Or, how I got a horse with two bum legs to the Grand Prix level.
I figured that I would write a bit about my experiences and all I've learned in my time with Rico's injuries. I'm in LA right now and won't be around horses until next week! So prepare for some unconventional blog posts.
This is going to be long so feel free to skip parts or just ignore it all together.
DISCLAIMER: I am
not a vet. If you think your horse has a soft tissue injury, you should call your vet and talk to
them. Trust your vet, don't trust this blog. This is information I have gathered and it's biased because I'm not a vet and only have my personal experiences to base this off of, rather than years and years of experience with many varied cases and horses.
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Rico and I earning my USDF Gold medal 4 years after I chose
to retire him for good because of his tendon problems |
Rico's History
Over the course of about three years, Rico was diagnosed with three soft tissue injuries. First was the suspensory ligament strain in his right front in 2009, which I got help rehabbing by a barn that specialized in rehab. Next was the lesion in his deep digital flexor tendon in his right front in 2010, which he had surgery on and I rehabbed myself. Finally was the check ligament strain in his left front in early 2012 that I also rehabbed myself. He has also suffered collateral ligament damage in both front feet (which rehabbed at the same time as the DDFT) and has two splints, one on each front leg (which were both short rehabs).
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| Rico in the AquaPacer at his suspensory rehab |
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| DDFT rehab- LOVE this hose contraption |
The Structures
We can refer to a lot of things when we say "soft tissue" but in this post, I'm referring to specifically tendon and ligament injuries. These are the shitty long-rehab slow-recovery injuries that suck to find on your horse. Learn more about them
here.
Tendons typically connect muscles to bone. They are basically the structures that allow your horse's muscles to move your horse's bones. Very important. The main tendons of the lower legs that like to get injured are the Deep Digital Flexor Tendon (aka DDFT, runs from the DDF muscle to the coffin joint down the back of the leg) and the Superficial Flexor Tendon (aka SFFT, runs from the SFF muscle, wraps around the DDFT, and then splits into two and attaches to the short pastern bone).
Ligaments typically connect bone to bone, or tendon to bone, or tendon to tendon. For example, when I say collateral ligaments in Rico's feet, I mean the ligaments connecting his coffin joints together. The ligaments you will most likely hear of getting injured are the Check ligament (typically the anterior check which is lower in the leg and connects the DDFT to the cannon bone) and the Suspensory ligament (originates in the back of the knee/cannon bone, runs parallel with the tendons, then splits into two around the fetlock joint and joins the CDET in the front of the leg).
Tendon/ligament damage takes a while to heal because the horse doesn't get much blood flow down their legs and the way they get this limited blood flow is by walking. What do we
NOT want our rehab horses doing? Moving very much. What do the structures need to heal? Blood (well, the stuff blood carries in it to repair tendons/ligaments). How do horses get blood to their lower legs? Moving. Damnit, right?!
The reason why horses need to move (and why some of them get stocked up when they don't) to get their blood pumping is because the digital cushion (frog and area above the frog) is actually full of capillaries. Gravity helps bring the blood down into the capillaries, and the pressure from walking squeezes the capillaries shut, shooting the blood back toward the horse's heart.
How Injuries Occur
What do you mean my horse doesn't have tendons and ligaments made of steel? Typically these injuries occur when there is a combination of the following:
Overuse
IMO the easiest way to injure your horse is to work the shit out of them when they aren't fit enough. Remember that tendons attach muscle to bone. When the muscles get tired, more strain is placed on the tendons, which are a lot less stretchy and harder to heal than muscles are. You can overuse a horse by simply not keeping them fit enough and pushing them one day, not giving them enough breaks in their work, or even just riding them too much too fast.
Footing
Bad footing isn't great for tendons. People always bash deep footing (I'll go over why deep footing isn't bad later), but the worst is uneven footing by far. You know the feeling when you think there are no more stairs left and suddenly you fall down them? Tendon injury.
Conformation
Sometimes horses just have shitty conformation and this leaves them prone to injury. Long toes, long sloping pasterns, and low heels are tendon injuries waiting to happen. I just described my horse's front legs. Gah!
The Diagnosis
Rico's check swelled like CRAZY when he hurt himself. His DDFT looked like a windpuff. His suspensory looked like a splint. I had a client's horse with a SFFT tear and it looked just a bit thick. They don't always look the same. They also aren't always lame. Rico was NEVER lame when he had a tendon injury. My client's horse was slightly off only every couple of steps.
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| Check ligament- HUGE for such a tiny ligament |
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| From the front |
A lot of people see a swelling and play the waiting game- a few days off, bute, rest, try to bring them back, kinda sound, then bad again, so rest, bute... I can't do that (see above- Rico was never lame, it freaked me out too much). When something is wrong, the vet is immediately out to diagnose. It's not to say that waiting isn't a good thing to do. I've known people to wait a bit, slowly rehab themselves, guessing at the time line, and have the horse, and their bank account, be totally fine.
