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Managing Stifle Issues


As any horse owner who has dealt with them can attest to, stifle issues can be tough to diagnose, treat, and manage. In the blog below, I’ll share my top tips for what has helped my horse Luna stay comfortable and healthy over the years. As with any health issue, I highly recommend working closely with your veterinarian to develop a program tailored for your individual horse.

My mare Luna was diagnosed with upward fixation of the patella (UFP) or “sticky stifles” about 4 years ago. UFP is a mechanical issue in which the patellar ligaments can get caught on the notch of the stifle, causing the leg to “lock” in position. While UFP is considered an incurable condition, there are several management techniques that may help to minimize locking up.

  1. As much turnout as possible
    For Luna, constant movement is critically important to helping her stay comfortable (and happy). She does best on 24/7 turnout, where the constant, gentle movement helps keep her from stiffening up. Even if 24/7 turnout is not possible, increasing your horse’s time outside as much as possible may be beneficial.
  2. Balanced hoof care
    Luna has benefited from adding hind shoes, and while not all horses will require this, making sure the hind hooves are well-balanced is important to ensure proper breakover. Working closely with your hoof care professional to find the right shoeing or trimming techniques can result in significant improvement.
  3. Consistent work schedule
    Horses with UFP tend to do well on a very consistent work schedule that emphasizes fitness and keeps them moving. I’ve found that Luna thrives on an every-other-day work schedule and gets stiff if she is not worked for 3 or more days. Developing and maintaining a baseline fitness level has helped her UFP to improve significantly, and I can’t stress the importance of this enough. Unfortunately horses with this condition don’t seem to do well when given long breaks or time off, so try to avoid this if possible.
  4. Specific exercises
    There are several exercises that can be done to help strengthen the muscles around the stifle joint, which can help take the stress off those ligaments and result in decreased fixation of the stifle. The most common one is backing up, which is often recommended to include daily. Another common recommendation is to include hill work, if possible. Going up and down hills regularly is especially beneficial for strengthening stifles. If hills aren’t accessible in your area, you can also use cavaletti or raised poles to encourage your horse to lift and strengthen the stifles.
  5. Joint supplement
    While UFP is primarily a mechanical issue, it can cause additional stress on the hocks and stifle joints. For this reason, I support Luna with SmartFlex III Resilience Pellets to help keep her joints, tendons and ligaments healthy. She loves the testy pellets and I have peace of mind knowing I’m providing key ingredients to support joint health.
    I hope you found these tips helpful! Please share your favorite tips for managing stifle issues in the comments below, and have a great ride!
Posted in Health & Nutrition

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13 comments on “Managing Stifle Issues
  1. Valerie says:

    Our mare has a bit of arthritis in her left stifle. She does great on one injection a month of Pentaussie to keep her joint lubricated and top shape. It is pricey but I would recommend it over such other products like Adequan.
    Another exercise on top of what you suggested is to walk over a hay bale. It can be done in hand. The benefit in using those rather than a cavaletti is that the horse has to stretch across a lot longer to reach the other side. Key being he has to walk over it and not jump it!
    Glad she has you as a caring owner. 🙂

  2. Gayle Wright says:

    Thank you so much for this information. I have a 4 y/o that has locking stifles and this info is helpful.

  3. laurie goldstein says:

    my horse maddie had a double tear in her right rear stiffle. It was devistating but maddie made a full recovery thanks to her amazing vets. She had arthoscopic surgery to clean up the area and stem cell treatments(which she later had a reaction to-not good) she was off for about 1 1/2 years. Maddie is back to full work walk trot canter lead changes and jumping small cross rail 2 foot vertical and her favorite mini oxers. Maddie was recommended cortizone injections when needed for swelling bute for pain when needed(although never has been) adequan injections and Cosequin ASU. She is 21 and thriving. She is a favorite at the barn and we are all greatfull for her

    • Justine says:

      How was the vet that you used for surgery? My 17 yr. old had orthoscopic surgery on a meniscus tear and they couldn’t get to the tear, plus we did stem cell treatment, and he didn’t recover. He is still lame and can only be ridden for pleasure. Wish I could fix him and have him go back to Dressage again. Can you please give me the vet/surgeon’s name? I am thinking about a second opinion.

