They’re Off! (To the Gym)

Just days after arthroscopic surgery to remove bone chips from an inflamed ankle, the athlete was back in training, huffing hard as he jogged on an underwater treadmill.

Twenty Jacuzzi jets massaged his legs as he pushed through the low-impact workout. He’d hit the gym next for a cool-down walk. Then his coach might direct him to swim laps, or to run through his physical therapy exercises -- or maybe to stretch out and ease his aches under the soothing heat lamps in the solarium.

He’d do whatever was asked. Just so long as he made it back to his stall in time for his afternoon hay.

With a snort, the mahogany thoroughbred stepped off the treadmill. Water streamed off his sleek, muscled flanks as his trainers hosed off the chlorine. The racehorse tossed his wet mane and snorted once more.

“He’s like, ‘Oooh! That feels good!’ ” translated Kirsten Johnson, co-owner of the Kentucky Equine Sports Medicine and Rehabilitation Center.

As recently as a decade ago, horses recovering from surgery all followed a standard routine. They rested in their stalls, almost motionless, for 30 to 45 days. Then their grooms would start leading them on short daily walks. After a few weeks, they’d be turned out to pasture for a month of unsupervised roaming.

Johnson considers such treatment barbaric -- as old-fashioned and ill-advised as ordering a human track star to lie in bed for months after knee surgery. Nowadays, such patients are exercising within hours. She fails to see why horses should be any different.

It’s an approach that’s beginning to take root across the nation. Thousands of chiropractors, acupuncturists, physical therapists, masseurs and even mental health counselors are making the rounds from barn to racetrack to show ring, putting techniques that work for human patients to the test on the stars of the equine world.

Spurred by a new understanding of equine physiology -- made possible by horse-sized diagnostic tools, such as giant MRIs -- about a dozen veterinary colleges have opened sports medicine departments in recent years.

“These are world-class athletes. We’re talking the Michael Jordans of horses. And we saw we could do more for them than stick them in a stall and wait for them to heal,” said Jack R. Snyder, chief of equine surgery at the School of Veterinary Medicine at UC Davis.

Snyder has worked for years with Olympic-caliber horses, and he says the more active approach to rehab suits the animals’ competitive nature: “They don’t want to just sit on the couch.”

So vets are increasingly prescribing a full schedule of physical therapy: The horses swim. They stretch. They power-walk on the treadmill.

Therapists push them through range-of-motion drills -- or massage away their aches with magnets, lasers, ultrasonic pulses and electric shocks. Pet psychics counsel them through performance anxiety.

Here at the Kentucky rehab center, the most seriously injured spend time in the hyperbaric oxygen chamber. Under a vet’s supervision, they breathe pressurized air for an hour or two, emerging relaxed and ravenous. At other facilities, horses are injected with equine stem cells or platelet-rich plasma to stimulate healing.

Clinical studies have proved that some of these therapies can speed recovery by several months, at least for certain injuries. Others are supported only by anecdotal evidence -- or wishful thinking. In a world where even pet fish can get broken bones set, owners of performance horses demand the most cutting-edge treatments, even when the methods have not been tested on equines.

“They’re always saying: ‘Can’t we try this for my horse? It worked for me,’ ” said Fairfield Bain, a veterinarian at the largest equine hospital in the world, Haggard, Davidson & McGee in Lexington, Ky.

“The problem is,” Bain said, “with a 1,000-pound patient, it’s not always easy to do all the same things we do for human athletes.”

That hasn’t stopped horse lovers from trying.

Just a handful of centers across the nation offer comprehensive rehab programs like the ones here. But independent therapists, who generally charge $50 to $125 an hour, abound. And they’re in demand.

More than 60% of veterinarians refer horses to chiropractors, according to the American Assn. of Equine Practitioners. More than 55% prescribe acupuncture; 30% recommend massage.

Surveying its 8,000 members in 1998 and again in 2002, the association found that the number of vets performing physical therapy on their patients had more than doubled to 33%.

Using equine versions of CAT scans, MRIs, EKGs, video endoscopes and nuclear imaging technology, veterinarians have identified subtle injuries and illnesses that can slow a racehorse down without producing visible symptoms.

They have also come to appreciate that a healthy horse is a phenomenal athlete. Sprinting around a track at 45 mph, a top-caliber thoroughbred -- like those that will compete in next week’s Belmont Stakes -- puts 1,700 pounds of pressure on each leg at every step. Its lungs take in so much oxygen, it could suck the air from a 100-square-foot room with just a few breaths.

At maximum exertion, a horse can get its heart pumping 250 beats a minute, 10 times as fast as its resting pulse. Even the fittest human athlete can increase his heart rate only by a factor of three, according to Stephen B. Adams, a professor in the Equine Sports Medicine Center at Purdue University.

“We’re understanding these horses are not machines,” said Mimi Porter, who teaches equine physical therapy at Midway College in central Kentucky.

