likely to succumb to injuries.
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What is the difference between physiotherapy, chiropractic and osteopathy?Physiotherapy considers the whole horse including the entire musculoskeletal system, bones, muscles, ligaments, tendons and joints. It aims to restore or maximise movement and function through specific physical therapy and prescription of a series of exercises for rehabilitation or enhancement of function and performance. Animal chiropractors use chiropractic techniques that have been adapted from human medicine to treat primarily spinal problems as well as other joints. Adjustments are made to spinal areas with decreased range of motion (vertebral subluxation complexes) to induce a therapeutic response. Animal osteopathy similarly uses manual techniques adapted from human osteopathy to manipulate and strengthen the musculoskeletal framework, improving mobility and therefore function. The techniques primarily focus on the joints, muscles and spine. Read more here.
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What are your qualifications?Our equine veterinary physiotherapist Dr Lorna Brokenshire-Dyke BA MA PGDip LCGI MRAMP MNAVP VetMB MRCVS is both a fully qualified, registered and practising Equine Veterinary Surgeon and a fully qualified, registered and practising Equine Veterinary Physiotherapist. She has degrees in Equine Studies and Veterinary Medicine, and a postgraduate certificate in Veterinary Physiotherapy. She is currently (2023) writing up her thesis for a Masters degree in Veterinary Physiotherapy. She is both a member of RAMP (Register of Animal Musculoskeletal Therapist) and NAVP (National Association of Veterinary Physiotherapists). Read more here.
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My horse is lame, is physiotherapy appropriate?Yes, absolutely, physiotherapy is excellent for rehabilitation cases through musculoskeletal restoration. However under The Veterinary Surgeons Act 1966 only qualified and registered veterinary surgeons can diagnose and treat animals, and give advice based on this, as these are all considered acts of veterinary surgery. This means that, when an animal has pathology (lameness and/or musculoskeletal pain) physiotherapists can only work as part of a vet-led team under the direction of a veterinary surgeon, ie. permission must be given to treat. This is NOT required for provision of maintenance or performance services in healthy animals. At Equilibre, Lorna, our equine veterinary physiotherapist, is also a qualified, registered and practising veterinary surgeon. This makes navigating the legislation considerably easier and gives clients a truly complete approach to musculoskeletal assessment and treatment. As a qualified veterinary surgeon Lorna is legally permitted to make a veterinary assessment and diagnosis. However, for horses receiving active treatment related to a clinical condition, rather than maintenance therapy, Lorna will - with your permission - liaise directly with your own veterinary surgeon to ensure appropriate continuity of clinical care. Read more here.
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My horse is sound, can physiotherapy still be beneficial?Yes absolutely, physiotherapy is excellent for maintenance cases. It allows thorough assessment of any early, sub-clinical musculoskeletal niggles, which can then receive appropriate therapy BEFORE they become a significant issue. Specifically it can promote full range of motion through all joints, ensure any areas of muscular tension are addressed before they become a problem and provide a format for appropriate ongoing maintenance exercises.
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Can physiotherapy enhance performance?Yes absolutely, physiotherapy is excellent for performance cases to maximise physical function. Modern sports horses are athletes where fully physical function and mobility are vital for every discipline, from dressage horses, to show ponies, to three-day event horses. Physiotherapy can help maximise musculoskeletal performance through correct development of the strength, stability and suppleness required for our elite athletes.
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How do I choose a musculoskeletal therapist?There are no statutory regulations for MSK therapists. Anybody can call themselves an equine physiotherapist, chiropractor or osteopath, without any training, experience or even insurance. Whilst in the human medical field the terms physiotherapist, chiropractor and osteopath are reserved exclusively for those with specific and appropriately recognised qualifications, in the animal world, so long as the prefix equine- or animal- is used, these professional terms aren’t protected. Whilst there are many excellent therapists out there, there are some who are poorly qualified and inexperienced. They may not even recognise their own knowledge gaps and inexperience. Read more here to be sure you find the right therapist for you.
