HELP: Rehabbing a high suspensory / blind splint

[SakiBasenji]

My 8yo Arab was diagnosed with a moderate (3/5) high suspensory lesion in January. She was put on strict stall rest with daily hand walking. A recheck ultrasound in May showed about 90% healing, and some calcification on a “blind splint.”

The vets did not think this was an issue and gave me instructions to rehab the mare. They also feel that she will not be limited as an endurance horse, and even said I could start her back racing this fall.

But I’m not sure they know how taxing endurance can be? They’re maybe thinking “trail horse” rather than FEI eventer? I’m so worried about reinjuring her leg.

Anybody out there with advice, or experience?

My mare is HOT. Ever since her injury, when I ride her, it’s in a bit and running martingale b/c she likes to jump around and that’s the easiest way to keep her on the ground (so she doesn’t reinjure herself). So she gets mad and plays with the bit, sometimes nodding her head. I can’t tell if she is nodding / slightly lame, versus nodding just because she’s playing with the bit. But it seems like most often she is nodding the same way as when she was lame.

She doesn’t seem off when lunged, but she counterbends so badly and seems so stiff it’s hard to tell. I’m thinking about getting body work done in case the stiffness is from all the layup rest and inability for her to move. She’s in a paddock now.

My funds are limited. I can do one of these things a month: Body work / chiropractic, vs another trip to her vet for follow up ultrasound / x rays.

What do you all think??? Is there a chance she’ll be totally sound for endurance again?

[Lieselotte]

First off, yes, horses with fairly poor prognoses have made it back into Endurance, maybe not actual racing, but definitely successfully completing many more rides. So yours can come back too but it takes patience and no agenda other than that you have all the time in the world… Your horse is only 8, so it’s really really important to do this right and not have her re-injure herself.

How did she get hurt in the first place? In the pasture? An accident at a competition? Cumulative because of work load? To me that’s very important to differentiate and then adjust your future riding accordingly, unless it was a pasture incident in which case that’s just really bad luck.

It’s several months past May when you were cleared so what kind of rehab have you done so far? It would have been good to start from scratch with long walk-only rides, starting then and for the rest of the year. I would absolutely not compete with her this fall (sounds like your vet does not understand how hard this sport is on horses) but rather work on her strength and trail behavior. So back to basics and lots of long slow rides and lots of arena work too, especially bending and getting her flexible again. Ask a good dressage trainer to teach you some exercises to strengthen her and get her off her forehand, and make sure you are a balanced and fit rider yourself. (Get off and walk down hills, jog down the trail with her in hand, etc.)

It also sounds she needs a pasture situation to give her something to do and get rid of all that excess energy.

Not sure where you are located but if you can, keep working through the fall and winter and only pick up the speed in the spring to get ready for a sloooooow 50 come next summer. I think taking 12 months for a slow and conservative rehab is the way to go if you want to keep her sound in the future. Best of luck! The trails will still be there next season

[chicamux]

Years ago I brought a mare back from a high suspensory injury. I caught it immediately, actually knew the exact step she took that caused the injury. She came down onto the top of a trimmed sapling stump and her leg buckled off to one side and that was that. I took her within a few days to my “leg” vet.

Ultra-sound located the injury and the image was recorded. This vet had her practice at a race track and she was a horse owner and rider. She told me about being given a nice gelding that had a chronic suspensory injury. The owner had given up on the horse ever being sound and gave the gelding to the vet. She had really learned, the hard way, what it can take to successfully rehab this injury. She laid out the exact steps that I should take for my horse to have a safe and successful recover.

#1 step was no turn-out, not until I had gone thru the measured steps of controlled exercise over a period of 4 months for this moderate injury. I used some orally administered Ace for the first 2-3 weeks under saddle to keep her calm enough for walking. There was no lunging, and NO turning her loose in a paddock to rip and tear. So many people just won’t make the effort to contain their horse because it isn’t easy. My mare obviously was too worked up in her stall when left in alone. I ended up setting up a tiny pen bedded thickly with sawdust, inside of a larger corral and put an old pony into the corral. Pony’s hay was next to mares pen and all was well. Later on the pen was done away with and mare and pony lived in corral together but she was at W/T/C under saddle by then.

