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View Full Version : Rehab Plan



Lone
Dec. 28, 2009, 11:59 PM
Little bit of background-
My mare, Cadia, is a 5 year old OTTB. I purchased her in January, had a very thorough vet check with x-rays done and everything looked great. Things were perfect through spring and summer, she was doing solid training level dressage work, schooling 'smurf' and beg. novice fences, went to a few mini events and Cadia was awesome.

Quick synopsis of our fall- in early Oct she came up short on her left hind. We had our local vet look at her (didn't have a diagnosis), gave her more time off, lameness got worse, had a bigger name vet from near by city looked at her (I didn't think diagnosis was correct- and turned out I was right!), lameness got worse, and went down to Portland for a bone scan and lameness evaluation down there.

Our Findings-
- Inflammation (probably arthritis) in SI joint with lots of scar tissue
- Inflammation in both hocks
- Cyst in left fore fetlock
- Small torn meniscus in right stifle (we think this is older and probably not related to the current problems)
- Scar tissue/tearing in right shoulder bicep (again, looks older)

We injected her SI joint, lower back, hocks and fetlock. For now we aren't going to worry about the shoulder or stifle- the vet doesn't think those are currently causing problems, but we'll readdress those issues at a later date if we need to.

She got several more weeks off and is ready to go back to work around the 1st. She hasn't been ridden since the 3rd of Oct, but she's had turnout pretty much this whole time, so she's not coming off stall rest or anything.

I posted over on the dressage boards and got some great advice about exercises I can do with her once she's in work to build up her topline and back (which the vet said was super important). But I'm wondering what our schedule should look like for the first couple weeks of riding. I've rehabbed a few horses from various injuries, but it's been a while and I want to make sure I do this absolutely right. Could someone offer me some suggestions on what the first few weeks of work should look like- what we should be doing, for how long etc?

Thank you!

Peggy
Dec. 29, 2009, 12:13 AM
I highly recommend the Back to Work book by Lydia someone. It's on Amazon. Also recommend asking your vet if you haven't already.

I'd walk u/s for a couple of weeks to a month. Maybe start with 20 minutes and work to 30-40 minutes. Then start introducing trot, 5 minutes a week (with only long sides the first week) until get to 20 minutes. Then start introducing canter the same way. That will take you three months. Then I'd do a month of normal flat work with circles, lateral work, and so on before starting to jump. But YMMV and I'm not a vet.

CookiePony
Dec. 29, 2009, 09:26 AM
Ditto-- the author is Lucinda Dyer.

asterix
Dec. 29, 2009, 10:10 AM
I like Peggy's plan. I've rehabbed a lot, sadly, and that sounds about right. On the one hand, she's a young TB, so will get fit faster. On the other hand, she's probably weaker than she should be due to the cumulative effects of these injuries, and taking it slow will never hurt!

bornfreenowexpensive
Dec. 29, 2009, 10:56 AM
Hard to say with all her injuries...but walking for a month I would say is pretty conservative for a horse that has been on turn out.

Never hurts to be conservative. But since this isn't a tendon issue...I'd probably start with 15-20 minutes walking. First few times in the ring and then out hacking if you can (if the footing is good). Build up to walking 30-40 minutes over the course of one week and then start to add a little trot work in. So in two weeks you are walking 30-40 minutes and trotting 10. How much more I would do depends on how they feel. If they feel really weak...keep walking...if they feel like it is easy...slowly increase. No small circles or lateral work....make sure you are not asking her to be in a frame for any length of time. Just be gradual. But the more you can do out hacking and out of the ring, probably the better.

UNLESS you vet says it is better to keep her on level footing.

That said...I've had very bad luck with a partially torn meniscus. He had probably raced on the partial tear and my vet thought it was why he had arthritis and other issues with his hocks and hind end. It didn't end well for my boy (he fully tore it in turnout)---but his partial tear was probably worse than your mare's.

A bone cyst is also nothing to sneeze at...is it near a joint?

Good luck...I really hope she comes back fully for you!

Lone
Dec. 29, 2009, 12:36 PM
Thanks for the suggestions- I'll try and find that book on Amazon!

Yes, bornfreenowexpensive, the cyst is right near a joint. When she's just standing or walking it doesn't look like it'll cause a problem, but when the joint has to flex extra (landing from a jump, galloping, etc) the cyst rotates right into the joint. The vet didn't think that surgery would be a good option at this point. Sorry about your guy's torn meniscus. Did it ever rehab back fully?

The vet didn't specify that she needs to be on level ground- but I don't have many other options! The barn has a gravel lane I can walk down for 10ish minutes, but it's pretty flat so most of our work will be in the arena or the lane depending on weather.

When we're walking, should I be asking her to stretch, or be on basic contact at all? The vet stressed it was essential for her SI joint that we develop muscle along her back and topline. I want to start working on that as soon as it's appropriate, but of course I don't want to push things too early either.

She's *usually* very well behaved- she's a good girl. On days when she's a little extra energetic or feeling feisty I usually just put her right to work- transitions, figures, etc and she settles right down. But, that's not an option now. Any suggestions on what to do if she's feeling silly?

Fancy That
Dec. 29, 2009, 12:55 PM
Love this thread.

I'd like to hear more details on "how" they can be ridden, specifically to build up thier topline.

My mare has been out of action since August, and is now sound to ride.

I've ridden her at the walk on a little hack, but I'm wondering when I can start asking her to carry herself more correctly.

Hacking out was just "loosy goosy", not really asking for anything...just walking along w/ a buddy.

Bumping this up to get more answers on specifics regarding "how" to walk them and trot them :) as they are building up condition.

If they simply need to be ridden out to build a baseline of stamina....and THEN....ask for contact and stretchy, etc....I get it.

Just want to make sure I get this right, too.

bornfreenowexpensive
Dec. 29, 2009, 12:55 PM
No, unfortunately my guy never was 100% from the stifle.
He was ok for low level things and hacking.

I am also dealing with a bone cyst with my mare. Hers is below her coffin joint in a non surgical location. Found with an MRI. It didn't cause any issues until she was doing a lot (prelim). I'm rehabbing her now. There are a lot of things you can do with a bone cyst depending on the location. Hope it turns out well for both of us.

As for walking, I ask them for a long and low sort of frame and do put them together (in the stretchy low sort of way...not asking them to come off their forehand until they are stronger) but not all the time. When walking...we are walking with a purpose, not meandering around if that makes sense. But how much time you give them on the buckle depends on how good they are ;)

Peggy
Dec. 29, 2009, 08:08 PM
At the walk we did what bfne described in the post immediately above. That was once he was sound and we were walking for conditioning. We didn't walk with a lot of purpose when we were sauntering around b/w rechecks hoping he'd get sound. Pretty much the same at the trot, but the vet said he could definitely trot forward on the bit. It depended on how good he was being. He got a bit excited when we first cantered and had to be ridden in a somewhat upper-level-ish frame for control for a week or two.

dirtgirl
Jan. 2, 2010, 11:41 AM
Lone - I am also working on bringing back my 25 year old Han/TB gelding (annular ligament strain in front leg) and Mary Bromiley's book, "Equine Injury, Therapy and Rehabilitation" is a great resource.

To keep his mind engaged, I do a lot of change of direction and just make sure that the turns are big so as to not overstress his joints and soft tissue.

Good luck!