Higher, faster, stronger. It's human nature to push our horses to the edge, whether it be in the jumping ring, reining pen, or on the racetrack. But when our willing equine partners exert themselves on our behalf, they can sometimes push tissues past their limits. And when microtraumas--tiny, almost imperceptible signs of stress to tissues, ranging from torn muscle fibers to microscopic bone fractures--begin to accumulate, they can leave horses lame and laid up. It's no wonder we're constantly looking for new ways to heal our horses faster.
Today we have a wide range of therapeutic gadgets. Some of these are only useful in the hands of a veterinarian; others can be safely applied by just about anyone.
Taking Water to the Next Level
Horse owners have long recognized hydrotherapy--applying water to the skin surface--as one of the most effective ways to deal with equine injuries. Cold water or ice applied to a fresh injury can help reduce swelling and heat, and it can provide temporary analgesia (thanks to its numbing effect) all at the same time. Hot water aimed at an older injury can stimulate blood circulation and encourage the body to deal with any lingering edema in the area.
One of the latest approaches is to combine cold therapy with compression. Two therapeutic systems, the Game Ready Equine unit (www.gamereadyequine.com) and the ThermoTek ProThermo (www.prothermo.com) manage this. Both companies claim that their product produces a rapid reduction of soft tissue swelling on new injuries and faster recovery times for many types of leg injuries.
The Game Ready system has a variety of leg wraps to attach, via hoses, to a portable cooling unit filled with ice. The leg wrap delivers "dry cold" therapy (the skin is never directly exposed to water or ice) while simultaneously applying adjustable cyclical air compression to the tissues.
The ProThermo device is similar, but it circulates a water-based fluid through the wraps that can be either cooled or warmed in a range from 3-41°C (37-105°F).
These next-generation devices offer considerable advantages over cold wraps alone. Cyclical compression mimics the muscle contractions that serve to help sweep excess edema out of an inflamed area and encourage blood flow, which carries nutrients and oxygen to injured tissues. Static compression can limit the amount of fluid that enters an injury site, but it does little to reduce existing swelling, and it can restrict fresh blood flow to the area.
Combined cold and compression can be a useful way to treat tendon and suspensory injuries, swelling due to bruises, bangs and contusions, and inflamed, arthritic joints. It can also be used preventively, according to the manufacturers, by cooling the legs before and after intense workouts.
Units like these allow users to adjust temperature, pressure, and the length of each treatment, and they can even program and save treatment regimens.
There are few contraindications for this type of treatment. The manufacturers caution that horses with certain circulatory conditions or congestive heart failure should not receive compression therapy and that caution should be used with the wraps placed on areas that are not sensitive to pain (as with a nerved horse).
Owners with large numbers of horses to keep fit and a significant financial commitment in doing so might also want to consider the ultimate in hydrotherapy: an "equine spa" unit, which functions like a horse-sized whirlpool tub. Where once horses were ridden down to stand in the ocean for its therapeutic effects, now the ocean can come to your barn!
When a horse steps inside the spa unit, which superficially resembles a roofless horse trailer, and the seals are all in place, it gradually fills with cool salt water that is swirled around the legs with air jets. The salt solution, manufacturers claim, acts as a hypertonic (causes osmotic shrinkage of cells, and therefore reduces swelling) poultice, and it has a natural healing effect on wounds. Since water density increases with salt concentration, it can also subtly increase pressure on the tissues to aid in the dispersal of excess fluid and the waste products of the inflammatory process. The depth of the water can be adjusted depending on the location of the injury being treated.
Bowed tendons, suspensory strains and tears, arthritic joints, bucked shins, bursitis (such as fetlock windpuffs and hock thoroughpins), hoof injuries such as stone bruises, corns, nail pricks, and abscesses, and open wounds such as over-reach nicks, rain rot, and scratches (a.k.a. mud fever) are just some of the health problems for which an equine spa can be used. Its proponents claim that acute laminitis responds well to spa treatment. The first few sessions in the confinement of a spa unit might require mild sedation for some horses.
