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New stirrups for painful knees and ankles?

From: Sally Anne

Dear Jessica, I know you have written about stirrups several times before, but I am hoping that you will do so again. I need to ask about some new stirrups that you mentioned a month or two ago in HORSE-SENSE. They were called "Smart Stirrups" and you said they sounded very interesting but you had not tried them. I am hoping that by now you have tried them and can tell me if you think they could help me.

I am 53 years old and some days I feel fine but other days I feel like 73 or 83 years old! When I was young I did a lot of ice-skating and when I was in high school I played softball. I broke toes and cracked my right ankle bone twice when I was skating, and then when I played softball, I pretty much messed up my knees the summer our catcher got sick and was out for two months and I had to fill in for her. If I had known what it would do to my knees I wouldn't have agreed, but I loved softball and I was just so happy to be on the starting team! Oh well, live and learn! I started taking riding lessons when I was 48 and my youngest son went off to college (I had my kids late, and I love them to pieces, but now I love having an empty nest!). Riding is something I had always wanted to learn to do, and it's something I really love. Last year I was learning to jump and loving that a lot when I started to get pain in my legs. The pain is definitely from riding. I know I have ACL damage in both knees, but more in my right knee, which is basically held in place just by a few muscles, because the ligaments are basically shot. For the last three years, my doctor has been trying to get me to have my knees replaced. I guess that's a good surgery and I guess I will probably have to have it someday, but I'm just not ready for that yet!

When I'm on the horse I can ride for just so long before my ankles begin to hurt. My knees don't hurt much when I am on the horse, but then when I get off the horse, my knees are horrible, sort of locked into position as if somebody hammered a spike into them so they couldn't move. It's not so bad when I'm on the horse, but every time I ride I can barely walk for the next twelve or sixteen hours. I usually ride for about two hours, three or four days a week, and I have a lesson for about an hour and a half every Saturday. My instructor is nice about it but I can tell that she is getting annoyed with me for complaining. She thinks I should have the surgery. I try not to complain but it's really painful. She has adjusted my stirrups higher and lower and even tried making them uneven because my right leg hurts more than my left, and I am "toed out" on the right. My right foot sticks out to the side a lot more than my left foot does. Nothing is working. My husband bought me some pads that wrap around the stirrups and make them softer, and that helped for a little while but it didn't help much and now I can't tell the difference. I'm always afraid of losing a stirrup because it hurts so much to get them back. I was just about to buy some of those Herm Sprenger bendy stirrups with the rubber sides, and then I read your HORSE-SENSE letter about the new "smart stirrups". I looked for them online and couldn't find a website or anything about them, so I thought I would wait and see if you were going to try those and tell us about them. I need to do something different because I have to arrange everything I do around my knee problem. For example if I ride on Monday, I have to stay at home and do sitting-down work on Tuesday. Or if I drive for a couple of hours on Monday, I can't ride on Tuesday, and if I ride on Monday, I can't drive for a couple of hours on Tuesday. My mother lives about two hours from me, and her health is not the best, so I often need to drive over to her home, but if I rode the day before I'm still too painful to be a safe driver.

If you have had a chance to check out those stirrups, would you talk about them? I asked my instructor about them and she didn't know anything about them. She said she thought she had seen them in a magazine but just remembered that it sounded like a gimmick and they were very pricey. At this point I'll try anything if I have a reason to think it might help. And if you have any ideas for other things I can do to make riding less painful, please tell me your thoughts. I heard that you wrecked your own knees a few years ago, so I bet you know all the tricks there are about riding with bad knees and just generally dealing with life when you have bad knees.

Thank you for HORSE-SENSE, it's my lifeline. I started reading it just before I started taking riding lessons, and it has helped me a lot over the years. When I hear people at the barn arguing about something and I don't know who is right, or if my instructor says something that I just don't understand, I know I can go to HORSE-SENSE for the answer! Now if you could only tell me how to get my bones unbroken and my ligaments back in my knees, you would be perfect!

