It was two days after the 4th of July when I decided to take my horse Milagro for a ride alone on the trail. We live in an equestrian community with well-groomed bridle paths, and I planned to have him out for about an hour. We were only about half a block from home when it happened.

I heard a car coming down the street we had just turned off. One minute I heard the motor, and the next minute, a loud pop. Someone had thrown a firecracker out of the car window in our direction.

Milagro is solid on the trail—he’s my North American Trail Ride Conference (NATRC) competitive trail horse—but firecrackers are his nemesis. He bolted in terror, racing up the trail at a mad gallop, away from the sound.

In an effort to stop him, I turned his head and pushed him with my leg into a tight circle. But the bridle path that once seemed wide and safe was not big enough for a terrified, runaway horse.

As I turned him, his back hoof landed on the sloped driveway of one of the homes adjacent to the trail. I felt his back end going down. He scrambled and got his feet under him, but not before he let out a horrible scream.

I jumped off and examined his back legs. I didn’t see anything obvious, even as I led him home. His adrenaline was racing, and he was practically dragging me.

An hour later in his paddock, he had calmed down. It was then that I noticed he was dragging his left hind toe. I called out the vet, who examined him by lifting the affected leg and stretching it out behind him. Instead of bending at the hock, the leg extended straight out in a way that turned my stomach.

“He’s got a rupture of the peroneus tertius tendon,” my veterinarian said.

How Tendon Injuries Happen

Tendon injuries can occur in two ways: through chronic overuse, or through trauma. Because horses’ legs are made up of a number of tendons, they are prone to stress and injury.

“Tendon injuries result from sudden tears or ruptures from a single overloading event, or chronic strains from overuse,” says Annette McCoy, DVM, M.S., Ph.D., Dipl. ACVS, associate professor of Equine Surgery at the University of Illinois College of Veterinary Medicine.

“The former are usually recognized right away after an athletic episode, and usually have the hallmarks of heat, focal pain when touched, and obvious swelling,” she explains. “The latter can result in low-grade chronic lameness that can be difficult to diagnose.”

The most commonly injured tendons and collateral ligaments that support joint stability in non-racing horses are the suspensory ligament, deep digital flexor tendon, the check ligament and the superficial digital flexor tendon, according to Jennifer G. Barrett, DVM, Ph.D., DACVS-LA, DACVSMR-EQ, Theodora Ayer Randolph professor of Equine Surgery at Marion duPont Scott Equine Medical Center at the Virginia Maryland College of Veterinary Medicine.

Varied Treatment of Tendon Injuries

The way a tendon injury is handled right after it’s discovered can make a big difference in the ultimate outcome.

“Right after an injury happens, we are trying to combat inflammation and swelling,” says McCoy. “This is accomplished with a combination of cold therapy like icing or cold-hosing, compression with bandaging, systemic medications like a non-steroidal anti-inflammatory drug [NSAID] such as phenylbutazone [bute], and stall rest.”

Although scarring of the tendon as it heals cannot be prevented, making the scar tissue as functional as possible is the goal.

“Controlled exercise in a rehabilitation program helps us to do that,” says McCoy. “Periodic re-evaluation with ultrasound helps us determine the healing progress. A rehab program might need to be altered, depending on how the tendon is healing.”

A number of adjunct therapies can also be used to help tendons heal, including extracorporeal shock-wave therapy, therapeutic ultrasound, and low-level laser and magnetic therapy, although not all of these therapies have been studied in clinical research.

“Biological therapies such as platelet rich plasma [PRP], autologous conditioned serum, and mesenchymal stem cells injected directly into a tendon injury under ultrasound guidance have shown some promise at either speeding healing, improving the quality of the healed tissue, or helping to reduce the incidence of re-injury,” says McCoy.

“More work is needed to understand exactly how these treatments work, and what injuries are best addressed by using them,” she adds. “This is a very active area of ongoing research.”

There are some tendon and ligament injuries that can benefit from surgical treatment, according to Barrett.

“Examples include the suspensory ligament in hind limbs, the deep digital flexor tendon, and superficial digital flexor tendon when they are injured in a tendon sheath or bursa,” she says.

Slow Recovery

When a horse injures a tendon, the issue can require a temporary layup or permanent retirement.

“Prognosis is entirely dependent on the severity and location of the injury, but typically ranges from fair to guarded for future athletic use,” says McCoy. “An owner should expect that their horse will be out of full work for nine to 12 months while the injury heals. Unfortunately, horses that have had a tendon injury are highly prone to re-injury.”

