Minor suspensory injury - SMB boots?

[Jarrn]

So last week, my horse all of a sudden came up lame while being lunged. The vet came out and determined that both of his suspensories were sore, one moreso than the other. The prescribed action was 2 weeks of stall rest, bute, and light turn out near the end of the 2 weeks.
He also stated that should start using SMB-type boots while he is turned out (I live in SoCal so he is not turned out unsupervised) and while being ridden. He wanted them put on while the leg was unloaded (being held up as if to pick his feet), so that when he put his leg back down it would support the leg better.
Now, I hate SMB boots. Hate them. They are too hot, too bulky, and I have never heard of them actually helping a horse’s leg. But I also don’t want to go against the vet’s advice, especially with a leg injury.
So is there any truth to this whole SMB boot thing, do they actually help at all?
If not, what would you recommend using? I know that, in general, boots do not provide that kind of support, but is there anything that might marginally help?

If I am wrong and SMB boots are the way to go, then I will gladly use them. I just don’t want to use them if they aren’t going to do anything.

Any opinions/advice? If I’m being silly, feel free to tell me I’m an idiot and to just use the SMB boots already :lol:

[Sansena]

In 39yrs working with horses, I’ve never once heard of anyone saying boots of any kind helped ‘support’ a leg. Polos, yes, if applied properly. Boots? Never.

But I am not a vet and I do not sell any products. What’s your vet’s relations to the SMB company? Ask your vet how they came to believe in SMBs, specifically for ligament issues.

Is your horse older? Poorly shod? Footing uneven and cup? Cushingoind? That might be contributing to suspensory issues, not the fact that he was lacking boots.

Hope he recovers quickly.

[Hunterkid]

I hate smbs,I personally don’t think any boot or wrap will help. Polo wraps certainly do not provide any support.

[alibi_18]

Did the vet ultrasound the legs?

Eskadron Climatex bandages would be a better idea.

[gumtree]

I am with others not worth the money nor effort. The last time they were recommended to me was about 7 years ago. I no longer used that vet.
As you said they are hot. My horse’s legs would get very hot under them which IMO and experience is exactly the opposite I want with any ligament and or tendon on the “repair”. SMB boots rubbed my horse’s legs pretty good also. Two horses were left with “white hairs” to this day.

I am of the same mind as Hunterkid and Sansena. Though I don’t think Polo’s bring much to the table. It has also been my experience and based on some top advise that you may want to change the way his feet are trimmed. You want to let his heels grow out so his ankles “set up” under his ankle and more directly “inline” with his cannon. Giving a bit more of an “upright look” to his pasterns.

I would be putting him in ice boots daily and when he goes back into work. Depending on things do him up in a mud poultice or Animalintex at night. I have also been advised and used a mild blister on the area after the swelling has retreated.

You didn’t mention if an Ultrasound has been done. Which I find surprising. IMO and experience no vet is that good to be able to know exactly what is, what has been going on by just feel and visual. I would want to know exactly what I am dealing with and only an US can give those details. IME the US should be done by an US specialist. Not a general practitioner no matter how many years they have been practicing.

IMO and experience your horse’s suspensory issues did not come to light because of the lunging they just became more pronounced. The tight turning brought them to a “head”.

I work with racehorse, flat and steeplechase. Legs are checked and monitored meticulously every day. Any sign/feel of heat, reaction to being manipulation and or filling in the slightest I bring in my US specialist. Even if they show no sign of being “off” what so ever. More times than not my “gut” was correct and some “changes” were found. We had to back off his training but not nearly as long if the problems hadn’t been caught early.

I understand your reasons for not wanting to go against you vets advise. They can be a bit “touchy” on these things and take it personally. Some things are widely accepted by most vets. But I have not found this to be true with the use of SMB.

As Sansena said; “I’ve never once heard of anyone saying boots of any kind helped ‘support’ a leg” I have had several Sports vet say the same. There are studies out there that back this up.

[merrygoround]

I agree with the above posters. It tried SMB’s years ago when they were new. My horse hated them.

The only boots I ever use are for protection. Same with wraps.

[joiedevie99]

I asked my vet a similar question about leg protection post a suspensory branch injury (minor swelling only - cleared on ultrasound at 6 weeks). She laughed at me and suggested I read less magazine ads.

She said keep the horse on a short shoeing schedule (4-5 weeks) so his feet stay balanced and avoid deep footing (both for turnout and riding).

She also had me ice if after work for at least 6 months.