Sally Anne


Hi Sally Anne! Believe me, if I knew how to unbreak bones and make knee ligaments sound again, I'd be much more comfortable myself...

I sympathize with your physical problems - and yes, I empathize as well. You're quite right, I did wreck my knees (first one, then the other) several years ago and I'm still dealing with the repercussions. I completely understand your "ride on Monday, can't do a long drive on Tuesday" schedule issues. What I've learned is that when your cartilage is bad and your ligaments are overstretched to the point of being useless, the only thing that gives you any real, round-the-clock knee stability is your own leg muscles. Bandages and braces can help, but you're unlikely to be able to wear them all day and all night, whereas your own muscles, once you've made them strong, are ALWAYS there (as long as you keep them strong).

You might want to have a serious talk with your doctor about those knee replacements. If your knees didn't hurt, it would be different, but since you're experiencing almost constant pain, why continue to "tough it out" if surgery is an option for you? The interesting thing about knee replacements (also hip replacements) is that I haven't yet met anyone who regrets having had the surgery - everyone has made the same comment: "I just wish I'd done it a lot sooner." It would be nice for you to be out of pain, and to have the option of driving several hours and then riding the next day, or vice versa.

In the meantime, though, I can make some suggestions that might help your riding become more comfortable, and I can also tell you what you want to know about those new stirrups. But no matter what stirrups you use, I'd like you to think about a few other things that may be able to help you reduce your knee pain.

You probably already know that it helps to drop your stirrups periodically and move your feet around, do ankle circles in both directions, pull your toes up and push them down, and generally restore circulation to your lower legs. It also helps - no matter what kind of riding you do or what type of stirrups you use - to remember that you should NOT twist your knees. If your toes and kness don't point straight ahead, don't try to force them just so that you can achieve an "ideal" riding position. Everyone's conformation is different; everyone's soundness and history of injuries is different. Your knees and ankles will be much less painful if you are careful to check regularly and be sure that they are pointing in the same direction. If your knees are pointing away from the saddle and your toes are pointing straight ahead, then either you have very strange conformation (not likely) or (very likely) you're twisting your legs and putting a lot of torque and pressure on your knees in an attempt to keep your feet parallel with the horse's sides.

First, check your stirrup leathers.

Don't just look at the holes or numbers - remove them from the saddle and hold them up to compare their lengths. This is particularly important if you haven't been in the habit of changing them each week (putting the left one on the right side of the saddle, and the right one on the left side). If you've gone a long time without doing this, you may find that the left stirrup leather is considerably longer than the right one. Riding with your left leather longer than the right one will put your whole body off balance - and it forces your body to bend the right knee more than the left knee. You may put even MORE weight into your right stirrup - and on your right knee - if you are trying to sit straight and balanced when a too-long left stirrup leather is tipping your entire body to the left. The more time you spend in the saddle when you are unbalanced from the feet up and your body is trying to compensate for it, the more pain you are likely to experience at the end of your ride. Compensation involves muscles and joints from your toes all the way up to your neck! Someone who doesn't have knee problems and rides occasionally, casually, and for perhaps twenty minutes might barely notice the problem caused by uneven stirrup leathers, but since you ride for much longer than that, your body (not just your knee!) is probably twisted like a pretzel by the time your two-hour ride ends.

Second, think about your base of support, and monitor your level of relaxation throughout your body.

If you'll ride with your weight distributed through your seatbones AND YOUR THIGHS, you'll find that you put much less weight in your stirrups and that your lower legs remain more flexible. Don't try to put all your weight into your stirrups - this just stresses your knees (and your ankles, and your hips) unnecessarily, especially if you are also trying to hold your lower legs in a particular position. Riding should be all about balance, not GRIP - as soon as you try to hold on to the horse with your legs, you're using much more energy and force than you should use, and you're making yourself tense and stiff. Keep a bend in your knee, keep your body alignment correct (ears-shoulders-hips-heels), but instead of pushing your heels down or gripping with your lower legs, try stretching your upper body tall whilst allowing your weight to drop into your heels. If you can ride with a long, stretched, relaxed leg, your correct body alignment and the bend at your knee will allow you to drop weight into your heels without causing tension or stiffness.

