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A simple guide to rehab a horse coming from tendon injury. 
Written by Alberto Rullan on Oct. 15th 2022
in this article, i will give you a step-by-step guide on what to do with your horse after it has been treated for a tendon injury. 
After reviewing hundreds of recoveries at Equine Performance Innovative Center (EPIC), we have used the following technique to properly recover a tendon or ligament injury.  Ideally, you will start this rehabilitation procedure after your horse has received regenerative therapies such as stem cells, amnion, prp or any other form of equine regenerative therapy. 

For centuries, horse people have been searching for the "one-shot" approach to rehabilitation and recovery.  This has not been discovered yet. However, every day we have more data and science on how to get horses back to battle faster and more efficiently than ten even 5 years ago. 

The age of let's wait and see what happens is probably about to be extinct.  We welcome the new age of let's make it happen.  Therefore, this is how we make it happen. 

The first thing I need to explain to you is that it takes a range of 7 to 15 days for these treatments to arrive where they need to be and begin their magic.  Then after those days, the repair will continue to happen. Expecting a sound horse before the product can biologically make an effect on the horse can lead to frustrations and desperate decisions.  Once the product arrives and starts the repair, then the horse will gradually start feeling better. 

The second most important fact, and perhaps this should be equally important, is the understanding that every lameness in the horse has a biomechanical part. What does this mean? In simple terms, it means we need to work with a very good farrier or blacksmith in order to relieve the pressures and tensions that are causing or aggravating the lameness.  Your farrier-veterinarian-trainer team will join forces and determine what is the best biomechanic arrangement for your horse. 

Now, then most sought question is : How long until exercise? 

If your horse has been treated due to a tendon injury or ligament injury, then the following applies. 

First month of rehabilitation

  • Stall rest for 24 to 48 hrs (give antinflamatories if directed by your veterinarian) 
  • ​Followed by hand walk 10 to 15 minutes a day,
  • Daily stretching exercises 4 weeks
  • ​Every 4 weeks, there has to be an ultrasound evaluation in order to measure progress and increased exercise. 

Second month of rehabilitation

  • Walking 20 to 25 minutes a day. Straight line or very large circles (100 feet diameter preferred)
  • Underwater treadmill 3 to 4 times a week if available. 
  • Standing wraps (no sweat) every day while in stall
  • ​shock wave every 7 to 10 days
  • ​Ultrasound evaluation at day 60
Here is the tricky part of the first 2 months after your horse has received treatment. Remember I told you that every lameness has a biomechanical reason? Now its a critical part because we will start seeing other areas of the horse that need balancing as well.

In another article I will talk to you about chiropractic work, acupuncture, physiotherapy, magna wave, underwater treadmill and more.  

Third month of rehabilitation

  • Walking 30 to 45 minutes a day, 5 to 6 days per week. In this part of the rehab you can do smaller circle diameter if you need to, such as 50 to 75 feet. 
  • Underwater treadmill 3 to 4 times a week if available. 
  • ​Allow small pasture turn out 1 to 2 hours a day assuming the horse will will stay quiet. 
  • Standing wraps (no sweat) every day while in stall
  • ​shock wave every 7 to 10 days
  • ​Ultrasound evaluation at day 90 - Ultrasound will determine what will be the next step in the rehabilitation process. 
  • ​If horse is sound, lameness locator can be used to identify other sources of lameness
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About PEVS
Performance Equine Veterinary Services was founded in 2009 with the mission to provide the best available treatments to the horse with the best customer service available for the horse owner. 

About Author: Alberto Rullan

Dr. Rullan graduated from the University of Pennsylvania, School of Veterinary Medicine in 2006. Dr. Rullan did a one-year equine medicine and surgery internship at Louisiana State University Veterinary Teaching Hospital and Clinic where he obtained advanced training in diagnostic and therapeutic techniques in equine medicine and surgery.
Dr. Alberto Rullan co-founded Performance Equine Veterinary Services with his brother William in 2009.
In 2017, Dr. Rullan founded Equine Performance Innovative Center. EPIC is a comprehensive Equine Rehabilitation Facility in Ocala, FL and unique in its class. 
One of his favorites quotes is : "Work hard, achieve the impossible"
If you want to know more about Dr Rullan click here

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