Recovering from Collateral Ligament Injury

[Rubs_Not_Pats]

On a number of points actually. My own vet and surgeon gave me much less of a chance of ever being usable again. The second thing was that once we started recovery and did our second follow up U/S. I found that the fiber allignment was not optimal. The consensus was to continue walking but the vets here wanted handwalking. The radiologist said that the handwalking was not helping and clearly the horse needed resistance work (like a rider on her). So I chose to go that way. After a month, the U/S was drastically improved. What I was told was that clearly what we were doing was not working out in our case and if we wanted more malalligned fibers, we could go right on ahead and keep doing it. The fact that he was so sure about it and my vet and surgeon were hedging so much, I went with it. Besides, it made intuitive sense. BUT, how many people are going to walk their horse for 1 hour 6 days a week? The devil is always in the details. The horse requires resurpine and ace to do it. Remember these drugs are your friends!

I have been given many choices about starting back to trot work, again being told the longer I give her off the better. Personally, I am into this lameness and injury including all expenses, like board, training and medical close to 20K. What’s another month or two or four? I just want my girl back and sound. I don’t want to think that every time she trips, that if I had only given her off another 30 days. At this point it is so ridiculous I have stopped even caring. Now I could have saved money by taking her home and riding her myself, removing her shoes, skipping the shockwave, stem cell or follow-ups, so I really don’t want to scare anyone. But this has not exactly been a budget rehab.

[3Hanns]

Rubs- glad to hear your girl is starting to trot again and is still doing well.

To the OP- the recommendations to take it s-l-o-w are so true. My mare had a 70% tear in her collateral ligament just over a year ago and now is still sound (Thank goodness!) after about 5 months of going back to work. We still just do light work…lots of trot walk transitions, trail/ hillwork, and some canter…I get so much pressure from others to start jumping her, but I just can’t do it…I know she would love to, but I am still too scared at this point. Everytime she trips or takes a bad step my heart flutters.

Obviously I still am ultra paranoid- and recently she came up lame on that same foot and I almost cried, but it turned out to be a hot nail I never thought I would be sooooo happy about her getting a hot nail!

I am trying everthing I can to get her to use her hind end more (she injured her RF) and stay off her front…this is not an easy task for her, so it definately keeps us busy

Good luck!!!

[3Spots]

Thanks, Rubs, your insight is well-appreciated, thanks for sharing.

The weighted walk is what makes intuitive sense to me as well – did you stay on hard ground or do soft arena, or some combination of both along with weighted walk?

Since I am a trail rider, I can stay at a walk for many, many months and be quite content. But I do have small hills and uneven trails (not treacherous, but deep sand in the creek, fire roads, and an occasionally shaley patch) that she would have to negotiate - and I am not sure when/how to introduce uneven footing though I’d begin in our sand arena. For the most part, our trails don’t have good enough footing for more than 100 yards of canter/trot, lol.

3Hanns, did you elect a follow-up u/s? Did doing so (or not doing so) change your back to work approach?

jan

[3Hanns]

3spots- Yes I did do a follow-up U/S. Actually I think we did 2 total…

The first f/u U/S was about 2-3 months after the injury- showed some healing- I think the lesion went from a 70% tear to 40%, vet was pleased- but she was still lame, even at the walk

The second one was at about 4- 5 months- and it showed the lesion was 100% healed, fibers were perfect-you could not even tell there was a previous injury. However, she was still slightly lame trotting in L circles.

I think at about month 6-7 she trotted sound in both directions in circles…

Yes- The follow up u/s did make a difference in the rehab work. Vet was not comfortable w/ trot work until u/s showed lesion was fully healed.

[Rubs_Not_Pats]

First trot was today and she was lame. She is due for shoes so we will redo them Friday and see what we have but suffice to say, I am very dissappointed.

[3Hanns]

Rubs- don’t be dissapointed…I know EXACTLY how you feel. Laney was still lame after her last U/S showed COMPLETE healing…I was so sad and vet was concerned.

