Catching stifles gut check - rehab plan

[fivestrideline]

Obligatory “yes the vet is involved” and has given me a generic and rather nebulous rehab plan. I’m very guilty of going TOO slow, to the point that I’m not making any progress so I’m looking for suggestions of timeline or any good exercises I’m missing!

Anyways, my coming 5yo OTTB was diagnosed with generic “catching stifles”, the right worse than the left. Vet says he needs to work, it doesn’t look like an injury, but if it gets worse or he starts being reactive to palpation to give them a call.
The weather hasn’t cooperated with doing ANYTHING so he’s got a grand total of 6 or so weeks of 24/7 turnout on a hill and 10 days of consistent handwalking for about 30 minutes.

At the walk, you can barely tell unless we are going downhill for a bit. It shows up at the trot on the lunge as a classic stifle catch/hitch/wonkiness, and a bit of a shorter stride on the right hind. I’ve barely seen him canter in turnout, but when picking up the trot to the right on the lunge he does a half-hop step of canter to start.

I fully realize that it’s way too early to see much progress considering the lack of work I’ve been able to do with him. What I’m worried about is the fact that the lameness doesn’t really show up at the walk, so I would hate to spend weeks and weeks walking and it turn out the horse is regressing or not making progress and I needed to call the vet.

Anyway, here’s my plan:

• continue building up time hand walking on our hills, adding 5 minutes every other day or so, up to 45 minutes
• use the EquiCore 3 times a week on our walks after a warmup
• add some backing in hand focusing on good stride length. Conflicting ideas on whether backing uphill is beneficial
• tail pulls daily, and add stretching after work

What I can’t come up with is a good plan for when to get on him, when to add trot, and how long for each of those things. I cannot longline and we do not have poles or cavaletti at this time, though I may be able to make some poles.

Do I get on him after we hit 45 minutes of handwalking? I don’t like lunging for stifles, so would it be better to add some trot on straight lines under saddle vs on the lunge? I asked my vet and they basically said “just work him” and gave me a printout of stretches. Everything I can find gets really vague after the groundwork stage.

Help my anxious and list-loving brain come up with a plan? Also, yes I’m aware I’ll need to make adjustments based on how he responds and don’t need to follow a timeline to the letter.

[Bonnie2]

IF he’s not the fresh sort that might get you in trouble, riding will be more effective than hand walking for building strength. Add in trotting up hill in reasonable increments. You may need to walk downhill slowly with some connection to start. Also walk through the woods where he has to mind his feet and pick them up over branches and such. It’s hard to do any meaningful strengthening work in the ring but you could do some poles and a little lateral work. Estrone (the stuff baseball players got in trouble for) can be very helpful but is only effective in conjunction with work. Part of the trouble with a work schedule is you, your horse, and your exigencies ( weather, real life etc) are individual. If your horse is doing x well, try x plus 5%. If he regresses, go back two steps. Best of luck!

[fivestrideline]

We have woods! But no ring

Thanks - I thought that riding him might be good, I just wasn’t sure when. He’s a good boy under saddle!

[IPEsq]

Fixing his feet should go a long way to helping with this.

[JB]

@fivestrideline

add some backing in hand focusing on good stride length. Conflicting ideas on whether backing uphill is beneficial

It IS beneficial at some point, just maybe not yet. I’d rather first work on backing in curves, both ways. It’s harder than it sounds! From a logistics perspective I mean. It IS harder than just backing straight, but not nearly as hard as backing up an incline

@fivestrideline

Do I get on him after we hit 45 minutes of handwalking?

I think that’s a great plan. Then, you’d back the work down to 25-30 minutes, because the rule is - increase time, OR intensity, but not both, in a ride, and the mere fact of you being up there is an increase in intensity. And definitely no lunging for stifles.

You can work a lot on halt/walk transitions from the start (not too many the first few times, increase as the rides go), then after a week or so of that, start a minute or so of trotting each way. You can increase time every 2-3 rides, by 1-2 minutes, and as you feel him get more fit, 4-5 minute increments are fine. I would say by the time you’re trotting 2-3 minutes each direction, you can start adding w/t transitions

[IPEsq]

As far as exercise, in the beginning I tend to do long and low trot sets increasing up to 20 mins straight of trotting. (Break it up at first). Under saddle is best if you have a larger area to ride so not so many turns. This is for stifle injuries as well as weakness. From there, I would add poles and hills. But baseline fitness first.

[TWH_Girl]

This is a tough issue- I’ve had two horses with this condition. One with a pretty significant hitch that is still there to some degree . He’s 14 now and lives in a pasture and retired from riding. The other is 6 and he doesn’t have any sort of hitch and the catch happens only minimally. It was hard for me to strengthen them and ride him properly as he also was having some issues with his neck and head. Hopefully that has been addressed now. It’s a slow process and sometimes an age related issue that improves as they mature.

