Weak stifles?

[Lunabear1988]

*full disclosure that I’m a paranoid owner from losing a NQR horse *
How are weak stifles diagnosed? Just ruling everything else out, plus the look and feel of the horse’s stifle?
Iposted awhile back about my horses back soreness. Thankfully with a few weeks off, new saddle that fits, Chiropractic, massage and treating for ulcers, I haven’t seen any signs of back pain. I honestly think it was the saddle not fitting and then ulcers. When I moved barns, he really started to react to multiple ulcer points but now he’s very nonreactive and calm.

But I’ve noticed every since having time off (altogether he had 4 weeks off) his gotten much more weak behind. He wasn’t able to get his leads in the canter on the lunge. So I stopped asking for any canter for the last two weeks. I tested him on the lunge and he can now get the leads but fatigues quickly.

I’ve started taking lessons with a Dressage trainer who wants to take things very slow because of his age and because of what she thinks it’s weak stifles. So we have only been doing walk and trot work. I’ve just started introducing poles.

He lives in a stall with a 60 ft paddock attached which is on decent incline. He goes out everyday with some geldings in a pasture.

My question is, trainer thinks I should just focus on strengthening him for the next two months. I am leaning towards having my vet out though. She’s the type of vet that if she thinks nothing special needs done, she won’t. I’d feel better getting a lameness exam and some x-rays that I should have done when I bought him.

[Lunabear1988]

And those who were worried about his feet in my previous post, my vet specializes in feet so I’ll have her check them. I’m using a new farrier next week now that we moved, I asked my vet for a recommendation so hopefully he’s good and we can eliminate any feet issues.

[anon55755751]

I have a vet like yours and having gone through something similar myself, I decided the right threshold for me was this: If I am too worried to commit to the requisite strength training work without having my vet look at him, I go ahead an have the vet out. In your case, if it really is just suspected to be muscle weakness, I’d give the conditioning a few weeks, and if you aren’t seeing improvement, then get the vet out - then you will have more information for the vet about your observations given what you’ve tried, etc. On the other hand, consider whether vitamin E deficiency is a possibility given the time of year and what sounds like rapid muscle atrophy from time off.

Weak stifles can be seen by the naked eye when the horse is in motion by someone who has an eye for it, though it doesn’t rule other issues out. The way they engage the joint just seems like it lacks power or is unstable or similar. Could be a conformational predisposition, or a symptom of something more serious. X-rays would reveal bony changes in the joint - could point to a cause for weakness, but I’m not sure I’d jump to that if you’re just worried about weakness (especially if bilateral) and not seeing gait irregularities or other lameness symptoms.

[BigMama1]

Have the vet out so you can find out where the problem is and how to address it. If it is just muscle weakness then you may just need to start a slow and steady conditioning program with lots of hill walking, trot poles, etc, or maybe a muscle building supplement like Myoplast might help. But maybe there is a physiological reason for muscle weakness such as vitamin E or selenium deficiency. Or maybe there is slight soreness in the fetlocks or hocks that is creating a domino effect that restricts the stifles. Ask your vet.

[wildlifer]

@anon55755751

I have a vet like yours and having gone through something similar myself, I decided the right threshold for me was this: If I am too worried to commit to the requisite strength training work without having my vet look at him, I go ahead an have the vet out. In your case, if it really is just suspected to be muscle weakness, I’d give the conditioning a few weeks, and if you aren’t seeing improvement, then get the vet out - then you will have more information for the vet about your observations given what you’ve tried, etc.

I am very similar to this & agree. I completely understand the paranoia, as I had to retire a horse from sport at 12 because he tore a cruciate ligament (extremely rare in horses) in pasture so that stifle was done – so stifles are one of my ulcer-creators! My vet is very kind about phone calls & also very practical & respectful about not charging me if he doesn’t have to, so if I’m unsure about something, I gather as much data as I can, then call him & ask for his recommendation. He’s been my vet for a long time, so I trust his judgement when he says I need to bring a horse in or it can wait. He also understands that sometimes I just need an answer so I can sleep, heh.

