VETERINARY SPINAL MANIPULATION THERAPY – J. Maree Hinken, DVM, CVA, CVSMT

Maree graduated from University of Illinois College of Veterinary Medicine in 1985.  Practiced small animal emergency medicine in South Florida for a year post graduation.  In the spring of 1986 took a job as state veterinarian for the Dept. Of Pari-mutual Wagering.  Eventually the hours became too much as I was working evenings 4 days a week ( 6pm – 8am), then days 6 days a week (12pm – 5:30pm).so I left my position at the small animal emergency and worked full time at the race track for the state of Florida.

My dream had always been to be a racetrack practitioner dating back to my reading the Black Stallion series by Walter Farley.  As a young girl, on my birthdays my mother would take me to Arlington Park Racecourse in Arlington Heights, Illinois providing the track was racing.  It was heaven for me.  I fell in love with the Thoroughbred racehorse and have been devoted to them ever since.  So, when a position opened to join a private practice on the track and to use the skills I had learned through 8 years of school, I jumped at the chance.  I spent 2 years working at the South Florida racetracks where I was exposed to the top racehorses in the country.

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After 4 years in Florida, I found myself longing for the changing seasons I had grown up with.  Arlington Park had experienced a great fire in 1985 and was reopening for racing in the spring of 1989.  I decided to make the move back to Illinois and start a practice of my own.  I struggled for many years to build the practice and eventually was quite successful.

In 1999 I became certified in veterinary acupuncture through the Chi Institute in Ocala, Florida.  I integrated this into my practice but was still left searching for more ways to help my patients perform to the best of their ability.  In 2010 I decided to pursue certification in veterinary spinal manipulation or more commonly called chiropractic.  For many reasons I decided to give up my racetrack practice and start anew with performance horses.  I designed my new practice so I would have time to actually analyze my patients and determine what the best course of treatment for each one would be, whether it was spinal manipulation, acupuncture, herbal or traditional veterinary protocols.  I still travel to the track as I still love the TB racehorse, but now I am able to help the horses in a way that I feel is correcting their ailments versus simply treating the symptoms.  My favorite question now is “Why is that?”

Through my pursuit of knowledge I became very good friends with Dr. Megan Ross who has a thriving holistic type practice in Southern Pines.  Through her urging and that of several friends combined with the horrific winter last year my husband, Rich and I decided to move to this area.  We absolutely love the southern hospitality and I am certainly enjoying riding my horses in this equestrian heaven.

What I Do

Veterinary spinal manipulation therapy is so much more than simply “popping bones into place.” As my mentor, Dr. Carl DeStefano liked to say, “Bones are stupid, they only do what muscles tell them to do.  Muscles aren’t any smarter as they only do what nerves tell them to do.”  For this reason, I like to think of spinal manipulation as a therapy to fine tune the nervous system.  Think how important it is for every muscle to function as efficiently as possible.  When there is an imbalance in muscle function, joint instability is created.  Why is this important?  Chronic joint disability leads to all those archeological finds we like to show clients when we take radiographs.  Fossil relics just tell me that there has been joint instability for a long period of time.  Joints are meant to float in their own tissues and fluids.  When there is muscle imbalance, the joint no longer floats, but begins to bang into itself causing the inflammatory cascade that is associated with joint inflammation.  I remember from my racetrack days radiographing an inflamed joint and being disappointed that I didn’t have a bone fragment or a spur or a flattened condyle to have a reason for the inflamed joint.  I look at things so differently now.  An inflamed joint is an unstable joint.  This means that there is a mismatch in the firing rates of the muscles and tendons determining the motion of that joint.  My job is to find these aberrantly firing muscles, find the cause and fix them.

So, the obvious question is “How do I do that?”  There are several ways.  The basic spinal manipulation course I took taught me to find areas in the vertebral or spinal column that are hypomobile.  These hypomobile areas indicate an area of dysafferentation.  Dysafferentation is abnormal afferent information entering the spinal cord.  Afferent information is all the information being generated by receptors in the body or peripheral nervous system and traveling toward the CNS.  The hypomobility is corrected via low amplitude, but high velocity thrust in the area of the hypomobility.  As the saying goes, junk in, junk out.  If there is abnormal information entering the central nervous system, it will respond by sending abnormal signals to things like muscles, glands, organs, etc. and they will not function at the optimal level.  Never being satisfied with simple, I take things a few steps further.

