Fascial Sequencing for the Equestrian Athlete
PRIOR TO VISIT After you submit your request for consult, you will speak with Dr. Wang on the phone to discuss your equestrian related needs and injuries. We will make sure we are the correct fit for each other. This is to ensure that you receive the best possible care.
VISIT The in-person visit itself is approximately 1.5 hours. We will go over you riding-goals and health history in great depth. This will be followed by an in-depth examination that includes functional movement, palpatory, and ultrasound evaluation to sequence and diagnose involved fascial planes/lines. To aid in diagnosis and prognosticate response, treatment starts at this first visit and includes self-care recommendations.
AFTER-VISIT/FOLLOW-UP Following your visit, you will monitor your response. Your response will help us prognosticate your condition and determine when your next follow up visit should occur. Follow-up visits are typically 1-1.5hours. In some occasions, more invasive interventions like Fascial Layer Specific Hydromanipulation and Prolotherapy may be needed to heal injured tissue. In most cases, you may continue to ride and train as usual.
The Equine Athlete Health Consortium
Drs. Tina Wang, MD and Toni Ward, DC have established a collaborative Chiropractic and Physical Medicine consortium to provide concierge care for the equestrian athlete. With a combined 30+ years of experience, they have successfully provided care to equestrian athletes. Their specialized services include dynamic evaluation of the equestrian athlete on their horse, chiropractic care for biomechanical corrections and fascial sequencing for ongoing correction of biomechanical dysfunction, functional medicine for overall health of the athlete and regenerative medicine procedures for repairing and strengthening injured tissues.
Being a competitive equestrian athlete, Dr. Ward is uniquely positioned to be able to analyze the equestrian rider on the horse to identify injuries, biomechanical faults as well as weaknesses during the athlete’s riding relationship with the horse. In addition, she specializes in Functional Medicine for the equestrian athlete to improve and maintain the athlete in top condition throughout the riding season and beyond.
Dr. Wang specializes in fascial dysfunctions that contribute to equestrian injuries. Dr. Wang has extensive experience with all types of athletes using Regenerative Medicine including prolotherapy, plasma-rich platelet (PRP) injections, Fascial Layer Specific Hydromanipulation (FLuSH) and dynamic musculoskeletal ultrasound imaging.
Drs. Ward and Wang have taken this unique and successful concierge service into the show environment to provide access to direct, on-site services to the equestrian athlete.
Equestrian arts are a popular recreational and competitive sport in the United States..(1) The sport has a high burden of injury with a total prevalence of 85.8%(2) and a 1-year prevalence of 26.6%.(3) Blunt traumas make up a large proportion of these traumas(5–7) with a high proportion resulting in serious injury requiring surgery.(4)
In addition, there is a high rate of overuse injury(3,8) and chronic injuries(9) accounting for approximately half of all equestrian related injuries.(3) Fifty-nine percent of equestrian traumas result in long-term pain and dysfunction.(9) Many of these injuries prohibit riders from continuing to ride or inhibit their performance.
Studies of equestrian riders show that structural asymmetry in the rider is a risk factor for injuries.(8,10) These factors are modifiable with fascial sequencing using the Fascial Manipulation(R) diagnostic technique.
1. Stowe CJ. 2018 American Horse Publications (AHP) Equine Industry Survey sponsored by Zoetis. [Internet]. Dept. of Agricultural Economics (University of Kentucky); Available from:
2. O’Connor S, Hitchens PL, Fortington LV. Hospital-treated injuries from horse riding in Victoria, Australia: time to refocus on injury prevention? BMJ Open Sport Exerc Med. 2018;4(1):e000321.
3. Ekberg J, Timpka T, Ramel H, Valter L. Injury rates and risk-factors associated with eventing: a total cohort study of injury events among adult Swedish eventing athletes. Int J Inj Contr Saf Promot. 2011 Dec;18(4):261–7.
4. Mitchell PD, Pecheva M, Modi N. Acute Musculoskeletal Sports Injuries in School Age Children in Britain. Injury. 2021 Mar;S0020138321002618.
5. Dick L, Yule M, Green J, Young J. Patterns of injury following equine trauma: a non-trauma centre experience. Scott Med J. 2021 Feb 11;003693302199426.
6. Adler CR, Hopp A, Hrelic D, Patrie JT, Fox MG. Retrospective analysis of equestrian-related injuries presenting to a level 1 trauma center. Emerg Radiol. 2019 Dec;26(6):639–45.
7. Acton AS, Gaw CE, Chounthirath T, Smith GA. Nonfatal horse-related injuries treated in emergency departments in the United States, 1990–2017. Am J Emerg Med. 2020 Jun;38(6):1062–8.
8. Cejudo A, Ginés-Díaz A, Rodríguez-Ferrán O, Santonja-Medina F, Sainz de Baranda P. Trunk Lateral Flexor Endurance and Body Fat: Predictive Risk Factors for Low Back Pain in Child Equestrian Athletes. Children. 2020 Oct 9;7(10):172.
9. Guyton K, Houchen-Wise E, Peck E, Mayberry J. Equestrian injury is costly, disabling, and frequently preventable: the imperative for improved safety awareness. Am Surg. 2013 Jan;79(1):76–83.