In the world of equine competition, one of the most common injuries we face is injury to the tendons. As an owner, rider and competitor, you are probably already familiar with the position of the horse’s tendon behind the cannon bone, and probably already implement measures to help protect them in your training and daily routine. Measures such as hosing down the legs after work and wearing boots during jumping, lunging or conditioning training sessions are all considered part of good horsemanship.
Taking it a step further
There are in fact many tendons within the horse’s body and limbs, and any one of them can become injured. The most commonly affected tendon is in the front leg and is the one you feel when you run your hand down the back of the cannon bone. However, injuries can occur to tendons elsewhere, and will all heal in different ways and at different speeds.
More important than knowing where all of these tendons are and what they do is knowing how they become injured. Tendon injuries can occur in one of two ways – through trauma, or through repetitive strain.
Causes of injury
Trauma can occur when the tendon is suddenly severely overstretched, such as during a bad landing from a jump or during a fall, or when an external object such as a fence rail, the hind hoof, or basically anything (we know how horses injure themselves on ‘air’ sometimes!) collides with the tendon with force.
Repetitive strain is by far the more common cause of injury to the tendons. Tendons are said to have a small safety margin, because they have a limited ability to cope with strain. The amount of stretch placed on the tendons during galloping, for example, is very close to the amount of stretch or strain where damage to the fibres of the tendons occur.
That’s not a really great concept to contemplate, I know! But being aware of it will help you prevent injury to your horse’s tendons.
Protecting horses from repetitive strain is certainly possible through correct, progressive training programmes. We need to allow the horse time to rest between high-intensity workdays and to vary the workload – for example we can include flatwork, in-hand work and hacks into the training routine between jumping and galloping sessions. This variation allows you to progressively increase the strain placed on the tendons so that they can cope with the work you require your horse to do, without allowing repetitive strain to accumulate in the tendons, which leads to an injury.
Good management will also help. Cool the tendons after high-intensity exercise sessions through icing or hosing down, to prevent any heat from building up in them. Heat is not a friend to your horse’s tendons!
Signs of injury
Being aware of the signs of injury is essential – injuries can be much subtler than we think. As with all things injury related, the sooner we intervene, the more successful the outcome. Look out for these signs:
- Lameness. Even a very mild lameness that resolves after a few days can indicate a tendon injury. Many horses remain sound even when there is significant damage to the tendon.
- Swelling or thickening of the tendon. This can be very noticeable or very subtle. It is good practice to run your hands down your horse’s leg as they stand, and with the hoof held off the ground, to feel through the tendons of the lower leg for any swelling or thickening.
- Heat anywhere along the length of the tendons is a sure-fire warning sign. Feel for heat when you are feeling for swelling.
- You may also find pain as you are running your hands over the tendon.
- In the event of a severe trauma, you may see the fetlock dropped to the ground. This means the tendon has been completely cut through and is unable to support the leg at all.
As you can see, these signs can be easily missed if we are not paying close attention to our athletes. Any lameness should throw up warning signs for you, even when it is short lived, and should be cause for medical intervention to determine the cause of the lameness and the extent of the damage done.
If a tendon is mildly strained and the horse returns to work because the lameness appears to be resolved, there is a huge risk of severely injuring the tendon.
You can easily feel through the legs to look for heat, swelling or pain when you are tacking up and picking out hooves, as well as when you hose down the legs. Make this a part of your everyday routine to ensure you find the signs as early and as quickly as possible.
Unfortunately, tendon injuries don’t heal quickly, or well for that matter, and require careful management. Your Vet and Vetrehabber will work together to formulate a treatment plan for your horse, depending on the tendon affected and the degree of damage present in the tendon.
To start with, they will want to reduce inflammation and pain. Your horse will probably be put on anti-inflammatory pain medication, and you will need to do some cold hosing and apply pressure bandages to the legs on a daily basis.
Exercise management is the most important aspect of healing and recovery – the tendon must be protected and allowed time to heal, while at the same time being incrementally more stressed to ensure the fibres in the tendon heal well. This will probably mean strict stall rest with a hand-walking programme that progresses slowly over time.
Other treatment options may be available, and it is best to speak to your Vet and Vetrehabber about these alternative options.
What to expect
The thing that makes tendon injuries so hard to deal with is the time it takes for them to recover. Generally speaking, you are looking at a 9- to 12-month recovery period, with regular ultrasound scans to measure the progression of healing, and regular adjustments and monitoring of the exercise programme to ensure the progression of the programme is carefully matched to the progression of healing.
An additional challenging factor is that tendon fibre just does not heal very well. The healed tissue is almost always more rigid and less able to take strain than the tissue around it, which leads to a weak point in the tendon. Once a horse has sustained an injury, there is always a risk of re-injury and the area needs to be carefully monitored as the horse returns to competition.
Some tendon injuries carry a very poor prognosis for a return to function – but not all. Working closely together with your Vet, Vetrehabber, farrier and trainer will help you get the best possible outcome for your horse!
Prevention is better than cure – by adjusting a few things in your routine, you can give your horse the best chance at preventing injury.
- Use cross training to allow the body (not just the tendons) to recover from high- intensity exercise sessions.
- Use your hands and consciously feel through the legs as you groom and clean out the hooves every day.
- Cool the legs down after high-intensity exercise sessions.
- Don’t ignore any signs of lameness – seek medical attention!
And yes, although it is a hard road, these injuries can and do heal. Work with your team of professionals, stay patient and consistent, and you will see your equine athlete return to fine form.