Comparing rehab schedules: stifle injury

[beowulf]

What is your “getting back into shape” method? I have always been super guarded bringing a horse back into shape - and sometimes have been guilty of “taking it too slow/easy”. Keep in mind my trails are very super hilly.

My plan was to do something very similar to this - with one or two days off a week - and adjusting based on if his stifle is getting stronger. A vet is involved but gave me a cookie-cutter rehab/fitness schedule.

THE ADJUSTABLE REGIME PENDING:
WEEK 1: walk, 20 mins
WEEK 2: trailride, walk, 30 mins
WEEK 3: trailride, walk, 45 mins, add some short (30 second trots) on trails
WEEK 4: trailride / schooling, 45 mins - 2-3 min trot 2x
WEEK 5: trailride/schooling mix - interval trot sets @ 2 mins
WEEK 6: if we’ve made it that far, see from there.

[beowulf]

As an addendum: normally, I’d follow something like the link below: but it looks to me like it may be too hard for him with his stifle:

http://www.examiner.com/article/a-12-week-fitness-program-for-an-event-horse

[achcosuva]

I’m interested in this topic as well. I have a dressage horse who injured a tendon at the end of last summer. He had a couple months completely off until sound, and since then all winter we’ve just plodded about here-and-there in the walk on the weekends (typically one day a week, bareback, for 10-15 minutes, just because I miss him and he likes his job). He has been on 24/7 turnout since Labor Day and is 11 y/o, I think. He mostly stands around in his field (next to the hay bale), so doesn’t get much self-exercise.

I plan on starting his real rehab work starting March 10 (daylight savings!). My plan is very similar to yours. I, too, tend to be over cautious, particularly since this is this horses’ second tendon injury. I will probably ride him 3-4 days a week. Our walk will be mostly working walk, as opposed to plodding.

I am planning the following:
Week 1: Walk, 15-20 minutes, well-groomed footing
Week 2: Walk, 15-20 minutes, outside of ring (weather depending) on firm, level footing
Week 3: Walk, 25-30 minutes, outside of ring
Week 4: Walk, 25-30 minutes, outside of ring, plus 1-2 times trotting around the enormous jumping arena each way
Week 5: Reevaluate, think about gentle hills, think about more trotting.

[beowulf]

Hah! What kind of tendon injury? Sorry to hear it’s his second one… Do you have hills where you are?

I’ve brought a horse back from a suspensory, but never a stifle… I can be of little help. Our conditioning schedules are very similar! Hills helped my gelding with the suspensory, and to be honest, I only rode him 3-4x a week for a few months on 45mins ~ 1hr trail rides with moderate hills. Didn’t do much besides walk as I’ve noticed the walk seems the best for them. He then graduated to be my younger sister’s debut EV horse and hasn’t had an issue since - but she is very careful with him.

Hope your horse takes well to being back in work!

[achcosuva]

[QUOTE=beowulf;6832004]
Hah! What kind of tendon injury? Sorry to hear it’s his second one… Do you have hills where you are?

I’ve brought a horse back from a suspensory, but never a stifle… I can be of little help. Our conditioning schedules are very similar! Hills helped my gelding with the suspensory, and to be honest, I rode him 3-5x a week for a few months on 45mins ~ 1hr trail rides with moderate hills. Didn’t do much besides walk as I’ve noticed the walk seems the best for them.

Hope your horse takes well to being back in work![/QUOTE]
It was a front suspensory this time. Before, a deep digital flexor tendon.

Good to know your horse did well with hills and a suspensory. I wasn’t sure if they would be a good idea or not and was going to ask the vet when he’s out in April. We have very gentle rolling hills that are easy to get to, and also a really big (steep and long) hill and medium rolling hills, but those are up a steeper and rockier trail. I’ve taken his shoes off as that seems to be his soundest way (both times of coming back sound has been after pulling shoes). I plan to keep him barefoot, but might have to get boots to get to the bigger hills because of the rocky trail. Before I invest in those, I want to make sure he’s going to stay sound. I also need to research good riding boots!

He’ll be pleased to get back into work. He’s good natured, though somewhat lazy, and loves riding because it means he gets a carrot.

I hope your OTTB stays calm and focused through all the walk work. I have a mostly retired OTTB and it can be trying when attempting to keep him at a walk. He seems not to have made the connection between his spin-and-bolt and stiffness the next day. :lol:

[chism]

In regards to the suspensory… I assume you’ve had an ultrasound to determine that the injury is healed? A slow and steady return to work is key… feel his legs every day before every ride so you know what’s normal. Take it back a notch at any sign of heat or swelling. Pay keen attention to footing, suspensory’s do better with firmer footing, avoid deep footing like the plague. Our OTTB injured his at the age of 9, went back to eventing the following year and is still in steady work at 19 years with no re-injury.

[beowulf]

Chism would know… the 19 yr old gelding she’s talking about is the horse I was talking about! I’d ask your vet for his opinion before you tackle the hills… the only reason why I did was because all we have here is hills.

[achcosuva]

No worries, definitely still planning on asking the vet about hills, etc.

Didn’t mean to hi-jack your thread, beowulf! Did you start your rehab horse today?

[beowulf]

You aren’t hijacking at all… any information regardless of injury is important, right?
I wont be starting until he comes up to NY which is estimated to be sometime in the beginning of March.

[ndirish07]

I’m interested to hear what everyone says too. My guy strained a tendon in his hock early fall and is getting ready to start back.

Vet right now has us at 10 minutes at walk under saddle.