I did have her ultra-sounded three times. At the time of the injury, at the 6 month point and after her first CTR when she had some filling in the injury area after that first competition. The controlled exercise in rehab is to minimize scar tissue and to get the “fibers” to align straight as they fill back into the injury “hole”. I’m not a vet so my terminology is dicey! Anyway, exercise actually stimulates growth of the fibers and speeds up healing but non-controlled exercise (like turning them loose to rip and tear) increases the likelihood of re-injury. Scar tissue (misaligned muscle fibers laid down higgledy-piggledly) is prone to being tweaked when stretched or stressed. It may cause some filling without there actually being a new tear or injury.

My mare was fine, confirmed with another ultra-sound. She never was lame again and that filling after a ride only happened once. She did more 50’s and CTRs for several years after her injury. Eventually she was retired to being someone’s pleasure horse because of arthritic hocks.

I had another horse have a very, very minor ligament injury that rehabbed completely using the same controlled exercise. I got a bit lazy about the needed exercise during the winter and the healing of the injured area slowed down, confirmed and pointed out to be by the vet after an ultra-sound. The exercise is important to the filling in of fibers.

Turning out an injured horse is a real risk.

chicamuxen

[tabula_rashah]

Have you asked your vet about shockwave? I’ve seen it do some pretty remarkable things with rehabbing suspensories

[NVRIDER]

One of my endurance horses had a front high suspensory injury back in 2009. He was ultrasounded and radiographed to rule out there being a blind splint. He didn’t have one, so I’m not able to tell you what to do there or if it will lead to a problem for your horse. On the suspensory injury, I used a TENS unit on that leg for 3 hours a day. Plus did the gradual walking increasing to trotting rehab as recommended by the vet. The suspensory completely healed within 90 days and we completed a tough 50 three months after diagnosis. This horse had about 1500 miles at the time and now has over 8,000. He’s been pretty sound, completing many multidays and a few 100’s even Tevis 3 times. I’d say the odds of a full recovery are really good so long as you stick to the rehab schedule. I’ve healed other injuries over the years with a TENS and it (if used properly and religiously) heals things very quickly, and thoroughly. Of the various injuries I’ve used it on over the years none of them ever resurfaced again. TENS units are cheap - you can get one for less than the cost of a chiro treatment.

[SakiBasenji]

Thanks so much! I am not sure how she did it. I think it was a combination of workload, then a stumble in sand that she was off from for one day but fine after for a month, then a pasture accident that aggravated it (her old field had those mud “potholes” that froze, and she is a runner in turnout when she’s racing fit). So let’s go with “all of the above.”

So what I’ve done… after months in a stall with no turnout and hand walking, last May she went to a stall with two-hour turnout in a round pen where she was brought in if she started getting hyper. During this time I put in months of veterinary-recommended rehab, starting by walking, then adding in trots then short canters gradually. I found a good way to do this was to time it to songs on my iPod, so I could keep the exercises symmetrical and track how long I was having her do each gait. Like, one week we’d do two songs walking then one trotting. The next week we’d do two walking and two trotting. Etc.

In September I put her at the retirement farm my 30yo is at, turned out in a large paddock with oldies who don’t rile up and run, so she was sedentary. I added long slow hacks over countryside and farm fields, easy stuff in good level footing. That’s about when I posted. Since then, she has settled into her hack routine and quit playing with the bit / nodding.

In November they turned her out into a big field with a hill, 11 months post-injury. It is well-maintained and lacks the potholes. She runs sometimes, but there are no tight turns or corners to make her slam to a halt. So I’ve been happy. Oh I also had her ultrasounded one last time in December, and the vets say she’s 100% better with no restrictions.

Last year throughout her entire rehab, I hooked up with another endurance rider who is an expert and had an extra horse. I rode over 600 miles of competition rides, got ultra fit, and started running next to that horse on the downhills, sometimes 3 miles at a stretch, and hiking up the steep climbs. This gave me the right outlet for my competitive streak and desire to race, while teaching me how to take care of a horse on a distance ride, and how much of a break they need in between. While I kept rehabbing my mare with slow 10 mile walk-trot hacks, I kept myself fit for 100s and learned from people who’ve been there.

As of now she has started back into competition slowly, with one 15-mile training ride and a slow, slow 30 LD. Hoping to get her to a 50 this month or next, but I think that this time, I’m a better rider… fingers crossed! Thanks for the advice!