The Journey Back

How three equine athletes returned from injury to the show ring

At some point in your horse care journey, you’ve likely ridden a beautiful round, brought your horse in from turnout, or unloaded him from the trailer and realized something was “off.” Maybe it was a lame step or the slightest bit of swelling but, either way, it prompted a call to your veterinarian. If you were lucky, the root cause was something minor that would resolve with time off and anti-inflammatories. With the more challenging cases, however, you and your veterinarian might have pursued further diagnostics to determine the cause.

After reaching a diagnosis and settling on a treatment plan, you began the arduous process of healing and rehabilitation. This stage can be trying for even the most patient equestrian. But, with a good equine care team and some time, it can be smooth and fruitful.

To see what effective rehabilitation looks like, we found three real-life examples of equine athletes that made full recoveries from their injuries. We’ll share each one’s diagnostic challenges, rehab modalities, and recovery details.

Chanel

Chanel, a 10-year-old Quarter Horse mare competing in Western pleasure, had been struggling for years with a nagging intermittent left front lameness. Her owner and veterinarian managed this with routine coffin joint corticosteroid injections for about two years. However, the injections ultimately proved to be ineffective at keeping Chanel completely sound and comfortable, so she was referred to Carrie Schlachter, VMD, Dipl. ACVSMR, who founded and designed Circle Oak Equine Sports Medicine’s rehabilitation and fitness programs and also founded Animals In Motion, a practice that focuses on integrative sports medicine, rehabilitation, and injury prevention.

“The case was pretty routine,” says Schlachter. “We nerve-blocked (used local anesthesia to numb and pinpoint the painful area) her foot, then we X rayed the area, and the X rays showed some mild abnormality in her coffin bone. We recommended an MRI so we could look at the area more deeply.”

The MRI showed that Chanel actually had two injuries to her left front foot. “The first was mild coffin bone bruising and remodeling in the area we had been looking at radiographically,” Schlachter says. “But, on the opposite side of the foot, she also had a collateral ligament injury.” Collateral ligaments are located on either side of most joints.

This was the “aha!” moment, she says: “Without the MRI I wouldn’t have known about the collateral ligament injury so, because the owners were willing to do the MRI, I was not only able to confirm my diagnosis of the bone bruising and remodeling but I was also able to see the reason for it.”

Chanel had likely been compensating for the collateral ligament injury by bearing more weight on one side of her foot, creating the bruising in the coffin bone. The injections helped initially because they suffused the area with steroids, reducing inflammation and allowing her to continue working soundly for a brief period.

With a diagnosis in place, Schlachter recommended putting Chanel in a bar shoe to support and stabilize the collateral ligament and the coffin bone. She and her team also injected the coffin joint and the collateral ligament with autologous protein solution (a biologic therapy that stimulates the body’s production of anti-inflammatory mediators and growth factors) and treated the area with extracorporeal shock wave therapy (believed to improve new blood vessel growth, recruit mesenchymal stem cells, and have pain relieving effects).

Schlachter also recommended for Chanel a controlled exercise program, which she modifies to meet the needs of different injuries and disciplines but typically involves:

  • Eight weeks of stall rest with handwalking multiple times each day;
  • Eight weeks of walking under saddle;
  • Eight weeks of walking and trotting under saddle;
  • Six to eight weeks of walk-trot-canter (or lope, as it were) under saddle with sport-specific additions (such as jumps) added at the end of this stage.

Two months post-diagnosis, Schlachter reevaluated Chanel. “At that point she was 80-90% better, so we allowed her to be walked under saddle for the next two months,” she says. “When we looked at her again at the four-month mark, she was 100% sound, so we started her on some trot work.”

Once she was sound at the canter, Chanel began working back into training. Eight months post-diagnosis she was still sound and back in the show ring. She is now free of bar shoes, and her only maintenance since recovering has been a round of hock and sacroiliac joint injections to manage normal wear and tear.

“Chanel was a wonderful patient,” Schlachter says. ”She is the picture perfect example of what a good diagnosis, good treatment, compliant owners, and a well-behaved horse can do.”

JR

Melissa King, DVM, PhD, Dipl. ACVSMR, is an associate professor at the Colorado State University (CSU) Veterinary Teaching Hospital, in Fort Collins, where she specializes in equine sports medicine and rehabilitation. King treated JR, a 16-year-old Thoroughbred who had shown as a four-star eventer. From repetitive use in his job, JR developed an insertional lesion in his deep digital flexor tendon (DDFT, which runs from the knee down the back of the leg and around the navicular bone, attaching to the coffin bone) and a second, discrete tear at the pastern level. This article continues in the August 2020 issue of The Horse: Your Guide to Equine Health Care. Subscribe now and get an immediate download of the issue to continue reading. Current magazine subscribers can access the digital edition here.

The Horse, August 2020


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