Rehab and Conditioning for Equine Athletes
Tendons and ligaments get a bad rap for not healing… in fact, they will return to full strength and allow the horse to fulfill their potential without reinjury if an appropriate rehab plan is implemented.
Rehabilitation and Conditioning.
On the one hand, you have an equine athlete who is unable to perform basic exercises, on the other you are striving towards your competitive goals.
How are these two concepts connected in a single discussion?
It’s simple. If we bring our focus to the horse when we think of our riding career, how does our mount grow with us to reach our competitive goals? It’s through constant conditioning; growing from one state to another in constant improvement.
When you think about rehabilitation, it’s really just growing from one state to another in constant improvement. Instead of the objective being competitive achievement, the goal is to reach baseline performance once more. Only from that baseline can we hope to be competitive again.
To understand effective rehabilitation is to understand effective conditioning. Without appreciating both, you may inevitably be spending more time in the former than the latter.
In equestrian sport, when we hear the word ‘rehab’ it’s inevitable that the next thought is ‘tendon’ or ‘ligament.’ I’m here to tell you that those wonderful connective tissues — tendons and ligaments — get a bad rap for not healing that they don’t deserve. In my research, I have seen firsthand the consistent return to normal strength range, allowing the horse to fulfill their athletic potential without risk of re-injury. The key here is having both an appropriate rehabilitation plan and an effective conditioning plan.
If you’ve never had a soft tissue injury, count your blessings and keep reading. The conditioning practices mentioned herein will help you keep those blessings intact, and prevent you from having to go through the rehabilitation process.
Understanding Soft Tissue
The bell rings and a clamor of metal gates cascades into a thunder of hoofbeats as twelves horses bolt down the chute to the roar of the stands. Multicolored silks of jockeys blur past and the announcer calls the race over the PA. Each horse battles for their position as instinct takes over and every fiber in their body works in unison to summon speed out of thin air. Across the tremoring ground the rumble can be felt in the hearts of every onlooker, and in observance of what seems to be the manifestation of some immense power no one dares to think that these incredible creatures are dancing on the razor’s edge with every stride.
Like the massive cables that hold up the Golden Gate Bridge, the tendons and ligaments working to conjure speed are made from many fibers, bound together for strength and flexibility. They pull and give on each hoofbeat, and at a gallop, when they pull, they pull to the very limitations of their strength. All it takes is one deep step into the dark brown surface of the track and the same creature that seemed to be born of the very wind itself will get an undeniable invitation to return to the earth.
Tendons and ligaments are the threads that bring our horses to motion, and as critical as they are to the wonder that horses provide us in movement, they are equally as vulnerable. Once more like cables on a bridge, it only takes minor damage, over time, to pluck away at the strands until what would once take a galloping misstep to injure can be ruptured at a trot.
Be Vigilant
Continuing with our analogy of the bridge, let’s say you drive across it every day for work, not questioning the integrity of the structures that keep it strong. After all, you wouldn’t really know where to look to check for damage to begin with. Even if you did, you can’t see inside the cables to see if some of their inner fibers may be damaged.
You can however place your hand on the steel and feel the heat of excess friction occurring within. You can notice the bulge of irregularity along a certain stretch of cable that should be uniform throughout.
Now consider your horse the same. Because let’s be honest, you cannot see the fibrous cables running down the length of your horse’s legs. You ride and ride, not seeing the broken strands within. But if you are vigilant, you can place your hand along the joint and feel the excess warmth. You can notice the swelling that occurs after your ride.
When you do notice something that’s off, it’s time to call in someone who can see the fibers within.
Equine Ultrasound
A veterinary expert in equine ultrasound can see the fibers that compose your horse’s tendons and ligaments. This is the best tool for getting the most detailed information on your horse’s soft tissue health. Even a small degree of abnormality seen on an ultrasound exam translates into a significant loss of strength.
While it can be easy to dismiss minor lameness in lieu of paying vet bills, both the emotional and fiscal cost of a more serious injury will far outweigh the expenses of soft tissue vigilance.
When you notice early and call in the expert, you tip the scales considerably in favor of your horse regaining their full strength within a reasonable amount of time. But even short rehabilitation requires discipline.
Soft Tissue Rehab
When it comes to soft tissue rehab, accurate diagnosis is the essential first step. It can save you time, effort, and money, by focusing on the specifics of the injury, and the care it needs. Working with a veterinarian who is an expert can save you in the long run.
Diagnosis in hand, it’s time to build out a rehabilitation program. With rehab, we have two aims in mind:
Control inflammation
Maximize healing of injured tissue back to normal strength and flexibility
Why Turnout Fails
At some point, almost every horseman has either been given or heard someone given the advice to turn their horse out to pasture and give them time to heal. This does not work.
In fact, the high occurrence of soft tissue re-injury across the United States reflects a cycle of partial healing followed by a repeat injury.
While the pain may go away, the injury itself takes 8-10 months to completely heal.
Partial healing occurs with equine athletes who are put out to pasture, even over longer terms. When they come back into work they tolerate lower level exercise before being moved into more strenuous work. Once moved into more difficult exercise the injury recurs, and we are back at square one.
The horse must experience another year of discomfort associated with their soft tissue injury.
The owner must shell out more money to cover the associate expenses.
Work with your veterinarian to build an effective program and follow it closely. It starts with controlling their inflammation.
Inflammation Control
Inflammation is swelling around the injured area and can be a constant source of pain for your equine partner. While a little inflammation is good, as it initiates healing, too much is harmful and can result in further tissue damage.
