Equine Tendon Injuries: Welfare Management and Recovery

Tendon Injuries in Horses: A Major Welfare Challenge

Tendon injuries — particularly superficial digital flexor tendon (SDFT) injury — are among the most common, welfare-significant, and economically costly musculoskeletal problems in athletic horses. The poor vascular supply to tendons, slow healing rates, and high re-injury risk make these injuries prolonged welfare challenges requiring careful, patient management.

Anatomy and Vulnerability

The equine lower limb contains multiple tendons that transmit muscle force to the skeleton. The SDFT — running down the back of the cannon bone — is the most commonly injured in sport horses, particularly racehorses and event horses. The deep digital flexor tendon (DDFT), suspensory ligament, and check ligaments are also commonly injured.

The SDFT experiences forces approaching and exceeding its failure stress during high-speed galloping and jumping — particularly during weight-bearing phase when the fetlock drops toward ground. Fatigue accumulation, sudden overload, or asymmetric loading causes fibre disruption and injury.

Acute Injury: Recognition and First Aid

Acute tendon injury presents with: sudden-onset lameness during exercise, localised heat and swelling over the tendon, pain on palpation, and often a visible 'bowing' deformity of the tendon outline in severe cases. Immediate first aid — cold water hosing or ice therapy, stable rest, and veterinary assessment — limits secondary damage from inflammation.

Ultrasonographic Assessment

Ultrasonographic examination provides definitive diagnosis and grading of tendon injuries. Core lesion percentage (proportion of cross-sectional area affected), fibre alignment, and echogenicity guide prognosis and rehabilitation planning. Serial ultrasound examination at 4-6 week intervals monitors healing and guides return-to-work decisions.

Pain Management and Welfare

Tendon injuries are painful — particularly in the acute inflammatory phase. NSAIDs (phenylbutazone, meloxicam) provide essential analgesia while managing inflammation. Pain assessment using clinical signs and behaviour monitoring guides analgesic adequacy. Adequate stable rest with deep bedding maintains comfort during the immobilisation phase.

Rehabilitation Programme

SDFT injuries require 6-18 months of carefully structured rehabilitation before return to athletic work. A typical programme progresses from complete box rest through controlled walking, trotting, cantering, and eventually competition work — each step guided by serial ultrasonography. Premature return to work before adequate healing causes re-injury, extending the welfare burden and worsening prognosis.

Regenerative Therapies

Platelet-rich plasma (PRP), mesenchymal stem cells, and extracorporeal shock wave therapy are increasingly used alongside conventional rest and rehabilitation. Evidence for improved outcomes exists for some treatments; however, the fundamental requirement for adequate rest and progressive rehabilitation cannot be replaced by regenerative therapy alone.

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