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Is veterinary consent required?The Veterinary Surgeons Act 1966 ensures that animals are treated by only those who are qualified to do so. This means that the diagnosis and treatment of animals, including the giving of advice based on this, and performance of surgical operations, are ALL are considered acts of veterinary surgery, to be performed ONLY by veterinary surgeons. The Veterinary Surgeons Exemption Order 2015 allows MSK therapists to work as part of a vet-led team. This requires delegation by a veterinary surgeon who has already examined the animal and prescribed the treatment to include MSK therapy. Only if the MSK therapy is for maintenance of a healthy animal, rather than treatment, can an MSK therapist practise without prior referral from a veterinary surgeon. At Equilibre, Lorna, our equine veterinary physiotherapist, is also a qualified, registered and practising veterinary surgeon. This makes navigating the legislation considerably easier and gives clients a truly complete approach to musculoskeletal assessment and treatment. As a qualified veterinary surgeon, Lorna is legally permitted to make a veterinary assessment and diagnosis. However, for horses receiving active treatment related to a clinical condition, rather than maintenance therapy, Lorna will - with your permission - liaise directly with your own veterinary surgeon to ensure appropriate continuity of clinical care.
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How long does a physiotherapy session take?Typically an initial consultation, assessment and starting treatment will take approximately one hour, sometimes more. A full report will be provided following this consultation. Follow-up treatments allow more in depth treatment and also typically take an hour. Occasionally follow-up treatments and reassessments are shorter if minimal treatments are required.
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Which treatments will be used?Every horse presents a unique set of issues and every owner/rider has a unique set of goals. This means that all treatment plans are bespoke to the individual. A mixture of manual techniques and, if indicated, electrotherapies will be used, and exercises will be prescribed for the owner/trainer to continue beyond the physiotherapy session. Read more about our services here.
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Will there be work for me to do afterwards?Yes in the majority of cases. “There are no shortcuts to any place worth going”. Physiotherapy is a process and progression to restoration of full movement potential requires work. Each progression plan is unique for each patient, taking into account individual pathologies and goals. Read more about our services and rehabilitation plans here.
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How many sessions will my horse need?This is very variable and depends on assessment of your horse, any pathologies identified, your goals, and of course any financial constraints. A bespoke plan will be tailored for your unique circumstances. Typically we will see rehabilitation cases for a course of 3-6 sessions, these may be weekly, fortnightly or spaced further apart. Occasionally, specific pathologies will require shorter and more frequent sessions, for example low level laser therapy for targeted tissue healing. In these cases, a bespoke package will be discussed with you and prepared for your animal. Some cases will benefit from a single session and a bespoke rehabilitation plan. Maintenance and performance cases are typically seen every 2-6 months, again depending on assessment, training goals and, of course, budget.
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Do I need to be present for the treatment?Yes, certainly for the initial consultation and assessment. An important part of our work is understanding the history and the specific issues that need to be addressed, so we will need to work closely with you to achieve this. Likewise, follow up exercises and prescriptive rehabilitation, maintenance or performance plans will need to be explained and exercises shown. You as the owner/trainer are a vital part of the team! For ongoing treatments and follow-ups, if therapist and owner are mutually comfortable and in agreement, and the horse of a suitable temperament, we are happy to work alone and follow up with you by phone call afterwards.
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How should I prepare my horse for treatment?Please have your horse ready in a stable or area of hard-standing, ideally under cover if the weather is unpleasant. We will contact you en-route to confirm exact timings so that you and your horse are not kept waiting. We like to arrive to unstressed horses. Please also ensure that your horse is clean and dry as wet, muddy coats make many therapies difficult or impossible. Please do not schedule physiotherapy sessions within 48 hours of routine farriery, dentistry or vaccinations. If this is unavoidable, please ensure that your physiotherapy sessions FOLLOWS farriery or dentistry, and PRECEDES vaccination. This is to ensure that maximum benefits are gained from the therapies and not compromised by the necessary but prolonged abnormal positioning and postures required for routine procedures. If your horse needs to be vaccinated around the time of your physiotherapy session, please ask your veterinary surgeon to consider vaccinating in the pectoral muscles so that any cervical work is not diminished by post-vaccination muscular pain.
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What aftercare will my horse need?Typically we recommend 1-2 easy days following each session depending on the intensities of treatments performed. Please discuss with us any upcoming competition schedules so that we can plan timings effectively. Please do not schedule physiotherapy sessions within 48 hours of routine farriery, dentistry or vaccinations. If this is unavoidable, please ensure that your physiotherapy sessions FOLLOWS farriery or dentistry, and PRECEDES vaccination. This is to ensure that maximum benefits are gained from the therapies and not compromised by the necessary but prolonged abnormal positioning and postures required for routine procedures. If your horse needs to be vaccinated around the time of your physiotherapy session, please ask your veterinary surgeon to consider vaccinating in the pectoral muscles so that any cervical work is not diminished by post-vaccination muscular pain.