[Clair2014]

I actually do use SMB’s regularly but they are the newer style that they call Ventech and they are not as hot and bulky as the older style. That being said, I use them for protection, not support. One of my FEI horses interferes in such a way that normal dressage boots don’t offer enough protection and I guess I’m too lazy to deal with wraps every time I ride. That being said, my vet is a firm believer that there are no boots on the market that offer any kind of support. I have met other vets in the past that have said differently but they also turned out to be less-than-fantastic vets.

[meaty_ogre]

http://onlinelibrary.wiley.com/doi/10.2746/042516402776250423/abstract

Cut and paste of summary:
Summary

Metacarpophalangeal (MCP) joint extension is primarily resisted by the digital flexortendons and suspensory ligament. A variety of external support techniques are used to protect these supporting structures from or after injury by resisting MCP joint extension, although not all are effective and/or practical for use in an exercising horse. In this study, 7 forelimbs were loaded in vitro to determine the effect of a simple gamgee bandage, a 3-layered bandage with and without a contoured palmar splint, a neoprene exercise boot, and an innovative carbon fibre composite exercise boot (Dalmar tendon support boot). There was no significant resistance to MCP joint extension by the gamgee or neoprene exercise boot. The 3-layered bandage had a significant (P < 0.01) supporting effect at MCP angles of ?245°, and when combined with the contoured splint at angles of ?230°. The Dalmartendon support boot resisted MCP extension at angles of ?245° (settings 1 and 2) and ?225° (setting 3). These data demonstrate that the contoured splint and the Dalmar tendon support boot (which is also easily fitted for use during exercise) are useful for the management of tendon/ligament injury and during rehabilitation.

For whatever that is worth (in vitro means they tested cadaver limbs, not real horses working out, so bear that in mind).

Neoprene boots hold a lot of heat. California summers, fresh injuries and neoprene boots don’t seem to go together in my mind, but I’m not a vet. I will tell you though that after my own significant knee injury that required surgery, I have found pain and swelling relief with a neoprene brace (this was 6 months + after surgery), though it definitely does not provide support (I have a custom exoskeleton type brace for that). If I’m out doing things in the winter/cold, I do find the neoprene brace very helpful, especially with biofreeze underneath. But, I’m not a horse. I also am not a fan of neoprene horse boots, but I will say that I have seen dramatic edema reduction in windpuffs with them, and I do think that some horses with arthritis in the fetlocks can benefit from the warmth factor, especially in the cold. But, that’s about the only time I use SMB or other sport boots.

[meaty_ogre]

http://onlinelibrary.wiley.com/doi/10.2746/042516402776250423/abstract

Cut and paste of summary:
Summary

Metacarpophalangeal (MCP) joint extension is primarily resisted by the digital flexortendons and suspensory ligament. A variety of external support techniques are used to protect these supporting structures from or after injury by resisting MCP joint extension, although not all are effective and/or practical for use in an exercising horse. In this study, 7 forelimbs were loaded in vitro to determine the effect of a simple gamgee bandage, a 3-layered bandage with and without a contoured palmar splint, a neoprene exercise boot, and an innovative carbon fibre composite exercise boot (Dalmar tendon support boot). There was no significant resistance to MCP joint extension by the gamgee or neoprene exercise boot. The 3-layered bandage had a significant (P < 0.01) supporting effect at MCP angles of ?245°, and when combined with the contoured splint at angles of ?230°. The Dalmartendon support boot resisted MCP extension at angles of ?245° (settings 1 and 2) and ?225° (setting 3). These data demonstrate that the contoured splint and the Dalmar tendon support boot (which is also easily fitted for use during exercise) are useful for the management of tendon/ligament injury and during rehabilitation.

For whatever that is worth (in vitro means they tested cadaver limbs, not real horses working out, so bear that in mind).

Neoprene boots hold a lot of heat. California summers, fresh injuries and neoprene boots don’t seem to go together in my mind, but I’m not a vet. I will tell you though that after my own significant knee injury that required surgery, I have found pain and swelling relief with a neoprene brace (this was 6 months + after surgery), though it definitely does not provide support (I have a custom exoskeleton type brace for that). If I’m out doing things in the winter/cold, I do find the neoprene brace very helpful, especially with biofreeze underneath. But, I’m not a horse. I also am not a fan of neoprene horse boots, but I will say that I have seen dramatic edema reduction in windpuffs with them, and I do think that some horses with arthritis in the fetlocks can benefit from the warmth factor, especially in the cold. But, that’s about the only time I use SMB or other sport boots.

