Diagnosing shoulder injuries

[luckycricket123]

While researching lameness for a friend’s horse, I actually came across a blurb on shoulder injuries that sounds exactly like the mystery lameness on one of my horses.

He is lame on his front left, but it is only really apparent when tracking right. It’s pretty subtle on a bigger circle but he’s short strides and does a bit of a hop on that foot.

Anyways, I know shoulder injuries are uncommon, but he was blocked up to the knee with no change during a lameness exam.

I wasn’t familiar with shoulder lameness symptoms at the time so I didn’t really suspect that. He actually had an acute shoulder injury a couple years back that swelled up and then healed on its own (or so I thought).

Anyways, I’m kind of curious what kind of diagnostics there are to determine if this is a shoulder lameness, what kind of shoulder injuries are out there and what prognoses might look like.

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[No1]

You can block the shoulder.

Also, your vet can ultrasound or refer the horse for a bone scan.

I’ve only known two horses with actual shoulder injuries that were not humeral fractures. One was not really diagnosed, just injected and the horse got better and continued on. One was a muscle tear with an avulsion. That horse had a protracted rehab and did come back to some amount of work, though not the level he was at before (he was an advanced event horse before).

[IPEsq]

I think you can identify several possible problems via ultrasound.

[suzyq]

I had a horse with a shoulder injury. It was very advanced arthritis, most likely caused by acute trauma before I got him, according the vet. He did not show lameness until he went very lame. But he was very resistant to work from the time I got him, I did an extensive ppe and had several vets look at him after i bought him and no one found the issue until he broke down. His shoulder was xrayed with a big machine at the vet clinic after he did not block sound up the leg, most of his cartilage was gone. There was nothing that could be done, they injected with cortisone for pain but I had to put him down about a year and a half later.

[luckycricket123]

@suzyq

I had a horse with a shoulder injury. It was very advanced arthritis, most likely caused by acute trauma before I got him, according the vet. He did not show lameness until he went very lame. But he was very resistant to work from the time I got him, I did an extensive ppe and had several vets look at him after i bought him and no one found the issue until he broke down. His shoulder was xrayed with a big machine at the vet clinic after he did not block sound up the leg, most of his cartilage was gone. There was nothing that could be done, they injected with cortisone for pain but I had to put him down about a year and a half later.

Had you blocked the shoulder? Or just the whole way up the leg?

And to make sure I am understanding, you had to go to the vet clinic in order to get an x-ray powerful enough to penetrate the tissues of the shoulder?

[RomeosGirl]

Great timing on this thread. I am currently going through a shoulder lameness issue. From the time I got this horse he would intermittently go lame on his right front leg, which would resolve itself with a few days off. 2 years ago we did a lameness exam & he blocked out as heel pain in the right front, so we put bar shoes & pads on him. Seemed to be better, but kept resurfacing itself.
This year he was lame on the right front for a longer period of time, so had the vet back out We were going to start blocking at the bottom again. Vet happened to ask my horse to flex that shoulder & he said “No Thank You”. So we ultra-sounded his shoulder. He found some swelling of the bursa & mineralization of the biscep muscle. Suggested possibly shockwaving it (not in my budget). We opted for Surpass & my friend had a hand held laser so I’ve been treating him with that.
We started this at the end of May - waking under tack adding 5 minutes every week. He did a re-check about 3 weeks ago & said he is making progress, about 70% better, so we added 5 minutes of trot. Vet is coming back for another visit the second week of Sept & I plan to ask him about doing another ultra-sound to see what it looks like now.
Like your horse mine is more lame tracking left, because he does not want to stretch out that right shoulder. Also cantering right he would tend to curl up (not really bulging out the left shoulder, more dropping the right one and not wanting to be upright in a right turn).

[luckycricket123]

Did you feel that the surpass helps? I had considered surpass since this horse is somewhat sensitive and we try to avoid systemic NSAIDs, but I didn’t think a topical would be as helpful on the shoulder. I guess it could be worth a try

[suzyq]

@luckycricket123

Had you blocked the shoulder? Or just the whole way up the leg?

And to make sure I am understanding, you had to go to the vet clinic in order to get an x-ray powerful enough to penetrate the tissues of the shoulder?

The whole way up the leg. I don’t know if they can block the shoulder. The local vet blocked and said shoulder, he did xray but i think his eqpt wasnt good enough. He thought it was Sweeny shoulder caused by an accident since it came on so quickly. We rested him for 3 months, he was still lame so I took him to the vet clinic. They said its never the shoulder (!) re-blocked and then xrayed the shoulder.