Walking in Water
Not to be confused with the equine spa is the underwater treadmill for horses (variously known as an Aquaciser, Aqua-Tred, Aqua Trainer, AquaPacer, or HydroHorse unit, to name a few brands). While spas and treadmills are similar in size and expense, their uses are quite different. Aqua treadmill units combine the constant movement of a treadmill with the resistance of moving through water. They're a wonderful addition to a rehabilitation program for a horse who is in the final stages of recovering from an injury--treadmills help condition heart and lungs while reducing the strain on healing tendons or ligaments--but they should not be used when an injury is at the early, acute stage and exercise is not recommended.
With a price tag upwards of $50,000, an underwater treadmill unit is out of reach of most small horse owners, but many therapeutic centers for performance horses and large racing stables find that the investment is worth it. An underwater treadmill is a great way to help a horse work toward fitness after recovering from a tendon injury, saucer fracture, bucked shins, surgery for removal of a bone chip, or quarter crack. Because the unit can be filled with enough water to partially submerge the horse, he becomes buoyant, which minimizes the impact on his hard tissues, but the movement required by the treadmill is in most respects a more natural gait for him than swimming would be. Some units combine treadmill motion with whirlpool jets for massaging action, and some have temperature controls to allow the handler to use warm or cold water.
Light Beams and Shock Waves
Once upon a time, lasers were the stuff of science fiction, but today they're a routine part of many a horse owner's health-care arsenal. Non-invasive, safe, and portable, "cold" lasers, which emit a beam of red and near-infrared light without heat, seem to help reduce inflammation, provide some pain relief, and speed healing of certain types of injuries through a series of complex chemical reactions within the cells. All one has to do is aim a handheld laser probe over the area of the injury for a minute or two, and repeat at regular intervals.
Tissue cultures studies have gone a long way toward explaining what occurs when animal cells are stimulated by laser light. Within each cell are enzymes called chromophores, which absorb energy from light (chlorophyll is the equivalent in a plant cell), and use it to help the cell produce adenosine triphosphate (ATP, supplier of energy to cells in the body). When chromophores absorb laser light, the result is increased levels of cellular ATP, which in turn fuels increased cell growth and reproduction and a higher level of activity within the cell. Enzymes are produced and activated at an increased rate, ions move across the cell membrane more efficiently, and proteins and DNA and RNA are synthesized faster.
On a tissue level, treatment with laser light appears to increase the production and quality of collagen (a key component of healing tissues), encourage cells to grow faster, and increase the capillarization of tissues (the growth of tiny blood vessels that help deliver nutrients to the cells).
All this means pain relief, the quicker resolution of inflammation, and an improvement in the speed and quality of healing for the horse. Cold lasers have been shown to be valuable for treating traumatic and inflammatory injuries such as strained tendons, muscle tears, torn ligaments, and joint sprains, as well as arthritic lesions such as bone spavin and ringbone. They've also encouraged healing in ulcerated, slow-to-heal wounds, and proponents say they can prevent or minimize the development of scar tissue and adhesions. Skin lesions, such as rain rot, scratches, and aural plaques (those crusty growths in horses' ears), which might not readily respond to other treatments, react well to lasers, as do muscle spasms and chronic back pain.
Lasers have a couple of significant advantages over other types of therapy. They can be used almost immediately after an injury has occurred, and they often provide instant pain relief. And unlike some other therapies, lasers can be safely used over bony prominences and on broken bones repaired with metal pins or plates.
Lasers can be aimed at very specific areas, which can be both an advantage and a disadvantage. Although you can achieve great accuracy, a large injury site can take some time to treat, requiring repeated lasering every one to two inches in a grid pattern. The effectiveness of a treatment also depends on the power, wavelength, and frequency of the laser. Sophisticated cold lasers available for veterinary use are battery-powered and might have a number of different settings and interchangeable probes. Smaller, less-expensive units available to non-veterinarians have limited applications.
One of the challenges is pinpointing the exact area you should be lasering. While lasering the wrong spot is not harmful, it won't do him much good, either.