[keysfins]

Check out the Iconoclast boots.

http://www.cowhorseproductions.com/iconoclast-horse-boots.html

[I]"Iconoclast® Support Boots aIconoclast® Support Boots are specifically designed to support and protect the suspensory and sesamoidial areas of the equine leg better than any other boot on the market.

The Patented Orthopedic Wedge® design feature, working in conjunction with their patented Double Sling Strap, provides unparalleled 360-degree support of the equine leg.

Never has this method of support been provided for the equine athlete through a strap on, non-restricting device. Iconoclast® Support Boots not only protect against flexion injury, but they also offer effective benefit during rehabilitation from previous injury."[/I]

My vet recommends these in specific situations, and feels that they DO support the suspensory. The difference is a design that has TWO straps that support the joint, unlike SMBs and similar that have one. One strap wraps outside to inside, the other wraps inside to outside.

Initially, they are a PITA to put on properly. The velcro grabs on everything, and you do need to apply them correctly. But once you get used to using them, they are quick to put on.

[Appsolute]

I like you - I HATE sports medicine boots -and I have seen a horse basically get “bandaged bowed” by them, when they were accidentally left on overnight.

They are hot hot hot - I thought that studies showed excessive heat makes tendons and ligaments more prone to injury? I couldn’t imagine turning out in our summers in them.

And back when I was a working student at a BIG eventing barn - on the same premises as a state of the art vet clinic (did a lot of holding for the vet, and rehabbing client horses) - I never once heard SMB recommended for any injury. And I rehabbed a number of suspensory injuries (properly applied stables bandages, cold hosing, hand walking, swimming, very specific under saddle exercise regimes - yes. SMBs, no)

Vets are people - and have their own opinions and experiences, and personally, I do not take every word out of their mouth as gospel. If my vet recommended SMB boots, I personally wouldn’t follow the recommendation.

[Jarrn]

[QUOTE=Sansena;8185534]
In 39yrs working with horses, I’ve never once heard of anyone saying boots of any kind helped ‘support’ a leg. Polos, yes, if applied properly. Boots? Never.

But I am not a vet and I do not sell any products. What’s your vet’s relations to the SMB company? Ask your vet how they came to believe in SMBs, specifically for ligament issues.

Is your horse older? Poorly shod? Footing uneven and cup? Cushingoind? That might be contributing to suspensory issues, not the fact that he was lacking boots.

Hope he recovers quickly.[/QUOTE]
Vet has no relation to SMB, and recommended any SMB-type boot. I am in a primarily western (barrel racing) area so I’m thinking maybe that might be why he is recommending them, as nearly everyone here uses those type of boots.

He’s 15, not well trimmed at the moment, as I’ve had two farrier cancellations and then this (he couldn’t hold his opposite leg up, so I had to cancel the farrier that was supposed to come). Normally, he is trimmed every 5-6 weeks, and is in light work.

[QUOTE=alibi_18;8185603]Did the vet ultrasound the legs?

Eskadron Climatex bandages would be a better idea.[/QUOTE]
No ultrasound. He determined it by palpation and watching him move.

I can try those bandages, at least while I am riding. The BO is the one who will be turning him out, so I don’t want to make her do more work (wrapping the legs) then usual (just throwing some boots on). I can ask her if she would mind doing it though.

[QUOTE=gumtree;8185628]I am with others not worth the money nor effort. The last time they were recommended to me was about 7 years ago. I no longer used that vet.
As you said they are hot. My horse’s legs would get very hot under them which IMO and experience is exactly the opposite I want with any ligament and or tendon on the “repair”. SMB boots rubbed my horse’s legs pretty good also. Two horses were left with “white hairs” to this day.

I am of the same mind as Hunterkid and Sansena. Though I don’t think Polo’s bring much to the table. It has also been my experience and based on some top advise that you may want to change the way his feet are trimmed. You want to let his heels grow out so his ankles “set up” under his ankle and more directly “inline” with his cannon. Giving a bit more of an “upright look” to his pasterns.

I would be putting him in ice boots daily and when he goes back into work. Depending on things do him up in a mud poultice or Animalintex at night. I have also been advised and used a mild blister on the area after the swelling has retreated.

You didn’t mention if an Ultrasound has been done. Which I find surprising. IMO and experience no vet is that good to be able to know exactly what is, what has been going on by just feel and visual. I would want to know exactly what I am dealing with and only an US can give those details. IME the US should be done by an US specialist. Not a general practitioner no matter how many years they have been practicing.

IMO and experience your horse’s suspensory issues did not come to light because of the lunging they just became more pronounced. The tight turning brought them to a “head”.

