shock wave on horse's hind limb

Modalities ranging from PEMF to vibration plates might help manage equine injury or improve performance

Veterinarians and therapy professionals have access to many modalities designed to support equine athletes’ optimal performance, recovery, and ­rehabilitation. Similar to approaches used in humans, these equine therapies can be invaluable for improving performance and reducing recovery times.

Many treatment protocols were initially developed after extrapolation from scientifically validated use in humans. However, many unproven—and at times unhelpful or even harmful—therapies also exist. Rehabilitation and physical therapy for horses has become a popular topic with increasing treatment options and formal training, such as that provided through the American College of Veterinary Sports Medicine and Rehabilitation board-­certification program. While limited published research supports the use of some of these treatments, vets and researchers are striving to put more science behind them.

In this article we’ll focus on the supportive and noninvasive treatments being used in horses. Veterinarians typically recommend these as adjuncts to other medications and therapies. Reviewing their benefits and limitations can help you understand how they might fit into your sport horse care strategy. Work with a practitioner who is well-versed in these treatments and has thoroughly examined your horse to determine how to best manage an injury or improve performance.

Shock Wave Therapy

Veterinarians use extracorporeal shock wave therapy (ESWT) to treat a wide variety of equine injuries, primarily musculoskeletal. Shock wave describes the intense, short pulses of energy the generator creates and transmits rapidly through a probe to the desired area of treatment. While ESWT’s exact mechanism remains unknown, equine practitioners have found success with the therapy and have developed detailed protocols for managing many conditions. Common uses include treating desmitis and tendinitis (ligament and tendon injury and inflammation, respectively), osteoarthritis, muscle pain, and podotrochlosis (aka navicular syndrome), often alongside other therapies, with varying levels of effectiveness.

“I typically use shock wave and (Class IV) laser in conjunction when treating tendon or ligament injuries,” says Nathan Mitts, DVM, of Peterson Smith Equine Hospital, in Ocala, Florida. “The combined use of modalities, along with regular, thorough rechecks, leads to the best recovery and outcome.”

Some horses might need to be sedated for ESWT administration, depending on the targeted tissue, because it can cause momentary discomfort. Shock wave therapy can exert an analgesic, or pain-relieving, effect that lasts as long as four days, so rest and recovery should account for this. Its analgesic properties have also led organizations such as the United States Equestrian Federation (USEF) and the Fédération Equestre Internationale (FEI) to place restrictions on treatments prior or during competition.

Pulsed Electromagnetic Field Therapy

Pulsed electromagnetic field (PEMF) therapy involves using blankets or loops that emit electromagnetic pulses to ­different areas of the body. These pulses appear to promote healing through a variety of pathways that reduce inflammation and improve tissue repair (Gaynor et al., 2018). A single treatment might only provide a short duration of increased comfort. However, with frequency of use, PEMF might be an effective healing aid. Several PEMF products are on the market, but studies assessing their mode of action and efficacy are limited.

In a recent study (King et al., 2022), a type of PEMF known as bio-­electromagnetic energy regulation, or BEMER, improved epaxial (back muscle) pain in a small group of horses. It’s provided via a blanket or by cuffs to smaller portions of the body. Vets might recommend this Class II medical device to temporarily improve circulation, which can decrease inflammation and improve healing and

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