About a month or two later- she was 100% sound, and has been ever since…

I bet you’ll have the same luck

[Rubs_Not_Pats]

Thank you 3 Hanns!

Did you back off work until horse was sound? Do you think I should re U/S and send out again? The last one showed great healing but not 100%. I guess my problem is that she was lamer now then when she stopped work due to the injury. They told me she could start back after the last U/S a month ago. I elected to go slower as they felt it meant longer term soundness.

[SimpleSimon]

@Rubs Not Pats;2733583

Thank you 3 Hanns!

I guess my problem is that she was lamer now then when she stopped work due to the injury. They told me she could start back after the last U/S a month ago. I elected to go slower as they felt it meant longer term soundness.

My horse’s medial collateral ligament injury was not as severe as your horse’s. However, MRI on both front feet showed a strained (no visible tear) collateral ligament on the right front and a bone bruise on the left front. That was in April (after 60 days stall rest). By June he was MUCH lamer on the right front than he had previously presented. I think this was due to the bone bruise healing in the left front allowing him to bear more weight on the left and baby the right more.

By August he was sound - completely and U/S showed no enlargement of the ligament. It may be that your horse had something similar as well - apparently, it is not uncommon for an injury (such as the bone bruise) to occur in the “good” leg.

The WSU vet I was working with still wanted us to proceed with turn-out (limited paddock size). He felt that some movement and increased blood flow would help the healing process in the ligament. I was cleared for under-saddle walk rehab in mid-August.

I think this is a hard injury to compare notes on due to the wide spectrum of severity. My horse was given a 70% chance of 100% recovery with no future work limitations and deemed no more likely for a re-injury than any horse would be to get injured the first time around (how do you put that in to clear, concise wording?). I did not do shock-wave, stem-cell or anything other than time off per my vet’s recommendation. So far, so good.

Don’t give up!! Follow your vet’s rehab program to the exact note - remember he/she is the only one who has seen the MRI or u/s pictures and knows more about your horse’s situation than any one else.

[Rubs_Not_Pats]

O.K, so today we trotted with new shoes. She was significantly better. We will see what time does. I will probably have her trot thru the weekend then recheck on Tuesday. I will keep everyone posted.

[3Hanns]

Oh Rubs- I am so glad she was better

I think (if I remember correctly) at the stage of 100% healing per u/s results- Her work plan was something like 40 min of walk, 10 min. trot. Trot only in staright lines (no corners), for brief periods. Vet also wanted to continue handwalking as well for 20-30 min. a day on top of under saddle excercise.

So to answer your question- Yes-I did continue to work her, but we were stuck at that stage a little longer…after she was sound, I think the trot increased by 5 minutes every week- so the next week her schedule was 35 min. walk, 15 min. trot (and so on)

Keep us posted…

[Rubs_Not_Pats]

still trotting

Actually she looks great! I mistakingly took her off sedation one day and she managed to demonstrate her amazing pent up athletisism. I never knew little Tuna could buck like she did! I am lucky to be alive! We are currently back on sedation! Rubs seems really comfortable. I have started lengthening and shortening exercises with her to keep her focused. She seems way, way sounder than before. I had her doing a big dressage trot and then came back that she was just right before a piaffe. She was amazing. No lameness, no swelling and I am trotting ten times around each direction now.

The problem is that I so see the temptation to bring her back to work. I think she is fine but in my mind I know she is not. I am thinking we will trot another month then U/S. If all looks well, then canter for another two months and that would give us her year. I will re U/S before cantering.

[mellsmom]

Been there, done that bought the t-shirt.

