We have had the opportunity to work with hundreds of tendon and ligament injuries. Many horses have returned to peak performance levels and this is our main goal at KVS. As a result we have developed a very strict controlled rehab program which is initiated soon after injury. Other important issues to address during and after rehab are foot care, footing, and adequate fitness. Nutrition is an important consideration therefore we commonly structure a diet in order to gain maximum healing while maintaining a strong musculoskeletal frame. Importantly sufficient protein, amino acids and collagen must be maintained to provide for proper healing (Myoplast supplementation and collagen).
Stall rest is important to ensure the initial healing response. Stall rest must be continued during the total controlled rehab program as well. Many years ago, Dr. Kleider attended the Dubai International Equine Symposium on tendon and ligament injuries where an 80% re-injury rate was quoted for a horse that was turned out, i.e. an uncontrolled rehab program.
Walking in conjunction with stall rest is allowed until trot work is initiated (according to Dr. Kleider and Dr. Hodge’s recommendations based on ultrasound findings). Start at 5 minutes and working up to 20 minutes a day prior to starting trot work. Walking can be done two to three times a days if so desired.
If he walks a lot in the stall and is likely to hurt himself/handler being hand walked or ridden then common senses should prevail – leave him in a stall. A larger stall is a favorite alternative.
If your horse does not like being in a stall or gets stressed out being confined, we recommend:
– Providing a friend either beside or across from your horse. Horses are social animals and hate being left alone. If a horse is not possible then a goat or other animal may be a source of amusement.
– Entertainment devices such as Jolly Balls, Lick its, music, and believe it or not even videos of horses frolicking can be a source of entertainment.
– Short acting and long acting sedation can be used on an as need basis.
– A stall sized paddock outside can be made by making the existing paddock smaller.
Rehab at the walk – Intended for stretching and is especially important for tendon and ligament injuries. Horses rarely re injure themselves at this gait unless they get away from the handler or rider, so judicial use of sedatives and proper use of restraint is advisable when rehabbing horses at this gait. In riding horses flat work training at the walk is useful to keep their mind occupied and prevent them from “exploding”. For example shoulder in, leg yield, half pass, renvers, travers, and rein back can all be done to promote healing as long as the transition into each exercise is fluent and not abrupt.
Rehab at the trot – Most of the strengthening work is done at this gait because the load is shared with the diagonal hind or fore limb and it is not as fast as the canter and therefore it is safer (the horse is not as prone to re-injury).
Rehab at the canter – Canter is done at the end of the program. At the canter, weight bearing occurs on each leg individually so there is maximum load on the bones, joints, tendons, and ligaments. Remember “Speed Kills” so initially keep the pace slow, at least until the end of the program. Introduce sharp turns late in the program since any imbalance may cause re-injury.
Generally hard footing is better for suspensory and SFT injuries, while soft footing is better for bone and DFT issues. Regardless the consistency is more important than the type. A horse stepping from a hard surface into a soft spot is much more prone to re-injury.
Going the opposite way of the lameness for example: if a horse is off in the right front longing to the left then do most or all of your work initially to the right for the first few months or until the tendon/ligament injury is healed. This strengthens the limb without over stretching. Doing more straight lines and fewer circles, stay away from tight circles until the end of the program and then introduce them gradually.
If time off is needed, unless it’s greater than two weeks, rehab programs may be continued where they left off.