My horse has a right hind suspensory tear which was diagnosed last August. Since then he has been on stall rest with hand walking, and we had a round of PRP, a round of bone marrow PRP, and a round of shock wave.
He is a show jumper, showing 110 schooling 130, the vet said he has a possible chance for 100% recovery. But is that a real possibility? I know every horse heals differently, but I want to hear anybody’s success stories after suspensory.
It depends on the horse, the lesion/location, and the involvement of other structures, the management, and the time/consideration taken to bring the horse back to work. I will say from personal experience that hinds are much, much harder to rehab and bring back to the same level of work, but not impossible. I know a mare that had a high hind end suspensory rupture; most horses don’t come back from that… she needed 3 years of Dr Green with PRP & lots of shockwave, and returned to work last year. During her time off she had a really nice foal and was kept mentally stimulated. She’s a nice horse and definitely the exception to the norm… but she’s one of those horses where I don’t think much could stop her.
My first OTTB pulled his suspensory in his RF, due to bad shoeing - I didn’t know then what I knew now (to be fair, we were new to horses and I was 13). This was well before shockwave and PRP. He had 2 years off and was brought very carefully back into work and he competed successfully in eventing and even schooled up to Training before other unrelated issues (he was older, we didn’t think it was fair to ask him) caught up to him. He carried my sister around from Tadpole XC to Training level XC fences and the suspensory never bothered him again. His rehab was a PITA, as he was not a good stall candidate - we tried to keep him in and he was a lunatic – we ended up just throwing him outside for the rest of the rehab protocol because he was doing more damage to himself in than out. I think him being out 24/7 really helped keep his body semi-conditioned and definitely helped rebuild the elasticity/remodeling of the ligament. I do not think he would have been anywhere near as sound if he had been kept in a stall for the entire lay-up. YMMV. He was much quieter outside and was not the type to run around or do anything silly.
The best thing you can do is take it slow - it doesn’t hurt to take it too easy with these injuries, it really doesn’t. I prefer to see them out 24/7 after initial lay-up + medical paddock clearance (vet approval first, obviously), as I find moving around helps strengthen (without too much loading/stress) the limb.
Additionally, every rehab protocol is different, but it’s really important to build up work slowly - if it took the horse 6 months to heal and be put back to work, you need to take a year to bring him back to work/fitness - generally, with any injury, however much time they had in rehab you need to multiply that by 2 for the reconditioning/work fitness. I prefer to spend the first 2 months back into work doing walking on short hacks only - no big huge hills, no trotting in the ring, etc. The worst thing you can do for a suspensory is fatigue it, so avoid circles and ring work until the suspensory is properly strengthened – which I do with lots of long, slow distance.
My previous horse suffered the same thing and it never healed. He couldn’t handle stall rest and hand walking was rather scary. I would agree that putting them in a field for a year or two is your best bet. So many people underestimate the power of dr. green. Good luck sorry your going through this
My previous jumper tore his front suspensory as a 6 year old. We spent a couple of years rehabbing him and got him back up to the same level in the jumper ring as well as crossing over into dressage (he was a far more talented dressage horse so figured it would be a good avenue to sell him). After moving to a dressage barn, him being champion every time out at third level he wound up selling to a jumper kid (go figure…) spent a few more years in the jumper ring until she wanted a more careful horse and he ended up back as a dressage horse and at 20 was competing 4th level schooling all upper level movements: passage, tempis etc. and was still jumper sound.
My first horse had a LF suspensory tear. We did PRP and shockwave. He was on stall rest and hand/tack walks for a solid 8 months before he got cleared for more turnout and additional work. At the time of his injury, he was doing about 1.20. After his recovery, we didn’t quite get back to that height because of some unrelated health issues. But the suspensory never bothered him again.
I think it’s all a matter of how severe it is and how they’re rehabbed. Looking back, I wish I would have turned him out for a year instead of making him do stall rest. He was miserable, and I think moving around would’ve done him more good and prevented his other issues. But I was young and listened to recommendations from a few vets and my trainer. I made the best decision I could with the information I had at the time. That’s all we really can do.
Good luck!
As others have said it will very much depend on the horse & the injury.
My jumper/field hunter had a front suspensory injury in Sept 15. It was reasonably minor, but found very quickly (I knew something was wrong, even though he was barely lame) so my vet recommended leaving him on his normal 24/7 turnout, with a quiet buddy and not doing any of the treatments as she doesn’t believe they would have had a significant impact (he’s insured, so cost wasn’t a factor).
I did his rehab fairly conservatively, but I tried to stick to her timelines as you do need the ligament to be placed under careful stress so that it will heal with full functionality. I was much more conservative about adding back in jumping and it wasn’t until 1yr post injury that we started jumping any height again.
Pre injury we were competing 1.10 - 1.15m. I started competing him again in Jan and we did our first 1m round on Sunday – he seems fine. I am rather paranoid though and am very careful to warm him up & cool him down properly – lots & lots of walking.
My trainer’s horse slipped and did a front suspensory a few months before my horse – that horse is now doing 1.40m+, fortunately it wasn’t a severe injury and was caught & treated extremely early.
Good luck – all you can do is stay positive and do your best.
Thanks for all the replies, they are making me a bit more confident in his recovery!
A lot depends on the extent of the injury, the amount of scar tissue, and how cooperative the horse is, Hind leg suspensories can be more problematic. A long slow rehab is your best option here.
There was a long thread about Proximal Suspensory Surgery, and the recovery involved but looking in Search just returns me to this one thread.
