Tendon injury question

[HorseMaid]

Friends horse has damaged a tendon, scan showed a hole across 75% of it (foreleg, I'm not sure which tendon). There's a bit of a disagreement on the rehab plan, so I wanted to ask what the "norm" is for length of time on box rest, adding in walking etc?

 

[Season’s Bleatings]

I think the rehab period is up to 9-12 months from injury.

My horse was injured in late March, although not properly diagnosed (MRI) until June. He had surgery at end of June, started (in hand) walking two weeks after that. Initially 5 mins twice daily, now up to 30 mins twice daily and likely to stay at that until December; we will review again with his surgeon then.

 

[Abacus]

I haven't had a tendon injury for ages (thank goodness) but a while ago vets seemed to say 6 weeks, although it may depend on the extent of the damage. Sounds bonkers to me, I think it's at least 6 months until I would trust that it is really healed. I'm not a box rest and walking fan though, I would do a small paddock and not even look at it for months... this may be against vet advice and I am absolutely not recommending it... it's just what I'd do.

 

[Birker2020]

Friends horse has damaged a tendon, scan showed a hole across 75% of it (foreleg, I'm not sure which tendon). There's a bit of a disagreement on the rehab plan, so I wanted to ask what the "norm" is for length of time on box rest, adding in walking etc?

It depends on which tendon or if its a tendon branch.

My previous horse did her suspensory branch and in the end received PRP. We were onto a much quicker and more successful outcome because of the extensive early ice therapy, bandaging and anti inflammatories from the outset and this was followed with a controlled exercise programme. She was also out in a small paddock a lot quicker than recommended due to other conditions which meant that extensive box rest wasn't really in her best interests.

She also did, many years later her check ligament and this had much quicker healing than the predicted 9 months for her due to early ice therapy and LW ultrasound therapy which she received daily.

Can you friend consult a physio who will lend her some equipment to help assist?

 

[ILuvCowparsely]

My mare was in for 6 months box rest, no turnout till 5 1/2 months, walking in hand 5 mins twice a day after 2 weeks strict box rest. After as lot of research I came across this article
https://rainlandfarm.com/tendons-and-ligaments-structure-and-injury/
and this one


she was back out in the field 6 months later

https://thehorse.com/154472/collagen-shown-more-effective-for-arthritic-horses/,

So collagen was the key, I did more googling and found this company Pharma Horse in Netherlands who were the only ones I found that did a horse powder collagen,https://www.pharmahorse.co.uk/collagen-horse.html

I bought some, told my vet, and on the first scan after the injury ( 6 weeks) she said I am pleasantly suppressed there is more healing starting Than I would have expected.

THIS happened on every scan vet was amazed by the healing progress.




Now I have my other mare who has damaged her DDFT and collateral due to her navicular shoes( what was done). Not had our first scan yet since RVC but she has been on collagen since diagnosed, and I can really see the difference in her comfort level. she was 5/10 lame before.


I will be keeping her on it till she has the all clear. #

Lovely company quick shipping, regular emails of order progress. 10/10 for this collagen

 

[Season’s Bleatings]

Ahh yes just to add some context my fella injured his DDFT and the bulk of the damage was within the foot. He’s also had PRP and laser on top of the walking, as well as remedial shoeing- currently in a 3 degree wedge, which the surgeon wants to slowly wean him off. We’ve also had a vet chiro on hand (by vet chiro, she is a vet) who has seen him regularly. It’s intense!

 

[Birker2020]

Ahh yes just to add some context my fella injured his DDFT and the bulk of the damage was within the foot. He’s also had PRP and laser on top of the walking, as well as remedial shoeing- currently in a 3 degree wedge, which the surgeon wants to slowly wean him off. We’ve also had a vet chiro on hand (by vet chiro, she is a vet) who has seen him regularly. It’s intense!

I imagine it is intense for you, its quite a long period of box rest for that kind of injury. PRP was very effective for mine. I also had remedial shoeing.

 

[Season’s Bleatings]

I imagine it is intense for you, its quite a long period of box rest for that kind of injury. PRP was very effective for mine. I also had remedial shoeing.

