Horse owners and veterinarians are on a perpetual quest to heal horses’ injuries faster, better, and stronger. Veterinary technology has advanced over the years to provide us with more options to do just that. One relatively recent modality is extracorporeal shock wave therapy (ESWT), a noninvasive procedure that uses sound waves to stimulate blood flow and tissue healing. But is it superior to traditional treatments when it comes to healing tendon and ligament injuries?

At the 2015 American Association of Equine Practitioners’ Convention, held Dec. 5-9 in Las Vegas, Amy Norvall, DVM, presented recent study results suggesting that focused ESWT helps horses return to function from hind-limb proximal suspensory desmopathy (PSD) faster than surgery or rest. Norvall, now a resident at the University of California, Davis, School of Veterinary Medicine, completed the study when she was based at Virginia Equine Imaging, in The Plains, Virginia, along with Susan Johns, DVM, and Kent Allen, DVM.

Horses with PSD have inflammation and tissue damage in the upper part of the suspensory ligament, a structure that connects to the top back of the cannon bone, divides into two branches which attach to the proximal sesamoid bones, and lies under the superficial and deep digital flexor tendons and the check ligament. Traditional treatment approaches generally involve an extended, expensive period of confinement or inactivity. Surgeons also treat PSD with procedures such as neurectomy of the deep branch of the lateral plantar nerve (cutting or transecting the nerve) and fasciotomy (ligament splitting) or desmoplasty (a procedure in which numerous small longitudinal stab incisions are made in the ligament).