The Joy of Defending a Doctorate Dissertation on Equine Myofascial Pain

Since I was a child, I have always loved horses. I always knew there was something I could do for them. As a physiotherapist, I focused on treating human patients with myofascial pain, which I always thought was key. I wondered how myofascial pain would affect horses. Slowly, my curiosity and passion for horses led me to my doctorate studies, where I could combine everything I had learned and contribute something meaningful to equine physiotherapy.

It was a joy to defend my doctoral thesis on equine myofascial pain, titled “Effectiveness of dry needling in the treatment of local pain caused by trigger points in the equine brachiocephalicus muscle,” which was awarded with the Cum Laude distinction. This achievement is the result of years of effort, dedication, and passion for what I do, and it fills me with pride.

The Ph.D. Journey: A Challenging Path

A PhD is like a mountain route: it starts with slow steps, walking along a flat path, exploring what other authors have researched before, with enthusiasm for what is yet to come. Everything seems relevant. Little by little, the first slopes appear. They are climbed with energy and motivation until the first questions arise:

“There don’t seem to be many controlled studies.”

“This article doesn’t describe its methodology properly.”

“Here they mention trigger points, but don’t define them correctly.”

“Why does everyone improve in this study?”

“Isn’t there any research between 1993 and 2014?”

Thus, the slope becomes steeper, and difficulties start to emerge. But the view is spectacular. And that inspires.

Throughout these four years, I never lost my curiosity or enthusiasm, although the path had moments of ascent and others of rest. In the most challenging sections, I would put my backpack aside for a while to return to everyday life, but I always came back to carry it and keep climbing. At my own pace, with effort, but without stopping.

One of the greatest challenges was concentration. Even the flight of a fly would distract me. When I walked through familiar terrain, everything seemed easy. But suddenly, the integrated hypothesis expanded, the understanding of ASICs 1 and 3 became confusing, the relevance of quantum release was questioned (Gerwin, 2004), and the myoprotective mechanisms seemed to fail (Gerwin, 2023).

The Challenge of Researching Myofascial Pain in Horses

Researching myofascial pain in horses has been a fascinating challenge. We have only a couple of studies as a starting point (McGregor, 2014; Bowen, 2016). Research in dogs has served as a guide (Simons, 1976; Janssens, 1991; Basko, 1996; Marks, 1999; Frank, 1999; Altug, 2010; Wall, 2014; Formentón, 2023), as well as other isolated studies (Ridgway, 1999; Schoen, 2000; Haussler, 2009, 2018, 2021; Sato, 2020; Story, 2021). However, I found no research on the effectiveness of dry needling for myofascial pain in horses. There is none.

The questions were constant:

“How can we measure it?”

“How has it been done in humans?”

“Is it applicable to horses?”

“How many measurements should I take?

Thanks to Dr. Jan Dommerholt, who was always there to help.

The path continued with preliminary studies on the reliability of palpation, algometry on trigger points in the equine brachiocephalic muscle, and the presence of pain in sports and field horses (Nemery, 2016; Calatayud-Bonilla, 2018, 2019, 2020).

The moment of intervention arrived: 98 horses from three different stables, 66 in the treatment group and 32 in the control group. Organization, recruiting assistants, planning… an immense and exciting challenge. It was a pleasure to have the help of four physiotherapy students from the Universitat Europea de València: Emma, Eva, Fanny, and Anne. Their energy and enthusiasm were invaluable.

Then came the statistical analysis, which was a challenge until Dr. Carmona, my professor at the University of Colombia, helped me understand it, internalize it, and even enjoy it. Along with my director, Dr. Prades, we formed a great team. I was very fortunate to have both. Finally, writing the thesis was like the last part of the climb: the effort was constant but also rewarding. Writing, deleting, reorganizing, referencing, classifying images… until the final edit.

The Impact of the Research and an Integrative Vision

Myofascial pain is a key diagnostic aspect in our equine patients, especially when veterinary medicine doesn’t offer clear answers. I hope my research contributes, even if only in a small way, to giving back to horses some of what they have given us.

Being a physiotherapist with a doctorate in veterinary medicine has allowed me to position myself at an intersection where both disciplines nourish and enrich each other. Animal physiotherapy wouldn’t be possible without the integrated knowledge of both fields.

Finally, my gratitude to Dr. Dommerholt for believing in my project of needling horses from the very beginning. I still remember when I suggested organizing a dry needling course for horses with Myopain Seminars. He didn’t hesitate for a second: “Perfect,” he said.

And then began another adventure: teaching clinicians to needle horses.

Maria Calatayud, PhD, PT, MsC