Rehab for a tendon injury...how tough might it be?

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palo1

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My lovely 8 year old mare has a tendon injury: I'm waiting to get scans, prognosis and possible rehab plan but suspected moderate injury of the ddft. The waiting is awful - every possible worst case is going through my mind, particularly around how tough rehab might be! I think a form of rehab will be possible as horse is weight bearing and with generally improving signs. My vet advised planning on considerable time being needed and that, in itself is not an issue. But I am wondering how tough, in terms of time and emotion rehab might be. I can do a walking rehab and shoes have been removed - I think I can put the physical work in but could do with some hopeful/positive rehab stories....
 
Yes it’s painful, long and sometimes (well in my case) not a great outcome.

I rehabbed my mare from a 2/3 jellification of the SDFT (vet’s exact words) she had injections, box rest, remedial shoeing and eventually came sound but would never be even low level pc sound again.
 
Roasted Chestnuts said:
Yes it’s painful, long and sometimes (well in my case) not a great outcome.

I rehabbed my mare from a 2/3 jellification of the SDFT (vet’s exact words) she had injections, box rest, remedial shoeing and eventually came sound but would never be even low level pc sound again.
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Yes, I fear this outcome but appreciate your experience. Thank you.
 
I have shared mine but have always I only aimed for mine to come back to hacking and flatwork.

Mine did box rest due to acute lameness - she was three legged lame, not grumbling lame. That was pretty dreadful. The rest though, was actually very rewarding and we have a wonderful relationship as a result of the time we took to do things on the ground together.
 
LadyGascoyne said:
I have shared mine but have always I only aimed for mine to come back to hacking and flatwork.

Mine did box rest due to acute lameness - she was three legged lame, not grumbling lame. That was pretty dreadful. The rest though, was actually very rewarding and we have a wonderful relationship as a result of the time we took to do things on the ground together.
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Yes, I have been reading your account with interest. A hacking and flatwork outcome would work for me too - I guess I am irrationally fearful of subsequent re-injury but of course horses get injured in any case. I have several months ahead to get some work done, if that is advised, before the winter weather will make things more difficult here. That feels like a bit of pressure too though I know that time is the key factor in healing.
 
palo1 said:
Yes, I have been reading your account with interest. A hacking and flatwork outcome would work for me too - I guess I am irrationally fearful of subsequent re-injury but of course horses get injured in any case. I have several months ahead to get some work done, if that is advised, before the winter weather will make things more difficult here. That feels like a bit of pressure too though I know that time is the key factor in healing.
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I have a great, small, lightweight rider and I genuinely just didn't watch the first rides. I can see lame steps on a bicycle these days I am so neurotic.

But once I'd got over myself, then it's been brilliant. Every time we have a breakthrough in how she's going, it's so so rewarding.
 
palo1 said:
My lovely 8 year old mare has a tendon injury: I'm waiting to get scans, prognosis and possible rehab plan but suspected moderate injury of the ddft. The waiting is awful - every possible worst case is going through my mind, particularly around how tough rehab might be! I think a form of rehab will be possible as horse is weight bearing and with generally improving signs. My vet advised planning on considerable time being needed and that, in itself is not an issue. But I am wondering how tough, in terms of time and emotion rehab might be. I can do a walking rehab and shoes have been removed - I think I can put the physical work in but could do with some hopeful/positive rehab stories....
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It’s painful and hard. Especially if they don’t progress how you hope in the start. Mine did his sdft getting stuck in mud. At the worst spot a roughly 25% tear back in February. We used a type of stem cell treatment called renovo that oddly worked a bit too well and we ended up with a bow below the worst part of the injury not even a week later so had to start all over again. He also started turn out as soon as he was comfortable enough to walk out to the medic paddock. Mind you not sound but where he was wanting to walk more during hand grazings. About 3 days after the injury. While our vet is more a fan of stall rest she agreed for him the pros out weigh the cons. His last attempt at stall rest resulted in a jumped wheelbarrow and him running around for 20 minutes absolutely feral. This horse is probably the easiest thing on earth to catch but he was over it and let everyone know. He’s also 22 with cushings and fusing hocks. Stall rest just isn’t in the cards when he is a lovely chap in turn out. Anyway the first 2-3 months were yeah the tear is looking good healing very nicely but that bow is angry. We were cleared to hand walk however with the fact that he was walking 98% sound on it and last month started him with pemf. That was a game changer. A month later you can see the fibers and that tear you actively have to search for where it was to find the signs it was there at all. He’s feeling fresh and great and we’re actually long lining our walks in the back hay field for some mental stimulation and help him use his body. I’m a strong believer in Dr. Green and modern treatments. Trial and error and they’re going to be stupid and at some point you just gotta let them and either the tendon will strengthen to the job required of it or the tendon was never going to heal properly and hold.
 
