Soft tissue rehab - knowing when to do more

[drop_shot]

I’m currently rehabbing my horse’s check ligament strain. The strain happened in the first week of June and after months of hand walking, some shockwave, some PRP, we are finally able to start to trot under saddle (woo!).

This is the first horse that I’ve done a soft tissue rehab on and I’m planning on bringing him back very slowly. Right now, he feels pretty good, but not quite as good as he did pre-injury (understandable since he is definitely out of shape). My question is, how can you tell when they are ready for the next step?

[erinmeri]

I just keep SLOWLY progressing until the horse says “no”.

Having rehabbed check, SDFT and suspensory, I have always followed a very symmetrical, regimented plan… and have always gone slower than the vet recommends. We usually add on a minute of trot every few days, ensuring we are dividing walk and trot times each direction evenly, until we are at about 30m trot (with a lot of walk breaks in between) before adding in canter. If you can swing it, dividing up into two rides is better for horse (and human sanity). The latter stages are the worst, because it is a LOT of saddle time.

We have always progressed as per schedule unless the horse said otherwise (seemed “off” or “hinky” or “ouchy”).

I am super OCD, so I kind of enjoy it until it becomes super unbearable and monotonous.

ETA: horse has never said no. But if it did, I would have gone back… if that makes sense.

[drop_shot]

Makes sense! I had been planning on adding an additional lap of trot work each direction every week.

Do you typically only add additional work if they feel pretty much perfect that day? Currently mine looks very sound and feels pretty good relatively speaking, but feels more shuffle-y than he did pre-stall rest.

[erinmeri]

I have to go back and look, but someone here gave me a great recommendation for an app,

[IPEsq]

Some general rules of thumb, increase duration or intensity, not both at once. So, say you are walking 45 minutes and trotting 1 for now. Don’t add on a minute of more trot without backing off the wall time some. At the beginning phase, this isn’t critical (walking is almost always good), but think about when it’s time to add a minute of canter. You might want to back off as much as 5 minutes of your trot that day, assuming you’ve built up to about 30 mins of trot before you start canter.

Also another common rule is no more than 5 minutes change each week. You might find your horse feeling fatigued and needing to hold at a schedule for a full second or third week before increasing. Fatigue leads to bad steps.

Being a bit shuffly is ok because he’s out of shape. On days where you don’t trot (keep some walk only sessions on the schedule), you can start to play with contact and eventually some easy lateral work to build those core muscles that will help with the shuffly part. You could also alternate days with something like the Equicore system.

It’s always ok to go slower with it than to try to stick to a schedule. Be sure to do a good walk warm up and cool down. And do any aftercare your vet recommends (icing etc.).

[drop_shot]

Thank you! That is a super helpful reminder to back off on certain gaits when new ones are introduced and to throw walk days into the mix as well.

[erinmeri]

The intensity/duration advice is good! I have typically replaced the final trot set with canter when adding in canter - starting with one lap each way, then gradually adding on. So the 30m trot isn’t 30m once canter is added. Have also used the Equicore. Also we only ride rehab horses in the arena and on good footing, to minimize risk of bad steps (no trail rides or walking out between the pastures).

Sorry I missed your question previously… I have been fortunate that I haven’t had any set backs or unsound days during the rehabs I have done once we got going - although if I did, I wouldn’t add on any additional trot/canter (depending on where you are), and would probably consult vet if I did. The first few days of trot on my mare were a bit awkward - she has a hinky trot to begin with and I was really worried she wasn’t sound, so I always had someone to watch when we first added in trot.

Typically, we have had the vet out (IIRC) about a week after starting trot and before starting canter to reassess, and again before jumping.

This app was recommended to me, and I’ll be using it if I have to go through this again: Interval Timer. If you change the interval name it reads out the directions (eg: change “Warm Up”, “High Intensity”, Low Intensity”, etc to “Walk Left”, “Change Direxction”, “Walk Right”, etc.)

[RedHorses]

The last time I rehabbed an injury my Equestic told me it was too soon to canter by revealing an increasing asymmetry in the trot before it became obvious. I found it very helpful and adjusted the next ride based on the symmetry of the previous ride. I had been using it for a while before the injury and knew what degree of
asymmetry was normal and in which direction for that horse, but even if Ii hadn’t had that baseline the change that appeared during rides that I added canter was evident.

[piccolopony]

I haven’t been using my Equestic with my new, injured and rehabbing, mare yet but I really should. Maybe I’ll try it for my rehab ride today.

I’ve been surviving an extremely long rehab (started last November) thanks to the Interval Timer app. I’ve been paying for premium so I can build my own interval plan and it is so so so helpful for helping me stick to the correct intervals. For a long time I had it helping me break up an hour of hand walk work and now I’m using it to get the right amount of walk and trot (and soon canter) under saddle. I’d Highly recommend it.

[drop_shot]

Thank you all for the recommendation on the Equestic! I’m definitely adding that to my wishlist.

Update on the patient: He is going super well. Once he started to re-develop the strength in his back, the funky feeling in the trot went away. It’s been kind of nice to take the time to rebuild him back up. He’s much lighter through his shoulder now than he was before his injury. We’re going to start introducing the canter again as of this week.