Recovery time for classic bowed tendon

Hey all,

I just got an OTTB 3 weeks ago and everything was going wonderfully and then he bowed his tendon sometime on Sunday…Superfical flexor tendon all the way from below the the knee down to the ankle…vet says 6 motnhs of stall rest with nothing but ??? as far as what this horse will be capable after recovery. Obviously I am upset…this guy has the best mind for learning things and he is super quiet…cute as a button and put together decently and was showing some real aptitude for a new career as a possible eventer. He however is a serious cribber …anyhoo… I’d really like to hear anyone’s experiences with this type of injury…your thoughts, advice anything and thanks in advance.

Give him proper rest and he’ll likely come back fine. There are plenty of campaigners in all disciplines with old bows. Once properly healed, not usually a problem.

In Feb my horse suffered the exact same injury. My rehab experience is discussed in my blog as well, but here’s the details:

My rehab plan is a year long plan and I have been told to expect a return to full work (eventing).

I’m in my sixth month rehabbing (SDFT core lesion). We are just adding in trot work. Note, I think above all the rehab plan depends on what the injury is, and what is right for that horse.

In my case, we stalled for the first 60 days.

I followed a strict rehab protocol that my vet gave me, it originally came from UC Davis, there is a vet there, I’m thinking her name is Carol Gilis (I might have spelled her name wrong). The sheet I have is a general rehab protocol we tailored to my horse.

I did stem cell and PRP.

I used a game ready for the first 30 days to deal with the acute trauma/swelling phase.

I also did cold laser, but that’s a huge discussion and I don’t know enough about it to really explain it and I think there are lots of different lasers on the market, being used differently by different vets. I think it helped and I think it was beneficial.

First 30 days: 15 mins of hand walking, twice a day.
Days 30-60: worked up to 40 mins of hand walking.
Day 60: check up ultrasound, with significant healing.
Days 60-90: worked up to 60 mins hand walking.

Day 60-90: supervised turn out, with hay as a distractor in a 24x24 pen for up to three hours a day

Day 90: turn out in a small pen 16x 36 24/7

Days 90-120: rode at a walk 30 mins/day

Day 120 - check up ultrasound with even more significant healing - the lesion is only barely visable at an acute angle of the ultrasound wand - ie. you’d have to go looking for it

Days 120-150: worked up to 1 hour of walking/day

Starting at Day 150 we changed his turn out to a large grass paddock, about 80x120 (alone) about 16 hours overnight and stalled during the day because of the summer heat.

Days 150-180: add 2 mins of trot each week, so week 1 you trot 2 mins a day, week 2 you trot 4 mins a day, etc (at the end of this month, you’re up to 8 mins of trot/day)

Days 180-210: continue to add trotting at 2 mins/week, add in canter (my plan says to add 5 mins every two weeks, I will probably do it in two min/week like I did trot) (at the end of this month you’re up to 16 mins of trot/day and 8 mins of canter/day)

Day 210-240 (we’re up to month 8 at this point), same as days 180-210, adding in (at the end of this month you’re up to 24 mins of trot/day and 16 mins of canter/day)

Day 240-270 full flat work (month 9)

Day 270-300 (month 10) begin jumping

This is all assuming no flare ups and continued clear ultrasounds.

53 has the right idea and 1 year is not out of the question in fact very conservative.
Proper attention to his feet keep toe back and level w/ plenty of heel supprot.
Cold hosing, ice pack wraps, poultice till heat is all gone.

Keep his mind occupied w/ various hay bags hung around the stall etc. I have used a grazing muzzle for a serious stall cribber, they can drink but not crib.

Keep up the ultra sounds up they are you barameter on his progress…good luck.

thanks for the replys… doing stem cell is not in the budget and PRP is not really in the budget either but I might consider it IF it would make recovery and future soundness considerably more favorable…53…I’ve got the same start to the rehab as instructed by my vet. …at least for the first 30 days…I looked into the gameready kit and that’s pricey as well…I have no insurance on this guy…he was a rescue off the track…Has anyone had success without doing stellcell or PRP or any other costly procedures. Please don’t misunderstand…I am not cheap and go without so my horses can have the best care but this horse rescue came up unexpectedly and I wanted to help out but I never thought luck would be so bad that he’d bow a tendon within a couple weeks of getting him home. I just don’t have thousands for rehab…

I know of one who came in with a fresh bow who rehabbed very well with no special or expensive treatment. Just stall rest and careful wrapping for a while, then careful hand walking, then eventual light turnout and then full turnout for a while. I don’t remember what the time frames were but he recovered extremely well and was very sound. He was not a jumping prospect but it was his second bow on the same leg (which I would blame on racing on a very poor trim/shoeing job). He probably could have, just fine, just not a risk we wanted to take. I know of several others who had their initial treatment with their track trainers, who are perfectly sound for jumping/eventing, but do not know what the treatment protocol was for them in the first 60 days.

You may want to grab the Bowed Tendon Book, I’ve heard that’s a good resource.

I just pulled out my bill for Phinn.