No personal experience, but friend on same yard has rehabbed her big cob. Surgery, box rest, restricted turn out, walking in hand etc.. Eighteen months and three rehab periods later the vet announced that she is as sound as she is going to get, and only 30% ever come back fully sound. She is now turned out with the herd, and probably won't be ridden again. Please ask your vet to be honest with you about the expectations, given the location and severity of the injury. Sorry to chuck a negative post in, but if you are expecting your horse to 'recover' after intervention and rehab., it can be very disheartening to remain at stage one. I truly hope this works for you.
 
palo1 said:
Yes, I fear this outcome but appreciate your experience. Thank you.
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If my original vet had been honest at the time and told me that she would have only been light hack/broodmare sound then I will be honest I wouldn’t have rehabbed her. I would have PTS.

That vet got sacked for being rather dodgy and the head vet came out to do her last scan and said so what’s the plan now and I said to return to what we were doing before and that’s when I was told she would never return to any sort of proper work. I was devastated and seriously pissed off. Head vet was really nice and told me if I wanted to put her in foal to contact him. I toyed with the idea but then I lost my job (forced redundancy) and I had to find her a home. That was a whole other sh1t show I won’t go into as I still regret it but you live and learn the hard way.

Just make sure your vet is giving you the right options for you as I got sh@t upon from a height.
 
palo1 said:
My lovely 8 year old mare has a tendon injury: I'm waiting to get scans, prognosis and possible rehab plan but suspected moderate injury of the ddft. The waiting is awful - every possible worst case is going through my mind, particularly around how tough rehab might be! I think a form of rehab will be possible as horse is weight bearing and with generally improving signs. My vet advised planning on considerable time being needed and that, in itself is not an issue. But I am wondering how tough, in terms of time and emotion rehab might be. I can do a walking rehab and shoes have been removed - I think I can put the physical work in but could do with some hopeful/positive rehab stories....
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You should ideally be already icing and/or cold hosing, box resting and bandaging and anti inflammatories.

It can take weeks or months, normally an initial period of box rest, followed by in hand walking and then turnout into a very small postage stamp paddock before gradually increasing the size.

If you can consult a physio they may be able to lend you some equipment, I have used long eave ultrasound very successfully on my horses in the past.

Then when you go back to riding you will need to follow a program devised between your vet and/or physio.

Good luck, I have done this heaps of times with both Bailey and suspensory branch injuries and a check ligament and once with Lari.

Why it's essential to ice immediately following a tendon/ligament injury.

This is why I think t's very good to instigate cold therapy as soon as your horse has a tendon/ligament injury. This is me going by my other user name (long story but two user names as don't have access on computer to old user name only phone). Picture 1 December 2019, around the 28th December...
forums.horseandhound.co.uk forums.horseandhound.co.uk
 
Highmileagecob said:
No personal experience, but friend on same yard has rehabbed her big cob. Surgery, box rest, restricted turn out, walking in hand etc.. Eighteen months and three rehab periods later the vet announced that she is as sound as she is going to get, and only 30% ever come back fully sound. She is now turned out with the herd, and probably won't be ridden again. Please ask your vet to be honest with you about the expectations, given the location and severity of the injury. Sorry to chuck a negative post in, but if you are expecting your horse to 'recover' after intervention and rehab., it can be very disheartening to remain at stage one. I truly hope this works for you.
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I totally agree - it is unethical for vets to suggest an outcome that is unlikely. I have been there before. I will not put my horse through more than 1 whole-hearted effort at rehab. If that doesn't work then long term turn away or pts will be my choice, depending on her level of comfort.
 
