Strange shoulder lameness- need thoughts **videos included**

[CHoff]

Hey everyone,
I posted awhile back about my 5 year old mare- 4/5 “shot in the leg” lameness (RF) when pulled out of her stall every AM on a lunge. Lameness FULLY resolves if she is lunged, stands, lunges a little more, stands etc. Can be anywhere from 60 seconds to 45 minutes to fully leave. If it’s a bad day I’ll send her around for a few minutes, throw her back in her stall, and she’ll usually come out sound 30m later. If I arrive to ride in the afternoon and pull her out of her turnout, she has never been lame and no amount of flexing can make her lame. W/T/C jump

Clean xrays all around. Vet came out in the AM and ruled out below the knee via blocks. Blocked her shoulder and she was sound. Xrayed shoulder and vet didn’t see anything alarming.
When viewing the shoulders from front (in the AM)- the right one is higher and comes to a point. Elbow is held away from body on right side. In PM much less pronounced.

This started back in September. She’ll have an episode of this morning lameness- will last 1-2 weeks, then disappear for awhile, then come back.

Video- What she looks like pulled out of her stall VS 20m later ridden (different days, but it is this degree-lame then sound- every day.

https://youtu.be/rWhQKjgthjQ

Vet is puzzled, and suspects possible soft tissue. I’ve read about sweeney shoulder- but if this were the case she wouldn’t be fully resolving it every day??

We are trying 2 weeks robaxin then possibly injecting.

Thoughts?

[JB]

Hard tissue things like arthritis tend to get better with work.

Soft tissue things like ligaments/tendons tend to get worse with work

Muscle can go either way depending on the cause. If it’s actual tears/strains, it may get worse with work. But if it’s some knotting, it can get better as blood flow starts to loosen it up. Or not LOL

Can you post a frontal picture of her? Uneven shoulder height usually starts with the feet. Is she more upright on the RF? A side view of the feet will be useful too
Good Hoof Photos - How to take Good Hoof Photos

I remember your last thread but don’t remember if she’s had any body work done? Can you find a Masterson therapist? I’d start there to see if they can find the root of whatever, since while Robaxin may help, it won’t tell you what the cause is.

[Posting_Trot]

Pretty horse!

When you’re riding her in the video, she still looks like she’s a little off, although clearly not as off as she was in the beginning of the video on the lunge.

Is she the same on different surfaces? (Hard surfaces, like the driveway, versus relatively soft surfaces like the footing in the indoor?) Does the size of the circle, or being on the straight make a difference?

I assume the vet has done some x-rays? And nerve blocks? Nothing came up? Arthritic stiffness and pain (as JB noted) does tend to get better as the horse warms up. The fact that she looks so much better when you ride her could be a function of being warmed up combined with good riding that is asking her to use herself. That might also combine with some stoicism on her part.

Has the horse been tested for lyme disease? Perhaps a distant possibility, but off and on lameness that doesn’t have any obvious arthritis or muscle related origin can be a symptom.

Good luck chasing this down!

[NancyM]

For what it’s worth… a senior vet, race track vet and Olympic team vet, generally well thought of in our area for being extremely experienced and thorough by both horsemen and other veterinarians, once told me that “if it looks like shoulder, it’s probably knee”. I dunno if this is the case here, but it was true with the horse involved when he gave me this insight. A sweeny may occur when the limb is not being used fully or correctly over a long period of time. The sweeny may be secondary. Good luck.

[sascha]

@CHoff

no amount of flexing can make her lame.

Did that include flexing both hind legs?

Have any sort of neuro tests been done?

The thing that comes to mind when seeing the video is sort of how we humans behave when we have a limb go to sleep, “Bleh, oh gah, cannot use limb! Limb is functionally dead. Oh no! Worse, the pins and needles have come on!!! … Oh, all good.”

Editing to say, I don’t mean to make light of it at all with my pins and needles comparison - but the semi-transient (I don’t see a fully sound horse under saddle) nature, makes me think some weird nerve thing that releases (mostly) after moving around. The trick is which nerve and why. I do hope you get an answer and that it’s something that is manageable!

[beowulf]

I’m not intimately familiar with the fascia a shoulder-block affects, but did you x-ray this horse’s elbow too? I recently saw a horse who presented similarly and he had advanced arthritis in his elbow necessitating an early retirement - he was 5.