And, yes, the stirrups you use can make quite a difference to your riding comfort.

I have long recommended two types of English-style stirrups - those with the "flexing" sides (e.g. the Herm Sprenger stirrups you were considering purchasing), and those with the eye set at a 90-degree angle to the stirrup (e.g. Icelandic safety stirrups). The flexing stirrups make riding much more comfortable for anyone who has foot, leg, or joint damage due to age or injury, and are justifiably popular with older riders. The Icelandic stirrups make riding more comfortable in a different way - they don't have the "flex" feature, but that offset eye (that part that the stirrup leather goes through) means that the stirrups hang in a position makes it much easier for riders to find their stirrups, or to pick them up after they've lost them - or after they've taken their feet out of the stirrups to do some stretches or ankle rotations. I've noticed that quite a few older or injured riders stop doing those very helpful stretches and rotations. They don't give up the exercises out of laziness or ignorance; they just don't want to drop their stirrups for ANY reason, because of the pain and difficulty involved in picking up their stirrups again.

So, at last, I come to the new stirrups that you asked about: the MDC "Intelligent" Stirrups. Go back online and use "Intelligent Stirrups" or "MDC Intelligent Stirrups" as search terms, and you'll find the company's web site. Or click on this link: http://www.mdccorporation.us/stirrups/

I have indeed had the opportunity to try these stirrups, and I must say that I'm impressed. The design is very clever, and very practical. The model I tested (MDC Ultimate Stirrup®) will probably be the #1 English stirrup that I recommend from now on, because it combines the best features of both the types of stirrups I generally recommend.

With the MDC stirrups, the eye is not offset in a fixed position - these stirrups give you a choice of THREE different positions. That is, you can adjust them to hang flat against the horse's sides (traditional position), or to hang at a 90-degree angle, perpendicular to the horse's sides (as the Icelandic stirrups do), OR to hang at a 45-degree angle - halfway between those two positions.

This solves several problems at once. You can pick up these stirrups easily, without twisting or torquing your ankles or knees, and without having to make two or three tries before your foot "finds" the stirrup. The 90-degree and 45-degree angle options make life better for riders whose natural conformation causes them to "toe out" a little - and those options also allow stirrups to be set individually (one at 45 degrees, one at 90 degrees) for riders like yourself who have one foot that "toes out" much more than the other.

Some riders are made uncomfortable by the pressure that the leathers themselves can bring to bear against their boots or shins, and this, too, is addressed by these "Intelligent" stirrups. If you set them at the 45-degree angle, you will feel only half of the usual pressure from the stirrup leathers; if you set them at the 90-degree angle, you will feel NO pressure at all from the stirrup leathers. This may seem like a small and unimportant change, but ANY incremental increase in your comfort can have a big effect on your enjoyment of your ride.

Before you buy a pair, you should probably visit the company's web site and look at the different models, sizes, and colours (they come in black as well as traditional stainless steel). You should be aware that - aside from the colour issue - there are two different functional versions of these stirrups.

The MDC Comfort Stirrup® is the basic model with the three different adjustments.

The MDC Ultimate Stirrup® offers the same three adjustments AND the flexing feature. This is the model I've tested, and I can tell you that it's a wonderful combination of form and function, providing riders with enhanced safety, shock absorption, customized comfort, and convenience. Yes, you could say that these stirrups are pricey, but I don't think you'll regret your purchase for a single moment.

Good luck, and if you do decide to have the surgery, please let me know how it goes for you - I may be next!

Jessica

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