The way the layup and rehabilitation are handled can make a huge difference in whether the horse is able to return to his previous activity.

“The hardest thing for owners to understand is that healing takes a very long time for tendons and ligaments,” says Barrett. “Humans can rest by taking the weight off the limb completely. This is not possible for horses, so we rely on reducing exercise as much as possible during healing.”

Stall rest is the best we can do to limit trotting and overuse of a healing tendon, but stall rest is hard for owners, and is often seen as hard for horses too, according to Barrett.

“The same way you need to be on crutches to heal a tendon, horses need stall rest and very controlled exercise once your veterinarian determines it appropriate,” she says. “All of the difficult and expensive care your veterinarian provides [might] be wasted if the exercise recommendations are not followed.”

The length of stall rest and the limited exercise needed to help the horse recover depends on the injury. Extensive stall rest is usually prescribed early in recovery, with a gradual return to gentle exercise as the tendon heals.

“Early loading—exercise—of the tissue is the most essential aspect of healing, but we can’t load too much, otherwise it breaks again,” says Henk Offereins, DVM, of equinetendon.com, an Ireland-based equine management service specializing in the area of tendon injuries. “Getting that balance right [is the difference between] success and failure in rehabilitation.”

Update on Milagro

Milagro made a full recovery after rupturing his peroneus tertius tendon, but only after a one-year layup that required three straight months of stall rest with physical therapy on the affected leg. He eventually graduated to hand-walking, slowly building up the amount of time he could be walked over a period of months.

Today, he is back to trail riding around our community as well as competing in NATRC events. He is so sound these days, I often forget he ever suffered this horrible injury. I believe the long layup and following my veterinarian’s instructions on rehabilitation made all the difference.

Key Takeaway

Tendon injuries are as complicated as equine injuries come—and certainly time-consuming to recover from. Understanding treatment options and the recovery timeframe can help horse owners and caretakers to better manage any future tendon injuries.

Further Reading:
◆ Managing Horses with Tendon and Ligament Issues
◆ Taking Care of Your Horse’s Tendons

This article about equine tendon injuries appeared in the April 2024 issue of Horse Illustrated magazine. Click here to subscribe!

The post Treatment of Equine Tendon Injuries appeared first on Horse Illustrated Magazine.

Post-workout leg care can be as hot-button a topic as blanketing among horse owners. Some riders cold hose, wrap, and/or poultice their horse’s legs, while others simply leave their horses alone. But is there a “right” way to care for equine limbs after athletic exertion?

No matter if you piaffe, jump, trail ride, work cows or anything in between, we all want to ensure we’re doing the best by our four-legged partners. Read on to discover how two vets—both competitors themselves—care for their own horses, and how they recommend their clients do, as well.

Ins and Outs of Post-Workout Leg Care for the Horse

Lori Bidwell, DVM, Dipl. ACVA, is the co-owner and founder of East-West Equine Sports Medicine, which has locations in Kentucky and California. Bidwell is a certified veterinary acupuncturist, massage therapist and anesthesiologist. She travels from coast to coast with the hunter/jumper circuit and actively competes in the amateur jumpers.

Bidwell is a Fédération Equestre Internationale (FEI) Official Veterinarian, so she is well-versed in caring for elite athletes. She encourages her clients to begin thinking of their horse’s post-workout leg care as soon as their round ends.

“A cool-down until the horse’s respiratory and breathing [rates return to resting levels] are sufficient, but a nice, relaxing walk after strenuous work is best to keep the muscles loose,” she says.

Put it on Ice: Bidwell also recommends icing a competition horse’s legs for 20 minutes.

“If you’re using ice boots, wet the boot and the leg first,” she says. “You can cause freezer burn or have poor contact if you don’t [wet the leg before icing].”

Bidwell notes that the exact method of icing doesn’t matter. Having the horse stand in a bucket with ice works just as well as ice boots (assuming the horse will stand still). Twenty minutes is the standard time to ice if using boots; after that, the ice melts and the boots become too warm to offer the horse any benefit.

That’s a Wrap: Though it’s customary to see show horses standing in bandages in deeply bedded stalls when they’re not being ridden, Bidwell cautions that wrapping is not necessarily a good thing, even if the person applying the wraps does everything correctly.

“High temperatures in wraps—especially in warmer climates or during the summer show season—can actually overheat tendons, specifically the deep digital flexor tendon, because it has limited blood flow,” she says.