Platelet Rich Plasma: $1189.91
Bone Marrow Concentration with PRP: $600

If I had to choose, I would do PRP and Game Ready.

Game Ready, IIRC, with shipping and mandatory insurance came out to just under $600 for 4 weeks.

If I had to choose only one, it would be a toss up between the game ready and the PRP.

:slight_smile: I have never used any IRAP, PRP, IIRC or used Game Ready.
Each and every Bow has been treated the old fashioned way…hosing, ice, poultice, rubbing wrapping and TIME.
Time and patience will be your horses best friend…
I do follow up w/ ultra-sounds and have rehabbed 2nd re-bows to almost imperceptable appearence.
Good attention to proper balanced foot and good feeed suppliments.
I get plenty of compliments from the Vets and Trainers for my Bow recoveries.
I try to keep any excess weight off the horse also, stall bound horses get several times a day hand grazing in a very quiet small safe enclosed area that helps w/ the sanity.

I agree that time is the best friend of a bowed horse. If the horse lives in a 4 season environment, turning out in snow is premier. If not, lots of cold hosing and limited turn-out initially is optimal. Many, many bowed horses recover well for careers that don’t “bow to the bow”.

Best of luck to you.

I have a mare who bowed both fronts at the track. I doubt her trainer spent thousands on her rehab, but who knows? I can say that she is as sound as can be, and while the bows are unsightly, they don’t cause her any discomfort or hinder her in any way. I got her a year after she was vanned off track as a result of the bowing…

Horses have been successfully recovering from bowed tendons long before any of these expensive techniques were developed.

Back in the 60s we had a mare who bowed both front tendons. It took a while, but she returned to full soundness, and was sound for many more years of active competition.

I had an OTTB that bowed on the track at 3 yrs old as well, after being claimed by us…he was a very large horse (17.1) so that could have contributed to the injury.

We stall rested minimally (he was never unsound and I was concerned about his mind in stall w/out turnout for very long). We wrapped religously (with White Lotion) and turned out in a round pen for 3 months. He then went on to a larger paddock for another 6 months.

When put back to work, after 1 yr of turnout, I just hacked him for a year and then started over fences (so 2 yrs from the injury)…

He went on to show with me in the A/Os, A/As and in the First Yrs in FL and the north east. I never had a problem. The tendon set up great.

I was always careful about the footing; never rode him in deep going or mud.

I feel badly your horse was injured but the tendon should heal. Time is a factor and patience too. Good luck!!

Have to agree with all the above. As a long time racetracker, if you have the funds, the stem cell, prp and game ready are all very useful. However, if you truly check into stem cell you will see that the protocols all anticipate a minimum 1 year for healing. Most take 1 yr to 18 months, a few go to 2yrs before completely healed.

A couple of things we found to be most important in treating any bow is to get the inflammation down as quickly as possible, ice is the cheapest way to go and easiest to use with neoprene 9 pocket ice boots. For a number of years we have used a Centurion Mini Pulse boot. It is pulsed electromagnetic therapy with different settings for each level of treatment. It works extremely well for reducing swelling pain. You essentially put a polo on the leg, attach the mini pulse with the two velco straps and turn it on. It has a timer which beeps at 30 min to let you know the therapy is done. In acute situations, we used it twice at day. The nice thing about Centurion is you can rent the products and any rent will be applied to the purchase if you decide you want to keep it. I can’t tell you what the current cost is because we have had ours for such a long time, but it was reasonable. With the winter coming up, unless you are in a heated barn, it is well worth the cost of not having to deal with ice.

The other thing that is very important to remember, is that although the hand walking can be a chore, the purpose is to gently stretch the tendor fibers so they don’t heal with adhesions which could complicate the recovery process.

Lots of old fashioned hand rubbing will also help healing by removal of the cellular debris and increasing the amount of oxygen rich blood to the area.

It is certainly a bummer to have this happen, but if you give it time to completely heal you won’t have a problem.

53; covers treatment and rehab very well. I have treated both bows and suspensory with PRP and feel it is well worth the money. But I also agree with Judybigred’s method which has been the standard since the first bow. That’s the way we dealt with them for years, but once the swelling is down I would blister. There are no quick fixes. No matter how much money you throw at it. Time heals everything as they say.
Not knowing what the ultra sound showed but if it was a “run of the mill” bow and most are I think your vet gave you very poor advise, 6 months in a stall, for reasons that others pointed out of the healing process. Use a Sport Vet for these kind of injuries not a “general” vet.

Sorry, I can’t agree with the “blistering.” It is an archaic procedure which most modern race track practioners and vet hospitals no longer utilize because of the the pain and scarring.

We have found shock wave therapy to speed healing and relieve pain because of the increased blood supply. However, we have also found the effectiveness of SW varies among practioners. Additionally, the cost is staggered across the spectrum. We had the same horse treated by a local vet for $900. Later on when she failed to significantly improve, we shipped her to large vet clinic in KY where we paid $75 and and the horse’s condition quickly improved and healed. Usually ESW is performed in a series of three treatments; it is not mandatory but provides optimum results.

