As a practice that has always focused on lameness, we have the experience of working with hundreds of cases involving some of the most difficult types of injuries to rehabilitate. Many of our patients with tendon or ligament injuries are able to return to peak performance levels. This is our primary goal at KVS. As a result we have developed controlled exercise rehab programs which are initiated soon after injury. These programs emphasize incremental stretching and strengthening for the tissue that is healing while working to prevent re-injury. Other important issues to address during and after rehab are therapeutic shoeing, working on proper footing, and creating adequate fitness. Nutrition during rehab is also an important consideration. We commonly structure a diet to promote healing and maintain muscle strength while limiting excess calories or energy. It is important to supply sufficient protein with the right amino acid ratio along with collagen as the cellular matrix for proper healing.
Stall rest is important part of any controlled exercise program. 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 horses allowed turn out. Many horses will feel better or play too hard in spite of their injuries causing them to re-injure winding up back at square one.
If your horse does not like being in a stall or becomes stressed during confinement, we recommend:
– Provide a friend either beside or across from your horse. Horses are social animals and hate being left alone. If a horse buddy is not available then a goat or another type of 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 is especially important for tendon and ligament injuries. Horses rarely re injure themselves at this stage unless they get away from the handler or rider. Judicial use of sedatives (if required) and proper use of restraint is advisable when rehabbing horses at the walk. For horses under saddle, flat work training during the walk is useful to keep their mind occupied and prevent them from “exploding”. Gymnastic exercises such as 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 firm footing is better for suspensory and SFT injuries, while softer footing is better for bone and DFT issues. Regardless of hard or soft, the consistency is more important than the type. A horse working in inconsistent footing, slipping or stepping from a hard surface into a soft spot is much more prone to re-injury.
Planning the work to spend more time going the opposite way of the lameness is also helpful. 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. Work more in straight lines with fewer circles. Stay away from tight circles until the end of the program and then introduce them gradually.