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Soft Tissue Recovery

My OTTB was recently diagnosed with a pulled suspensory ligament in one of his front legs (we think he hurt himself during turnout). My vet said to expect that he’ll be out of work for at least 6 months. What would you recommend I do to help his healing process? I’ve been reading about your new product SmartFlex Rehab and wondering if it’s appropriate in this situation. Thank you for your insight.
– T.O., Texas

Dear T.O.,

So sorry to hear about your horse’s injury. Unfortunately you are not alone, as a survey by the Center for Equine Health at the School of Veterinary Medicine, University of California-Davis found that, next to colic, injuries to the suspensory ligament were most frequently cited.

Hopefully your veterinarian identified the problem and provided the six-month prognosis using the “gold standard” of tendon and ligament injury diagnosis, the ultrasound examination (along with lameness evaluation and local nerve blocks). That’s because without visualizing the injury to the tissue it’s even harder to predict how severe it is and how long it will take to heal. Fortunately there are several things you can do to give your horse the best chance of returning to his former level of work.

Experts agree that in the early stages, stall rest, cold therapy and the use of anti-inflammatories is critical (whether or not to bandage is up to you, your veterinarian and your horse). While some inflammation is good, too much can actually destroy tissue and prevent the healing process. Anti-inflammatories include corticosteroids such as dexamethasone or prednisolone and non-steroidal anti-inflammatories (NSAIDs) such as bute, Banamine or Equioxx. Natural inflammation-fighters that can be added to these prescription medications include MSM, Devil’s Claw, Yucca, Boswellia, Ginger, Bromelain, and Willow Bark – all found in the product you mentioned – SmartFlex Rehab.

Another reason I like this product as an adjunct to the normal recovery process is for the antioxidants it contains. Super Oxide Dismutase, Curcumin, Quercetin, Grape Seed Extract, Bioflavonoids and Omega 3 Fatty Acids from fish oil all help protect fragile tissue from free radical damage by neutralizing these harmful molecules that are produced in excess after an injury. Finally, SmartFlex Rehab contains collagen and silica, building blocks of healthy connective tissue, as well as Vitamin C, an important co-factor in the construction of tendons, ligaments and other structures.

I also encourage you to explore with your veterinarian some of the new and exciting treatments for soft tissues injuries such as stem cell, bone marrow or platelet rich plasma injections; shock wave therapy; and others. But the most important thing you can do for your horse during his rehabilitation is initiate controlled exercise based on how well his ligament appears to be healing as determined by regular, subsequent ultrasound examinations. Careful exercise introduced slowly has been shown to help stimulate healthy new fiber growth that is correctly aligned and has the necessary cross-linking for strength and elasticity. Your veterinarian will help you outline a program of handwalking, lunging – first at the walk then the trot – riding (again first at the walk then the trot), and a gradual return to cantering, circles, corners, lateral work and other exercise.

Some resources for you:

I referred to this book twice on my own horse: once when he was recovering from a pulled suspensory like your horse, and once when he was recovering from colic surgery.

Back to Work: How to Recondition or Rehabilitate Your Horse by Lucinda Dyer

These are some articles I have written previously on the health and care of soft tissues like tendons and ligaments:

Tendon & Ligament Health:

Support for Equine Ligament Injury:

“Bowed” Tendons and “Pulled” Suspensories:

Tendon Trouble, Ligament Lameness and Muscle Misery: Soft tissue lameness in the horse:

How To Wrap Your Horse’s Legs:

Lydia F. Gray, DVM, MA SmartPak Staff Veterinarian and Medical Director Dr. Lydia Gray has earned a Bachelor of Science in agriculture, a Doctor of Veterinary Medicine (DVM), and a Master of Arts focusing on interpersonal and organizational communication. After “retiring” from private practice, she put her experience and education to work as the American Association of Equine Practitioner’s first-ever Director of Owner Education. Dr. Gray continues to provide health and nutrition information to horse owners through her position at SmartPak, through publication in more than a dozen general and trade publications, and through presentations around the country. She is the very proud owner of a Trakehner named Newman that she actively competes with in dressage and combined driving. In addition to memberships in the USDF and USEF, Dr. Gray is also a member of the Illinois Dressage and Combined Training Association (IDCTA). She is a USDF “L” Program Graduate and is currently working on her Bronze Medal. Find Dr. Gray on Google+

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3 comments on “Soft Tissue Recovery
  1. Amanda says:

    some horses at my barn had this exact injury! Bute your horses for the first 5 days ONLY! for about 1 month, hand walk your horse for about 15 minutes, getting a little longer as time goes on. Then for the next month ride your horse at the walk for about 1 hour every day, the next step would be to ride for 2 or 3 hours every day. I would then get your vet to come back and re evaluate your horse!

  2. Ward says:

    To those concerned about soft tissue injury to the horses legs.
    In reading the suggestions of recovery modalities and care of the injured horse I notice no mention of providing proper support to the leg or legs during recovery/exercise. I also find no recommendation for prevention of injury or reinjury. For any interested party that may read this note I suggest a visit to to learn about the “Iconoclast equine support boots”
    Thousands of horses have been saved and injuries aided in successful recovery by using these boots.
    If you send these folks a message you will find great help and personal assistance in dealing with your horses needs. The Iconoclast boots are recommended by hundreds of leading veterinarians. Give them a visit, it will change your horses life!

  3. Emma says:

    Hi my horse is a x race horse in his racing days he tore the tendons in his fetlock . I had him scanned last week and he’s torn the same tendons in his fetlock . The vet said they can do a opp but recovery is 1 year on box rest . I can’t do that to him . Any other suggestions . Xx

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