I think that it makes a difference if it’s front or back leg.
Mine did a left front lateral, 4 months rest, return to work, then unsound again, left front medial collateral. 4 months rest, then turned out a year. He was a lower level event horse. Now he’s a walk/trot dressage horse. He’s basically a 12 yo retired neurotic field ornament. I loff him though, so what’s a girl to do. I just put back shoes on him again and will most likely inject his hocks this spring. He can’t stand up to a lot of consistent work, but mentally needs to be ridden, so I try to get on him when I can. Anyone in Western Goochland Va who wants to play with him, call me He loofs to jump but i am afraid to. He has got some other subclinical stuff going on that makes him iffy to put into full work and I am terrified to canter him as that’s how it all started. One misstep at canter.

[Samotis]

Lisa, glad to hear Rubs is doing better. It is hard to not do more when they feel so good, but be careful. I have learned the hard way over the last 2 years! She is a lot younger then Otis, but he would have pain, but not be lame and I just kept riding him, then his leg would swell! Be patient.
I know that you guys use Platinum Performance at Sherry’s. I would also buy their Osteon supplement. I have had my horse on it for 6 months and he has had no swelling and I have jumped him at a show as well at home for the last 3 months. That is the only thing I have changed in the last 6 months and he hasn’t had any puffiness at all since then. It isn’t too expensive either. Good Luck.
Sam
ps, Gracie is getting faaattt! I stopped riding her this week because it is obviously becoming uncomfortable for her. (she is 8 months)

[3Spots]

Oh, here you guys are… great news, Rubs. Hearing of the setback and recovery is reassuring to know; glad you guys are leading the way for the rest of us, though I can feel the emotional up/down.

Is anyone taking their horse over rougher footing (like on trail), or has all the walk/trot work to date been in the arena or flat grounds of your barns?

jan

[Rubs_Not_Pats]

I am in an areana. I have no need to take this thorse over rough ground. The deepest footing she sees is in her stall. Kid you not but getting them to bed less was a bit of a challenge.

[3Spots]

>bedding less I remember that!

Well, maybe I’ll have to blaze the way for getting back onto rougher footing. I’m just talking fireroads for now; only on the flat. They aren’t really that rough; mountain bikers would think they are tame, but a little more uneven than the arena. I would personally find it easier to hike the fireroad that do the equivalent time in the arena as our arenas seem deep to me – like hiking at the beach!

I am just wistfully thinking ahead, I won’t have to worry about it until I get 30 min/mounted per day accomplished.

Hey, are you doing turns at the trot, or just straight lines?
jan

[Flying_Hearts]

Ooh, what a good thread. All these stories of horses getting better are really encouraging for me to hear right now! Here is my situation (sorry it’s long!) I have a 3 year old TB/WB gelding. He was lame off and on for his whole 2 year old year and it went either misdiagnosed or undiagnosed (long story) until finally I had a vet tell me he thought it was either a collateral ligament tear in his hoof, or a deep digital flexor tendon tear in his hoof. I did not and do not have the money for MRI’s, stem cell, or shockwave therapy. Ultrasounds won’t work to see inside the hoof. So technically he’s still undiagnosed, but it is everyone’s best guess and we are treating it as such.

So the horse went on stall rest the end of April. He was DEAD lame at that point. He improved a lot in one month, but got loose at the end of May (ooh, don’t even get me started on that haha) and was very lame again. So now he’s been in a stall since the end of May, which puts him at 5 1/2 months of stall rest right now. He has been sound at the walk for a few months (he is not hand walked, only across the aisleway to another stall while I clean his sometimes). He was prance-trotting the other day when I moved him across the aisle and was sound.

I do not have good advice on making this horse’s rehab schedule, so I’m really interested in hearing what your guys vets recommended for your horses. I was planning on keeping him on stall rest for 10 months (keep in mind the extent of the tear is unknown), followed by one month of handwalking (is that enough?) Then putting him on 24/7 turnout in a small paddock with a shelter for maybe a few months? Followed by 24/7 turnout in a big field (all ground is level) for a looong time until I start to train him to saddle, assuming he is sound. Now how does that compare to what your guys vets recommended?