I would think whatever you’re dealing with, if it’s better after lots of motion it might be hard tissue since soft tissue tends to get worse with workload. Does she trot as poorly when ridden in as small a circle as the lunging video?

What a stark difference in the riding versus lunge line. I hope you get some answers and please keep us updated.

[No1]

My first question is, did you do all of the blocking on one day? If so, did the vet come back and repeat the shoulder block on another morning when she was straight out of the stall, to make sure it was repeateable?

One of the frustrating things about lamenesses that they warm up out of it that they can warm up enough to be sound during the blocking process. Which can be super confusing.

[Jealoushe]

I wouldn’t put tack on that horse or lunge it again until its a lot sounder.

[Huntin_Pony]

I had a horse who pulled (sprained) his deep pectoral muscle. He came out lame and warmed out of it within 15-20 minutes most days. It is a difficult spot to reach for a body-worker but we were able to help him release it periodically and it eventually went away.

Speculation was a “splits” maneuver in the pasture caused it originally. We’ll never know for sure.

[fivestrideline]

Not super helpful here but I wouldn’t say that’s a sound horse even at her “best”. Better by far? Yes. But not 100%. The “pins and needles” comparison is interesting, I’d be curious if she’s been neuro tested in any way? Neurological symptoms, a pinched nerve, etc can have some bizarre presentations.

[OceansAway]

I know everyone keeps saying soft tissue typically presents as worse with work and something like arthritis typically improves, but in my experience I’ve seen the opposite at least twice. My gelding looked exactly like your horse on the lunge, and after about 1 or 2 revolutions, the lameness would disappear. It turned out to be an enlarged DDFT, confirmed by MRI. The other horse has double suspensory strains and she would get more sound as you went, making it hard for the vets to assess. I have also seen nerve issues present similar to your horse, like if something is being compressed by swelling/inflammation.

While I know your horse blocked for lameness at the shoulder, I just wanted to point out that it can indeed still be something soft tissue. My friend’s horse ran into a tree and injured her shoulder very badly. The prognosis was she wouldn’t be ridden again, but a year later, she was sound and progressed to third level work. In this case, a barn worker saw the incident, which saved a lot of investigative work. I hope you get to the bottom of this soon, as I know exactly how frustrating it can be.

[frugalannie]

Have you tried a bute trial just to see what would happen? Any chance it might be neck arthritis? A vet who is really good at chiro and acupuncture might bring additional insight to what your vet is working up.

And that’s a very attractive horse. Hope you get an answer soon.

[CHoff]

@ JB: Right- then I’m wondering if it is something in the joint. Blocks (to my understanding) would only address an issue within the joint itself, not the surrounding tissue.

What’s strange with the shoulder asymmetry is it returns to normal in the PM.

Nancy- I also thought knee. I asked my vet and after flexing he said “there’s nothing there”. So who knows.

Beowulf- Elbow is something to consider, I will ask my vet what he thinks. Once resolved, she can do small circles U/S and it does not show up.

@ other suggestions, I will also look into neuro. Thanks everyone. I will keep you updated.

[SusanO]

I looked at the video and she is definitely lame on the lunge line. But I also noticed when you were riding her at the end of the video and you were circling on the left rein she was off behind. What does this mean? I don’t know but there is more going on than the front end lameness.

[IPEsq]

Have you done an ultrasound? Xray of the humerus, elbow, and neck of the scapula? What’s passive ROM like?

[JB]

@CHoff

What’s strange with the shoulder asymmetry is it returns to normal in the PM.

oh, that’s weird, I must have missed that. That suggests a muscle issue. For example - when foals have typical contracted tendons, it’s actually a muscle issue. When you force the foal to rest (ie put him in a stall overnight) in the morning things look pretty normal because muscles have relaxed and the tendon has “let down”. Then as they move and are more active and muscles fatigue, they get tighter and pull on the tendon and you get some contracture.

So maybe it’s the opposite here - lack of movement may be causing muscle spasms to contract, and then movement somehow works it out.

[TWH_Girl]

Just saw you said blocked to shoulder, in which case yes, I would inject and I wouldn’t anticipate roboxin to do much. Please keep us posted! So frustrating.

[2tempe]

OP - reading and wondering if the vets considered cervical arthritis?

[TWH_Girl]

That’s a good thought as well.