It is, but in fairness to the horse - he has been a fantastic patient. So it has probably been as “easy” as it could be, just time consuming. He has his moments but has been incredibly civil (touch wood). Thank goodness he’s been well behaved, cos he’s a solid 17hh ISH and I’m only about 5ft 2 ?

 

[BBP]

My yearling had an 80% rupture but it was hindlimb and above the hock. He did 10 weeks of small pen rest (size of 2-3 stables) then into a 10x10m space. Then I gradually increase it to field turnout in company by end month 5. I didn’t hand walk at all. Probably not the right way, and as he’s only 2 now he gets another year or 2 before he even has to think about whether it will repair well enough to be ridden, so that takes a lot of pressure off.

 

[huskydamage]

It took about a year for my horse, from injury to ridden again. I never had her on box rest, she was 24 and that would have killed her off! I put her in small pens in the field, it was a load of faff moving the electric all the time (they got muddy v quickly) and i used to hand walk her and ice cup it. A lot of work but paid off in the end. Vet wasnt sure at the time she would ever fully recover from it, so were really pleased with how it healed. I never went back to the same amount of riding as before (we used to do endurance) but only really because she is old I think shes earned a quieter life, I dont want to risk it getting re injured. She is still happy to charge about out hacking.

 

[ILuvCowparsely]

My connie mare is now on her 8th week box rest, and 1 short period in a tiny cordoned off area.

I will book her first scan in about 2 weeks time. She has tried to bounce in the stable so must be feeling better. Her DDFT is severely damaged by the dental stuff, I have videoed her progress for MEO.

She has not needed sedating like my other mare, she has been really good

 

[Gamebird]

Friends horse has damaged a tendon, scan showed a hole across 75% of it (foreleg, I'm not sure which tendon). There's a bit of a disagreement on the rehab plan, so I wanted to ask what the "norm" is for length of time on box rest, adding in walking etc?

Honestly there are so many variables that there isn't a norm that people can give you. It depends a lot on which tendon, where on the leg, degree of lameness, what the scan looks like, the age, temperament and job of the horse, the facilities and skill of the rehabber. I would take all of these variables into account before formulating a rehab plan. For instance yesterday I scanned a 3yo racehorse with a small SDFT tear. It will have quite a different plan to the same injury in a 16yo riding club horse. We do tend to get them walking earlier now than we used to, but the key is controlled exercise.

I would suggest your friend goes with the plan suggested by the person who scanned it. If they really disagree with that vet, then have a conversation with them about their concerns (I often change plans if for example the horse won't do box rest, or is going to be dangerous to walk in hand). If they still have a disagreement, then get a second opinion from another vet. Two plans can be quite different without one being necessarily right and another being necessarily wrong.

 

[Elf On A Shelf]

The general consensus in racing is 3 months box rest, 3 months walking, 3 months turnout, 3 months training, race at the end of a year.

Though this is changing and some vets think that 2 weeks box rest before walling to stimulate the tendon. But it will be a year before you expect to be in 100% work.

SDFT is easier to fix than DDFT. 75% is a hefty hole so the horse may not return to the work it did before.

 

[Abacus]

A vet recently told me that recent thinking is that after the initial period of cooling treatments to reduce the inflammation, it is better to keep damaged tendons and ligaments warm. They heal quicker at body temperature (the temperature at which all bodily processes function best) and icing beyond that initial period can slow down healing. I don't have any research but it would make sense.

 

[Birker2020]

I and i used to hand walk her and ice cup it.

Ooh I've never met anyone who has ice cupped before, clearly you have the same physio/vet as me!

 

[Birker2020]

A vet recently told me that recent thinking is that after the initial period of cooling treatments to reduce the inflammation, it is better to keep damaged tendons and ligaments warm. They heal quicker at body temperature (the temperature at which all bodily processes function best) and icing beyond that initial period can slow down healing. I don't have any research but it would make sense.

Gosh I didn't know that, thanks for letting me know. I've iced for weeks on end, a mixture of ice cupping, ice vibe boots and cold hosing. Oops

 

[Hormonal Filly]

Depends if it’s DDFT or SDFT..

SDFT field injury, big hole when scanned. 8 weeks box rest with me hosing twice a day for the first 2 weeks until swelling had gone. Scan showed a big improvement already. Followed by short small turnout but he couldn’t contain himself and jumped out.. so sadly stayed in another 3 months but was allowed to be walked inhand and then ridden. He coped really well. Totally unphased by it all.

