The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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48 TheHorse.com THE HORSE December 2017 the best outcome," says Denton. "I ask clients to be proactive. Palpate for heat and swelling. Don't mask problems with anti-inflammatories and keep working; it could go from a mild strain to a tear, caus- ing the joint to become more inflamed and do more damage to the cartilage." Healing Phase Protocols Once diagnosed, treatment and rehabil- itation can begin. Assemble a knowledge- able veterinary and management team that can tailor a plan to address your spe- cific situation. "In the limbs, we're wor- ried about tendon, ligament, bones, hoof capsule, and fascia (connective tissue that surrounds muscles and muscle groups), which … is still poorly understood," says Schlachter. As a very general rule, Denton and Schlachter adopt the following big- picture rehabilitation approaches for treating each of these areas. Soft tissue While in the acute phase, one to three weeks post-injury, Denton recommends rest with the goal of halting inflammation, including icing the injury, bandaging, and administering anti- inflammatories. Denton says it takes 10 to 15 minutes of ice application to lower the temperature to an effective level, but warns against overdoing it. Total icing time should take 20 to 30 minutes. Once the inflammation settles, usually around Week 3, the healing phase begins, which, he says, is an ideal time to target the area with various therapies. He uses regenerative medicine, shock wave, or ultrasound, followed by underwater treadmill sessions to reintroduce work while reducing the load on the affected tendon or ligament. Ligament injuries, says Schlachter, make up the bulk of limb insults she sees in her practice, where she treats primarily middle-aged sport horses. "The vast ma- jority of ligament injuries respond really well to a course of controlled exercise," she says. "The next thing I would go to is shock wave, and the third direction I would go to is regenerative medicine." Schlachter says tendon injuries require a different approach. "Tendon injuries tend to heal faster and better than liga- ment injuries," she says. Her gamut of therapies for these injuries runs from platelet-rich plasma (PRP) injections and laser to shock wave and functional electrical stimulation (FES). She says she uses PRP to deliver a high concentration of platelets in the form of blood plasma to a lesion, increasing the amount of growth factors at the site to help the injury heal, and applies cold laser to treat edema (flu- id swelling) and inflammation. Schlachter finds shock wave useful for chronic issues, particularly those with scar tissue, and she employs FES and therapeutic ultrasound for re-injuries or old tendon injuries that aren't acutely inflamed. 1351 WEST HIGHWAY 56 • OLATHE, KANSAS 66061 • 913-390-6184 • CENTAURANIMALHEALTH.COM SPORTS MEDICINE The vast majority of ligament injuries respond really well to a course of controlled exercise." DR. CARRIE SCHLACHTER