In my experience though, stifles are also often the first thing to lose condition & it happens quickly & they don’t come back right away (like, not in a week or two). After a month off, I’d definitely expect some loss of strength there. Some horses are also just weaker there/lose condition faster there than others & some will also “show” it more than others depending on their build, movement, balance, & stoicism. It can be connected to other body parts, but also might not be. A big part of it is knowing your horse & what is normal for him.

I doubt I would do x-rays unless the vet found something that warranted that level of inquiry. And since I recently experienced something similar to this, I know exactly what he would say. I did take the horse in, just because stifle paranoia, but he just did a very basic jog/visual/feely exam & said he didn’t see or feel any red flags & I should give the horse 4-6 weeks of conditioning. If anything seemed alarming or popped up during that time, we could revisit, but he was right & it didn’t. It cost me $85 and it was worth it.

As for your question about diagnosing, it’s complicated but yes, part of it is ruling other things out & also you want someone with a good eye for lameness/problems high up in the body with lots of experience.

[Lunabear1988]

Thank you guys. Very helpful. I’ve never dealt with any stifle issues before so I am a little uneasy about knowing when to stick it out or call the vet. I think I will at least call my vet. Usually she’s great about looking at a quick video/listening to what I’ve seen and deciding whether she should come out or not.

It’s definitely not been long enough to see any big progress so maybe I’m just being impatient. I just don’t want push him if something else is going on or if he needs a little help (like estrone or something.) He’s been very willing which hopefully is a good sign. But I want to keep his good attitude by making sure we are doing the right things for him.

He definitely is a little butt high right now which I’m sure isn’t helping. But I do see a bit of a toe drag which does concern me.

[Defying_Logic]

I’ve got an OTTB who has been prone to weak stifles. He more or less sat in a stall for 6 months before I got him, so he had no muscle tone and his stifles were all over the place. For the first six months or so, if he had a few days off in a row, there was a loss of power through his stifle. Now he lives in a hilly pasture and is over all much stronger, so it isn’t as noticeable, but I imagine if he lost condition again, it would re-emerge as an issue.

At first, I had my vet out and he was confident it was weakness rather than lameness, so we marched on, but I did periodically send him a video to co firm he still thought weakness as we built muscle. I think the main thing is what gives you piece of mind to commit to the work needed.

[DMK]

I think we underestimate how much fitness it really takes… My Fjord can have weak stifles, mostly on the left, presenting in the classic “flat tire” presentation especially on rides the days after really hard works.

When he was started it was really minor, but then again he wasn’t working hard or expected to carry himself in a way that challenged his Fjord conformation. But as he got older and the bar was raised it became more obvious. I didn’t take him to my vet (although we had conversations) because the answer was obvious, more correct work to build more strength to help support the stifle. And since he was being trained for a career of CDE in the winter and dressage in the summer, along with trail riding in the mountains throughout AND my fitness road work is rolling hills… oh yes, and mine are never in a stall. 24/7 access between stall, dry lot (and pasture… No problem, right? I certainly didn’t think so!

Last year after his first CDE season when I thought he was pretty damn fit (almost 7 years old) and we went into dressagin’ I was still battling flat tires and bracing against my leg so I took him in for a workup. Good news, nothing really there except a mildly flat profile on the head of the femur (I think) that allows the patella to slip. And yes he was mildly sore on that left stifle. That wasn’t too surprising, CDE is a tough sport and we are all a bit battered and tired at the end of the season. So we did a course of adequan and proceeded with fitness work. All summer I showed at first level and we schooled 2nd level most of summer.

After Labor Day I transition back to driving and gradually fit him up for the season. So we have a pony schooling 2nd level and intermediate driven work… And I’m still seeing some weak moments. Make no mistake, it’s considerably less than the same time last year, but damn… He’s already the fittest thing I’ve ever ridden, how much more fitness and strength does it take? So mid November I take him to my vet and we inject the stifles. The idea is that it will give him a boost going into the really really hard part of our season, the part where I have to get him fit enough to trot 15km while pulling his weight and periodically gallop/turning through hazards, all with only a 10 minutes breather/vet hold after section a (the warm up)… Because if you have to battle ouchiness as you build fitness, you have to back off. And if you back off, you backslide. That’s quandary with stifles.

