My (successful) experience with rehabbing a hind suspensory is that patience is the most important virtue. My vet (Reynolds Cowles, Blue Ridge) gave us a program that made a lot of sense. After the requisite stall rest period (6 weeks?) and small turnout (another 6 weeks) when we did start work it was so....incremental. It did "jive" with a program that I saw on CoTH but basically it was: start with walking each direction 2 minutes each direction. Incremental increase 2 minutes each week until you are up to 20 minutes. Then the trot starts, with the same incremental increase - maintaining the same walking regime. So 10 minutes walking will start and end each ride with the incremental trot sessions in between. By the time we were cantering, we were walking 10 - trotting 20 walking 10 minutes. He said the walking at the end was as important as the walking at the beginning. During the stall rest/limited turn out we did do shock wave therapy. She was sound after about a year. Good Luck!
Right hind suspensory (twice). Both times occurred from my horse being silly out in the field. The first time as a 6 year old, lots of patience and love with stall rest, handwalking, and then slowly bringing her back over 9 months. Then she had a reinjury 3 years later (this spring). This time I took her in for a PRP injection and it did wonders, I would recommend this to anyone!! Even the vet couldn't believe how quickly the tear healed. But we still took it slow bringing her back, 6 months later and we're starting to canter long sides a few times a week. My vet gave me this great article about suspensory injuries in horses in different desciplines. They had different treatments and were brought back to work at different paces and looked at how successful the horses riding careers were afterwards. In all cases the most important factor was TIME bringing the horse back to work. It's so difficult, especially when they start to feel really good again but be patient, it will be so worth it in the end. Good luck!
Ugh! How to decide what is best to do?? My mare has a small lesion on her RF, no hole - seems pretty minor but the ultrasound shows there might have been a previous injury (vet says it is probably from her racing days and may even have gone undiagnosed.) She's on stall rest and we are doing 3 shock wave treatments (one every 2 weeks) and I assume will re-ultrasound and evaluate after the treatments are done and figure out how to proceed from there. He's saying probably 6 months off total. My trainer thinks vet is being too conservative and we can move faster. Her feet are good according to the farrier. I don't want to make a mistake and rush but if we can get back to work sooner, I'd certainly be open to that idea. She's lame on palpation but otherwise sound and bored. Juxtapoze - how did you decide who is the "best" for leg issues? My vet is very experienced but hes's pretty much the only game in town here locally. I'd have to go to Ocala for a better quality second opinion...
I suggest we start a new drinking game, take a shot each time you hear of a new therapy/regimen!
Seriously, it is so different in every case. Fronts are different than hind. New injury vs. old. old horse/young horse. They're all different, therefore different therapies.
So given this set of facts, is there a real, live rush to having your horse back 3 months earlier? 6 months earlier?
So given the fact that you hopefully have 5-10-20 more years ahead of training, feeding, care, would someone be wise to go slowly to preserve the horse? No one has the secret key to the lock. No one knows the time. If you rush it and find you were wrong, best wishes to you and your trainer who pushed you to go faster.
No one knows and thats the best thing you'll know.
My aged pony had a pasture accident when he was 18 and strained a suspensory. Ultrasound showed plenty of prior wear and tear from half a lifetime as a barrel racer. He did 9 months of stall rest with Surpass and wrapping. Slow rehab and came back 100% sound to the level he was doing pre-injury (2'0 jumps). Stayed sound for 2 more years until he was retired for a wholly independent reason (too old for adults/needed a weight limit, no kids left to ride). Still sound out in pasture at age 23.
@aleg: my trainer also pushed me to bring my horse back quickly this summer. As much as our trainers love their students and horses, this is their business. I got the impression that my trainer was disappointed that I wasn't showing (as was I!) and was missing out on my show fees and money from lessons. Do what your vet says, they know what's best! You cannot rush these things.
I have posted several times on this subject and went into detail of treatments tired and rehab. My experience has only be with TB flat and steeplechase horses. Long and short, IMO every horse will respond differently no matter the treatment and rehab. One thing’s for sure IMO and experience any soft tissue injury especially suspensory and bows to a lesser extent require a lot of time at least a year. Depending on the severity. For me even a minor suspensory tear I will give at least 6 months before going back into a work routine. IMO soft tissue issues are a PIA to really know when enough time has been given. So IMO more time is ALWAYS better then less. Patients pays off most of the time. The but patients is expensive when you are paying board and only have one horse to work with.
Advise to those who ask for feed back with suspensory and bows. Give details, size, measured in CM, location, etc. of what an ultrasound revealed that was performed by a specialist not a general practitioner. No disrespect to general practitioners but they just don’t have the trained eye and experience of a Vet that specializes in doing nothing but ultrasound diagnoses who then works with the “treating” vet. This only adds a bit more on to the over all cost of treatment.
There are several “treatments” on the market, Stem cell and there are different types, PRP (platelet rich plasma) injection, and tendon/ligament splitting that I know of. None have been proven conclusively to hang your hopes on for full and complete recovery with no worries for the future. Stem cell is the most expensive and my research indicated that it does not merit the expense at this time. I feel PRP at a cost of around $1000 is worth the money because it has proven to provide a better quality of healing. Proscribed stall rest and a lot of hand walking. Though the specialists we have worked with feel there is nothing wrong with “ride walking” aided by some Ace depending on the horse. We ultrasound about 3 months after treatment to see how things look and then decide on a rehab program of walk, trot, canter. When things look good after several months of riding rehab we turn out 24-7 for another 6 months at least. It all comes down to the quality of the healing, amount of scarring and location of the injury. Though I have not used Hyperbaric Chamber treatment my research and conversations with those that have suggests that it is most worthy of the expense.
IMO suspensory injuries don’t just happen in a field there is always preexisting issues going on somewhere that were overlooked or not picked up on by the rider. But even the best can and will miss something. It is not an exact science. We beat ourselves up pretty good when these things happen. I am a firm believer in the expense of routine ultra sounding just to make sure.
Unless it was an extreme tear, which is rare, most if not all will be able to go back to work. A very good chance at the same level. IMO there is no such thing as a full recovery from this sort of injury and any vet that tells you there is offering up false hope. But IMO they will only have so many bullets left in the chamber before re-injury in the same leg or somewhere else do to favoring the injured leg. I took a chance on a beautiful Dynaformer gelding that did his suspensory on the flat at 3. Got him just short of his 5 birthday and trained him for Steeplechasing. This horse was the real deal over Timber. Competed at the very top and would be in the record books if it weren’t for “shite happens”. He still had recurring suspensory issues as to be expected. He was 2 from home in the Virginia Gold Cup a couple of years ago on top by as many as 40 lengths jock pulled him up having felt him getting short. Bowed in his “good” leg. Both look as good as to be expected now and may race again time will tell but is fine for hunting and showing. A good friend of mine trained a horse that did both hind suspensory and was told the horse could never race again. He did and won the Maryland Hunt Cup.
Of course this is all my opinion use what you want throw out what you don’t.
My Jr/AO Jumper had a swollen suspensory injury in her left hind leg that wouldn't heal for 2 years.
I used this rehab program (that was recommended to me by the daughter of the soft tissue specialist of UPenn) and stuck to it with fantastic results! She came back 100% and continued on competing with me until she was sold and is currently competing successfully with another Junior.