If you have a senior equine that may need the support or one that stocks up easily, wrapping may still not be the answer you’re looking for. Bidwell prefers time outside of a stall over wrapping, particularly when temperatures climb.

“Getting a horse out for work and frequent walks is ideal,” she says. Still a diehard fan of wrapping? Bidwell offers two additional pieces of advice: Never wrap over liniment, and don’t keep a horse’s legs wrapped for more than eight hours at a stretch.

The jury’s still out on poultice efficacy, but it doesn’t hurt, so if you want to feel like you’re doing something “more” for your steed, slathering his limbs in poultice—but not wrapping over it—could be an option.

Bedding: An easier way to keep competition horses comfortable is to bed them sufficiently. Deep bedding will help ease potential aches in a horse’s joints, according to Bidwell.

Determining what is adequate takes into account multiple variables, including what material the floor of the stall is made of. Concrete- or asphalt-based stalls will need more bedding to make them comfortable to the horse than dirt floors or matted stalls.

Packing Hooves: For those of you who like to pack your horse’s feet, Bidwell says to skip this potentially messy step.

“Packing feet can actually put more pressure on the soles, depending on what product is used and how it’s applied,” she cautions.

Walking & Stretching: Bidwell encourages her clients to use a simple, common-sense approach to competition leg care, with turnout (when possible) and exercise as the cornerstones for healthy legs following athletic exertion.

“Getting the horse out of his stall a few times a day [is ideal to keep muscles limber],” she says. If time and money permit, massage can also help loosen stiff muscles.

Owners and riders should also get into a routine of doing tail stretches or carrot stretches every time a horse exits the stall, whether that’s to hand-walk or compete.

“Think of horses like you think of yourself,” says Bidwell. “I’m very stiff when I get up in the morning. I need time to move and stretch, and I get very stiff if I am not active.” Horses are the same.

Keep It Simple

Ben Mitchell, DVM, of Southern Equine in Aiken, S.C., grew up riding and competing in western events. He currently owns four Quarter Horses that he trail rides and competes in speed events. Having grown up in the western performance horse industry, Mitchell is well versed in its athletic requirements.

Mitchell, too, is a proponent of the “less is more” mentality when it comes to caring for equine limbs. He recommends riders tack-walk or hand-walk their horses for 15 to 20 minutes after an event to cool them, followed by cold hosing or icing the lower legs and joints for 15 to 20 minutes.

If you can afford the price point, he recommends ice boots.

“Ice boots are helpful in decreasing inflammation to the distal limbs; they’re worth the investment,” says Mitchell.

After all the sweat and dirt have been washed from the horse, he recommends applying liniment to the horse’s legs once they begin to dry.

“Liniment is a good [method] for cooling a horses’ distal limbs, but I don’t recommend wrapping over liniment,” he says. Mitchell is also not a fan of wrapping legs except when necessary.

Instead, if you’re showing at a location where the horse is stabled, he recommends bringing (or renting) portable stall mats.

“Portable stall mats are great for supporting distal limbs,” says Mitchell. “I don’t wrap legs unless a horse is prone to swelling.” Even then, this should be done with care. “I prefer horses be taken out of the stall for short walks multiple times a day [over wrapping them],” he emphasizes.

“I typically only recommend wrapping when there’s a history of swelling when the horse is stalled or traveling, or when there is noticeable swelling of a limb,” says Mitchell. He prefers bandages be reset every 10 to 12 hours if the horse must wear them.

Like Bidwell, Mitchell advocates cushioning for equine joints.

“Deeply bedded stalls and portable stall mats are great tools for keeping the horses comfortable,” he says. “Keeping your horse’s stall clean and deeply bedded makes him feel more comfortable to lie down and rest, which makes for a stronger horse the next day.”

If a horse will be spending time in a stall or tied for multiple hours with no shavings or mats, Mitchell recommends owners use Soft Ride boots to support the horse’s feet. Additionally, the use of rubbing alcohol can cool down lower legs and keep them clean when the horse is working on muddy ground.

Though our horsekeeping traditions often encourage us to wrap our horses for hours on end and to apply all sorts of products to their legs, it’s clear that simple is better when it comes to equine leg care. Using ice, providing lots of walks, and a deeply bedded stall without unnecessary leg wraps can all assist in keeping your horse healthy and primed for competition.

This article about post-workout leg care for the horse appeared in the April 2023 issue of Horse Illustrated magazine. Click here to subscribe!

The post Post-Workout Leg Care for Your Horse appeared first on Horse Illustrated Magazine.