Birker2020 said:
You should ideally be already icing and/or cold hosing, box resting and bandaging and anti inflammatories.

It can take weeks or months, normally an initial period of box rest, followed by in hand walking and then turnout into a very small postage stamp paddock before gradually increasing the size.

If you can consult a physio they may be able to lend you some equipment, I have used long eave ultrasound very successfully on my horses in the past.

Then when you go back to riding you will need to follow a program devised between your vet and/or physio.

Good luck, I have done this heaps of times with both Bailey and suspensory branch injuries and a check ligament and once with Lari.

Why it's essential to ice immediately following a tendon/ligament injury.

This is why I think t's very good to instigate cold therapy as soon as your horse has a tendon/ligament injury. This is me going by my other user name (long story but two user names as don't have access on computer to old user name only phone). Picture 1 December 2019, around the 28th December...
forums.horseandhound.co.uk forums.horseandhound.co.uk
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Yes, icing and pain relief are on board.Bandaging was not advised and vet was happy with yard, rather than strict box rest.
 
Roasted Chestnuts said:
If my original vet had been honest at the time and told me that she would have only been light hack/broodmare sound then I will be honest I wouldn’t have rehabbed her. I would have PTS.

That vet got sacked for being rather dodgy and the head vet came out to do her last scan and said so what’s the plan now and I said to return to what we were doing before and that’s when I was told she would never return to any sort of proper work. I was devastated and seriously pissed off. Head vet was really nice and told me if I wanted to put her in foal to contact him. I toyed with the idea but then I lost my job (forced redundancy) and I had to find her a home. That was a whole other sh1t show I won’t go into as I still regret it but you live and learn the hard way.

Just make sure your vet is giving you the right options for you as I got sh@t upon from a height.
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Thank you. I will be asking very clear questions whilst understanding the variety of outcomes that can reasonably be expected. I wouldn't put my girl in foal I don't think either but would either retire/long term turn away or pts depending on the mare's level of comfort. It is devastating to think of but I need to be realistic too.
 
palo1 said:
Thank you. I will be asking very clear questions whilst understanding the variety of outcomes that can reasonably be expected. I wouldn't put my girl in foal I don't think either but would either retire/long term turn away or pts depending on the mare's level of comfort. It is devastating to think of but I need to be realistic too.
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I didn't attempt to rehab (there's other stuff wrong too). I got my own place about 4 months after diagnosis so she hasn't been ridden since - heading for 4 years. She's happy enough and compensates for her right fore by being a left banana and growing quirky shaped feet.

Because she's fat and has EMS the vets suggested light hacking but she was never a great hack and my roads are busy. I walk her out in hand and tbh she's sound enough now that I could probably get on and hack, but she'd need shoes, tack etc and was awful solo hacking so fat companion she'll remain.

My problem was the injury was probably chronic by the time we identified it. Everyone was looking at the left hind and only after that had steroids / arthramid did the right fore show up. Right fore also wasn't insured and I'd been in rehab for forever so just decided the gods were telling me something. Perhaps a better prognosis if we'd caught it early.

I hope very much that you have a better result xx
 
My (non ridden) horse had surgery on the ddft and annular ligament 7 weeks ago. Box rest and rehab has been hard, it’s time consuming, emotional and soul destroying when you just want them out in the field comfortable and being happy…

My advice to anyone in the same situation I was in- take it day by day. Things change, plans change BUT, if you’re only planning one day ahead it’s a little easier to cope with these changes.