I have over 400 hours of continuing education in the area of applied kinesiology, functional neurology and advanced neurology as it applies to spinal manipulation therapy.  I have also spent many days learning from my mentor Dr. Carl.  Through this advanced education and practice, I can determine which muscles of a limb are firing aberrantly, which muscles are causing a hypomobility in the vertebral column or limb, if there is an inappropriate expression of a central pattern generator (gait pattern), sensitivity to an outside stimulus such as a food supplement and malfunction in the endocrine system. I can determine the longitudinal level of a lesion causing the symptoms a patient is exhibiting. Sounds amazing!

In humans, applied kinesologists are able to individually test each muscle and assess its function.  However, when a parent would bring in a child for treatment it was difficult to always have the child’s cooperation.  These physicians found that they could use the parent as a surrogate and thereby assess the child’s muscle function.  I’m sure you’ve heard stories of someone touching an electric fence and not being able to let go.  Then a friend comes along and tries to pull this person off the fence, but they too become stuck to the person they were trying to free.  The surrogate system works in much the same way.

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I use a strong muscle in my surrogate, most commonly a deltoid, a muscle in the shoulder, and I determine its relative strength.  Then using a hand mode, which can be thought of as a frequency finder, I place my finger over various areas (usually muscle) and check for a change in the strength of my surrogate’s strong muscle.  This indicates an area of abnormality.  I then trace it back to find the cause of the abnormality and fix it.

Just doing this would be huge as far as increasing normal afferentation of the nervous system.  However, not being satisfied with easy, I go even further.  I mentioned earlier about central pattern generators or gait patterns.  These are the preprogrammed symphonies of movement.  When a foal is born, the mother doesn’t teach the foal how to walk, trot, run or any other pattern of movement.  It is innate.  There is a huge orchestration of precisely timed muscle contractions and relaxations of the limbs, the back, the abdominals the neck and the jaw to perform a gait.  All of this is done without thinking about it or as I like to say, without cortical control.  This being said, when an animal or human are just standing, there should not be an expression of a gait pattern.  There are indicator muscles which can be used to determine if a gait pattern is being inappropriately expressed.  How can this be?  The animal is standing so therefore no gait is occurring.  The brain can control the expression of CPG’s.  Take a human walking.  When we walk, our right arm and left leg work in unison as does our left arm and right leg.  However, if we think about it, we can walk with the right arm and leg moving together and the left arm and leg moving together.  Thus when standing, the animal can override the expression of the gait pattern.  So why would this be a problem.  Say the horse is showing an inappropriate expression of a pace gait.  The horse is still able to trot, walk and gallop as the system can override the inappropriate gait.  But is this the most efficient way of moving.  In a racehorse, mistiming of a hundredth of a second over the course of a race can make the difference between winning and losing.  We talked about timing of muscle contraction and relaxation and how if the muscles aren’t firing at the proper frequency it leads to joint instability.  Therefore, just correcting one aberrantly expressed gait pattern affects a huge amount of joint, muscle output.

Interestingly enough, there are combinations of inappropriately expressed gait patterns that can problems in the pelvis and the skull.  Because the linings of the spinal cord extend from the skull to the sacrum, a pelvic problem can cause problems in the skull and vice versa.  In fact, anytime there is tension on the meninges of the spinal cord, it will affect normal motion anywhere from the skull to the end of the sacrum.  In fact, certain abnormalities in the pelvis can make a horse appear lame in a front limb.  Other pelvic faults will cause excruciating pain in the lumbosacral area causing the horse to almost drop to the ground when touched there.  In my years on the track, I would often notice an exercise rider being thrown on the back of the TB and the horse would walk off squatting down in the back with hind limbs unable to get underneath him and walking on his hind toes.  I tried many things to alleviate this pain, but was basically just trying to mask the pain.  Now, it is a pretty easy correction with dramatic results.

Do the horses like it?

When I was practicing on the track, I found myself carrying pockets full of peppermint candies so I could befriend my patients.  It didn’t take them long to figure out that I was a person who usually did something unpleasant to them.  (Giving shots, hoof testers on sore feet, flexing inflamed joints, endoscopic exams, nasogastric tubing and many other things.)  As a solo practitioner and often without an assistant, it was important for me to be able to catch my charges, hence the peppermints.  Now, my patients appear to love me.  The first treatment they are often suspicious as veterinarians rarely do “nice” things to them.  The second treatment they are inquisitive and by the third time I have their total trust.  In fact, I had one patient that I tried to treat by the standard motion palpation I was taught in the basic course.  He became very agitated and wanted none of it.  This of course usually results in an unhappy owner.  However, the owner gave me another chance about a year later after I had undergone more extensive training.  Since I was only gently touching and not pushing and pulling, the horse relaxed, he received his treatment and became a much happier horse both in attitude and function.