Knock on wood, we may be ahead of the game! But make no mistake, he is FIT. He can do the I7 test which is 9 minutes long and almost all is the collected or medium trot, and yesterday we did 15k mostly on hills and he recovered in well under 10 minutes. Which is a level of fitness that most horses never get anywhere near, but appears to be the level of fitness it takes to be “stifle fit” for this horse!

[tipzythegreat]

How old exactly is this horse?

Is there any heat or swelling on his back legs, or has there been? My horse’s hind leg blew up one muddy spring day. I didn’t think too much about it and just poulticed and continued to work my horse. After all he was sound. Just weak. It was a suspensory injury I ignored.

If to you he feels ‘sucked back’, I’d get the vet out. That’s how my suspensory and si problems cropped up. I just thought my horse was lazy, but really he was in pain

If he is sound without any swelling, I would personally give it a few weeks of easy trot work with some poles. If you don’t see an improvement, get the vet out.

4 weeks isn’t that much time to have such a loss of strength. Unless he wasn’t ever fit or is really senior. But with his turn out option, he is able to roam freely so his stifles shouldn’t have had such a loss of use.

Good luck! Keep us posted.

[Lunabear1988]

@DMK I have my work cut out for me it sounds like!

[Kyrabee]

My mare has what I call weak stifles. What keeps her fairly asymptomatic is being able to move 24/7. If I have anything to say, she will never be stalled.

When she does show her weakness is usually in warm-up at the walk. She doesn’t get the leg quite forward enough and as she steps down it ‘gives’ feeling like a tire with a flat. I had her worked up as a youngster and the vet said she really didn’t have enough laxity to lock but had a very slight ‘catch’ as her leg came forward. Even though she isn’t getting much work right now, she hasn’t had many problems lately. Maybe she finally outgrew this at 17 y.o.??? I doubt it. She just has a nice base of fitness by being able to move 24/7.

I don’t have hills where I board. I do a lot of backing/reinback work and lots of transitions. There are a couple slight slopes on the driveway and when we are out hacking, I always stop and do 3 sets of backing UP the slope. I make very sure she is straight and using her right hind (weaker side). I tried to do poles once a week but don’t always have the time for set up and take down. The backing work seems to work well for her.

Susan

[Lunabear1988]

@tipzythegreat he’s 4 years old. And I honestly think he looked slightly weak before the time off (he also has never been super fit since he’s so young still.) And he’s definitely growing.

No swelling or heat. Not sucked back. Just doesn’t use himself like I know he could, although still mostly tracks up.

I think he looks worse on the lunge over ridden. Obviously not lunging him right now thinking it’s stifles.

[DunByMistake]

I bought a 6 year old OTTB last March who had mildly slipping stifles at his PPE. At the time, he’d been out of work since October and was getting pushed off food by his pasture mates so was very thin and lacking muscle. Vet told me she was 95% confident it was simply due to being weak. We did xray as part of PPE and found nothing.

I started him off pretty slow due to being so thin and we did a lot of work in hand for first 6 weeks. When I did start riding, I definitely felt the odd ‘leg going into post hole’ feeling occasionally but that became less frequent. He lives out 24/7 on varied terrain. I ride in my grass pasture which is flat-ish but definitely not like an arena. We do a lot of poles and cavaletti. I also have a sloped driveway which we walk up and down and back up a few steps at a time also. I built a DIY equicore system which has helped. Vet at PPE warned me it would always be something to watch for.

I would say the biggest thing that has helped him is being treated with PEMF. He has some overall body stiffness and sore muscles from being on track and getting those muscles (especially in hind end) to relax has allowed his topline to develop - even in last few months when I haven’t been riding due to winter/being pregnant. His butt is much stronger and muscle tone has greatly improved. I’ve noticed that he is resting a hind leg less than he was before. He pretty much cocked one hind leg as soon as he stopped moving.

If I were you, I’d give it a month of hill work and poles to try and improve fitness. I didn’t canter my horse for close to 2 months when I started riding because I knew he was weak and it would be a struggle. If stifles do not improve in that time or get worse, then I would call vet.