All the exercises sound appropriate but you will have to watch for any signs of increased soreness like extreme reaction when you touch or groom the stifle area. If they are sore, it can help to do joint injections and then work them to build the muscle and strength. If the catching is severe, you can do the MPL splitting procedure. I did that once. It does help to some degree but there’s a period of stall rest and slow rehab afterwards.

I did not find estrone helpful in either of the horses unfortunately. Incidentally, the steroids baseball players used were anabolic steroids which build muscle.

[NaturallyHappy]

@fivestrideline, you mentioned not having poles. Landscape timbers/trim or whatever they are called work well for cavaletti. They are easy to find…Lowe’s, etc have them.

[fivestrideline]

@JB

You can work a lot on halt/walk transitions from the start (not too many the first few times, increase as the rides go), then after a week or so of that, start a minute or so of trotting each way. You can increase time every 2-3 rides, by 1-2 minutes, and as you feel him get more fit, 4-5 minute increments are fine. I would say by the time you’re trotting 2-3 minutes each direction, you can start adding w/t transitions

Thanks! Yes this makes sense for him and doesn’t sound like too much.

We need to work on installing a “back up please” button in hand, so that’s a task for days when I can’t ride and just in general.

@IPEsq

As far as exercise, in the beginning I tend to do long and low trot sets increasing up to 20 mins straight of trotting. (Break it up at first). Under saddle is best if you have a larger area to ride so not so many turns. This is for stifle injuries as well as weakness. From there, I would add poles and hills. But baseline fitness first.

So maybe build up to 20 minutes of trotting in increments? That’s a good goal for us I think. We don’t have an arena or actually anywhere truly flat to ride, so he will have to deal with some hills from the get-go . However, I can avoid the steep areas and stick to walking downhill when possible.

@NaturallyHappy

you mentioned not having poles. Landscape timbers/trim or whatever they are called work well for cavaletti. They are easy to find…Lowe’s, etc have them.

Yep no poles. Anything I get needs to be light enough to set up and tear down every time - I ride in the pasture and around the fence line, and the BO keeps everything mowed regularly. I was thinking those flat landscaping poles instead of round ones, and maybe some cavaletti blocks or something I can DIY. Lots of big logs laying around but not in places I can walk him over - and they’re too heavy for me to move!

[fivestrideline]

Alright I sketched up a starting point plan, and would definitely take input if it’s way too fast or anything!

Week 1: hack 30 minutes, introduce w/h transitions
Week 2: hack 45 minutes
Week 3-5: ride 30-45 minutes total, add 1 minute trot every 2 days until trotting 10 minutes. Introduce w/t transitions around week 5
Week 6: ride 30-45 minutes, trot 15 minutes
Week 7: ride 30-45m, trot 20m
Week 8-10: ride 30-45m, trot 15m and add 1m canter every 2 days until cantering 10m. Introduce canter transitions and simple changes around week 10

Use Equi-Core for handwalks if the weather is bad or if rides must be shortened. Introduce tail pulls and backing in hand as well as stretches. Be flexible, giving extra days off or handwalk or walk hack as needed, adjusting timeline accordingly.

Reminder that nothing here is flat so this will be on somewhat sloped ground, hills and trails, though I’ll be able to avoid small circles very easily.

[IPEsq]

I think if you need to start by trotting uphill and walking down that it will take more time to get to these blocks of work than this timeline. And I would do the long trot sets for more weeks before adding canter, personally. If you were just legging up in general or if you were dealing with a healed injury, this isn’t bad adding in canter. But for stifles, canter is harder. Walk and trot a lot first. And be able to trot down a gentle hill comfortably as well first.

[fivestrideline]

@IPEsq

I think if you need to start by trotting uphill and walking down that it will take more time to get to these blocks of work than this timeline.

Perhaps. I don’t think so, based on having ridden out there, but I guess I’ll find out pretty quick

@IPEsq

And I would do the long trot sets for more weeks before adding canter

Okay - maybe an extra week at 15 and 20? Or longer? Obviously it all depends on whether the catching goes away or improves with exercise. Like I said, all the guidelines and stifle rehab suggestions I could find online get to the riding part and then get very vague. Same for the guidelines my vet gave me.

[IPEsq]

Stifle rehabs that I’ve done starting with a fit horse took weeks of trot work. If you add general legging up to that, it’s going to be longer. Hind foot angles also play a huge part in this. So I would consider the rehab type status to remain as long as his hoof angles and heel support are not good, which I suspect they are not based on your photos.

[fivestrideline]

Yeah his feet are a work in progress. I wish I could just snap my fingers and fix everything, but that’s not reality

[IPEsq]

But fixing the feet might just make the stifles a non-issue, though. I posted somewhere that my youngster will have a propensity to lock his stifles at the end of his shoeing cycle, which is typically only 4-5 weeks. X-rays after trimming look great. But I guess he gets more toe height than heel as he grows and so he will start catching on steeper hills or less than ideal footing when he’s due. It goes away after his trim.

