rehabbing from SI pain after injections

[AMT7180]

Over the past several months, I’ve worked with the vets to try to pin point exactly where my horse is sore. Vets think the pain is up high in the SI region. He’s been vacationing for about a month but can go back into work this weekend.

For those of you who have had horses with SI pain/injuries, what are some good exercises to incorporate, and how slowly should we get back into work?

Prior to his performance deteriorating the horse was working solidly at training level, moving towards first level. I was pregnant and stopped riding. Leaser began to jump horse a bit and he fell apart. First at the canter (got crow hoppy/lots of tail swishing), then thrashing/head shaking at the trot. We initially thought hocks (so injected them), checked teeth (floated them), chiro adjustments, time off, robaxin/bute regimen, treated for low positive chronic lyme. Most recently he had a sore stifle and vet prescribed estrone and putting him back into work. Now stifle is better but he was equally lame/not stepping under himself, which led to the SI conclusion. Just wanted to provide a little back story.

Thanks in advance. Just want to bring my guy back into work/shape slowly now that I’ve injected the SI. I now have a Back on Track sheet for him, so I’m hoping that helps him as well.

[SansPeurDansLaSelle]

I’m not a dressage rider but my TB mare has SI issues that are easily managed with injections every 6 to 9 months or so depending on how hard she is being worked. Same as your horse she starts crow-hopping in the corners especially and missing her changes behind. Generally I give her about ten days off after the injections, then flat her lightly for a week and then she’s good to go back jumping (in a sidesaddle too!). It sounds like your horse may have some other compounding issues but I have really not found the SI issues to be a huge game changer.

She has a very long back which I think may contribute to the strain on her SI so I do a lot of hill work, lateral work, grids, and such things to build her hindquarters, core, and back so she can better support herself.

[steeple]

After being diagnosed via a bone scan, I have had my horse’s SI injected twice (about once a year), and both times they told me to give him two days off for needle soreness and then once day of a light hack, then back to regular work.

My horse’s symptoms were kicking out and swapping leads behind at the canter. After the SI injection he was like a new horse. I was not told to do any particular exercises but I try to do a lot of quality flatwork to build the hind end and we do trails including hills when the weather is nice in the spring summer and fall.

[BatCoach]

It sounds like you have a good plan in place. Let us know if the BoT sheet helps. The one thing I would add is to be prepared if the injection doesn’t help - it may be a soft tissue strain in the SI region which will require a different treatment plan. Fingers crossed for you and your horse! Re-occuring mystery lameness is the worst.

[Bogie]

It sounds like you have a good plan in place. Let us know if the BoT sheet helps. The one thing I would add is to be prepared if the injection doesn’t help - it may be a soft tissue strain in the SI region which will require a different treatment plan.

I had my gelding’s SI joints injected in October/November time frame. Hasn’t helped much. Right now I’m treating him using massage (definitely makes him feel better) and strengthening. Hill work, transitions, walking & trotting over poles. I’m going to wait until the footing improves and then have him re-evaluated. My suspicion is that the SI was hurting, but that it was only part of the problem or that it’s a soft tissue strain.

In the meantime, I have a horse that can walk and trot just fine. Most of the time he canters to the right just fine. Cantering to the left? not so much.

[beowulf]

When the leasor was leasing, did she ride him in a different saddle – specifically, if he was a dressage horse he must have a dressage saddle… did she start riding him in a jump saddle?

IME SI issues seem to crop up after lots of back pain, hock pain, or stifle pain. Sometimes it’s just plain old KS, but IME the SI pain is usually secondary to something else.

Jumping can also aggravate something that might have been brewing, but not bursting yet - IE it could have been something asymptomatic but the jumping made it symptomatic. I can think of more than one horse that was diagnosed with KS that way – they were fine and seemed to not have symptoms until jumping was introduced.

[slp2]

So it sounds like you don’t have a complete diagnosis of the problem yet. I have a horse who had SI issues and was injected by one vet, and it made things worse. Then I found a vet that specializes in neck and back problems—and we started with a bone scan. The problem was an old SI ligament tear–which had developed scar tissue where normal ligaments should be. So an injection was not going to help with that type of injury. I only mention this because your vets aren’t sure what the problem is with the SI—and it could be a ligament tear, which usually will not be helped by an injection.

Anyway—here is the protocol we were on for rehab: to start—stall rest on bute with only handwalking. When we started back to riding—the exercises the vet had us do was to spiral in and out on a circle for up to 30 minutes. Started this in the walk, then added the trot in (after 1 month) and then the canter. This helps to break up the ligament fibers (steppiig in and across as the hind leg crosses under) and then they should develop healthy ligament fibers as they heal. The before and after ultrasounds of the ligament is amazing.

I have to say—it was a long rehab process—but it is fully healed and my horse has had NO issues with her SI since then. Very glad I got an accurate diagnosis and was able to help her be comfortable again!

[ChasseurSauteur]

We injected my horse’s SI last spring after a frustrating period of hind-end NQR-ness. My vet emphasized two things for re-building and continuing support of the area: keeping him very well-muscled through his back (he came to me underweight and unfit), and ensuring his hocks were well-maintained (because discomfort in the hocks often causes them to carry themselves in such a way as to stress the SI.)

We address the hock issue with an HA supplement and yearly injections. Meanwhile, we essentially put him on interval training for 2-3 months to build hind-end muscle. After a couple days’ stall rest and bute post-injection, we started with a few days of walk and canter only (I know this may be contrary to some vets’ opinions, but our vet felt it would help loosen the area more effectively.) We then did timed trot and walk intervals, starting with fifteen minute sessions and increasing to 45. After a couple of weeks we started integrating two rides a day, one normal ride and one doing hillwork. Horror of horrors, we did lots of this work in draw reins at the vet’s suggestion to encourage correct shape.

It was long and tedious but my horse came out of it looking and feeling alike a million bucks. He has had no further SI problems in the months since despite a significantly increased workload. If you are interested in the exact rehab plan we used, I have a copy of it at the barn and can provide it to you. Being extremely systematic with the rehab was really the key for my guy.

[AMT7180]

Thanks everyone. Apologies for not reviewing/replying sooner! I had one ride (just a short walk) on my guy so far and he felt significantly more comfortable than he normally does after a month or so of not working. He did not feel like a 2x4 that couldn’t steer or bend. I’m cautiously optimistic and will be hopping on a few more times this week.