30.5.17

Superficial digital flexor tendon injury recovery in 10 weeks

I kept quiet about Rama's injury not only because he is mum's horse and I don't feel right writing about other people's horses without permission, but also because we were all absolutely petrified that this injury would not only be the end of his ridden career, but also be the end of him. However, months later we are now looking at potentially having Rama 100% recovered and back in full training which is why I wanted to blog about what we have done and potentially give someone who is terrified for their horse a bit of hope for recovery from a superficial digital flexor tendon injury.

So what exactly happened?
On Valentine's Day, Rama spooked when coming in from the paddock and fell over on the icy track to the stables. Not only did he fall once, but once he had managed to slightly get up he then fell over again and struggled to get up for about a minute. There aren't words to describe how scary this was - I was sure that he had broken a leg, no horse can survive falling over twice on thick ice but once he managed to get his bearings and get up again, he then passaged to his stable after we did a thorough check through of him but nothing seemed to be wrong with him. 

A week later, a small lump appeared on his left front leg, just below the knee. Nothing really noticeable, but enough to freak out both mum and I. Lots of icing and several days of hand walking but three days later it was significant enough to get mum to call the vet to come visit us. A few days later the vet came to scan the leg and we got the news that it was either a massive bruise or then a ligament/tendon injury and we would only find out a few weeks later because the swelling was too big and blocking us from seeing what the actual injury was. A deep bruise like that takes a few weeks to go away so after two agonising weeks the vet was out again, and this time she confirmed our worst fears... a 20-30% SDFT injury. And for a 19 year old horse who needs to be in constant work, this was NOT good news.

Having been through 3 different leg injuries with Vallu and Basse over the last five years and with mum's experience of having owned horses for more than twenty odd years, we came up with a game plan with the vet. Luckily, the vet was of the opinion that there was a good chance that Rama would recover from this but of course she could not be certain if he was ever going to come back to full work, she was of the opinion that there was a high chance that he could be a happy hacker/in light work but anything more than that? Nobody knew.

Now I'm sure this sounds like a similar story to many others who have been through rehab after a tendon or ligament injury, but what makes this case special is the fact that even though we were looking at a 6-9 month rehab, instead Rama was back in very light ridden work in 10 weeks!
So obviously the initial treatment in the 14 days after an injury involves box rest, ice or cold hosing 2-3 times daily, bandaging to immobilise the limb and giving anti-inflammatories such as bute to aid in reduction of swelling and provide pain relief. With Rama, we did all of this apart from the box rest. We were willing to take the risk of turning him out as we wanted to keep him sane and happy rather than attempting to keep him inside all the time. This is of course totally dependent on the horse, for example Vallu did a month of box rest because he is more likely to re-injury himself in the paddock than Rama.

During the early recovery period when the injury starts to cool down, new collagen is produced to repair the damage to the ligament, which is the right period to start lightly 'stressing' the injured area as this stimulates the collagen formation and it encourages collagen fibers to align in the best way that maximises the possible strength. At this point, Rama was still being turned out but he started being walked in hand. Although everywhere it says to do short periods of walking 5-10mins x3 a day etc, with this horse we decided that a single 'long' walking session in the afternoons would be better for him as he is used to being ridden in the afternoon, so we would stick to his normal routine as closely as possible. Even though this went against what the vet recommended, we felt that this was much better for his mental state and would keep him calmer and therefore less likely to injury himself.

During following month, we did three things that I believe were essential in aiding Rama's quick recovery:
1. He wore (and still does) Equ-StreamZ during the day and Back on Track boots during the night.
2. We used the Handy Cures' Laser every day for 20 minutes.
3. Rama was given comfrey in his feeds, just like Vallu has been since it was recommended to me by a friend who has extensive Reiki and zoopharmacognosy experience. Comfrey has been used for centuries to encourage healthy bone formation and maintenance, as well as to support the body’s natural cell renewal. It has been used for tissue and bone problems, bruises, growth and repair of connective tissue and cartilage.
After 10 weeks, the vet declared that he had healed enough to start being ridden again and to slowly up his fitness back to normal over 1-2 months! I WISH we had a video or a photo of the vet's face whilst she was scanning his leg, trying to find the injury. She even questioned whether mum was showing her the correct leg, as she couldn't see the injury at all!

So far anyone reading this who currently has a horse with a SDFT injury, I would recommend trying those 3 things to help speed up the healing process! Always listen to your horse, and since I am not a vet always listen to your vet's advice but I do recommend thinking outside the box and be willing to try different things that might not be the most conventional as they could help heal your horse quicker than what the vets expect.

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