[Rubs_Not_Pats]

I started with just trotting straight lines but it was annoying and really pissing off the horse. So now I do real wide sweeping turns. It has not made any difference in how she goes. Truth be told, she has cantered a few steps when she freaks out or I push her forward. I have been trying to do some lengthening and shortening with her, to keep her interested in something other than bucking me off (so far, we are doing O.K)! I wanted to take her out to the racetrack we have at the facility to give her a change of pace but the footing is too deep and if she did get me off, she would go on quite the tour before getting back to the barn. So we have stayed in the ring for now. I don’t know about the turns thing because when they did her lameness exam before she was cleared to trot, she was put in a round pen for the vet.

Sam, I don’t use platimum, I use recovery EQ/HA and legend/adequan. I am glad to hear gracie is doing well. Where will you foal out?

[3Spots]

Flying Hearts,

I don’t think too many vets are recommending complete stall rest – it always seems to be 20-30min per day at a minimum. Go get Lucinda Dyer’s book: Back to Work. It has excellent rehab plans and several stories like this thread.

My vet recommended 8 weeks of 30min handwalk 5days a week, followed by 8 weeks of successively adding 5 min of trot a week until we were up to 30-40 min of trot per day 5 days a week. Then another 8 weeks of successively adding 5 min of canter.

No lateral work, choose footing that can keep the hoof most lateral (not too deep). No turnout. Stall size less than 24x24. Only after canter could controlled turnout begin.

The entire process was to be 9-12 months…

[ljc]

@Flying Hearts;2803996

Ooh, what a good thread. All these stories of horses getting better are really encouraging for me to hear right now! Here is my situation (sorry it’s long!) I have a 3 year old TB/WB gelding. He was lame off and on for his whole 2 year old year and it went either misdiagnosed or undiagnosed (long story) until finally I had a vet tell me he thought it was either a collateral ligament tear in his hoof, or a deep digital flexor tendon tear in his hoof. I did not and do not have the money for MRI’s, stem cell, or shockwave therapy. Ultrasounds won’t work to see inside the hoof. So technically he’s still undiagnosed, but it is everyone’s best guess and we are treating it as such.

So the horse went on stall rest the end of April. He was DEAD lame at that point. He improved a lot in one month, but got loose at the end of May (ooh, don’t even get me started on that haha) and was very lame again. So now he’s been in a stall since the end of May, which puts him at 5 1/2 months of stall rest right now. He has been sound at the walk for a few months (he is not hand walked, only across the aisleway to another stall while I clean his sometimes). He was prance-trotting the other day when I moved him across the aisle and was sound.

I do not have good advice on making this horse’s rehab schedule, so I’m really interested in hearing what your guys vets recommended for your horses. I was planning on keeping him on stall rest for 10 months (keep in mind the extent of the tear is unknown), followed by one month of handwalking (is that enough?) Then putting him on 24/7 turnout in a small paddock with a shelter for maybe a few months? Followed by 24/7 turnout in a big field (all ground is level) for a looong time until I start to train him to saddle, assuming he is sound. Now how does that compare to what your guys vets recommended?

I’m sure you’ll hear all sorts of lay-up/rehab programs. For what it’s worth, here’s mine (via MRI, horse diagnosed with DDFT on left front, impar ligament tear on right front). My gelding has been in a 24X24 paddock with cover for six weeks (another 10 to go, making a total of 4 months in a confined space). We’re up to 30 minutes of handwalking every day (we started at 15 minutes and added five minutes every few weeks. I’ll probably be ready to tear my hair out when we reach 45 minutes!!!). At that point, I’m going to bring him home and turn him out in my field for a year.

I think it’s a good idea to get them out each day for some handwalking, difficult as it might be. I’ve always been told that it’s important to put a little bit of pressure/tension on the fibers as they are regrowing, so they can grow back stronger. I’d be worried that a horse kept totally confined in a stall (except for something like a broken leg) might not get the necessary stress on the soft tissue for regrowth.

Good luck – the whole thing is a royal pain, no matter how you do it!!!