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This Is How To Rehab Proximal Suspensory Injury
This Is How To Rehab Proximal Suspensory Injury Hind limb proximal suspensory injuries are one of the top three injuries that Dr. Sherry Johnson, managing partner of Equine Sports Medicine and Rehabilitation, sees at her clinic (Tendon injuries and the spectrum of osteoarthritis are the other two.) Here we pick her brain on how to best rehabilitate a horse with this condition—with the ultimate hope of returning to soundness, work, and competition. And, as always, Dr. Johnson recommends working alongside a veterinarian to assess and rehabilitate your horse. The first, crucial step in managing an equine athlete with a hindlimb proximal suspensory ligament injury is to work with your veterinarian to characterize the extent and source of injury as accurately as possible. This is most commonly approached through the process of diagnostic blocking and imaging. The advancements in MRI evaluation of this dense anatomic region in horses has really shed light on the intricacies of injury patterns. It’s also important to tease out particular features of each injury, such as: Is the hock also involved? Or, are the lower suspensory branches implicated as well? These are all features that ultimately change the trajectory of each case’s successful management. The biggest thing I tell my owners and trainers is that each suspensory injury is unique, and each horse’s path to recovery will look different. Of all the orthopedic injuries horses get, therapeutic responses to hind suspensory injury management can vary the most. Despite the nuances that make each case’s management different (medical management vs. surgical management, etc.), there is a general framework of useful tips and tricks to help your horse along the road to recovery. In the early phases of injury, support—from icing, NSAIDS, compression, and physical therapy—begin at a high level and are then reduced as the horse begins to show progress in recovery. It’s all a big recipe that begins with all the support aids that are then peeled away, one by one, as I’m able to increase the physical work load. In the beginning of the rehab process, exercise is typically very light, but it ultimately depends on the extent, severity and chronicity of injury. Hand walking, in addition to core physical therapy exercises, is commonly utilized. Strategies to activate hindlimb muscle groups to stabilize the entire pelvis are frequently incorporated. Alongside the gradual, physical work, I like to utilize icing after each workout session for pain modulation and to keep inflammation and swelling at bay. At ESMR, we use targeted flexibility and strength training in one-on-one sessions with the horse and one of our physical therapists. Once the horse begins to improve, we’re able to increase with exercise modifiers like ground pole passes, resistance bands, introducing light weights, or increasing speed. We tweak these regimens based on the trajectory of the individual case. There are so many layers and benchmarks, and I need to see the horse pass a level in comfort before they can transition to the next phase. There are so many thoughts and considerations that go into every single protocol decision in the rehab process. For example, I must consider if the horse is a young Thoroughbred, an older Warmblood, or a Quarter Horse reining prospect. Each athlete is different, and what their body needs to be physically prepared to do their job is quite unique. I truly believe in taking a global approach to the horse. Icing, nutrition, foot care, exercise, core physical therapy, medication—these are all part of the comprehensive package that we utilize at our clinics. Further treatment depends at which stage the horse will go home. Some don’t go home until they’re ready to be in training or to go show and some have owners that want them back sooner. Whichever stage of recovery the horse is in, I send the horse home with specific instructions and a plan with exercises and an icing regimen. I always recommend that my clients invest in Ice Horse suspensory wraps when rehabbing this injury because of the anatomic fit and because the Ice Horse ice packs mold to the leg to effectively deliver cold therapy. The Ice Horse wraps have the proper amount of compression and will stay cold for the long periods of time required to see benefits from icing. Dr. Sherry Johnson, DVM, MS, Ph.D., DACVSMR, was raised in Iowa on a row crop farm, spending most of her time on the back of a horse. She attended veterinary school at Iowa State University, followed by an internship at the Equine Medical Center of Ocala (EMCO). After completing an Equine Sports Medicine & Rehabilitation residency at Colorado State University and becoming DACVSMR board-certified, she completed her Ph.D. which focused on rehabilitation modalities related to tendon healing. For further updates, please follow Ice Horse on Instagram at @icehorse and visit the Ice Horse website at www.icehorse.com and the ESMR website at www.eqsmr.com.
Canada Knows Cold: Canadian Equestrian Team Selects Ice Horse Cold Therapy
FOR IMMEDIATE RELEASE Canada Knows Cold: Canadian Equestrian Team Selects Ice Horse Cold Therapy The Canadian Equestrian Team (CET) is pleased to announce they have selected MacKinnon Products’ Ice Horse as their official cold therapy treatment for the 2015 Pan American Games to be held in Toronto July 12-26. “We were thrilled to have received a call from one of the team veterinarians in late spring,” said Julie Garella, Ice Horse CEO. “They let us know the team had tried a couple of Ice Horse products at the 2014 World Equestrian Games in France. So good were the results, that the CET decided to use an assortment of products from Big Black Boots to Back Blankets while training for, and competing at, the upcoming games.” Canadian Eventing team veterinarian, Dr. Christiana Ober speaks to the benefits of Ice Horse products, “The Ice Horse products are an integral part of our preventive maintenance and soundness program. We use them after gallops and hard schools to prevent inflammation in legs and joints. We have used the boots religiously leading up to and during the TORONTO 2015 Pan American games. I believe in these products and their ability to alleviate inflammation.” About Ice Horse: For over 15 years Ice Horse has been the trusted name in cold therapy for horses and riders. The products feature inserts which when frozen turn to soft fluffy snow, mold to the horse legs and stay cold for over two hours. To learn more visit www.icehorse.net. About the Canadian Equestrian Team The Canadian Equestrian Team (CET), a committee of Equine Canada, is responsible for developing, selecting and training all international teams in the eight equestrian disciplines recognized by the Fédération Equestre Internationale (FEI). These eight include the three Olympic disciplines of dressage, eventing and jumping, as well as driving, endurance, para-equestrian, reining and vaulting. The CET sends Canadian riders across the globe to compete individually and as a team at the Olympic Games, Pan American Games, World Equestrian Games, World Cups, and more. To learn more, visit www.equinecanada.ca.