But for the sake of this blog post, I recommend calling the vet. Before they come out though, you want to reduce swelling. Ultrasounds (which is what is typically used to diagnose tendon/ligament damage like what we're talking about) don't read well through swelling so you should take a day or two to try to get the swelling down if it blows up. For Rico, I used NSAIDs, cold hosing, and wrapping. Under the wraps was usually a poultice or a sweat wrap. After a day or two, the swelling went down and the vet was able to ultrasound.
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| Cold hosing was Rico's favorite, obviously |
Once you have a diagnosis, you'll feel shitty. I did. It was a relief knowing what it was but at the same time a heaviness not knowing whether he'd ever be okay. He was. But the paranoia was always there and remains there to this day.
The Rehabilitation
I consider myself a pretty decent rehabilitator. If you're interested in getting a rehab schedule from me, shoot me an email (regentanzer at gmail).
My philosophy is "double it" when it comes to rehab. The vet says you can canter in three weeks? Double it. The vet says you should give the horse four weeks of hand walking? Double it. Yes this means that rehab is LONG and arduous, but I've never regretted taking my time. And Rico has never had a reinjury.
The vet will recommend how to go about rehab and you should listen to them because they're qualified and I'm not.
But here is my advice:
- Always break work into sets with rests in between (think interval training). If the vet says to trot for five minutes, start with 30 second sets of trotting with 1 minute rest in between and do that ten times.
- Slowly combine your sets. Say you want to work up from your 10 x 30second trot sets (5 min total) to fewer sets. First start doing maybe 7-8 x 45 second trot sets. Then do 5-6 x 1 minute trot sets. Then 4 x 1.5 minute trot sets. Then 3 x 2 minute trot sets. Then 2 x 2.5 minute trot sets. All the while adjusting your breaks in between. Using this example, around the 4 x 1.5 minute sets, I'd add two more sets to make it 6 x 1.5, then two more for 8, then start reducing again, then add sets again.
- Walk a lot. When Rico was in rehab, I did a 20 minute warm up and cool down before and after the ride in addition to quite a bit of walking during rest. Remember that overuse can cause problems. Walking is very important- it allows the horse to rest AND helps pump blood to those structures in the legs.
- Speaking of walking, talk to your vet about how large an area your horse is allowed to have. One of the key things for Rico was that he was always in a large flat paddock with excellent footing. However, I trust Rico not to run around very much, some horses may need to be in a box stall to prevent them from reinjuring themselves.
- Speaking of footing, make sure your arena footing is excellent at least while your horse is rehabbing.
- LOTS of straight lines, no lateral work, and no abrupt transitions for quite some time. Certain movements are harder on the tendons than others- anything sideways (including small circles), anything that throws a horse on the forehand, and anything extended should be avoided.
The Paranoia
Yes, you will feel incredibly paranoid. No, the feeling will not go away. It does, however, get easier. There are a few things I've found that you can do to reduce your paranoia/want to wrap your horse up in bubble wrap.
- Memorize your horse's legs. If I was a sculptor, I could sculpt Rico's legs from memory. I know what they look like when it has been cold out, when it's warm, when he hasn't moved around (I can actually look at his legs and know how much he's been moving). I know without a doubt that I can see when something isn't right.
- Know that the leg won't necessarily look the same after the injury. It might puff up a bit, it might look funny (Rico's check ligament, although all fibers are parallel and healed, is perpetually ever-so-slightly swollen). That doesn't always mean a reinjury.
- If the legs look funny or you feel like the horse isn't quite right, trust your gut. For me, I would always walk a LOT that day. Then, reduce sets by at least half the next day and evaluate soundness.
Prevention
Upon recovery, my biggest goal was always to prevent a re-injury or a new injury.
First, I changed Rico's shoes. You can't change conformation, but you can change shoeing if your farrier or vet thinks it will help. Foot x-rays are excellent to determine what needs to be done shoeing-wise. Rico has long toes and low heels so he was put on a 3 week shoeing cycle in front. To grow his heels, we put frog support pads, which took the pressure off the heel and onto the frog to allow the heels ample room to grow. To keep him from breaking over too late, he was given rocker shoes which brought the breakover back a bit.
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| Frog support pads every 3 weeks wasn't cheap... |
Then, I always kept Rico very fit. Rico was always a lot fitter than necessary for the level we were doing. He was on an eventing-like conditioning schedule through the Grand Prix level. Every ride was well documented so that I could see if I was slacking on time being ridden and then slowly bring him back. He never got more than a day off in a row, and when he did, I backed him off for a couple days to recoup.
Finally, I made sure that, at least when I could control it, the footing was perfect. A bit deep was how I prefered to keep it at home. I never wanted to visit a facility and think "ooo this is deep" because deep footing can strain tendons. I primarily tried to avoid footing that changed depth. Too deep wasn't a problem because of my footing at home, too shallow and I would avoid medium trot. But uneven meant that he'd be going along like normal and step in a too-deep spot without realizing it and it's like thinking that you're done walking down stairs when there is really another step. That's a good way to wrench a tendon.
Overall
Many horses come back from injuries easily and go on to do very well. The biggest thing IMO is taking your time to do it right. Hopefully this didn't help anyone and that no horse ever injures anything ever again.
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| Such a good horse, so worth the trouble we went through |
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