Current thinking on box rest

[Wheels]

I'm interested in views and peoples / vets / physios thoughts on box rest practises. Reading through michens thread has prompted my question as this shows that box resting for one problem can lead to others (not trying to single michen out btw, just that's a recent example)

I went to a talk with sue Dyson and a local ish vet and they both said that apart from very specific issues / conditions that they dont recommend box rest anymore but might recommend small turnout areas instead or even field rest so the horse can move around.

When my own horse had a soft tissue injury last summer he was prescribed field rest for a number of weeks

What has been your recent experiences and is there any current research you know of about when to and when not to box rest?

 

[milliepops]

No idea about research but from a horse owner's POV pen rest in the field is hard to achieve in an ideally managed way if you're dependent on livery which may be why box rest in a stable is so common.

Last one I had to box rest would only settle if she had a companion 24/7, so rather than force my other horse to stay in too, I chose to move her home to join the retirees and she did a few months in a pen that floated round their field to give her company and fresh grass every day. she healed fabulously so it was a good move for her, but only possible because it's my field to use as I choose and no one except my OH will pull a face about the state of it!

More research is definitely a good thing though. When I was rehabbing a soft tissue injury about 6 years ago my physio told me not to worry too much about keeping my jolly horse in walk, because research on racehorses had shown that the tissues healed well (better) if the horses were deliberately made to lightly jog rather than just plod in walk. I think if you can keep things fairly controlled and organised then we are going to end up finding that more movement is better than less, in many cases. the problem is the control element for those on livery who have to fit into a regime not of their choosing. then you don't have a range of options available to get the management perfect.

 

[SO1]

This is interesting. My pony was allowed small paddock turnout after 2 weeks of trotting in his rehab programme for liagment damage. He had already done 12 weeks of walking. YO was quite surprised as she said most horses normally not allowed turnout until they have been cantering. He will return to herd large field turnout after 6 weeks of cantering.

Just going out for a couple of hours a day in small paddock has made a huge difference to & he seems more chilled & easier to ride.

 

[TheMule]

In humans complete rest is rarely advised for anything other than fractures. If you have a soft tissue injury it's beneficial to strengthen the structures around it. Of course horses are prone to doing daft thins that can slow the healing as they over-exert it, but I would always do field rest if possible instead of box rest

 

[Michen]

Agree with MP. It’s completely dependent on the horse as well. Mine is a complete twit in the field and a small pen I think he made matters so much worse. He would be more settled turned away but my vet and the specialists consulted strongly felt the controlled walking was really important to make sure the structures healed as well as they could do.

Also there’s box rest and then box rest. My vet says there’s rarely a soft tissue injury that they would recommend complete rest for... and most rehab programmes ramp the walking up pretty quick. Within about 6 weeks mine was doing a fair bit of work, arguably more movement than some who don’t have turnout in winter.

I am lucky that the only one of us that really seemed upset re the box rest was me, Bog was totally settled in the box itself even left in on his own in recent weeks.

 

[tristar]

i prefer field rest after initial box rest to get to the problem, short as poss, i have the feeling horses are not so likely to move if it hurts, bit like us, you use yourself then rest, but i use a bare paddock normal size and hay to reduce energy plus companion.
i have everything from hay height grass to bare so its much easier manage the thing than on a livery yard, and less stimulus, but not needed to rest any for at least ten years, when a knee ligament was injured, but stayed out in normal paddock and was fine after.

 

[Shilasdair]

The BHS advice was always to box rest your horse for months, until it had gone fully berserk, then to ride it.
I was never keen on that advice, as I was earning a living as a rider at the time.
Veterinary advice for the past 30 or so years, has been to use controlled exercise for most conditions - so walking in hand, or ridden walk work, or field rather than box rest, particularly for tendons. Studies found that you get a better heal if you stress the leg a little. Plus it stops your horse (and the owner) becoming deranged.

So I don't box rest mine - if they are lame, or unwell, I just keep the two of them in a smaller field area. Much better for their mental health and welfare.

 

[Michen]

The BHS advice was always to box rest your horse for months, until it had gone fully berserk, then to ride it.
I was never keen on that advice, as I was earning a living as a rider at the time.
Veterinary advice for the past 30 or so years, has been to use controlled exercise for most conditions - so walking in hand, or ridden walk work, or field rather than box rest, particularly for tendons. Studies found that you get a better heal if you stress the leg a little. Plus it stops your horse (and the owner) becoming deranged.

So I don't box rest mine - if they are lame, or unwell, I just keep the two of them in a smaller field area. Much better for their mental health and welfare.

Not for all horses. When I turn mine out in a small area he loses the plot. I’ve Learned that the hard way, I should have just box rested for a bit longer then put him straight out in a normal size field.

 

[DabDab]

Depends on the horse for me too. I would say most are better with just field rest except for particular injuries. But there are some horses who won't sensibly field rest, and in a small field pen can be even worse, so the only choice really is to box rest with controlled exercise. They are also the ones who are often a bit of a handful in controlled exercise though too, so it can be a bit of a headache.

 

[Red-1]

I have never completely box rested. When it has been suggested, we have still done a mooch and a munch.

So, hopefully an hour each end of the day where we out some hay in the arena, walk in hand to the pile and have a munch. Then have a mooch to a second pile of hay, for a munch. Just that really, mooch from one pile/net of hay to the other. Start with 2 people, 1 each side, until the horse has the idea of mooch and munch, then no issues.

It is not marching round and round, just mooching and munching. Once they can start work, we simply up the walking and quit the munching, until they can start under saddle.

