Tendon injuries are among the most challenging equine welfare problems, requiring months of strict management to achieve healing while balancing the psychological needs of horses during prolonged rest.
Strict box rest for months causes significant psychological suffering in horses, who are prey animals evolved for continuous movement across large areas. Horses on box rest frequently develop weaving, crib-biting, and wood-chewing stereotypies that indicate chronic frustration and stress. The confinement imposes psychological costs even as it is physiologically necessary for tendon healing. The challenge is to balance physical healing requirements against psychological welfare needs — controlled hand-walking, paddock time on firm ground, and environmental enrichment can reduce but not eliminate the welfare cost of box rest. Reinjury — common when horses return to work too quickly — extends the suffering of both the horse (another prolonged rest period) and the owner.