I work with racehorse, flat and steeplechase. Legs are checked and monitored meticulously every day. Any sign/feel of heat, reaction to being manipulation and or filling in the slightest I bring in my US specialist. Even if they show no sign of being “off” what so ever. More times than not my “gut” was correct and some “changes” were found. We had to back off his training but not nearly as long if the problems hadn’t been caught early.

I understand your reasons for not wanting to go against you vets advise. They can be a bit “touchy” on these things and take it personally. Some things are widely accepted by most vets. But I have not found this to be true with the use of SMB.

As Sansena said; “I’ve never once heard of anyone saying boots of any kind helped ‘support’ a leg” I have had several Sports vet say the same. There are studies out there that back this up.[/QUOTE]

Thank you for the response! SMB boots also rub him pretty bad (I used them a few times years ago), so I really have nothing good to say about them. I think I will leave them off and just stick with icing, and then look into poulticing. The vet did not do an ultrasound (I’m not sure if he even does them at all), but the horse was already showing a huge improvement on 4 days stall rest without bute.

Thank you again, I will try implementing ice boots and he is definitely getting his feet done asap.

Thank you everyone else for your help!! It is super appreciated.

[alibi_18]

No ultrasound?!? Sorry but…Please get a second REAL diagnosis.

Really, you need to know what’s going on in there. Please, please call a better vet.

[Jarrn]

[QUOTE=alibi_18;8186997]
No ultrasound?!? Sorry but…Please get a second REAL diagnosis.

Really, you need to know what’s going on in there. Please, please call a better vet.[/QUOTE]
:lol: that IS the better vet. That’s the best vet that services this area (scary, isn’t it?). I have a call into my previous vet who is a lameness expert so I’ll see what she says!

[normandy_shores]

I can’t imagine it being such a minor strain it only requires two weeks off but the horse couldn’t stand on that leg and lift the opposite for the farrier. Soft tissue takes a while.

SMBs are hot and bulky, and like others have pointed out, studies have shown they don’t actually provide support. Heat build up would be the last thing I’d want for a soft tissue injury.

[Hawks_Nest]

Last summer my boy whacked his suspenseful right above the branch. Vet was out that day anyway for chiro and caught it when watching him jog (we had no idea). He was sore on palpating and flexion but it was minor enough that within 10 minutes of the flexion he was back to 95% sound.

Vet prescribed icing (or cold hosing) twice a day, surpass, and a support wrap when not being iced (wrapped below the fetlock to provide support to the suspensory). He was allowed turnout as long as he stayed wrapped and was quiet (the turnout was small and dirt).

He was 100% in a week, we spent a week building back up to normal work and it hasn’t bothered him since. Never once was it suggested that I do anything different with booting while riding, only that I ice after riding for a week or two. However, you couldn’t even tell my boy was off without flexions so when I say it was minor it was very very minor.

[fordtraktor]

I would not use SMBs on a horse. However, when I have a horse with an actual suspensory injury, the only product I think that is of any use whatsoever is Saratogas. On the flip side, they do not have a lot of give so unless you are very good at wrapping, I think it would probably be very easy to give a bandage bow with Saratogas and you ought to use a liner for sure. They are, however, I think the best at putting a horse back into work after a tendon injury. I also really like them for use with quilts in the initial stages of an injury. They never slide, they offer a very even pressure, just a great product. And I’ve been using the same 2 sets since 1999 and they still look great. I don’t think they really offer “support” per se, but they do offer some degree of protection and pressure, without being hot.

I agree with the others, if the horse is that sore I would be planning on several months off, not two weeks.

[ThreeFigs]

IMO, there’s no such thing as a “minor” suspensory injury. Hope your other vet has better diagnostic skills and advice.

[Lady_Eboshi]

[QUOTE=alibi_18;8186997]
No ultrasound?!? Sorry but…Please get a second REAL diagnosis.

Really, you need to know what’s going on in there. Please, please call a better vet.[/QUOTE]

I would not even assume suspensory issues without seeing a lesion on ultrasound. That procedure is commonplace and relatively inexpensive–and takes much of the guesswork out of Dx. Given the catastrophic, career-ending potential of a severe suspensory injury, this is one time I would definitely spend the money to find out what I’m dealing with–even if you have to throw the horse on the trailer and drive to the nearest university vet school clinic.

While SMB’s have been marketed for years as providing “support,” objective evidence that ANY boot or wrap actually does so is notably lacking. A standing bandage or polo can be applied to hold swelling down, to keep poultice, ice, or DMSO on the leg and covered, but “supporting” a 1,000 lb. animal would take a good deal more than that.

I’d skip the SMB’s and put that $120 toward the ultrasound.