“It is now 6 months since his initial ligament injury and we have just competed and been placed in all his championship dressage finals!”
What is the difference between a tendon and a ligament?
Both ligaments and tendons in horses are made up of fibrous connective tissues. The two differ greatly. Ligaments help stabilise the joint whereas tendons are located at each end of a muscle attaching the muscle to the bone.
Tendon and Ligament Injuries for Horses
More about tendons in horses
Tendons are elastic type structures which attach the muscles to the bones of the horse. Most tendons in horses are short in length, but the longer tendons which run down the limbs can be vulnerable to strains and damage, particularly in active work or exercise. The most common tendon injury in a horse is found in either of the two flexor tendons.
The flexor tendons consist of the DDFT, the deep digital flexor tendon, and the SDFT, the superficial digital flexor tendon. Both of these can be found running down the back of the horses legs from the hock (knee joint) downwards. Tendons are encased by a fluid filled sheath, with the most commonly known being the digital sheath close to the fetlock.
Along with the digital flexor tendons there are several short annular ligaments which help the horses ligaments stay in place in areas of high movement such as the horses joints and hips.
Horses tendons and ligaments contain minimal amounts of blood in comparison to muscles.
Common injuries to horses tendons
Equine tendon injuries occur more often in exercising horses due to the nature of the injuries often relating to movement.
Horses are at greater risk of sustaining tendon injuries if overweight or unfit although strenuous activity can create risk for any horse. Movements where the horse may over stretch such as jumping or turning tightly can lead to tendon strains. Galloping on uneven surfaces or flying around a barrel creates significant movement within the joint and which can naturally lead to tendon injuries. It is there for easy to recognise how common tendon injuries are experienced in horses as many of us push our horses to their full capacity.
The severity of the injury can vary which in turn dictates the required treatment.
If a horse receives a knock or bump which does not break the skin then sometimes bruising of the tendon can be caused, in severe cases the tendon may even rupture or tear. Tendons can develop a small hole which runs through the fibres and creating minor soreness to a localised area.
In more severe cases where a wound or laceration damages the tendon immediate attention is required. If the sheath surrounding the tendons is involved then this can lead to potentially life threatening infections.
How to detect a tendon injury in a horse
When a horse has a tendon injury this will often result in swelling and inflammation. The leg will often increase in temperature as the fibre damage creates heat. This can be detected by feeling the opposite limb and establishing the difference. It is rare for minor tendons injuries to create lameness but recognising any early sign of an injury will aid a reduction in the horses several recovery time by emphasising the need to recuperate.
Severe tendon injuries can be extremely painful to a horse and require immediate medical advice. Serious cases will lead to the horse being significantly lame.
If you believe any injury has occurred then a clinical examination will be required. The vet will establish the extent of the damage often requiring the use of technologies such as ultrasound scans to ensure an accurate diagnosis.
Common ways to treat equine tendon injuries
Treatment options with horse tendon injuries vary according to the severity of the injury. There are no guaranteed treatments which ensure a return to soundness. Some injuries can led to permanent scar tissue which make the tendons less elastic and thus impact the performance and overall mobility of the horse. Previous damaged tendons are more prone to injury than healthy tendons.
Commonly a period of roughly two weeks box rest would be recommended. In this time the horse will be recommended treatments that do not increase the temperature of the legs such as bandaging to immobilise the limb and ice applications to help reduce the heat within the tendon. Most horses will be administered anti-inflammatory medications to aid the reduction of the swelling and provide the horse with short term pain relief.
The most severe cases can often lead to surgical corrections or even Neurectomy (nerve blocking) techniques.
Physical therapy and rehabilitation techniques will be required in most cases.
More about horses ligaments
Horses ligaments are elastic soft tissue which attach their bones to their joints and provide support to the joint.
The main purpose for a horses ligament is to maintain their bones in alignment and to support and stabilise the horses joints, as our ligaments do for us. Some joints have one ligament supporting them on both sides so there are many ligaments within a horses anatomy.
Collateral ligaments are found in the coffin, fetlock and hock joints. Palmar annular ligaments are only found in the fetlock. Whilst the accessory (check) ligament is in next to the deep flexor tendon and the meniscal and cruciate ligaments support the stifle.
