Tendon injuries are among the most challenging equine welfare problems due to poor healing quality, and regenerative therapies including stem cells and PRP show genuine promise for improving outcomes.
Tendon injury welfare involves acute severe pain at injury followed by a prolonged, uncertain rehabilitation period. The initial injury - often occurring mid-exercise with sudden acute lameness - causes immediate severe pain. The subsequent months of box rest and restricted movement are welfare-challenging for horses accustomed to movement and social contact, increasing stereotypy risk and causing muscle atrophy. The uncertainty of healing adds emotional burden: owners invest substantial resources in rehabilitation only to face high re-injury rates if healing quality is poor. Regenerative therapies represent genuine progress in improving healing quality, but are expensive and not universally available. The evidence base is improving but not definitive - stem cell and PRP therapies show promise in controlled studies, but real-world outcomes vary. The best welfare outcome combines regenerative therapy with excellent rehabilitation management including controlled progressive loading, physiotherapy, and adequate paddock turnout when appropriate.