b'HIND-LIMB ENIGMASof hind-limb discomfort that might beby trotting for extended periods, doingBringing a horse back from soft tissue exacerbating SI pain), Abell says itshill work, and working in deep footing.injury involves returning him to work important to maintain the horses comfortCaruso advises owners against canteringslowly, either by hand- or tack-walking. with a good fitness regimen that allowsthese horses on the longe, however, whichMyhre stresses that bringing a horse back the gluteal muscles to develop and prop- can contribute to patella trauma. to work too quickly can be catastrophic. erly support this area of weakness. If exercise changes fail, surgical optionsOnce you overdo it, you start breaking include medial patellar ligament split- down tendon or ligament fibers, he says.Upward Fixation of the Patella ting, which involves making several smallRehabbing a soft tissue injury can be a Commonly known as a weak stifle,incisions in the medial patellar ligament.trial-and-error process. Is the lameness upward fixation of the patella (UFP) is aThis form of splitting has been shown togetting better? Is the tendon hot or still relatively prevalent condition in which aincrease the ligament diameter by two- toinflamed? If so, we may have to decrease horses hind leg gets stuck in extension.threefold over four to six weeks, in hopesexercise, says Myhre.UFP can manifest in young horses inthe stifle will stabilize, says Caruso. Your veterinarian might recommend early training, but it can also be associ- extracorporeal shock wave therapy, which ated with straight hind-limb conforma- Soft Tissue Injuries involves applying acoustic wave pulses tion or lack of proper musculature in allSoft tissue strains and tears and result- to soft tissues to improve healing. He or ages of horse.ing lameness are all too common. Onesshe might also suggest injecting biologic A horses inability to release the pas- veterinarians frequently diagnose in hindproducts such as PRP, IRAP, or stem cells sive stay apparatus (a network of mus- ends include tendinitis, suspensory liga- into core lesions to speed the healing cles, tendons, and ligaments that allowsment injuries, and degenerative suspen- process. Surgical approaches, such as a horse to stand with minimal effort) ofsory ligament desmitis. desmotomy (tendon splitting) and neu-the stifle results in upward fixation of theWhen first examining a soft tissuerectomy (cutting the nerve), might even patella, says Michael Caruso III, VMD,injury on the farm, your veterinarian willbe beneficial depending on the condi-Dipl. ACVS, owner of Reedsdale Equinelikely ultrasound the area of suspicion.tion. Proper imaging is pertinent to guide Specialists of Central Tennessee. Once you can establish the amountyour horses treatment protocol and give Treatment options range from con- of damage, then you can determine whathim the best opportunity for a successful servative to very radical. The easiestthat horse can do, says Grant Myhre,recovery.treatment option involves alterationsDVM, owner of Myhre Equine Clinic, in in your horses training to increase theRochester, New Hampshire. Take-Home Messagedevelopment of the quadriceps muscle,Rest is certainly a mainstay in treat- Hind-limb lameness can plague perfor-says Caruso. Increasing this musclesment, but it is not a cure-all. Controlledmance and backyard horses alike. Wheth-strength will effectively tighten the patel- exercise is really important, says Myhre.er the condition is sudden and acute or lar ligaments, thereby correcting upwardYou want there to be function, you wantinsidious and chronic, you have the best fixation of the patella in some horses.to have enough exercise to enhance the re- chances of diagnosing and treating it with You can help strengthen these muscleshabilitation of the soft tissue s tructures.your veterinary teams guidance.h20August 2020The Horse|TheHorse.com'