[RomeosGirl]

@luckycricket123

Did you feel that the surpass helps? I had considered surpass since this horse is somewhat sensitive and we try to avoid systemic NSAIDs, but I didn’t think a topical would be as helpful on the shoulder. I guess it could be worth a try

I do think it is helping. I was doing it daily twice a day for the first 2 weeks. Now I’m down do just applying it about 1/2 hour before I ride, so 4 times a week. Then I do the laser treatment after I ride. I actually use Voltaren (the human arthritis cream) because it’s a lot less expensive. My vet did warn me to test it on horse first because some are sensitive to the carrying agent of it & it could cause a reaction. My horse did not have a reaction (well except that the first time I did the laser treatment & then put the Voltaren on right after - that did burn him slightly).

[Peggy]

@RomeosGirl Did the vet have an explanation for why it blocked to the heel if it’s in the shoulder.

[RomeosGirl]

@Peggy

@RomeosGirl Did the vet have an explanation for why it blocked to the heel if it’s in the shoulder.

We think he’s probably always had an underlying shoulder issue that caused him to not want to use that leg properly, kind of the chicken & the egg - is the foot causing the shoulder, or is the shoulder causing the foot???
The odd thing is he has some white scar hairs on his left leg & left shoulder that I know nothing about. He did race & something in me wonders if he maybe crashed as he only raced 3 times.

[Peggy]

@RomeosGirl

We think he’s probably always had an underlying shoulder issue that caused him to not want to use that leg properly, kind of the chicken & the egg - is the foot causing the shoulder, or is the shoulder causing the foot???
The odd thing is he has some white scar hairs on his left leg & left shoulder that I know nothing about. He did race & something in me wonders if he maybe crashed as he only raced 3 times.

Thanks. The reason I asked is that my horse has an ongoing RF issue (stepped on a rock at a show a year ago May, soft tissue injuries in foot, reinjured this past spring) that blocks to the heel with a rider up. He’s sound on a lunge line on both hard and soft ground. The chiropractor noticed a knot in his shoulder area on that side that he thinks might be related. Again, a chicken or an egg thing where apparently there is a connection somehow between the DDFT and that area of the shoulder. The fact that he’s only off with a rider made me think maybe shoulder was involved as well. So that’s why your post caught my eye.

[RomeosGirl]

@Peggy

Thanks. The reason I asked is that my horse has an ongoing RF issue (stepped on a rock at a show a year ago May, soft tissue injuries in foot, reinjured this past spring) that blocks to the heel with a rider up. He’s sound on a lunge line on both hard and soft ground. The chiropractor noticed a knot in his shoulder area on that side that he thinks might be related. Again, a chicken or an egg thing where apparently there is a connection somehow between the DDFT and that area of the shoulder. The fact that he’s only off with a rider made me think maybe shoulder was involved as well. So that’s why your post caught my eye.

Yeah, my vet feels that shoulder pain often presents as heel pain & tougher to diagnose. For my horse the shoeing change we did may have helped the shoulder, but looks like it didn’t totally resolve it. So now we are working on the shoulder. He’s doing well so far, but we are just up to trotting for 10 minutes. Haven’t added any canter yet.
In hindsight. when I went to try him they told me he would always land on his left lead & his left to right lead change has always been harder to get. But he was also just coming back into work & barefoot at the time, so we didn’t think it was significant.
Good luck with finding the issue with your boy, some of these issues are really hard to track down.

[luckycricket123]

Well, this thread has convinced me I am not crazy for considering the shoulder, though I am still not sure how to proceed with the vet. I’ve already had them out to do several lameness exams. I know we never did any imaging or blocking to the shoulder, though that kind of diagnostics may have required a trip to the clinic, or so it sounds.

The horse is essentially retired. He is sound and comfortable for hacking so that’s what I do with him. Which is a pain because he is not quiet on the trails. I’ve kept him in work because I am hoping he will get better or get worse and at least give us something to go on. I would say he has probably gotten better, but then again who really knows - I have also drastically modified his exercise plan. Maybe I’ll try a week or two using surpass on the shoulder then try riding him in the ring and see if he is improved or the same and call the vet from there.

Frustrating injury indeed.

[Peggy]

FWIW my horse got a bone scan after the original foot injury and no abnormalities were noted in the shoulders at that time. But that was a bit over a year ago. One more ting to think about. The chiro has me massaging the shoulder. Maybe I’ll pick up some Volaren…

[luckycricket123]

Well that is an important consideration! Thank you for sharing.

My vet and I are both so wary of me wasting my money at this point. Especially since this guy is an ex-racer and a warhorse at that. So a lot of times, if we look closely anywhere we can find something.

If only I could know what kind of injury he had, that would really help me figure out how to diagnose it lol.