Having an effective regiment of anti-inflammatories is critical to successful rehabilitation.
Effective Anti-Inflammatories
NSAIDS
Systemic
Topical
Adequan
Glucosamine & HA
Laser
TX US
Hydrotherapy
Massage
After 3 to 4 weeks, anti-inflammatory agents are generally decreased or discontinued. This is dependent on whether there are any other health issues present, such as arthritis.
Corrective Shoeing
Corrective shoeing can play a big role in relieving pain, loading, and inflammation during the rehabilitation process. This may be as simple as balancing the feet left to right and assuring an aligned hoof/pastern axis for each foot.
In some cases, injuries can benefit from specialized support shoeing.
Hind feet are included in this as well!
Controlled Exercise
This starts on day 1 of rehab. Incorporate short walks at least twice a day. You can do this in hand or you can use an exerciser (walker) if it’s available. The duration of these walks will vary by case. Consult your veterinarian.
The key here is controlled. That means the horse is not put into a position where they are able to self exercise faster than a walk. This is why avoiding turnout during rehab is critical.
Exercise will gradually increase as healing progresses. Reassess your rehab plan with your vet at 6-8 week intervals.
The severity of the injury, age and use of the horse, and other health issues cause each rehab plan to be different.
Exercise Progression
As the hand-walking phase recedes, a typical exercise progression will work through these steps.
Walk under saddle, increasing duration
Walk and trot under saddle
Walk, trot, and canter under saddle
Turnout if desired
Training to return to competition
Returning to Trot Work
Soft tissue injuries can have many causes, often in areas of your horse’s body that are not near the injury itself. When getting back to trot work, be wary that the initial cause most likely still exists even though the injury is healing. Know the causes of soft tissue injuries and try to identify the cause of your horse’s injury before it happens again.
To learn more about the causes of soft tissue injuries, read my article on the Prevention of Tendon and Ligament Injuries.
Arthritis
Arthritis is a common condition that can cause complications during rehab, or be itself the cause of the original injury. When a horse is working in pain from arthritis, it may overload certain tendons and ligaments which can lead to soft tissue injury.
If your horse has arthritis, an effective management plan is necessary to have a successful rehab and to prevent future re-injury.
To learn more about arthritis, read my article on the Prevention and Management of Arthritis.
Here are some popular solutions for arthritis management.
Arthritis Rx
NSAID
Oral Glucosamin & HA*
Adequan
IA Injections
ECSW
Laser
Chiropractic Adjustment
Acupuncture
Supreme Top Form
*My recommended solution for Arthritis.
Rehab Success Tips
A slow feeder hay net kept filled and another horse in sight at all times goes a long way towards decreasing stress for your horse.
Note and avert such behavior as door-banging, kicking, and pacing the stall.
If management tactics fail, sedation is preferable to continuous re-injury.
The final and most important factor is the quality of the rehab program at each 6-8 week checkpoint.
As the rehab program progresses and the healing tissues gain strength, conditioning becomes incorporated into the exercise plan.
Conditioning
When beginning a new conditioning program, it’s critical to assess the body condition of the horse before designing your regiment. In terms of physical condition, the horse should have enough muscle mass and energy reserves to perform well without having excess weight to carry.
When monitoring the progress of conditioning, you need to take more into consideration than just cardiovascular fitness. Many conventional methods of tracking fitness rely heavily on cardio-respiratory response but don’t take into consideration that the musculoskeletal system develops much more slowly. This can lead to working at strain levels higher than what the tendons and ligaments are prepared for.
Most horses perform optimally when trained 4-5 days per week with alternate days off to allow for tissue response to work, repair of tissue micro-damage, and mental adaptation.
Throughout the conditioning process, monitor the fatigue of your horse and aim to finish each session with energy leftover, rather than at the point of exhaustion.
During the sessions give frequent short breaks and avoid over-repetition of specific exercises. Drilling the same exercise repeatedly can cause overstrain of the soft tissues as they don’t have an opportunity to recover mid-session.
When cross-training, avoid work that is harder than the horse’s intended athletic use.
Hill Work
There is no scientific evidence that hill work improves rate or quality of conditioning.
The risk far outweighs the reward, and this practice can be a significant source of soft tissue injuries.
So what does the research say about the effects of hill work? Working on only a 6% grade causes…
Increased strain on hind suspensory ligaments.
Increased hip joint strain.
Increased incidence of bleeding from the lungs.
Strained ligaments, joint strain, internal bleeding from the lungs — all situations that any compassionate horseman would be aiming to avoid by any means.
Hill work is not an effective way of building your horse’s stamina while also building resilience to soft-tissue injuries. It may in fact be the very cause of those injuries in the first place.
Before & After
If ever there were a practice that should be integrated into every program, it is a greater frequency and duration of walking. Both as a before-session and after-session practice, walking works wonders to protect and refresh soft tissues.
Taking 15 minutes before a training session to walk allows the tendons and ligaments to warm up. Getting the tendons and ligaments to stretch before a session makes it much less likely that they will experience ruptures at higher forces.
Walking also moves fluids around the joints, lubricating them and allowing more comfortable work for your horse.
After the session, taking 10 minutes to walk and cool your horse down metabolizes waste products that can build up within your horse’s legs during exercise. That post-ride cooldown can mean the difference between a sore horse and a sound horse for tomorrow’s ride.
In Closing
I hope that you now have a better understanding of the factors that go into effective rehabilitation and conditioning programs. If you are in need of veterinary guidance for your horse, please do not hesitate to contact me.
