Superficial digital flexor tendon (SDFT) injuries are among the most common and welfare-significant musculoskeletal problems in performance horses, requiring months of careful rehabilitation.
SDFT injury causes acute pain from the initial traumatic event and then chronic low-grade discomfort during the prolonged healing phase. Rehabilitation welfare requires managing the tension between physical rest requirements and the horse's psychological need for movement and social contact. Prolonged box rest without environmental enrichment causes stereotypies, anxiety, and reduced wellbeing in active horses. Welfare-positive rehabilitation includes: provision of social contact through stable companions or at-fence neighbours, appropriate mental stimulation, gradual controlled exercise increase guided by ultrasound assessment, and turnout in small paddocks as healing permits. Return-to-work decisions should be guided by ultrasound evidence of healing rather than time alone. Horses returning prematurely face re-injury — a welfare outcome significantly worse than extended rehabilitation.