Common injuries to horses ligaments
One of the most commonly reported ligament conditions found in horses is Suspensory Desmitis. This condition affects the suspensory ligaments which are strong fibrous ligaments keeping the horses fetlock from overextending.
The more active the horse, the more at risk they are from over extending. Horses in active work such as horses competing in barrel racing, eventing, rodeo, showjumping or racing are at much higher risk to ligament strains than a pet horse turned out at home.
The most commonly reported cause of a ligament injury is trauma through exercise.
Although ligament injuries are widely known it is with great interest how few ligament injuries are seen in the sports horse community. As an example, a professional showjumping horse will stretch its ligaments and tendons to almost impossible levels and be fine.
How to detect a tendon injury in a horse
Diagnosis of a ligament injury is first recognised by the presence of heat and/or swelling in the localised area. In some cases the horse will be sore to touch and be showing signs of pain. Their gait and overall mobility level may well reduce.
In the majority of cases where a ligament issue is diagnosed an ultrasound will be required to ascertain the extent of the injury. In many cases a full examination will be required by a medical professional to ascertain the level of lameness and the most appropriate treatment moving forward. MRI scans and X-Rays may be required.
In severe cases where the horse is in significant pain and natural recuperation is not enough nerve blocks may be issued until an accurate diagnosis is established.
Common ways to treat equine ligament injuries
The initial treatment of ligament injuries in a horse are treated similar to that of a tendon strain or injury. Again, there are no guaranteed treatments which ensure a return to soundness. Some injuries can led to permanent scar tissue of the ligament which make them less elastic and thus impact the performance and overall mobility of the horse moving forward. This can mean the end of a professional competing horses career. Previous damaged ligaments are more prone to injury than healthy ones so any horse with a history of ligament damage should be closely monitored.
Commonly a period of roughly two weeks box rest would be recommended. In this time the horse will be recommended treatments that do not increase the temperature of the legs such as bandaging to immobilise the limb and ice applications to help reduce the heat within the ligament. Most horses will be administered anti inflammatory medications to aid the reduction of the swelling and provide the horse with short term pain relief.
In severe cases surgery may be required. Other treatments include stem cell treatment, plasma therapy and shockwave therapy.
Following treatments a slow and controlled rehabilitation period would be required, sometimes as much as 6 months. The horse needs to increase its fitness levels and overall wellbeing and be completely sound before bring them back into work.
Frequently Asked Questions regarding Tendon or Ligament Injuries
Are tendon/ligament strains more common in sports horses?
As with us, the further horse pushes it the more at risk the horse is to over extending and thus damaging the muscle, tendon or ligament. It is therefor more common to experience torn, damaged or even ruptured tendons/ligaments in horses who have the opportunity to extend themselves in this way. Competing sports horses or younger horses who are naturally more active are more prone to this condition and as with an athlete means the horse will undergo an extensive recovery and rehabilitation process between competing or exercising.
Are tendon and ligament injuries due to the genetic make-up of my horse?
Not as such however the genetic make-up of the horse have significant impact on whether a horse will be more at risk to tendon or ligament issues at some stage. Poor confirmation has shown to lead to greater risk so it is advised to look at the confirmation at the back of the knees, how straight the hind limbs are and whether it has a long back and a short croup.
Can traditional magnetic boots and rugs be used with tendon injuries?
No. If you look at how traditional magnets operate they create a pulsating action from the face of the magnet. This process increases the heat locally. When looking to support tendon or ligament recovery avoiding heat is vital and thus traditional pulsating magnets could create further issues. A non invasive complimentary device such as EQU StreamZ and a joint supplement containing Glucosamine or similar, neither of which will increase heat in the tendon or ligament.
Can monitoring technologies such as Magnetic Resonance Imaging (MRI) and Ultrasounds (X-Rays) help diagnose tendon/ligament injuries?
Yes. Advancements in technology over the past few decades have led to extremely accurate diagnosis of tendon and ligament injuries. Although not cheap they are widely available from most equine professionals.