[c_est_moi]

I’m interested in this topic too. You mentioned that the horse in question has been on 24/7 turnout for three years, so I’m a little surprised to see that your fitness plan begins with a solid three weeks of nothing but walking under saddle.

I realize that your horse probably doesn’t walk around the pasture for hours at a time, but still, I would expect a horse that has not been confined in a stall for years to be able to easily walk around under saddle for a good 30-45 minutes.

I absolutely agree that a slow and steady approach to building fitness is the way to go, but if this was my horse, I would want to make sure that I was actually building fitness during our “workouts”, and not just taking my horse out for weeks of leisurely walks. I think it would be a good idea to start adding a couple of thirty second trot sets the second week of the rehab, and SLOWLY building from there. If this was a horse that had been on stall rest, or even limited turnout, I would be much more inclined to agree with your original plan, but I think your plan is a bit too conservative to be effective for a pasture-kept horse with no residual symptoms of a very old injury.

[beowulf]

c’es tmoi, I’m definitely guilty of the “take it slow” approach!

[Lord_Helpus]

My horse has a muscle/stifle inury that he is recovering from. The “muscle man” I had out yesterday (decades of working on horses and has more knowledge of skeleton and muscles than most vets) suggest I start with PT. This involves starting him walking (leading at first, then riding) over cavaletti at the walk. First with the cavaletti on the ground, then raised slightly, increasing the height until the horse is walking over 8" high cavaletti.

This exercise slowly stretches and strengthens the muscles holding the stifle in place, break up scar tissue that might have formed, and increases the range of motion in the joint.

Since the horse has been turned out, he can probably start trotting sooner than your schedule calls for. Walking, then trotting through cavaletti, with lots of trotting sets should be done before cantering, since the canter requires the stifle to swing the leg farther under the body.

[beowulf]

Over what time period did he suggest spanning this?

[EWim15]

A lot depends on the horse and how relevant/concerned you are about the injury - it’s a bit of a know your horse situation. If it’s a tendon or suspensory you could be walking for months and the vet is probably the best person to advise depending on the results of the scans.

The tools you’ve got are in-hand exercises, ridden walk, ridden trotting, lunging, cavalettis, and hills. Lunging is less good if you are worried about strain on joints, but good for introducing a bit of cardio without the weight of the rider.

I’d start off in the first week somewhere between 15-20min walking and increase it a few minutes a day (but pay attention to how things are going and drop back or stay just stay at the same level for a few days if needed). You could also do the in-hand exercises that Lord Helpus has mentioned (here is a Youtube playlist of a few exercises I put together because I too have recently spent a bit of time doing rehab! http://outsidethehorsebox.com/massage-stretches-and-in-hand-flexibility-exercises/). Then when you’re around 45min start adding in a bit of trot and increase as before. If you have gradual hills you could try those around the same time or maybe a little earlier. You can get a horse really fit in walk if you’ve got a few hills.

In short I’d probably aim to take out a week of walking you’ve got in your original schedule but then I’d also do more trotting before schooling. Once you add in circles you are going to start adding in more strain. The cavaletti exercises Lord Helpus mentioned are great too, so definitely add those in under saddle as well.

Just remember the walking should be energetic and forward and also try and achieve a nice stretch over the top-line as you go.

Good luck!

[beowulf]

Thank you for the feed back! I’m glad to see some people have had success with their stifle-horses, to be honest, I was a little worried.

EWim, that link on your blog is great - I’ll be sure to reference it for exercises as we go - thank you for the video too!

[kerlin]

This is an interesting and useful thread, thanks. I’m looking at bringing my eventer - who has been off since mid-August with a recurring and nasty foot issue - back in early April, hopefully. We’re doing some tentative handwalking now to see how he handles it.

At what point would you get back on versus handwalking? Ideally I’ll be up to ~20 minutes of handwalking 5x a week by early April. Is rider weight at the walk more or less negligible, or would you want a horse to be comfortably handwalking for a length of time before you got in the saddle, and if so, would you ratchet back the walk time once you did?

My guy is on limited turnout and as it’s winter doesn’t move around a ton in turnout.

[talkofthetown]

Beowulf, PT is physical therapy:) Good luck with your guy! I’ve never brought back an injured stifle, but I’ve ridden older guys that were weaker behind, and what you’re planning sounds like a great start. Good luck!

Just out of curiosity, to those with more knowledge on the subject- would swimming be a good way to rehab this? I know it’s not something that’s easily accessible, just hypothetically…wondering if it would help it or overstress it?

[NRB]

I’m bringing back my 18yo, he injured the suspensory branches in 2009. a year rehab and re-injured in 2010, turned out for 8 months then brought back into “work” in 2011. work being just walking around the farm for up to 20-30 min. Then in summer of 2012 we were doing a few days a week of w-t-c with the t and c being very short periods of time. Then he got the summer/fall off and this month I am bringing him back. He has arthiritic hocks and sticky stifles. I will walk for the 1st month, intro trot in the 2nd month and canter at the 3rd month. I have no goals per say for him, just want to slowly bring up the work load and see how he responds. His barn is basically on the side of a Mt so there is no way to avoid going down hill to get to more level ground. And he goes downhill very slowly.

When I was working with my vet on layup and rehab in the past the vet worked in 6 week increments. So this 4 week schedule doesn’t seem overly slow to me. And I think a lot of walk to create a base is always a good idea.

[beowulf]

@talkofthetown;6839120

Beowulf, PT is physical therapy:) Good luck with your guy! I’ve never brought back an injured stifle, but I’ve ridden older guys that were weaker behind, and what you’re planning sounds like a great start. Good luck!

Thank you… I hope it works!