Superficial digital flexor tendon injury rehabilitation has advanced significantly with biological therapies, but the welfare priority remains minimizing reinjury risk through evidence-based rehabilitation protocols.
Tendon injury rehabilitation welfare is defined by the tension between the horse's desire to move and the extended rest and controlled exercise requirements of healing. Horses confined during rehabilitation experience the frustration of restricted movement — a welfare cost of the rehabilitation process that must be managed through appropriate mental stimulation, appropriate controlled activity, and careful monitoring of behavioral signs of stress. The welfare cost of reinjury — which may require another full rehabilitation cycle and may ultimately result in retirement or euthanasia — substantially exceeds the cost of appropriate rehabilitation management. The evidence base for biological therapies including PRP and stem cells supports their use as welfare-positive adjuncts that improve tissue quality and potentially reduce reinjury risk. Rehabilitation guided by ultrasound assessment rather than arbitrary time periods provides the most evidence-based welfare outcome.