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Rehabbing/Reducing Scar Tissue in Chronic Muscle Injury?

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    Rehabbing/Reducing Scar Tissue in Chronic Muscle Injury?

    After almost 1.5 years of trying to figure out what was causing my horse her significant back/SI area discomfort and "weak" left hind, we have concluded (as much as we can without having the technology to image that area), that she has significant scar tissue from an old injury to her psoas and groin region. Nothing showed on her bone scan, x-rays were "clean", and the trans rectal ultrasound results were the only findings that coincided with her physical symptoms. Massage, chiro and acupuncture has only provided temporary relief. Unfortunately, the damage is too deep to reach for injections, massage, shockwave, mesotherapy, therapeutic ultrasound, etc. Had I been informed of the casting incident that occurred in turnout, I would have immediately seeked the help she needed and given her time to heal, but unfortunately, she did not get that. I feel so awful that she has been in pain and just want to focus on getting her to heal as much as she can, although I am sure the damage is done. It was suggested that she get 4-6 months of just stall at night/paddock during day, with no hand walking, to give her time to heal. We are going to do a few treatments of shockwave therapy to help reduce some of the outward muscle pain that she has. Previcox has not been helping so we are putting her on a therapeutic treatment of bute. My acupuncturist now has more guidelines that she can follow to try and encourage some healing and releasing of tension, we are also consulting with a herbologist. The prognosis is not the greatest and at this point, her recovery is up in the air. She is such a lovely mare and I not only want her to be pain-free, but if there is any chance to get her back under saddle comfortably, I want to give it to her.

    Does anybody have experience rehabbing or trying to reduce old damaged muscle that was in this area? Do you think that allowing 4-6 months of rest will cause more issues with the scar tissue and continued tightening/shortening of the muscle? Any thoughts on what I can try or what you have used successfully? Supplements? Injections? Any advice would be greatly appreciated.
    Last edited by bojolove; Jun. 11, 2013, 05:46 PM.

    This sounds very similar to what I am dealing with. I have a horse that was (finally) diagnosed with ligament damage in the SI area. Basically, on the right side of her SI ligament, she just has scar tissue where normal fibers should be. The vet said that it was an old injury that never healed correctly and just filled in with scar tissue. The bone scan was normal and there was no bony involvement. My vet was very confident that this old scar tissue will heal and remodel if I follow his plan.

    The plan he gave me was that she have 8 weeks on stall rest with 1 grams bute 2X per day. She could be handwalked 2-5 times per day on straight, hard, flat surfaces (for 5-20 minutes per walk). I also ice the SI area for 30 minutes a day (using a sheet with a "baggie" sewn into to hold a gel pack in it).

    Our 8 week check-up is this Friday (yay!!!) He said that the next phase will be under saddle rehab work to build up her core muscles to support the SI ligament. She will still be on stall rest. The riding plan will have me working (eventually) up to riding her for an hour. Once he feels that she has built up her support muscles enough, then I think we will talk about turning her out again. He hasn't told me how long it will be before she can be turned out (I don't think he wants to depress me!)

    He told me that the entire healing/rehab process for this type of injury will take 6 months.


      Original Poster

      Thank you! Your post is very encouraging. My vet originally said that in an "ideal world" I would have her on stall rest with controlled movement, hand walking, etc. but we are not sure she could handle that and if she is quiet in her paddock (which she is), he thought that would be fine. I should ask about the ice! I wonder if that could penetrate down that far?


        My vet said that she could be turned out in a really small paddock (like 14 X 16 or something), unfortunately, where I board, there are stalls and big pastures (no small runs). The big thing is to keep her in a space where she can't build up to any speed. She has had several rodeo sessions IN her stall (and I told him that) but he still said that it's okay.

        As far as icing goes--I suspect the bute is helping more with the inflammation than the icing. We also know where the problem is so we know where to ice. It sounds like your vet hasn't found exactly where your horses injury site is.


          Original Poster

          Thank you slp2!


            Hey BojoLove--I thought I'd give you an update on the rehab plan recommended after I had my recheck appointment. Might help you with your horse. After 8 weeks of stall rest, the change in the ultrasound was pretty amazing--the area that was fluid filled/inflammed scar tissue already started forming regular ligament fibers. So, now we we are cleared to start rehab work under saddle.

            She is still on stall rest full time. The vet is having me walk for 30 minutes a day in circles--spiral in and spiral out, both directions. We can also continue our hand walking/ or walking under saddle on hard surfaces/straight lines. After a session--I am supposed to ice the area for 30 minutes. We do that for a month and then we will start trotting. Same thing--on circles--spiral in and out. We are supposed to build up to an hour of walking / trotting (mostly on spiral work). Then we have another recheck and start on canter work. I don't think she will be able to be turned out for several more months. But it was encouraging to see the progress that was made on stall rest.