[FatCatFarm]

Ugh, Stifles!!! If they’re an issue it seems they are either pretty straight forward or very hard.

Easy: My daughter’s then 13 year old Section B Welsh gelding would get sticky stifles and have a hitch in his gettalong if he was not in regular work despite being turned out on rolling hills 24/7. Keeping him in a stall only made it worse. But a course of estrone and regular work and he was good as new in no time. Definitely just a fitness issue with him.

Hard: Now, the 17hd draft cross with good conformation has struggled with a weak stifle; right greater than left, since he was started as a 4 year old. Has always been turned out; never stalled, but his work has been intermittent. Canter work on a circle always hard. Improved with work. Estrone though was pretty much useless for him. Any time off and it was back to square one. Last year, carried him to my vet and had his stifles done where they just perforate the ligament to cause it to scar and thicken a bit. I think it helped a little but was not a game changer. So, he’s currently a super fancy trail horse as a 17hd Palomino Pinto. Can be brilliant in the dressage arena, but with my work and family schedule, the inconsistency is our downfall. That and he’s pretty opinionated. That coupled with some discomfort while trying to get him really fit, made for less than enjoyable riding.

So yes, fitness is key via the right exercises. Some are more of a struggle than others. Really have a good consult with a trusted vet before throwing a lot of money at it. MSM seems to help. I also supplement with vitamin E and I’m not big on supplements when feeding a premium feed and good hay on top of generous pasture time.

[Lunabear1988]

Good info here! Thanks guys. He doesn’t slip or fallout behind that I’ve seen. Just seems weak, especially right hind. Better when riding when I get him forward and more balanced.

Not sure if him not slipping is good or bad. I will say when I’m cleaning his right hind out that sometimes he almost “hyperextends” it for a second. Maybe that’s not the right explanation but since I hyperextend myself from EDS, it reminds me of that type of ligament weakness.

[FatCatFarm]

@Lunabear1988

Not sure if him not slipping is good or bad. I will say when I’m cleaning his right hind out that sometimes he almost “hyperextends” it for a second. Maybe that’s not the right explanation but since I hyperextend myself from EDS, it reminds me of that type of ligament weakness.

Sounds like it is catching just a bit. This is exactly what my daughter’s Welsh gelding did when out of shape. Fitness will be your friend.

[DMK]

Yep, what is weakness now can either resolve nicely with age and a bit of strength… ooooor it could go the other way. But honestly I’ve NEVER started a young horse that I didn’t feel was “weak in the stifles”. I mean they aren’t weak in the stifles to do the job they were born for (walking, grazing, occasionally running from predators), but collection, pulling weight, jumping and so on? Yep, I think they all need some extra time and work to get fit for that job, it’s just some of them have less issues than others. But it is a young horse thing, for sure.

I too add MSM and Vit E (especially when pasture is dormant or not available). MSM seems to have some anti-inflammatory properties (definitely reduces lactic acid levels in the muscles) so that can’t hurt when working on fitness. And if your horse is an airfern and lives on very mall amounts of food and grass hay (like a certain fjord outside of CDE season), you may need to look at your protein levels and consider whether they need supplementing. Insufficient protein = limited muscle development = those stifles aren’t going to get better.

[Lunabear1988]

@FatCatFarm yeah that’s what I was thinking… And maybe they are just sticky but not so noticable when ridden?

@DMK that’s what my trainer was thinking. Young and growing, not fit =weak stifles. I’m currently getting him on some low NSC grain because before he was only on a round bale, no supplements or anything. He definitely needs something more for weight anyways (he has a hay net but it’s not a round bale unfortunately) and I’ve noticed he’s using his salt lick like crazy. I’ve never had a horse go through one like him! So I definitely want to talk to my vet about his diet. I do have him on alfalfa pellets but maybe I need to bump up the amount a bit.
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[Lunabear1988]

Also you guys are awesome
So much for information, advice and everyone has been nothing but helpful. Thank you!

[Lunabear1988]

My vet is out of town this week, I certainly don’t think I need to panic over this so I’m going to talk with her when she’s back in town.