A few years back, I spent a great deal of time exploring the merits of the different types of stem cell treatments. At the time the most significant factor was the type of stems cells and there was a great deal of speculation as to which type would be most effective. Cornell U. was working with a UK company and Dr. Herthel at Alamo Pintado in CA was working independently. A point that all the experts agreed upon is that no matter which therapy was used, proper healing required time. Lots of time - on the average of 12-18 mos. IMHO, stem cell therapy has tons of potential, but the biggest obstacle right now is that the stem cells don’t live very long.

In 2005, Cornell’s stem cell program was closely aligned with a UK company for purposes of further development and marketing for equine use. I recall the UK site (sorry, I don’t recall the company’s name) had quite a bit of info on traditional treatment of bowed tendons in the UK.

You can find additional info on stem cells on wiki at:
http://en.wikipedia.org/wiki/Vet-Stem

. were some protocols of how horses were being brought back from the tendon injuries

i have a tb that just came in for sale. he bowed in nov. of last year. he was rehabed by the vet i work for. he was already starting to heal when they sent him so could not do the prp. but we do shock wave and it really does help. he was in a stall for 60-90 days, then small turnout and then was turned out 24/7, he is now in a stall during th day and out at night with another horse. he runs jumps and plays alot. he is going back to work this week. he is very sound.i too believe in the old fashion way as well. lots of cold hosing ,ice and rubbing. good luck

Equine08; Yes, I would agree blistering is archaic if done they way you describe. Like the term “breaking”, I prefer “starting”, “blistering” for lack of a better term, should not be taken literately. It should NEVER be done in such a way as to cause scaring and pain. When done correctly its therapeutic value is well documented. I forget that a lot of people reading these post are not as well versed as others and should have said a “MILD” blister. I would be interested in where you statement of fact, “most modern race track practitioners and vet hospitals no longer utilize” is referenced. We use several well known and respected sports vets all of which recommend a MILD blister treatment. Like many treatments the value of Shock Wave is not well established and opinions vary widely. There seems to be a strong condenses on the value of ultra sound treatment though.

The research I have done as to the value of Stem cell treatment, for bows and more importantly suspensory injuries At This Time does not warrant the expense. IMO a lot of people are paying a lot of money to be Guinea Pigs. I do feel a PRP procedure is well worth the money. There seems to be quite a bit of value using hyperbaric chamber treatments.
In the end “old school” treatments as pointed out by several posters are probably just as effective at this time. What ever treatment is employed all agree there is no getting around giving the horse time. And in the end it will come down to the “quality” of the healing as shown by ultra sound examination as to whether the horse will stand training.

I can tell you one thing for sure. If someone comes up with a treatment that absolutely shows a HIGH percentage of success people will be standing in line no matter what the cost.

[QUOTE=equine08;5790499]
Sorry, I can’t agree with the “blistering.” It is an archaic procedure which most modern race track practioners and vet hospitals no longer utilize because of the the pain and scarring.We have found shock wave therapy to speed healing and relieve pain because of the increased blood supply. However, we have also found the effectiveness of SW varies among practioners. Additionally, the cost is staggered across the spectrum. We had the same horse treated by a local vet for $900. Later on when she failed to significantly improve, we shipped her to large vet clinic in KY where we paid $75 and and the horse’s condition quickly improved and healed. Usually ESW is performed in a series of three treatments; it is not mandatory but provides optimum results.

A few years back, I spent a great deal of time exploring the merits of the different types of stem cell treatments. At the time the most significant factor was the type of stems cells and there was a great deal of speculation as to which type would be most effective. Cornell U. was working with a UK company and Dr. Herthel at Alamo Pintado in CA was working independently. A point that all the experts agreed upon is that no matter which therapy was used, proper healing required time. Lots of time - on the average of 12-18 mos. IMHO, stem cell therapy has tons of potential, but the biggest obstacle right now is that the stem cells don’t live very long.

In 2005, Cornell’s stem cell program was closely aligned with a UK company for purposes of further development and marketing for equine use. I recall the UK site (sorry, I don’t recall the company’s name) had quite a bit of info on traditional treatment of bowed tendons in the UK.

You can find additional info on stem cells on wiki at:
http://en.wikipedia.org/wiki/Vet-Stem

. were some protocols of how horses were being brought back from the tendon injuries[/QUOTE]

I agree, and the tendon needs to cool out, so to me it is contradictory as well.

Does anyone know if there are any medical situations that call for “blistering” human patients in the hospital?

Thanks everybody for your thoughts…my gelding has a significant bowed tendon …the core lesion is twice the size of normal and runs the entire length of the tendon…vet did tendon splitting on it two days ago…we have no idea whether this is bowed tendon is a brand new injury or a recurring injury… former owner had horse ontrack for just one year and swears horse was sound when he got it…don’t know history of horse prior to that other than he looks like he was pin fired on a blown splint… I’ll find out how much the splitting helped at least visually when I take the bandages off tommorow.,…for some reason I think this horse is going to have a good future ahead of him…perhaps I am nuts… and a dreaming optimist. …