A former college athletic trainer, Porter began trying ultrasound and high-intensity light therapy on horses in 1982 after seeing how well the techniques worked on basketball players. “I was received like a voodoo queen, a total weirdo,” she recalled.

In the last five years, however, the field has grown so hot, Porter now has a lucrative business working with veterinarians. She also consults at the Kentucky rehab center.

The facility, which opened two years ago, almost always has all 56 stalls occupied. The horses stay 45 days on average, cared for by a dozen veterinary technicians, trainers and handlers. Kirsten Johnson and her husband, Hub, develop each athlete’s workout program in consultation with the horse’s vet, bringing in dentists, chiropractors and other specialists as needed.

Behind a white fence in the hushed hills of thoroughbred country, the facility offers indoor and outdoor tracks, grazing paddocks and the Aqua-Tred, a $60,000 machine that Johnson calls “the perfect exercise” for a four-legged athlete. A narrow, padded chute holds the horse stationary, chest-deep in warm water, while its feet pound away at a submerged treadmill that looks much like one you’d find in Gold’s Gym, except the platform is 10 feet long.

On a recent afternoon, Johnson studied a 6-year-old American saddlebred’s form as he churned around the center’s other signature piece of equipment: the doughnut-shaped swimming pool.

“Look at him go!” she exclaimed. “You can really see him getting those legs up, Mom!”

The horse’s mom, part-owner Joan Hamilton, beamed.

A powerful show horse, Cafe Express had suffered a nasty fungal infection in his hoof. He could barely support his own weight. To keep him in shape, Hamilton started him swimming six days a week.

Now largely recovered, Cafe Express plunged into the cool water and started kicking so fast, the men holding his bridle lines on the edge of the pool had to jog to keep pace.

Chuffing loudly, his nostrils flared, Cafe Express swam 15 laps before he started to flag. The handlers pulled him toward the ramp and he lumbered out, chest heaving. Within minutes, he’d recovered enough for a 45-minute cool-down in the EquiGym. He pranced in place, whinnying at his fellow patients, as the revolving pen forced him forward at a steady pace.

“He’s already more fit now than he was when we were in full training a year ago,” Hamilton said.

She sounded almost envious. “This is like going to the spa for him.”

The center charges outpatients like Cafe Express $25 a day to swim. Boarders pay $60 a day to use the solarium, pool and treadmill, and indulge in the equine version of spa cuisine -- timothy hay, alfalfa and a custom-mixed high-fat, low-carb grain. Treatments in the hyperbaric oxygen chamber run about $400 a session.

More discreet than many personal trainers to the stars, the Johnsons won’t disclose the names of horses they treat. They will say only that their clients fly in from around the world. Top performers in sports such as dressage, cutting and reining, they’re worth anywhere from $20,000 to $30 million.

Many, including the mahogany colt on the treadmill, come from the unimaginably wealthy world of thoroughbred racing, where an untested 2-year-old with good bloodlines can sell for $4 million and the stud fee for a champion stallion can run $80,000 and up.

Owners in these rarefied circles pamper their equine athletes. If a horse likes a bottle of Guinness Extra Stout mixed with his organic feed, he gets it. If he responds well to sunlight, a skylight will be cut over his stall.

Some owners are even willing to pay $120 an hour for an “animal communicator,” who uses mental telepathy to counsel a horse through a traumatic injury -- or to ask which saddle he finds most comfortable.

“We can accelerate these animals’ healing just by talking with them, just by giving them a voice,” said Val Heart, a pet psychic based in San Antonio.

Marta Williams, who counsels animals from her home in Graton, Calif., says she can help horses understand why they need to be patient through certain therapies and drills. She says her intuition is so keen, she can communicate with just about any animal, at any distance, by closing her eyes and concentrating.

“If they’re having physical problems, I counsel them about how their person really wants to help them through this,” Williams said.

Such psychic counseling is largely unregulated. But then, so is much of equine sports medicine.

Veterinary chiropractors are certified by a trade association, which sets educational standards. But anyone can set up shop as a physical or massage therapist; there’s no licensing board or certification test.

Midway College, tucked into the Bluegrass hills here just south of Lexington, offers the nation’s only four-year degree in equine physical therapy. As the school year drew to a close this spring, Porter led her students to the college barn, where they gathered around a weary old quarter horse named Moonie.

Running her hands along Moonie’s back, Erin Kroiss probed his acupressure points for soreness. Then she lifted his front legs, one at a time, and gently stretched them forward, testing his flexibility.

“He has arthritis and it bothers him when the weather changes,” she explained.

As students took turns working Moonie’s knotted muscles with ultrasound, electrical impulses and high-intensity light, Beth Ann Mohan stepped up to massage his neck. The horse stood perfectly still.

Kroiss had no doubt what he was thinking.

“Oh, yeah,” she said, channeling Moonie’s delight. “Oh, yeah.”