Lots of enrichment for the horse in the stable, when you get to hand grazing stage- let them be helpful and do some weeding around the yard if appropriate to do so! Hand walking- hat and gloves! A long leadrope is a life saver and Footluce eventing on Instagram has a brilliant trick for treating the leadrope through the headcollar so they can’t stand on it when grazing.

Use your vets knowledge, don’t be worried to contact them for advice or to ask questions. That’s what they’re there for and 9/10 times they’re more than happy to help and advise!

And cry when you need to! It’s absolutely rubbish to have an injured horse especially when you’re playing the waiting game. Lean on people you have around you, if a friend is happy to stand and hold your horse so they can hand graze- let them! Sometimes that 5 minutes to just breathe is exactly what we need.

Good luck and please let us know how you get on!x
 
In some ways, and this is just from my experience, the best rehabs focus on posture and movement and lead the owner to find a joy in a whole new way of looking at their horse. Many vet and physio type rehabs (some really look at movement patterns, not many do) which focus on strengthening and a return to whatever level of work as the focus can be very hard. Changing expectations and seeing it as learning, as connection, as helping the horse simply be in the best condition they can be as time goes on, seems to work the best for both horse and rider.
 
sbloom said:
In some ways, and this is just from my experience, the best rehabs focus on posture and movement and lead the owner to find a joy in a whole new way of looking at their horse. Many vet and physio type rehabs (some really look at movement patterns, not many do) which focus on strengthening and a return to whatever level of work as the focus can be very hard. Changing expectations and seeing it as learning, as connection, as helping the horse simply be in the best condition they can be as time goes on, seems to work the best for both horse and rider.
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Yes, we have been doing work on that front previously and any rehab plan would absolutely involve postural work. I will need to find a decent physio if we can go forwards to rehab - I am not sure where to look in this area but I will ask around!

My mare is being scanned on Thursday - she is looking sound on the yard and when I take her for a pick of grass and swelling has significantly reduced (it wasn't huge to start with) and currently no heat either. I am swinging wildly between optimism and despair currently because I can't see what is going on in her leg but hopefully the scan will help. Tbh, previously I would have simply iced, rested and given bute prior to a gentle return to work at this point but given my initial vet's concern I am now very anxious. Sigh.
 
palo1 said:
Yes, we have been doing work on that front previously and any rehab plan would absolutely involve postural work. I will need to find a decent physio if we can go forwards to rehab - I am not sure where to look in this area but I will ask around!

My mare is being scanned on Thursday - she is looking sound on the yard and when I take her for a pick of grass and swelling has significantly reduced (it wasn't huge to start with) and currently no heat either. I am swinging wildly between optimism and despair currently because I can't see what is going on in her leg but hopefully the scan will help. Tbh, previously I would have simply iced, rested and given bute prior to a gentle return to work at this point but given my initial vet's concern I am now very anxious. Sigh.
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The anxiety of waiting to find out is the worst, I was besides myself thinking of all the scenarios in my head. I think as humans we automatically think the worst!

Luckily, vets and their technology&knowledge are incredible these days! They’ll help you come up with a plan that’s best for you&your horse on the day and hopefully you’ll leave the appointment feeling more confident and hopeful with a plan in place.

What area are you based for physio suggestions?x
 
DPDOT said:
The anxiety of waiting to find out is the worst, I was besides myself thinking of all the scenarios in my head. I think as humans we automatically think the worst!

Luckily, vets and their technology&knowledge are incredible these days! They’ll help you come up with a plan that’s best for you&your horse on the day and hopefully you’ll leave the appointment feeling more confident and hopeful with a plan in place.

What area are you based for physio suggestions?x
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Thank you. I feel constantly sick at the thought my sweet mare may have an irreparable injury tbh. I am on the South Wales borders/Brecon Beacons; I think my vet practice will be able to suggest physio too, if that is appropriate.
 
palo1 said:
Thank you. I feel constantly sick at the thought my sweet mare may have an irreparable injury tbh. I am on the South Wales borders/Brecon Beacons; I think my vet practice will be able to suggest physio too, if that is appropriate.
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Yes definitely ask for their recommendations, they will likely have a couple of people they work alongside already!

