New research shows that rehabilitation can help get horses back to health even more rapidly than we thought. Effectively returning to the top level in equine sports after an important injury is so difficult that those who accomplish this feat can even receive awards for their achievement. The "comeback of the year" usually suffers an injury or has been affected by a disease and traversed a difficult road to recovery before being able to regain former levels of ability and skills.
Rehabilitative medicine is a developing field and it focuses on guiding through that path to recovery and helping horses heal so that their return to activity is optimal. The equine athlete seems to be particularly good at healing and eventually returning to function after a severe injury.
A thorough postoperative monitoring, improved surgical handling of incisions and better communication between client and surgeon can all lead to faster healing and comebacks among horses.
Recent studies show that the vast majority of horses are able to return to activities that involve sports after an important surgical procedure and pretty much all of them returned to their previous level or to an even higher one.
Timing is key
One important aspect of equine sports rehabilitation that has probably been underdeveloped is the timing: the timing of return to an athletic activity is one of the most important aspects of the recovery path.
Veterinary surgeons have always adopted very conservative postoperative rehab programs. However, these recommendations do not reflect the most up-to-date scientific developments, and much more aggressive but medically safe rehab programs are able to help horses to come back to activities that involve sports even more rapidly.
Ligament and tendon rehabilitations
Rehabilitation of ligaments and tendons takes even longer at times because these tissues have a very specialised physiology. A slowed pattern of fibre regrowth and a worse blood supply can keep an athletic horse from returning to sports activities for many months after an injury to these structures. However, new techniques and technologies, like the use of platelet-rich plasma, stem cell injections and shock wave therapy, can actually help shorten the healing deadlines in several cases.
Scientific studies have demonstrated that ligaments and tendons heal more quickly and with a stronger fibre pattern when low-level loading stress is applied directly to these tissues. As a result, hand walking is typically encouraged early in the rehab process. However, very aggressive exercise can actually happen to be detrimental, and reinjury of ligaments and tendons is frequently worse than the initial issue.
The central aspect when it comes to bringing these injured equine athletes back more rapidly is being able to conclude if a horse is healing properly and can therefore be safely pushed to the next stage, or if a horse is not progressing adequately and should remain at present activity. Thermographic and ultrasonographic monitoring of ligament and tendon repair will help horse owners as well as trainers with their decision making process. Ultrasonography can show us changes in healing fibre patterns as well as an increase or decrease in fluid within a ligament or tendon.
Eliminating the guesswork from ligament and tendon healing evaluations translates into more aggressive yet more correct rehabilitation processes and therefore a faster return to function.
Equine joints are frequently damaged and will eventually require surgical reparation. The strong forces placed on the joints of horse athletes usually dictate that longer time will need to be spent on rehabilitation processes. The nature of the damage is at times not known, and the types of trauma can be so varied that each joint rehab case needs to be analysed individually, and also postsurgical exercise programs have to be unique.
Steady monitoring and the right pressure application and range-of-motion exercises can actually help shorten healing deadlines in these types of injuries.
We are still in the past
There is little scientific evidence to support the rehabs programs currently advocated. Rehabilitative guidelines seem to be based on tradition, old-school policies and safe, overly conservative methods rather than on current knowledge and research. Some quality recent evidence tells us that a more accelerated approach to getting horses back to activity is absolutely reasonable. However, most clinics and equine rehabilitation centres still advocate for the traditional and conservative methods and recommendations.
While no one is in favour of pushing horses back into work too quickly, aggressive postsurgical rehabilitation is reasonable for many horses.