Shoulder pain?

[the_sandiest_shoes]

Something has been off with my horse for several weeks now. It started with she one day got fussy when we were doing right lead collected canter transitions (shortening and lengthening the stride). She’s young (6) but not marish typically and not a horse that fights you - it was odd and we thought maybe she was just tired. The next day, she was fine until again we did more right lead canter work. A lot of other horses I would have thought it was behavioral, but it’s not in her nature to resist at all, so I figured something was wrong.

She wasn’t lame that you can see on hard or soft ground. We thought maybe the teeth or saddle/something in her back - she had a chiro appointment and everything was fine. The chiro gave better feedback than usual. Brought out the special vet who’s very good at diagnostics and after doing a bunch of testing and various things, the horse did start to look lame on her right front while longing on small circles on hard ground. So I thought, aha, she is sore. The vet thought it was a hot nail. Pulled the nail, said to give her some time to heal on the foot, then try her again. But after some rest, it was the same. Worse, actually - when I trotted right rein, at the moment she anticipated I would ask for canter (clever horse), she got fussy again.

Farrier came out - he had done some experimental shoeing on the horse two weeks prior, giving a slight lift on one foot because she is a little unbalanced in her front by conformation. We all thought that this may have thrown her too differently in movement and she may have strained herself on the right from the different shoes. Got rid of the experiment shoes, gave her two weeks of just walking (still on some minimal turn-out). She hates the rest and is desperate to take-off during hand walking. After two weeks of rest, did some light longing walk-trot, everything looked fine - tried her again this week under saddle and nope. Perfectly happy and energetic on the left, put trotting right rein (no canter even asked for), at the hint of flexion or a corner, she got really fussy again - shortening her stride, tensing her back. She doesn’t go lame exactly, but just isn’t right. Gets really stressed and doesn’t want to move forward on the right, wants to turn her head and body left.

The one thing that made me think shoulder (besides that it would seem consistent with the one-sidedness and initial hesitation about canter/ would make sense I think based on something she could have injured due to the right front shoe imbalance) is that she had a massage, and she’s usually really well behaved/loves the massage therapist, but the therapist said she was a little defensive about her right shoulder.

The horse had full x-rays last summer (including neck and back) for the PPE when I bought her - nothing of note at that time.

This was a novel - I hope to have better luck on the second round of diagnostics tomorrow…it’s hard when the horse presents not-exactly-lame (she hasn’t looked lame since the first time around with the vet doing lots of testing), has no heat or swelling anywhere, is ok on one rein and not the other. I know shoulder injuries aren’t that common but I’m wondering if this sounds like a possibility/ if anyone has experience with a horse having an injury like this? Thank you.

[suzyq]

Do you ever do front leg stretches with her? My horse who had a shoulder lameness got very upset when the chiro did front leg stretch. This was before the shoulder injury was diagnosed, we just thought he was wierd. He was never lame, just very resistant to work. Until he broke down. Then everything made sense. I also had a full ppe with xrays 1.5 yrs before he went lame. Ppe does not usually include shoulder flexions or xrays because it is a rare occurrence.

[CanteringCarrot]

This is going to sound odd, but I wouldn’t rule out the left stifle or something in the left hind. This may not be an issue, and hopefully your vet can help you determine this, but the horses symptoms sound a lot like a horse I was working with that had a stifle issue. Eerily similar. Including us thinking it was a right front issue, being prevalent at canter, etc. Could not be the case, just reminded me of that.

[Obsidian_Fire]

@Moderator 1 above post is spam.

[NancyM]

A good vet once told me, “If it looks like shoulder, it’s probably knee”. It’s not always true of course, occasionally it is shoulder, but not often. In the instance that this quote was issued, it was knee. Good luck.

[the_sandiest_shoes]

Thanks, all. She’s ok with leg stretches - but when the vet was there today you could see the mare was visibly in pain during palpitations on her right shoulder area.

She was sound on the longe, and under saddle ok walk/trot both ways (including with over-flexions right and left), and fine canter left - then canter right under saddle she fell apart again. The vet took a longggg look at her, and ultrasounded her shoulders, elbows, neck, back, SI joint and stifles. She saw a few “minor things” that mostly looked basically average, but didn’t see anything bad enough to explain the canter issue.

We decided to keep her in work doing light walk/trot under saddle and we’re going to try shockwave to see if it helps the “muscle spasms”. I’m frustrated it’s a mystery but glad she was more sound than before and happy there doesn’t look to be anything wrong with her tendons or joints. Vet said she could have done something funky in the field one day or even got herself cast. It all started out of nowhere, not gradual. Fingers crossed the shockwave helps…

[anon55755751]

Where in her shoulder is she reacting? How long are your tree points? It may be worthwhile to see if you can borrow a saddle with shorter points (if yours are long) or slightly different angle to see if she’s more comfortable. Whether or not that’s related to the initial cause, it could be helpful for minimizing further aggravation while she’s in light work.

