Tendon Injuries in Horses

Tendon injuries in horses

Tendons are made up of strands of fibrous connective tissue, which sit at either end of a muscle and attach the muscle to the skeleton. Overloading a tendon causes the fibres in the tendon to overstretch, resulting in damage or rupture. As with any injury, the body responds with inflammation. Symptoms of inflammation include heat, swelling, pain and reduced function (lameness). Tendon injuries mainly affect the flexor tendons.

Tendon injury symptoms?

The symptoms of a tendon injury consist of:

Heat in the area of the injured tendon
Swelling in the area of the injured tendon
Pain when pressing over the injured tendon
Change in structure and shape of the injured tendon
Lameness

What causes a tendon injury?

Repeated overloading of a tendon leads to small micro-injuries in the tissue, which, with continued overloading, can eventually lead to a more extensive tendon injury, or in the worst case, to the rupture of the tendon. A tendon injury can also occur acutely if the horse lands awkwardly.

There is a greater risk of an unfit horse suffering a tendon injury if it is over exercised before it is physically ready, rather than a horse who has been gradually and correctly trained for the task. Well-balanced young horse training strengthens the tendons and reduces the risk of future injury. At the same time, it is important not to overtrain the horse, as this also increases the risk of the horse suffering a tendon injury later on.

Tendons that are often affected are the superficial digital flexor tendon, the check ligaments and the deep digital flexor tendon. Different disciplines will place certain stresses on the horse, and you will commonly see specific injuries in horses used for certain disciplines.

Consequences of a tendon injury

Tendon injuries heal slowly, partly because tendons have a poor blood supply. It is therefore important to allow time for healing. A horse that has suffered a tendon injury is more likely to suffer it again, as a tendon that has been injured once will never be as durable and elastic as a healthy tendon. The more serious the injury, the greater the risk that the horse will suffer permanent damage, which can affect performance in the future. It is common for the horse to suffer chronic thickening in the injured area due to scar tissue. Another consequence is adhesions with surrounding tissues. Persistent lameness also occurs.

How is usability affected?

A tendon injury often involves a long convalescence period before the horse can be used normally again. Depending on the severity of the injury, it can take anywhere from a few months to a year, or more in some cases, for the injury to heal. Some horses never recover.

How do I prevent a tendon injury?

Tendons are a type of tissue that requires a long time to adapt to increased stress. In order to have a durable horse, it is therefore important that the young horse gets a lot of exercise, preferably in large hilly pastures, together with horses of the same age. Early training is also good, provided that the type and amount of training is adapted to the age and maturity of the horse. A horse that has been trained for its task since it was a young horse will have bones, muscles and tendons that can withstand more strain and is therefore less likely to suffer a tendon injury. However, it is important that they are not over-trained, as this can cause changes in the tendon tissue that increase the risk of tendon damage.

There are ways to reduce the risk of you horse damaging their tendons, and these include:

Increase your horse’s work load gradually, especially with unfit horses.
Turn your horse out as much as possible, preferably in large, hilly pastures with other horses.
Make use of natural obstacles in the field.
Keep young horses out in a herd as much as possible.
Avoid too much exercise on surfaces - especially avoid deep, soft surfaces.
Ensure a balanced diet.
Check your horse’s legs frequently.
Use tendon protection, such as tendon boots, if necessary.
Use studs if there is a risk of slippery surfaces.
Exercise appropriately.
Work with a good trainer who can help design an exercise programme.

Horse tendon injury treatment

A mild tendon injury does not produce obvious symptoms. A slight increase in heat and swelling in the affected tendon that quickly disappears may be the only sign. More serious injuries cause more heat, swelling and pain when pressure is applied to the injured tendon. In severe injuries, there will be significant changes in shape and texture of the tendon. It is common for the horse to become lame, but the lameness usually reduces significantly after a few days. In the case of more severe tendon injuries, the lameness risks becoming chronic.

What should I do?

Always contact a veterinarian if a tendon injury is suspected, so that the horse receives the right treatment quickly. The vet may be able to speed up the healing process by giving the horse some type of anti-inflammatory medication.

While you are waiting, cool the leg. During the first 48 hours after an injury, it is useful to cool the horse's leg. Cool 3-4 times a day, for about 20-30 minutes each time. Either with cold running water or cooling bandages. Cooling the injury reduces swelling and improves healing.

Support the leg by bandaging using a pad and stable bandage. Bandaging the leg improves healing by reducing swelling. If the horse is in a lot of pain in its injured leg, the opposite leg should also be bandaged to avoid overuse injuries in that leg. The bandages should be changed daily.

Rest the horse until it has been examined and the severity of the injury has been established.

What does the vet do?

The vet feels the affected leg to look for signs of inflammation. That is, heat, swelling, pain. The vet will also check if the horse is lame. In the case of a suspected tendon injury, the best examination method is ultrasound. Ultrasound can be used to study the suspected tendon both along the tendon and in cross-section. Ultrasound can also be used to monitor the healing process.

Many minor injuries heal well even without treatment to the tendon itself. However, the vet may recommend different treatments such as anti-inflammatory drugs or cortisone, local injections into the tendon with hyaluronic acid or stem cells, or surgery to remove the tendon tissue. This involves making longitudinal cuts in the tendon, in several places. The aim is to increase the blood supply to the area and thereby promote healing. Shock wave therapy is also commonly used.

To support the injured tendon, the vet will usually recommend different types of support bandages. The aim of the treatment is to reduce the inflammation as quickly as possible to minimise the formation of scar tissue, thereby increasing the chances of good healing and recovery.

Rehabilitation and aftercare

Tendon injuries heal slowly. To achieve the best possible healing, it is important to follow your veterinarian's advice on how to treat and train your horse. As soon as it is possible given the injury, the horse should start moving under controlled conditions, on a hard, even surface. This can be done by walking the horse, putting it in a walker, or riding the horse at a walk. Gradually, the training intensity is increased. By monitoring the injury with repeated ultrasound scans, it is possible to check that the healing is progressing properly and that the level of exercise is being increased at an appropriate rate. It is important to avoid re-aggravating the injury, as any further injury will result in less healing.

It is important to be patient with tendon injuries and not to start training the horse too quickly.