Hinds are trickier. Besides what’s been posted above, conformation can play a big part in future ability. Hip and hock angles can create more stress when the horse is asked to rock back and push off behind. You get away with it lower, not so much when the fences go up. If the injury didn’t occur until the fences went up ? Could be a concern.
I rehabbed a horse last year with one of these. He had surgery and was recovering and then he injured it again. Switched vets and new vet had me walk and then trot on a gravel road every day–while he was on stall rest. She said it was the only way to rehab them. He then went to another vet near his owner’s home who did A-cell on him and continued the work on a hard road. He has recovered fully. Not a jumper though so I don’t know how a jumper would fare.
Most hind suspensory injuries I’ve heard of have needed surgery to cut the facia, but I’m assuming not all need this?
I do know hind suspensory injuries don’t have quite as good of an outlook as front but have known of horses coming back after surgery.
I had one who had surgery on both hind suspensories, one healed great the other had some issues and he had some on and off moments but after some maintenance (he actually gets an injection every 6-8 months) he’s successfully been doing the junior hunters for 2 years.
His injury however wasn’t really a tear it was a disruption in the fiber pattern and his suspensories were too big so the surgery was needed to release the pressure.
We had a top top top Grand Prix show jumper in our yard that did such a severe suspensory injury that he fractured its sesamoid bone from the force of the injury. The owners have lost a horse due to a suspensory injury before so they flew over a vet from Ireland (to South Africa) who is supposedly a very progressive vet when it comes to soft tissue injuries.
He bought his “UTC Scanner” (which is a 3D colour scanner that is like a mix between an ultrasound scanner and MRI - just much more affordable). We had previously planned to box rest the horse for a few months but when he arrived 2 weeks after the injury he insisted the opposite. Although this is very unconventional - the reasoning makes sense to me.
Rest= scar tissue
Scar tissue = weakness
Weakness = reinjury.
His UTC scan showed that although the lesion was severe- not too much scar tissue had developed. He explained to us that when a horse injures soft tissue (ie a suspensory) the scar tissue that forms is not suspensory tissue (only way for body to generate more suspensory tissue is proper stem cells. Therefore, one has to “teach” the tissue to behave like suspensory tissue by starting early exercise with the horse. This all sounded great but was very impractical at the time as the horse is impossible in hand and one wrong step could injury the suspensory even further.
Resultantly, he rented us an Equinetendon Rehabilitation device (like a boot but fitted in 3 parts) which controlled the degree to which the fetlock could extend- thereby controlling how much strain was put on the horses suspensory. This allowed us to control the amount of support offered to the fetlock/suspensory throughout the rehab through 4 different settings. This also met that when the boot was set on the CORRECT setting for particular stage of healing the horse was in - is is practically impossible for the horse to injure himself further when in the device. This allowed us to safely turn the horse out from the get-go as he hates being in the stable.
For our horses rehab - he insisted we started walking the horse (UNDER SADDLE) for 10 min three times a day on setting 3 -the second “strictest” setting of this rehabilitation device/boot. Two weeks later we started trotting the horse for 2 min a day building up to 20 min of trotting a day over the following 2 months. All this work was done on firm ground in straight lines. Next we introduced cantering work. Throughout this process the vet was flown over from Ireland to rescan the horse every ±6 weeks with this UTC scanner. Because the scanner can differentiate between healthy tissue and scar tissue - we could spot (quite accurately) if the horse was not coping with the work level (a normal ultrasound scanner cannot give you this info).
(PS.This is the SAME scanner soccer teams like Barcelona use to scan their soccer players tendons as it can pick up chronic injuries before they rupture - and monitor the progress of them).
Almost exactly 5 months after the horse sustained the injury the horse started doing small jumping (±90cm) in the rehab device on setting 1 (this offers little support- but ensures the fetlock never extends past peakload where the horse is at risk of reinjuring the suspensory/tendon). Because of the way the device/boot supports/restricts the fetlock - we couldn’t jump higher than 90cm with the device/boot on.
Fast forward 2 months (7 months after injury) and the horse was back jumping in the 1.45m classes! A further month later and he jumped around a 155m World Cup qualifier.
I would categorically like to state that this is NOT the route we would have conventionally followed - but after seeing the success of the vets protocol rehabilitating top Gr 1 racehorses with diabolical SDF injury to return to Gr 1 races in 7 months from the date of injury we figured we had nothing to lose. Im not exactly sure where you are based - but I cannot recommend this vet and his protocol enough!
It saved our boy!!
I hope this gives you some hope regarding what you are going through. There really is so much one can do these days. Breakthroughs like the technology above really are giving many horses second chances which previously would not have been on the table.
My mare had a left hind suspensory tear about 5-6 years ago. Took probably a full year to year and a half before she was back in full work. Started with walking under tack for low time periods. After three or four months started to trot but only straight lines. After a couple months could turn corners. Got to canter straight lines, then finally canter corners. It’s a long road but she recovered and knock on wood no issues since. Went back to full work and showing. She has only ever done the 3 ft hunters and 1m jumpers (just to note).
My horse injured LF suspensory in rehab for a different injury in July, not really a tear as much as a fiber disruption/lesion. He’s now back to w/t/c footing dependent, ultrasound looks great, should be able to jump and do full work around the 1 year mark.
So, did OPs horse ever get back to the 1.10s and schooling 1.3 in the two years since starting the thread?
Hi, thank you all so much for sharing your experiences. My horse did get back to showing threads 1.10 and even schooling 140, he unfortunately had a relapse over the summer of 2018. No tear, just very minimally straining it. It was not super noticable, but there just enough we decided to lower his work load to prevent further injury. Which we have now given him 6 months of light work and he is sound and happy. This year we are going to spend time bringIng him back up so he can do his job again.
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