b'AAEP FORUM ERIN DENNEY-JONES, DVMTheHorse.com/AAEP-ForumTreating Soft Tissue InjuriesT he 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 anklehe 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 de-termines its severity, he or she might then recommend a specific treatment protocol using conventional as well as other treat-ment modalities. One part of conventional treatment is limiting the patients exercisewhat 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 dont understand how to take it easy. Another conventional treatment is controlling inflammation using cold therapy such as ice or cold hosing, as well as wrap-ping 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. COURTESY DR. ERIN DENNEY-JONESOther 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 thera-py, therapeutic ultrasound, and electrical stimulation. Your veterinarian would offer the first three of these treat-ment modalities as a service:1.Shockwave therapy is a noninvasive anti-inflammatoryElectrical stimulation might reactivate and/or stimulate muscles and can treatment that uses a pain-free pulse wave to help decreasebe used in conjunction with therapeutic ultrasound.inflammation naturally. For soft tissue injuries, your veteri-narian will likely administer it every 10 days to two weeks aslaser used but can be as often as twice weekly. an initial therapy.2.Therapeutic ultrasound, used at a low frequency, helps reduce 2. Platelet-rich plasma (PRP) therapy involves taking bloodinflammation while enabling healthy tissue to regenerate for from the horse, concentrating it to supply anti-inflammatoryhealing. proteins, then administering the blood plasma at the injury3.Electrical stimulation reactivates muscles and tendons and site. Veterinarians usually perform PRP early in the healingcan be used in conjunction with therapeutic ultrasound. Vet-process.erinarians typically perform both these therapies two to three 3.Stem cell therapy involves injecting cultured fat or bone mar- times a week initially, then less frequently depending on the row stem cells into the area of injury to potentially enhancehealing process.the regeneration of tendon or ligament cells rather than scarHorses generally tolerate these treatments well and dont need tissue.to be sedated.Veterinarians typically perform these treatments while theYour veterinarian can advise you on treatment options and horse is sedated. guide you and your horse through the healing process. He or she Your veterinarian or a nearby physical therapist or rehabilita- will determine when and how often to use certain treatments tion facility might offer the latter three modalities:based upon examinations and re-examinations of your horse. 1. Laser treatments might encourage localized healing bySoft tissue injuries are best seen soon after they occur, and strict increasing blood flow to the injured area and decreasingadherence to treatment protocols will give your horse the best inflammation. Treatment frequency depends on the type ofchance at a positive outcome.hAmerican Association of Equine Practitioners, 4033 Iron Works Parkway, Lexington, KY40511859/233-0147www.aaep.org10November 2019The Horse|TheHorse.comAAEPForum_Nov USE.indd 10 9/27/19 8:51 AM'