I’ve been through the same this year, it’s been heart wrenching and difficult but we are now coming up to 8 weeks post op and seeing my mare happily graze in her small pen is such a lovely sight.

Your horse is lucky to have you, wishing you all the best!x
 
My boy had a ddft injury 3 years ago now- his was diagnosed after MRI.
We were lucky in that we were able to send him for surgery to tidy up the mess he has made - don’t ask me for the details because I have no idea lol - he went down to a university vet hospital but mostly because of his size and concerns around the general anaesthetic. The surgeon did say she had done similar procedures at our local vet hospital but the university was a safer option for him.
He had PRP as well and about 2 weeks after surgery, we embarked on a laser therapy programme in conjunction with a chiropractic vet (qualified vet) we worked alongside for rehab. We had 10 sessions all in, the first few clustered together, with the last few spread out over a few weeks.
Our primary care vets worked closely with our chiro vet & farrier so we had a really good network of professionals working alongside us.
He was on box rest initially although the walking started two weeks after surgery - 5 mins twice a day for 2 weeks, increasing by 5 mins every 2 weeks until we hit 30 mins. I was lucky that he was a very good patient. We also saw our chiro vet regularly throughout.
We also made use of a gravel turnout pen and once the ground conditions were good, he returned to normal turnout. I did struggle with this a lot because I was so afraid he would hurt himself again.
He made a good recovery despite a very guarded prognosis, vet estimated 45% chance of returning to former work level. My other half and I agreed that we wouldn’t jump him again, but I enjoy a bit of hacking and schooling. We did get out and do a bit of dressage last year, but he ended up having some time off (unrelated) and a house move means he has had a bit of a chill few months, but he is in great form and seems very happy and sound. We have him at home now so it makes it very easy to manage him how we want (we were previously on livery).
Happy to answer any questions you might have, I know it’s a very tough situation to be in. Best wishes to you and your horse.
 
sheep said:
My boy had a ddft injury 3 years ago now- his was diagnosed after MRI.
We were lucky in that we were able to send him for surgery to tidy up the mess he has made - don’t ask me for the details because I have no idea lol - he went down to a university vet hospital but mostly because of his size and concerns around the general anaesthetic. The surgeon did say she had done similar procedures at our local vet hospital but the university was a safer option for him.
He had PRP as well and about 2 weeks after surgery, we embarked on a laser therapy programme in conjunction with a chiropractic vet (qualified vet) we worked alongside for rehab. We had 10 sessions all in, the first few clustered together, with the last few spread out over a few weeks.
Our primary care vets worked closely with our chiro vet & farrier so we had a really good network of professionals working alongside us.
He was on box rest initially although the walking started two weeks after surgery - 5 mins twice a day for 2 weeks, increasing by 5 mins every 2 weeks until we hit 30 mins. I was lucky that he was a very good patient. We also saw our chiro vet regularly throughout.
We also made use of a gravel turnout pen and once the ground conditions were good, he returned to normal turnout. I did struggle with this a lot because I was so afraid he would hurt himself again.
He made a good recovery despite a very guarded prognosis, vet estimated 45% chance of returning to former work level. My other half and I agreed that we wouldn’t jump him again, but I enjoy a bit of hacking and schooling. We did get out and do a bit of dressage last year, but he ended up having some time off (unrelated) and a house move means he has had a bit of a chill few months, but he is in great form and seems very happy and sound. We have him at home now so it makes it very easy to manage him how we want (we were previously on livery).
Happy to answer any questions you might have, I know it’s a very tough situation to be in. Best wishes to you and your horse.
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Thank you. I think once we have had scans done I will know what questions to ask! Surgery isn't a possibility for me but PRP, laser, Indiba etc may be and I would do all and any physio indicated. She is at home too but that also brings some challenges here.
 
