14/01/2026
Let’s talk… Tendon & Ligament Injuries!
Tendon and ligament injuries are relatively common. Anyone involved with horses knows how challenging they can be, and having rehabbed my own horse through bilateral hindlimb suspensory ligament injury, I know firsthand that it’s not for the faint-hearted 🤕
Tendons and ligaments are dense connective tissues vital for structural stability and movement. Horses have no muscle below the knees and hocks therefore blood supply is reduced🩸, meaning healing is slow 🐢
There is a lot we can do to help. Quality healing is essential — better scar tissue means a greater chance of returning to work and a reduced risk of re-injury.
So how do we go about rehabilitation in the initial stages?…
Box rest — the words no owner wants to hear. Crucial in the early stages, it allows the injured tissue to rest and begin healing while preventing further damage. Stable enrichment is important to keep horses content during this time.
In-hand walking becomes key as healing progresses. Scar tissue forms during rest, but lacks collagen and isn’t very elastic. The body begins to lay fibres down at the injury site but in a disorganised way. Gentle, controlled loading through in-hand walking helps encourage better fibre alignment, improving stretch and tissue quality.
Therapeutic ultrasound (US) is a useful electrotherapy which uses sound waves to:
• Increase cell membrane permeability for improved nutrient exchange
• Stimulate fibroblast activity and organised collagen production
• Encourage collagen fibres to align along lines of stress, particularly when combined with movement (the picture with the pick up sticks is a very good visual representation of fibre alignment!)
Rehabilitating these types of injuries can feel daunting and time consuming, but following these steps provides the best chance of optimal healing, a safe return to work, and a comfortable life❤️.