Ice Horse Behind the Scenes at World Equestrian Games
Ice Horse Behind the Scenes at World Equestrian Games Sharon Classen served as one of the International Equestrian Federation’s few “Permitted Equine Therapists” at the World Equestrian Games this past week. Her WEG role included helping competitors from across the globe who are not able to bring their own physical therapist. Sharon worked with the American reining team, the Bolivian show jumpers, the Irish Eventers and Para Dressage pairs. Sharon trusts Ice Horse cryotherapy when treating her high-performance clients. "Here at WEG using Ice Horse ice packs to treat the athletes... the ice packs are excellent and helping to keep these athletes performing to their best- love them!" - Sharon Classen, Permitted Equine Therapist Ice Horse Riders Represented at WEG Jumpers Earn Gold An impressive jump round by Ice Horse Rider Laura Kraut and Zeremonie helped the US Team win gold for the first time in 32 years! 🇺🇸 🏅 Driving to Victory Ice Horse Driver, Chester Weber, and the U.S. team secured their first ever gold medal. Chester also received an Individual Silver in Combined Driving! Reining Supreme Congratulations are in order for Cade McCutcheon and everyone at Tom McCutcheon Reining Horses for the winning the gold medal! 🏅 We are thrilled to be a part of their team! Congratulations to all our riders! #betterbymiles
Go inside the horse's hoof - the coffin bone and surrounding structures!
Go Inside the Horse's Hoof - The Coffin Bone and Surrounding Structures! What are the bones in the horse hoof? The most distal bone in the horse’s leg is the coffin bone. This critical bone has other names, such as distal phalanx, third phalanx, or even P3 for the abbreviation fans. The coffin bone is the hoof shaped bone that attaches to the laminae in the hoof. The coffin joint is the intersection between the coffin bone and the next bone up, the short pastern bone. Which is also called the second phalanx or P2. Adding one more bone to the mix, the navicular bone sits behind the coffin bone and below the small pastern bone. There’s a patch of cartilage between the navicular bone and the coffin joint, and a patch of cartilage between the navicular bone and associated tendons. The navicular area also has a bursa, which is a sack of fluid that helps the tendons within the hoof glide around. These structures and the coffin joint are within the hoof and support the weight of your horse. That’s a lotta weight for some small bones. Inside the hoof, the coffin bone attaches to the blood and nerve infused laminae layer. This sensitive layer connects to the insensitive laminae layer which connects to the hoof wall. Any trauma or disease to the hoof can severely affect the laminae and the bones inside the hoof. There’s also the deep digital flexor tendon (DDFT) inside the hoof, which comes from the back of the leg, into the hoof, under the navicular bone, and attaches to the back of the coffin bone. The DDFT functions to flex the coffin joint, helping your horse walk. There are so many structures in the hoof that many things can happen. Believe it or not - the coffin bone (or navicular bone for that matter) can fracture, despite the protection of the hoof. The coffin bone is also capable of becoming deformed due to the shape of the hoof. Think about a club foot or constricted heels that change the hoof shape. This can affect the coffin bone. The navicular bone is just visible here, sitting right on top of the end of the coffin bone. The coffin joint itself can become inflamed - much like a hock joint or a stifle joint. Wear and tear from repetitive motion creates inflammation. The navicular bursa can also become inflamed. Osteitis, specifically pedal osteitis, is another issue to be aware of. Osteitis is a demineralization of the bone - and in the case of the coffin joint, is largely due to concussion, hard ground, frequent bruising. The coffin bone itself is damaged. Supportive farrier work, rest, and even medications are often warranted. This will cause lameness, and can be seen on X-rays. And then you have the generalized navicular syndrome condition, often referring to a horse as “having navicular.” What causes this? Perhaps is the cartilage in the area degenerating, perhaps it’s a mechanical change, perhaps it’s an arthritic type of change. It’s been shown that navicular changes may also be related to toe first landing and other mechanical changes due to compression of the area and/or poor farrier care. Every horse will have a different set of circumstances. The take away message from all of this is that your horse’s coffin bone and surrounding structures take the weight of your entire horse. Daily attention to the digital pulse, regular health check ups including lameness exams, regular farrier care, and proactive X-rays of the hoof can save your horse a lot of discomfort if issues are caught early.
Ice Horse Riders at World Equestrian Games
The World Equestrian Games start August 23rd. Ice Horse will be there in full force with our sponsored riders Buck Davidson, Tom McCutcheon, Lars Petersen and Chester Weber competing. We have a booth at the games and we'd love to meet all of our fans. The Ice Horse stand is #E8. Come by and meet our riders. Be sure and check our Facebook page for dates and times. Some things to look out for: Chester Weber will be hanging out at the Ice Horse booth on September 2nd from 11:30 am to 12:30 pm Ice Horse sponsored Rider Tom McCutcheon (Time TBA) Ice Horse Sponsored Rider Lars Petersen will be signing (Time TBA) Our line of products will be present Our product consultants will available to discuss your issues and what products would work best for your horse Much more to come! Stay here for all your WEG information. We will be giving out more information as we get it. Come visit us at the Ice Horse booth and say Hi. We are so excited to see everyone! Good luck to all our sponsored riders!
