There are several different treatment options for tendon injuries.
Initial treatment in the 10-14 days after an injury usually involves;
· Box rest
· Ice application or cold hosing 2-3 times daily and/or application of kaolin poultice
· Bandaging to immobilise the limb
· Anti-inflammatories such as bute to aid in reduction of swelling and provide pain relief.
These steps are aimed at reducing the initial inflammation and pain along with preventing any further injury. Once the initial inflammation has stabilised a controlled exercise programme can be started.
This is the most important aspect of treatment. This will generally start with hand walking while still on box rest with gradual increasments every 1-2 weeks for a period of 3 months. In certain cases an initial period of total box rest is advised. Horses are often out of work for 6-12 months with these injuries. Controlled exercise helps the new tendon fibres align longitudinally ultimately resulting in increased strength and flexibility.
Repeat ultrasound scans are invaluable as an aid to determine the healing process and adjust the exercise programme accordingly, such as when to introduce trot work or steady canter exercise.
Other treatments options
None of the treatments available reduce the horse’s lay off period. But the aim is to improve the quality of repair and reduce the risk of re-injury on return to exercise.
Tendon splitting or fenestration. A scalpel incision or lots of needle holes can be made to release the initial blood clot from a core lesion and this may help new blood vessels to grow into the injured area. This treatment requires to be done within 1-2 weeks of the initial injury,
· Tendon injections. A group of drugs called PSGAG’s (Adequan / Cartrophen) can be used successfully to inject tendon injuries and assists in short term healing. More commonly we now use either stem cells or platelet rich plasma, both of which are injected directly into the tendon soon after injury.
· Surgery. This is sometimes performed in the case of tendon lacerations to help oppose the edges of the damaged tendon or in the case of tendon sheath sepsis to remove infection both of these procedures are carried out under general anaesthesia.
Ligaments are the elastic soft tissue structures that connect the ends of bone at joints. In certain cases they attach from a bone to a tendon e.g. the inferior check ligament. Their role is to maintain bones in alignment and provide support to a joint. They are usually located on either side of a joint. Therefore the name collateral is often in their name relating to positioning. Some joints have one ligament on each side and others such as the stifle.