Often we can only do an hour at one end of the day and half an hour the other. At least they get out of the box.

I don't do turnout until they are quiet under saddle. Small pen turnout gets the wind up me, as they still seem to get full steam ahead, then screech to a stop!

 

[Michen]

I have never completely box rested. When it has been suggested, we have still done a mooch and a munch.

So, hopefully an hour each end of the day where we out some hay in the arena, walk in hand to the pile and have a munch. Then have a mooch to a second pile of hay, for a munch. Just that really, mooch from one pile/net of hay to the other. Start with 2 people, 1 each side, until the horse has the idea of mooch and munch, then no issues.

It is not marching round and round, just mooching and munching. Once they can start work, we simply up the walking and quit the munching, until they can start under saddle.

Often we can only do an hour at one end of the day and half an hour the other. At least they get out of the box.

I don't do turnout until they are quiet under saddle. Small pen turnout gets the wind up me, as they still seem to get full steam ahead, then screech to a stop!

That’s what I did with Bog, about half an hour both ends of day on top of the walking. But more grazing him in hand on a big patch and him moving around at his will to graze sort of naturally.

Totally agree re small pen I wish I’d never done it!

 

[Pinkvboots]

I can't put mine in a small pen they just just stand there bucking and rearing the whole time, 5 years ago when Arabi did his suspensory he had nearly 6 months box rest, I was lucky that I can tape off my small hard standing outside my stables, he quite happily stood on that for part of the day with hay, he couldn't deal with a small pen in the field at all I would rather just keep him in his normal field or in the stable, my other horse who had 2 soft tissue injuries last year was just allowed to be turned out on vets advise after 8 months rest and some treatment he was sound, vets do seem to not want complete box rest nowadays it's definitely changed.

 

[milliepops]

all of this shows that regardless of what the research says is best for optimum healing, so much depends on the horse involved, what it will cope with, what its temperament and personal reactions are like and so on.
something that is objectively ideal for a particular injury might be a disaster for an individual horse so compromises will need to be made.

 

[SEL]

Vet practices around me aren't encouraging box rest any longer - obviously dependent on injury. One of the vets I know has her own horse turned away for 6 months with a suspensory injury which made me feel better because the PSSM mare can't box rest anyway.

I do wince when I see her having a mad moment, but fortunately they are pretty rare with 24:7 turnout. She's in her normal field with her normal companions so hopefully quietly mooching and moaning about the lack of food.

 

[irishdraft]

I have had this exact dilemma my horse has sustained as soft tissue injury in the hoof I was told box rest is not recommended now and to leave him in the field which is what I did . He is not one to charge about . 7 months later he has been written off by my vet as will never come sound . My friend who works for a very large equine practice absolutely lambasted me for not box resting as her practice still recommend this and in fact her own horse had 9 weeks box rest recently for a different problem although ironically he became worse and was pts. I do still worry that if I had box rested my own horse would I have had a different outcome .

 

[ycbm]

ID ime it's rare for box rest being prescribed for an injury inside the foot.

There are barefoot rehab yards dedicated to keeping horses with those injuries moving and their success rate is higher than any conventional intervention.

Please don't blame yourself.
.

 

[Nicnac]

I am not a fan of box rest however did it two years ago for young horse who had sustained fracture to radius from a kick. If he had hooned about there was a high risk of it spiralling and shattering the leg. Said horse didn't do "alone" so other horse was stabled too and in sight at all times. It was a hot summer and incredibly stressful for all.

 

[L&M]

Totally dependent on the injury, and the temperament of the horse.......

I had a little welsh cob who had a hind tendon injury, which resulted in 6 mnths box rest. He went from hunting fit to being confined and was as good as gold. His prognosis was not great initially but as he rested himself so well, came sound far quicker than anticipated, and stayed sound. Even when first turned out he did not have any major hoolies.

The other experience we had was 16.2hh warmblood, that had to have a bone chip removed in his fetlock. The prognosis was good, so went ahead with op relatively confident we would have our horse back in work within a few mnths. However the horse was a complete twit on box rest, bucking and spinning around the stable, so the vet advised to turn out. We built him a tiny turn out area which he then proceeded to do the wall of death around if he heard or saw another horse - he would come just about sound then do something stupid and go back to hopping lame again and just doing more damage. Sadly we called it a day after 3 mnths as he refused to let himself heal.....whether box or field rested.

I would always initially be guided by the vets recommendation, then make a judgment on the horses temperament and attitude to box rest, facilities available, and ground conditions - field rest in a confined area in winter I would imagine night on impossible as would end up a mud pit.

 

[blitznbobs]

I am not sure how reliable the pen could be ... electric fencing wouldn’t work for my fella (box rested post colic surgery) as he would’ve tried to jump out ... and permenant high fenced pens is essentially a type of stable isn’t it

 

[muddy_grey]

My mare had ddft surgery and was on box rest for nearly 6 months. 3 weeks total box rest and then hand walking building up to ridden walk and trot. She then went in a small very grassy pen (took her 2 days to lift her head) after nearly 6 months, small field at 8 months.
I couldn't hand graze her due to handstands, but she was very happy on box rest. I think the fact it was winter helped, she is not keen on cold wet turnout.
The reason for controlled exercise is to reduce adhesions and encourage them to be long and thin, making them less likely to rupture. It would be great if we could turn them out and tell them to be quiet and calm!
After a pretty depressing prognosis from the surgeon she has been back in full work for over 2 years. I am fully aware that it could go again at any time, but am enjoying what we get.