palo1 said:
Thank you. I think once we have had scans done I will know what questions to ask! Surgery isn't a possibility for me but PRP, laser, Indiba etc may be and I would do all and any physio indicated. She is at home too but that also brings some challenges here.
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Sounds like you have good professionals around you, I found the comms between them really invaluable in coming up with a plan that everyone was subscribed to. It helped me too that the chiro vet knew him pre injury as well, sounds like your physio will be something similar.
I have to say do be prepared to question your sanity at times, it is a tough commitment. If you have someone to help you with walking etc if/when you get to that stage, it is invaluable.
If you do have any questions or need moral support at any time - just shout!
 
sheep said:
Sounds like you have good professionals around you, I found the comms between them really invaluable in coming up with a plan that everyone was subscribed to. It helped me too that the chiro vet knew him pre injury as well, sounds like your physio will be something similar.
I have to say do be prepared to question your sanity at times, it is a tough commitment. If you have someone to help you with walking etc if/when you get to that stage, it is invaluable.
If you do have any questions or need moral support at any time - just shout!
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Thank you. It will be a hard road, literally and figuratively: I will be almost entirely on my own, with 1/2 a mile of steep Stony track to navigate before we get to a road (for walk work). Alternatively we have fields, some level, leading to the open hill - definitely not level! My mare will NOT be easy though she is polite - just giddy and strong. I can apply sedatives... It is really hard to find and get regular appointments with equine professionals here too(both locally and specifically) though there are professionals I use and trust. It's not a joke that even an undertaker refused to visit. We did sort that thankfully!! We are out of the way, off the road and I guess the lack of facilities are 'difficult' for some. We have a lovely barn set up with lighting and power though! My vet will help me navigate all of this I hope.
 
They will, your vet will support you and help you find solutions as you navigate the challenges ahead. And of course the good folks of HHO are a fantastic source of support.
Keep a diary too, if you can, it helps add a bit of perspective in “look how far you’ve come” when the going gets tough.
Apparently science supplements pro kalm is quite good for general “keep the edge off” - we thankfully didn’t need to use anything.
After the hand walking had finished, we went back to the same routine but under saddle, after that it was time to start hacking. That’s when we hit a spot of bother 😂 he was unhinged lol so we sent him away to a pro for 6 weeks for hacking.
 
I had one that tore 80% of his DDFT in his foot. Prognosis was very guarded but vet also said he was the soundest horse she’d ever seen with that injury (1/10ths lame by some miracle). I was heartbroken at the time at never expected such a bad result with low grade lameness.

I doubled the amount of time suggested for box rest and then did Dr Green. I think it was 1 month complete rest, 1 month box rest with hand walking, 3 months barn rest (I prefer this to stable sized field as find that leads to outbursts) then 6 months on a flat field, a year on a hilly, undulating field. In total he was unridden for almost two years.

I think it’s really important with rehab of these to give as much time as you can, avoid bursts of energy, but also make sure as they heal they are using that tendon, so it doesn’t heal “tight”. Putting him out on a hilly field was suggested by on old horseman and it did wonders. He kept his muscle up but also used the leg, keeping that tendon flexible. Box rest and straight line work absolutely has its place in the early stages but IMO if it heals fully via these means, rarely stands up to work.

I also figured if he couldn’t come sound on a hilly field, he’d never stand up to work.

Horse was brought back into work very slowly (3 months walk, 3 months trot… etc). He was loaned after this as a hack and they loved him and bought him off me. They have had him 6 years now, hacking, low level dressage, pole work and some very small jumps. He’ll be getting on a bit but remains sound.
 
Reading with interest. Best of luck everyone.

Do any of the little devices we see at various shows - really have much benefit?
 
Mine did a 3cm hole in his SDFT. Old fashioned ice, yard/small paddock rest. The most technical we got was Ice Vibes and Arc Equine. Carefully started work. He then fell over on the road, properly Bambi on ice style floundering around, whilst long reining. He tore a hole in his elbow, and wrenched various muscles in his hind quarters. More time off, more rehab ( and lots of physio).

Finally got him ridden fit again, and concentrated on flat work for a long while, ( year or so) but he's jumping again now.
 
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