[the_sandiest_shoes]

Oh boy. The vet thought about the long exam yesterday some more and re-reviewed all of the findings and sent me a report today - she actually thinks it’s a lot worse than she thought yesterday. She thinks it is more likely that the horse basically tore her shoulder muscle where it attaches to the body - an injury she thinks is consistent with a horse that got cast. The way she felt and moved, and the lack of improvement in her right lead canter/ the way the canter totally falls apart under saddle on the right but not the longe - it seems consistent to her with that kind of shoulder muscle injury (with the added weight of a rider throwing the muscle off).

I won’t waste words summarizing the report more, but the suggestion is a very detailed 14 week rehab program, without turn-out and limited to handwalking for a few weeks, then small introductions of a couple minutes trotting on the longe, etc. I thought muscle recovery would be better than tendon injuries but doesn’t seem that way. I’m seeing the vet again tomorrow. Just crossing my fingers that this is something the horse can come back from 100%. Poor mare. Oh my god, these horses and what they do to themselves.

[RedHorses]

The thing about horse shoulders is there is no bone to bone connection between forelegs and the rest of the skeleton. The barrel essentially rests in a sling of soft tissue between the. forelegs. Any injury to muscles or ligaments is going to be a big deal because we can’t take the load off the injury. The best we can do is try to restrict activity.

It sounds like your vet has a plan. Take your time and let it heal.

[CanteringCarrot]

@the sandiest shoes

Oh boy. The vet thought about the long exam yesterday some more and re-reviewed all of the findings and sent me a report today - she actually thinks it’s a lot worse than she thought yesterday. She thinks it is more likely that the horse basically tore her shoulder muscle where it attaches to the body - an injury she thinks is consistent with a horse that got cast. The way she felt and moved, and the lack of improvement in her right lead canter/ the way the canter totally falls apart under saddle on the right but not the longe - it seems consistent to her with that kind of shoulder muscle injury (with the added weight of a rider throwing the muscle off).

I won’t waste words summarizing the report more, but the suggestion is a very detailed 14 week rehab program, without turn-out and limited to handwalking for a few weeks, then small introductions of a couple minutes trotting on the longe, etc. I thought muscle recovery would be better than tendon injuries but doesn’t seem that way. I’m seeing the vet again tomorrow. Just crossing my fingers that this is something the horse can come back from 100%. Poor mare. Oh my god, these horses and what they do to themselves.

Ah yeah, that under saddle but not on the longe thing kind of detracts from my previous post, and at this point it seems to be quite clear that it is the shoulder.

There are so many things that “could have” caused it, and horses, the masters of mayhem that they are, cannot tell us what exactly that thing was. So you just get to deal with the result. Fun, eh?

Muscle recovery can also take a long time depending on severity. Although when my previous horse slid in turnout and did some damage to his hind quarters (just muscular damage), it healed faster than I expected. I did keep him in a small turnout as it was better for him. Better than seeing his head pop up over the stall bars every day as he reared and bucked about in his stall…meanwhile on turnout he just stood and ate hay. :rolleyes: But I did do hand walking too. I knew turnout was a risk, and perhaps his injury was not as severe as in the OP.

Hopefully your mare is a bit more civilized about this. I hope after those 14 weeks you have a good sound horse again. I do agree that the shoulder is a difficult area and patience is key.

[the_sandiest_shoes]

So mini update - I think I know that it was, almost for sure, the right shoulder as the issue. Wanted to put this here in case anyone has a similar freak thing happen in future.

Poor little mare is not happy about being denied turn-out and being relegated to 40 minutes of handwalk per day for now. However, she got a second session of shockwave today (which she LOVES - you can tell she thinks it feels good! the tech commented on how sweet she is for a mare and I said “yeah, she’s mare enough to be decidedly unsweet when she’s not happy, trust me!”). The shockwave tech also noted how her shoulder area seemed less swollen and tender, which is a relief!! I’m just happy to know with more confidence that the shoulder is indeed the source of the issue. I’d love to know what exactly the horse did to hurt herself, but unfortunately animal psychics aren’t real lol. The vet is pretty sure the horse got cast and ripped the shoulder pulling herself free. As mentioned, she pulled a shoe in her stall around the time when this must have happened, so that might add up.

So the plan is going to take a while, but the meds we have so far and the treatments are already helping - I’m going to just keep up with the Back on Track sheet, Back on Track shoulder guard, applying some heat, and doing all the other little things the vet and others suggested to can to help this get better and wait it out.