Melyni Worth, PhD, of Foxden Equine Products in Stuarts Draft, Va., says, "To use the equipment requires almost no training, (but) to be good at reading the horse and guesstimating where the injury is takes a lifetime. It's best to learn from an experienced individual."
It's not just light that has healing properties--there's also sound, as in extracorporeal shock wave therapy (ESWT). When scientists stumbled across it as a way to non-invasively dissolve human kidney stones, ESWT was hailed as a remarkable medical advance. But in the past few years, researchers have discovered that shock waves can do far more than that.
Imagine a therapeutic tool that is totally non-invasive and leaves no marks or scars, provides pain relief, and can stimulate rapid healing of all sorts of equine complaints, from splint bone fractures to "kissing" spine lesions. That is shock wave therapy.
Shock wave units emit high-energy acoustic waves that are distributed in pressure surges that can pass through fluid and soft tissue. Shock waves seem to induce the greatest changes in areas where hard and soft tissue meet--for example, at "insertion sites" where tendons attach to bone.
Veterinarians have observed the stimulation of bone formation at treatment sites, and accelerated cellular metabolism in soft tissues and improved vascularization of stimulated areas, both of which can contribute to faster healing.
In addition, shock wave therapy has a well-documented analgesic effect, which is something of a double-edged sword. Veterinarians regularly have to caution clients that horses treated with ESWT will feel better quite rapidly, but that healing is still continuing, so it's best not to rush back into training prematurely. The pain relief afforded by ESWT is significant enough that the Fèdèration Equestre Internationale (FEI) regulates its use in Olympic horses--shock wave therapy has to be discontinued three days before competition.
There are two main types of treatment apparatus: Radial units emit shock waves that spread out concentrically, like ripples in a pond, from the source, while focused units (generally larger and more expensive) can zero in on a specific treatment site.
The treatment protocol for shock wave therapy is fairly uncomplicated. Most horses benefit from two to three treatments, 10-14 days apart. The treatment site is clipped and scrubbed. Some horses might have to be twitched or mildly sedated to keep them quiet for the 10- to 20-minute treatment. The handpiece, which emits a low-level clicking sound, is applied directly to the skin with the assistance of a contact gel.
In most cases, the therapy is painless. Sometimes there can be discomfort when the treatment area has little soft tissue cushioning the underlying bone. Following treatment, a few animals experience some swelling or sensitivity for the next 48 hours. Stall rest is recommended for two to three days post-treatment.
Contraindications for ESWT are few, but it's currently not recommended for use near tumors (where its tendency to accelerate metabolism could have a disastrous effect) or to stimulate large nerves.
Also using the sound spectrum is therapeutic ultrasound, a variation on the diagnostic ultrasound probes with which many horse owners are already familiar. Therapeutic ultrasound has the effect of applying penetrating heat to healing tissues, which can aid joint flexion, restore elasticity to contracted tendons and ligaments, improve the alignment of healing tissue fibers and minimize scarring, reduce painful muscle spasms, and (in some cases) stimulate wound closure, to name only a few applications.
It's considered superior by many veterinarians and health-care practitioners to other forms of heat therapy because it seems to have the ability to reach underlying layers of tissue without overheating the skin surface. However, it must be used with knowledge and care because it does have the potential to burn.
This is only a sampling of the therapeutic devices currently on the market. There are many others, some based on less science than others.
Before you invest in a therapeutic modality, look not just for testimonials and anecdotal reports, but for hard scientific proof and comparable applications in human medicine. Before using any type of modality on your horse, be sure to discuss it with your veterinarian first.
About the Author
Karen Briggs is the author of six books, including the recently updated Understanding Equine Nutrition as well as Understanding The Pony, both published by Eclipse Press. She's written a few thousand articles on subjects ranging from guttural pouch infections to how to compost your manure. She is also a Canadian certified riding coach, an equine nutritionist, and works in media relations for the harness racing industry. She lives with her band of off-the-track Thoroughbreds on a farm near Guelph, Ontario, and dabbles in eventing.
POLL: Rehabbing the Injured Horse