Treating Soft Tissue Injuries in Horses
The steps for helping tendon and ligament injuries heal are simple but time-consuming. Think of a human athlete who pulls a hamstring or sprains an ankle—he or she will be out of the game for quite some time to heal. Your horse is an athlete, as well, and the repair process will take months.

After your veterinarian diagnoses a soft tissue injury and determines its severity, he or she might then recommend a specific treatment protocol using conventional as well as other treatment modalities. One part of conventional treatment is limiting the patient’s exercise—what we call controlled exercise. This typically involves hand-walking the horse on a firm surface with stall rest between walking sessions. The reason we prescribe this tedious process is because horses don’t understand how to “take it easy.”

Another conventional treatment is controlling inflammation using cold therapy such as ice or cold hosing, as well as wrapping the injured area to reduce swelling. If you suspect your horse has a soft tissue injury, you can start these treatments before your veterinarian arrives.

Other therapeutic modalities can enhance and possibly speed up soft tissue injury recovery when used in conjunction with conventional treatments. These include shockwave therapy, platelet-rich plasma injections, stem cell injections, laser therapy, therapeutic ultrasound, and electrical stimulation.

Your veterinarian would offer the first three of these treatment modalities as a service:

  1. Shockwave therapy is a noninvasive anti-inflammatory treatment that uses a pain-free pulse wave to help decrease inflammation naturally. For soft tissue injuries, your veterinarian will likely administer it every 10 days to two weeks as an initial therapy.
  2. Platelet-rich plasma (PRP) therapy involves taking blood from the horse, concentrating it to supply anti-inflammatory proteins, then administering the blood plasma at the injury site. Veterinarians usually perform PRP early in the healing process.
  3. Stem cell therapy involves injecting cultured fat or bone marrow stem cells into the area of injury to potentially enhance the regeneration of tendon or ligament cells rather than scar tissue.

Veterinarians typically perform these treatments while the horse is sedated.

Your veterinarian or a nearby physical therapist or rehabilitation facility might offer the latter three modalities:

  1. Laser treatments might encourage localized healing by increasing blood flow to the injured area and decreasing inflammation. Treatment frequency depends on the type of laser used but can be as often as twice weekly.
  2. Therapeutic ultrasound, used at a low frequency, helps reduce inflammation while enabling healthy tissue to regenerate for healing.
  3. Electrical stimulation reactivates muscles and tendons and can be used in conjunction with therapeutic ultrasound. Veterinarians typically perform both these therapies two to three times a week initially, then less frequently depending on the healing process.

Horses generally tolerate these treatments well and don’t need to be sedated.

Your veterinarian can advise you on treatment options and guide you and your horse through the healing process. He or she will determine when and how often to use certain treatments based upon examinations and re-examinations of your horse. Soft tissue injuries are best seen soon after they occur, and strict adherence to treatment protocols will give your horse the best chance at a positive outcome.