On one of your other threads, this horse’s stance behind is pretty awful. He is so camped under. Start with hoof X-rays and a better farrier and maybe you won’t have to stress so much about the fitness process.

[Festivity]

I found the blog on stifles by Jec Ballou to be helpful. She also has some stifle specific exercises in her corrective exercises book that seem to help my mare with locking stifles.

https://www.jecballou.com/trainingtips/strengthening-stifles

[fivestrideline]

@IPEsq

this horse’s stance behind is pretty awful.

Yes - though it has improved somewhat since he arrived. My vet is of the opinion that the stance could be caused in part by soreness in the hind end and stifles; generally that the whole thing is a feedback loop we need to break. He gets bodywork, hoof thing is in progress, he’s getting a saddle fit to him, and I’m trying to build a slow but useful exercise regimen. Doing the best I can here with the resources currently at my disposal - it’s not perfect but I’m trying.

[fivestrideline]

@Festivity

I found the blog on stifles by Jec Ballou to be helpful.

Yes! I’ve been doing the tail pulls and single leg stands, as well as the gentle hills in hand with some of the other exercises. Honestly he’s come a long way, he can now walk down the less steep slopes in hand with ease, but of course with rider weight we are back to going extra slow or zig zagging as needed.

He backs up great, actually, with good long even strides… when he’s paying attention . I also think he’s growing - I don’t have a stick and am aware that the height tape is in-exact on a good day, but he’s definitely taller behind than he was which doesn’t help. Horses!

[TWH_Girl]

@fivestrideline

Yes - though it has improved somewhat since he arrived. My vet is of the opinion that the stance could be caused in part by soreness in the hind end and stifles; generally that the whole thing is a feedback loop we need to break. He gets bodywork, hoof thing is in progress, he’s getting a saddle fit to him, and I’m trying to build a slow but useful exercise regimen. Doing the best I can here with the resources currently at my disposal - it’s not perfect but I’m trying.

Don’t worry about his stance. Young horses who are growing and have stifle issues stand funky. No need to micromanage every movement or position this or any horse is in every moment of every day. Not to say it doesn’t mean anything, just to say that you can only do so much at one time. It’s fine and you are doing a good job managing this. One step at a time.
Some Adequan may help if he is a little sore. Growing and strengthening can make them sore. Keep at it.

[MzCarol]

This one is right up my alley so i will share whats working for my guy:

Enzo is an 8yr old OTTB gelding. He has 2 spots of kissing spine, overall body tension and sticky stifles.

I am fortunate enough to have a board certified equine physiotherapist literally right up the road. I had her out for an assessment in January because Enzo had been functioning well with what i was already doing (daily bemer, frequent massage, focused stretches, back on track saddle blanket, winderen half pad) but he seemed to be backsliding in his comfort.

To summarize, the goal is to strengthen muscle which will support weakened areas.

She designed a rehab/workout program for him that will, in some form, be part of his life forever. This is what he requires to be healthy, strong and comfortable.

The main part of his program involves the use of equibands. Here is what it looks like:

Week 1 (every.single.day): 5 mins of walk, each side. I dont like longing so i would hop on and ride with the bands on and keep changing directions.

Week 2: 10 mins each side
Week 3: 15 mins each side

Every week add 5 more minutes to each side. When he reached 30 minutes each side you start all over with trot. For each 5 mins added in trot i reduced walk by the same 5 minutes.

It was my personal decision to do his walk work only and no riding beyond that. I was amazed to see just how HARD this work is on them and i wanted to ensure he wasnt being pushed too far too fast. He was getting an amazing workout in 15 minutes and didnt need more on top of that.

Once i started adding trot to the bands he had such a solid base, and was already so much stronger that i was able to remove the bands and continue riding, albeit for a shorter time. We would finish trot work and add a few laps of canter and then end our session.

Its a very structured program involving focused observation on how the horse handles it, adjusting accordingly. Never think they should do more, but some days they may be sore and need less.

The PT just saw him yesterday for a chiro appt. He hasnt been shown since Dec and i just wanted a fine tune before we head back to the show ring next week. She was very impressed by him! His topline is fabulous, his core is amazing. His issues are falling away (but will always be there in the shadows).

In summary: here is what our daily workouts look like today, after just 3 months:

1. Bemer before ride
2. Tack up and clip on bands
3. Mounted for all walk work (10-15 mins) and 15-20 mins trot work
4. Bands come off and continue trot work and go to canter/jump work.
5. After ride i go over his body to see if there is tension anywhere, massage if necessary, and do a few of the many stretches (i alternate them)
6. Give nom noms, a smooch and toss him outside to play with his buddies

I am a testimonial that slow and steady works and works well. All the best to you