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What is your availability?Lorna provides equine veterinary physiotherapy around a busy schedule as an ambulatory sport and leisure horse vet at Rossdales Newmarket. Lorna is able to see registered Rossdales clients for physiotherapy assessment during her working days at Rossdales - currently Mondays, Tuesdays and Thursdays. Please contact the Rossdales office here to book an appointment. Treatments for registered Rossdales clients strictly involving electrotherapies can be booked though Equilibre here. Lorna occasionally has space for a limited number of non-Rossdales clients for physiotherapy assessment, treatment, maintenance and rehabilitation. Appointments are available on Wednesdays and Fridays (evenings and weekends at our absolute discretion) and can be requested directly through Equilibre or following referral by your own veterinary surgeon.
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How do I book an appointment?Please contact us by telephone or email to discuss your requirements and make an appointment. Our contact details can be found here.
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How should I organise other appointments around a physiotherapy session?Please do not schedule physiotherapy sessions within 48 hours of routine farriery, dentistry or vaccinations. If this is unavoidable, please ensure that your physiotherapy sessions FOLLOWS farriery or dentistry, and PRECEDES vaccination. This is to ensure that maximum benefits are gained from the therapies and not compromised by the necessary but prolonged abnormal positioning and postures required for routine procedures. If your horse needs to be vaccinated around the time of your physiotherapy session, please ask your veterinary surgeon to consider vaccinating in the pectoral muscles so that any cervical work is not affected by post-vaccination muscular pain.
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How far do you travel?We provide assessments and treatments for horses throughout Suffolk, Cambridgeshire, Norfolk, Essex, Hertfordshire and Bedfordshire. Our travel costs and additional mileage are calculated from Newmarket. Shared visit fees and group discounts are available. Our prices and travel charges can be found here.
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How much does physiotherapy cost?Our current prices can be found here. All prices are not currently subject to VAT. We will always endeavour to work with you regarding a treatment plan that is both affordable and effective. Most insurance companies will pay for physiotherapy when indicated as part of a rehabilitation plan under a claim for veterinary fees.
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What are your payment terms?Payment terms are strictly payment at time for new clients and within 14 days for existing clients. Surcharges apply. Further information regarding pricing can be found here.
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What payment methods do you accept?Payments can be made by cheque, bank transfer, cash or card machine. Further information regarding pricing can be found here.
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Why are you more expensive than other therapists?Costs vary between practitioners and the price you pay does not necessarily guarantee the service you will get. However, musculoskeletal practitioners with greater experience and who have invested in a higher level of training will typically charge more than those with less rigorous qualifications. Lorna is both a qualified, registered and practising equine veterinary surgeon and a qualified, registered and practising equine veterinary physiotherapist. Our prices are comparable to similarly experienced and qualified clinicians both locally and further afield. As a qualified veterinary surgeon Lorna is permitted to make a veterinary assessment and diagnosis – and give advice on such, all of which are legally defined acts of veterinary surgery. Whilst she will endevaour to work closely with your own veterinary surgeon where applicable, this gives clients a truly complete and thorough approach to musculoskeletal assessment and treatment. Many clients find that the additional benefits of this experience are actually cost-effective in the long run. A comprehensive guide to choosing a musculoskeletal therapist can be found here.
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Do you offer group discounts?Yes discretionary discounts are available for multiple horses, block bookings and brief re-examinations. Further information regarding pricing can be found here.
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What if I need to cancel?Please give as much notice as possible if a cancellation needs to be made so that your appointment may be offered to another client. Cancellations made within 24 hours of a scheduled appointment will incur a £40 surcharge, payable strictly before any subsequent bookings.
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Is it possible to claim for treatment with my insurance policy?Most insurance companies will pay for physiotherapy when indicated as part of a rehabilitation plan under a claim for veterinary fees. Physiotherapy for maintenance and performance is considered elective therapy and is typically not covered by the majority of equine health insurance plans. Further information regarding pricing can be found here.
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