Tendon Strains

HarryEvery horse rider knows rabbit holes are a major nuisance, but for Harry the Clydesdale they caused huge problems after he landed in one with his off fore. 

The hole had been well covered so it was not noticed until he stumbled, over-extending his heel as his foot hit the hole.  Depending on the angle in which the pastern (or other joint) is stretched or twisted, there are several structures that such an accident can damageIn Harry’s case the sudden excess strain down the back of the flexor tendons injured the deeper of these two important structures.  This caused Harry to become noticeably lame and prompted his owner Liz to call veterinarian Dr Kara Watson to come out and investigate.

Kara performed a tendon scan with Franklin Vets’ portable ultrasound machine.  A large number of disrupted fibres (not lying in a straight orderly manner) were seen in the deep flexor tendon and Harry had fluid around the deeper suspensory ligament indicating there was a lot of inflammation.  This was diagnosed as a serious tendon strain.

For tendons to heal with correct fibre alignment and minimal scar tissue (which reduces elasticity of the area), it is crucial that patients be kept in a confined space with a strict controlled exercise regime to balance both resting the injury and preventing the area tightening up too much.  Harry’s regime involved living in a very small yard, which was gradually extended in size after six weeks.  He began doing light controlled in-hand exercise four weeks after the injury, building from 10 minutes to 45 minutes daily over eight weeks.  In the early stages he also received cold therapy and topical anti-inflammatories followed by light therapy (which helps healing and reduces fluid). 
After six weeks, a repeat ultrasound was performed to monitor healing.  The news was positive, with a reduction in fluid and swelling.  The tendon fibres were beginning to look normal, with less disruption.  Harry continued on his controlled exercise plan, and he was now able to be ridden at a walk on flat ground for 30 minutes twice a day. 

At the four month mark, another ultrasound was done.  This scan showed excellent healing with minimal scar tissue and the fibres nearly normal, although the damaged tendon was still larger than normal.  It was time for Harry to hit the hills. 

Harry As it was now the thick of winter, Harry stopped being ridden and was turned out into a nice hilly paddock to get some exercise and extra movement in the tendon.  By six months, the tendon was almost completely back to normal and Harry could start doing what he loved most – going for trail rides with his Liz.
Tendon injuries are frustrating because they have a long rehabilitation and need absolute commitment from the owner.  Harry was lucky to have Liz who dedicated herself to his treatment regime, aiding him to recover in the shortest possible time.  Just like Harry, any horse out exercising is at risk of serious tendon injuries, not just race horses, and it may even happen during paddock turn out.  Call the vet as soon as you are worried about a lameness or abnormality over a tendon.  By catching it early you could prevent scarring and long term performance-limiting damage to the structures involved, as well as getting your horse back on track much sooner.