Rescan at 6 months showed almost fully healed and I paid to scan again at 12 months (he had been in full work for a few months) which showed fully healed and couldn’t actually see where he had tore it. 2 years on, been in full work (jumping, dressage) and no issues.

 

[Abacus]

Gosh I didn't know that, thanks for letting me know. I've iced for weeks on end, a mixture of ice cupping, ice vibe boots and cold hosing. Oops

Please do check it, look for research, ask a vet. A very good trusted vet told me; I mentally filed it as useful information but haven't needed to make sure.

 

[Birker2020]

Please do check it, look for research, ask a vet. A very good trusted vet told me; I mentally filed it as useful information but haven't needed to make sure.

Well it was many years ago now so the information has no doubt been updated.
Its like a lot of things, apparently there are better things than PRP and chemical arthrodesis now as well, yet I swore by those previously lol

 

[Abacus]

Not horse related but:

https://www.sportsmedicineoregon.co...eat-sprains-strains-and-other-sports-injuries

"The RICE method is useful immediately following a sprain or strain and can also help with swelling or sharp pain following rigorous activity or exercise. Heat is often best for tight muscles, sore muscles, as well as the stiffness and pain associated with arthritis. Heat can also be used following an acute injury to increase blood flow once the swelling has subsided. Remember, though, that applying heat too soon following an acute injury can increase swelling. After sustaining a sudden injury, ice therapy should be used for the first 24 to 72 hours and, after that, individuals can transition to heat therapy in order to increase blood flow to the area."

 

[Birker2020]

Not horse related but:

https://www.sportsmedicineoregon.co...eat-sprains-strains-and-other-sports-injuries

"The RICE method is useful immediately following a sprain or strain and can also help with swelling or sharp pain following rigorous activity or exercise. Heat is often best for tight muscles, sore muscles, as well as the stiffness and pain associated with arthritis. Heat can also be used following an acute injury to increase blood flow once the swelling has subsided. Remember, though, that applying heat too soon following an acute injury can increase swelling. After sustaining a sudden injury, ice therapy should be used for the first 24 to 72 hours and, after that, individuals can transition to heat therapy in order to increase blood flow to the area."

Yes that's right now I think about it, my human physio told me to use cold therapy initially and then after a few days to use one of those hot bean bag things you heat in the microwave when I hurt my SI being thrown off Lari.

 

[HorseMaid]

Thanks for the replies, I know there are a lot of variables, I don't know which tendon it actually is (I don't think my friend does either), she has an area of swelling halfway down the cannon bone at the back of her foreleg, no heat now but still not sound. Friend isn't an experienced owner at all and doesn't know anything about rehab, and the vet hasn't given a rehab plan although she has been asking for one. I've never dealt with a tendon injury myself either but feel strongly my friend needs to get the best advice to have the best chance of mare coming sound.

I have encouraged her to get a second opinion as the basic advice from the vet was (I kid you not) "10 days box rest then start walking out in hand or ridden", which just doesn't sound right to me for an injury such as this. Added to this, this isn't a horse and rider combination who like to go slowly and her way of going (very up down/stompy) isn't the best either. Friend thinks me and other friend are being overly negative but I don't think she understands the gravity of it all. It's a very frustrating situation.

 

[Elf On A Shelf]

Sounds like an SDFT. I would get a second opinion. If you have a vet near you that works in or has previously worked in racing yards they will know exactly what they are doing. If not get the opinion and drop a racing yard an email asking what they normally do. Honestly most will reply and be helpful. It's something we deal with all the time. Each yard does things differently but the general time scale and theme of things is the same.

The current vet sounds a bit useless in these matters.

 

[AmyMay]

I don't think she understands the gravity of it all. It's a very frustrating situation.

I think all you can do in situations like this is to give your advice, and then leave well alone.

 

[HorseMaid]

Tricky as there is literally 3 of us that share a yard together so I can't really get away from the situation!

 

[AmyMay]

Tricky as there is literally 3 of us that share a yard together so I can't really get away from the situation!

Well, yes. But that doesn’t mean you have to get involved with the horse’s treatment.