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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51 December 2017 THE HORSE TheHorse.com period, Denton says he increases move- ment slowly. "I generally have a three- month slow back-to-work program for ligament and tendon injuries," he says. "This includes tack-walking, adding trot sets, and then canter sets over three months, increasing the trot and canter sets, always starting and ending with walk. At the end of that three-month buildup, they are usually easily able to handle 15 to 30 minutes of walking, 15 minutes of trot, and 15 minutes of canter. Once they can do that, they go back into their discipline work, easing in and slowly increasing that type of work, as well." For joint recovery Denton follows the same three-month schedule, while also including ground poles to improve range of motion and client-performed flexion and extension physical therapy exercises. He also places horses on the submerged treadmill to rebuild muscle without con- cussing the joint, particularly after sur- gery or a major injury. For each session he recommends first applying heat to loosen and limber the joint and icing the joint afterward to reduce inflammation. Schlachter says with acute soft-tissue injuries, she waits until the injury is past the inflammatory phase to begin rehabilitation —approximately 30 days. In the case of proximal hind suspensory injuries she waits about 45 to 60 days, because she finds the increased range of motion and extended caudal phase of the hind-limb stride cause this injury to persist. Citing her own experience, Schlachter says chronic soft-tissue cases, on the other hand, might respond well to the underwater treadmill and shock wave therapy. "For mild tendon injuries, you're generally looking at six months until back in full work, longer for more severe inju- ries," she says. "A ligament injury, on the other hand, may be eight to nine months unless severe, in which case it's a year and a half to two years. The exception to the tendon rule would be the deep digital flexor tendon, which may take a year and a half to two years. A lot these cases are chronic, but can come back with enough time to decrease inflammation and in- crease the tensile strength of tendon." Be Proactive, Remain Hopeful Don't hesitate to call your veterinarian when you realize something isn't right. "The best chance to correct a lameness is in the acute phase," says Denton. "If you notice something is wrong with your horse, don't wait. We can come up with a therapeutic plan and rehabilitation. Overall we see more improvement when we use modalities than when we don't." Have faith in the process, and work closely with a good veterinary team. And, says Schlachter, "Be patient. It's always two steps forward and one step back." h I generally have a three-month slow back- to-work program for ligament and tendon injuries." DR. STEPHEN DENTON