Dr. H, a recent graduate, was attending the American Association of Equine Practitioners (AAEP) meeting in Orlando, Fla., this past December. While standing in the convention-center lobby waiting for a lecture to begin, he noticed three older veterinarians over in a nearby corner engaged in serious discussion. He recognized all three as leading lameness experts and well-respected practitioners.

"Wow, there must be over 100 years of equine practice experience in that conversation," he thought to himself, wondering what they were discussing. Were they talking about new research? Discussing some revolutionary technique or procedure? Or just swapping "practice gems" developed over all those years?

Watch your back: Practitioners know they should lift with the legs, not the back, but that's not always possible if one wants to avoid being kicked.

"It's not my back that's hurting, it's my hip; and my orthopod is suggesting that I get a replacement soon," replied the vet to his left.

"Well, I'd rather be looking at a hip replacement than a knee replacement. I've heard that hips go well and you can come back fairly quickly and keep practicing, but knees are trickier and my right one is almost bone-on-bone now. What are you guys taking for pain management anyway?" asked the oldest vet.

"Wow," thought Dr. H, "they're just talking about all their aches and pains, and those guys sure sound pretty well worn out. I'm glad I'm not there yet," he mused as he ambled away and left the older vets to their consultation.

This incident actually happened. It is a realistic commentary on the toll that equine practice can take on the body of the average equine practitioner.

The types of animal-related incidents that cause serious injury and death have been catalogued for large-animal veterinarians but the unreported bumps, bruises and other injuries that occur in the day-to-day life of an equine veterinarian tend to accumulate.

Many veterinarians suffer from leg and back arthritis. Injuries or acquired conditions in the wrists, shoulders and neck are common, too.

A brief look at the types of procedures that equine veterinarians are required to perform daily shows that lifting or bending is required when flexing joints, inspecting or injecting joints and examining legs and feet. Often the bending and/or lifting must be done with attention to avoiding trauma, rather than the correct body positioning.

Two sources of injury

Veterinarians know that it is better to lift with the legs, not the back, but it is not always possible to be in the correct position with legs squarely under the weight to be lifted. "Far better to strain a back lifting than to get kicked in the knee because I wasn't out of the way" is the generally accepted viewpoint.

The other main cause of injury for equine veterinarians is the fact that many routine procedures require work with the hands above the shoulders.

"This is a very inefficient position," says Jake Irwin, doctor of physiotherapy and owner of Pro Performance Therapy in Alpharetta, Ga. "Lifting or doing forceful work with the hands above chest height puts the shoulder at risk for strain damage or worse," says Irwin, who provides performance training and therapy for athletes ranging from weekend warriors to professionals in the Atlanta area.

"A large percentage of single-arm sport athletes (tennis players and baseball pitchers, for example, whose sport requires them to use one arm predominantly in motions that keep the hand above the chest) have a significant amount of degeneration occurring in their shoulders," says Irwin, "even if they are currently asymptomatic."

Equine veterinarians routinely examine mouths and teeth, perform dental procedures and intra-nasally vaccinate horses that are significantly taller than the average human. Not all of these procedures can or should be done with tranquilization every time, so the amount of shoulder stress in equine practice is significant. As more and more women practitioners, who are generally shorter than men, enter the profession, the amount of shoulder stress caused by routine practice could possibly increase.