      • laurie goldstein says:

        sure it was dr sullivan and west coast equine and my vet is brad dygert at Progressive equine. Maddie is amazing and she wasnt ready to not work. I think some of it is personality driven she is way to stubborn. But we had a great result and the follow up care of the adequan, cortizone shots and cosequin ASU have made the difference. She still has all 4 straight steel shoes on as well. BTW i’m in california

      • aallegre says:

        Justine- I know I commented this below, but ask your vet about cold laser therapy. I used it for my dog’s ACL repair recovery and have also been using it on my horse’s stifle to great effect, as discussed below. You don’t actually need a vet to do it- you can order the laser directly- for the benefits it provides, it quickly pays for itself. It’s non-invasive, pain-free, promotes fibroblast activity and is just another (very handy) tool in the arsenal. I recently used the laser to work on a horse with a ligament injury who was looking at the end of his career- he went from completely lame to completely sound in 2 months using the laser three times a week.

      • Adip says:

        Miniature donkeys? Do you have a pnteitg zoo???? What else do you have? Baby Elephants? Llamas? If so is that why you were obsessed with them a while back (green lava vs green llama)? Am I just tripping by myself?

  4. laurie goldstein says:

    oh yah also just so you know she had a double miniscus tear.

  5. aallegre says:

    I’m also a HUGE fan of cold laser- using the cold laser on my horse’s stifle has provided more progress for him than joint injections, specific exercises and everything else combined. Of course, I still make a point of working on hills and backing- but I definitely recommend cold laser therapy. He also moves that leg up underneath himself better than he ever has in the almost 9 years I’ve had him.

  6. Karen says:

    I’m interested in whether you own the cold laser therapy device or if the vet applied it 3 times a week?
    My horse has a non specific hind end lameness(possibly groin or hamstring) and I’m wondering if cold laser therapy would help. Any advice is welcome. We’re going on 4 months lame.

    • aallegre says:

      My other comment is awaiting moderation because I put the link to the site that builds the lasers… so the content of the comment is below, without the link. If it’s not against the rules to include a link, then the info will show up in the original comment.

      Karen- I own it. I got the smaller one with fewer diodes (less surface area, but plenty effective) and actually have the LED device just because the wavelength is still effective but there’s less risk of putting your eye out than with the laser. I got it from a site that builds them to order.

      I’ve had it for a few months now and I incorporate it into my massage work (certified equine/canine massage therapist as well) for joint issues, etc. It’s a must have for chronic joint issues and healing tendons/ligaments, etc.

      As for the hind end lameness, laser can definitely help- you can use it on accupressure/accupuncture points or directly on the source of discomfort. You may also want to have a massage therapist come out- as that would quickly tell you if the hamstring was involved or what muscles are most reactive.

  7. Pam Gray says:

    As for the laser, I’m looking into the Photonic red light system. Is this similar to what you are using? Im considering using it on my Percheron gelding, Obie, who has done something to his back causing muscle atrophy probably when he fell in the trailer. He also looks like he pulled his suspensory. He has crapppy joints unfortunately.

    My Belgian mare, Ellie Mae, has shivers. I wanted to mention this because shivers is one of the odd ailments that affect the stifles and they can be difficult to differentiate. Shivers is a progressive degenerative neuromuscular ailment with no treatment. It most commonly affects large horses commonly drafts but also warmbloods, thoroughbreds standardbreds and quarter horses. The more common form (which is what Ellie has)is characterized by a rotation of the leg to the outside in the forward flexed position where it freezes for a variable amount of time. Often the tail is also raised and shakes (hence shivers) and some people have described the jaw also being affected. Affected horses will often have odd sweat patterns. It’s hard to figure out initially – I even thought she was colicing. The first symptoms noticed are the horse becomes difficult to trim behind. The is speculation that the horse experiences a cramping sensation. There is another type, but I hesitate to describe it because I’m not sure I remember the details correctly. Stringhalt is frequently confused with shivers, although I’m not sure why – the gait is so distinctive that once you see it you won’t forget it. The hind leg is snatched up to the centerline of the body and then stabbed down to the ground. You may hear some old folks describing a horse as “stringy”. The last is the upward fixation of the patella, as the horse Luna in the original post. As I understand it, the patella usually locks with the leg in the extended rearward position.

    I hope this helps someone. I know I was totally confused. The symptoms seem to come and go, at least in the initial stages.

    • aallegre says:

      I know this is an older thread, but I never realized another question was posted. I was doing some more research into IR/red-light/cold laser therapy and stifle joint anatomy and this thread came up in the results because of my original post! So… the device you’re looking at is probably similar to what I have. What’s most important is the wavelength of light. Visible red light (around 600-660nm) is best for surface and sub-dermal applications, but IR frequencies (880nm) are best for deeper penetration- muscles, joints, etc. My device has both types of diodes so it works well for joint issues and soreness, and I’ve used it with great success for tendon and ligament injuries as well. It also made a huge difference in healing my own IT band issues. Hoping things are going well for your horses!

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