Horse Tendon Health, by Margaret Paddock Hoof and Paws
This article is basic information and a guideline only.  Be sure to contact your veterinarian for diagnosis and treatment recommendations.

A tendon is the cordlike tissue at the end of each muscle bundle that connects it to bone. The tendons that travel over bony structures are enclosed within a sheath that lubricates the tendon, allowing it to slide easily over the bones. Although tendons are very strong, tendon injuries do occur, mostly in cases of over-use or misuse.

Bowed Tendon
A bowed tendon is the result of a case of tendonitis that has been undiagnosed or untreated. The horse has swelling and inflammation on the back side of the metacarpus. Depending on its location , the bowed tendon is called ''high,'' ''middle,'' or ''low'' (see graphic). In a low bowed tendon, the deep digital flexor tendon may be involved. Damaged fibers result in hemorrhage and swelling, weakening both damaged and healthy fibers. Prolonged disruption of blood flow to the area can result in irreversible tissue damage. Scar tissue that develops during the healing process may result in limited motion and elasticity to the tendon.
 
Treatment
During the first 48 hours inflammation should be controlled through immediate application of ice/cold therapy, cold water pressure bandages, removal of the shoes, administration of non -steroidal anti-inflamatories (NSAIDs) and sodium hyaluronate, topical application of DMSO and capsaicin, low level light therapy, massage, and passive range of motion exercises with stretching. The next step is to encourage repair of the tendinous tissues by application of warm moist heat to increase blood flow, cold therapy after exercise, therapeutic ultrasound, low level light therapy, controlled exercise, and, when effective, the use of systemic and topical anti-inflammatories. The healing process may take 12 months or more.
 
Tendon Rupture
Tendon rupture is the most severe of the tendon strains. A rupture can occur within the sheath or through a laceration in the sheath. Initially the fetlock will drop due to excessive stretching of the tendon. Inflammation, swelling and increased temperature at the site of injury, accompanied by lameness usually occur within the first 24 hours after injury. Damaged fibers result in hemorrhage and swelling, weakening both damaged and healthy fibers. Prolonged disruption of blood flow to the area can result in irreversible tissue damage. Scar tissue that develops during the healing process may result in limited motion and reduced elasticity of the tendon.

Treatment
Treatment includes immediate physical therapy and rehabilitation to minimize inflammation and the development of scar tissue while maintaining blood flow to the tendon. Physical therapy techniques for tendon rupture include warm moist heat, cold therapy, therapeutic ultrasound, low light therapy, massage, and passive exercise with stretching.
Systemic and topical anti-inflammatiories can be used to facilitate healing. As healing progresses, warm moist heat is alternated with ice/cold therapy. Low level light therapy and systemic and topical anti-inflammatories are continued. Hydromassage is used to combine massage and temperature effects. Passive exercise can be replaced with light walking. The next step is to encourage repair of the tendinous tissues by application of warm moist heat to increase blood flow, cold therapy after exercise, therapeutic ultrasound, low level light therapy, controlled exercise and, when effective, the use of systemic and topical anti-inflammatories.

Tendonitis
Tendonitis is inflammation within the tendon and its corresponding paratendon. Initially a slight swelling of the tissue and heat to the area is noted. When tendonitis occurs in a sheathed tendon, it is called tendosynovitis. If left untreated, additional inflammation can cause gait changes due to lameness, and can lead to bowed tendons. Damaged fibers result in hemorrhage and swelling weakening both damaged and healthy fibers. Prolonged disruption of blood flow to the area can result in irreversible tissue damage. Scar tissue that develops during the healing process may result in limited motion and elasticity to the tendon.
 
Treatment
Treatment includes immediate physical therapy and rehabilitation to minimize inflammation and the development of scar tissue while maintaining blood flow to the tendon. Physical therapy techniques for tendon rupture include warm moist heat, cold therapy, therapeutic ultrasound, low light therapy, massage, and passive exercise with stretching. Systemic and topical anti-inflammatiories can be used to facilitate healing. As healing progresses warm moist heat is alternated with ice/cold therapy. Low level light therapy and systemic and topical anti-inflammatories are continued. Hydromassage is used to combine massage and temperature effects. Passive exercise can be replaced with light walking. The next step is to encourage repair of the tendinous tissues by application of warm moist heat to increase blood flow, cold therapy after exercise, therapeutic ultrasound, low level light therapy, controlled exercise and, when effective, the use of systemic and topical anti-inflammatories.

For those searching for alternative treatments The Sauce is Sore No More liniment combined with Povidone Iodine. This herbal dressing combined with sugar may be the most effective sugardine combination yet. Sugardine is an old time remedy of mixing iodine and sugar to form a paste that is then applied to open wounds, abscesses, or resected hooves to reduce inflammation, infection, and healing time. Simply add sugar to make a hoof packing for abscesses and thrush. Use it straight as a topical anti-bacterial, anti-fungal paint to be used on scratches, hooves prone to thrush, infection, or traumatized areas.  Other helpful products are Gelotion - a thicker, non-runny , plant-based cool liniment that is perfect for working with ultra sound; Cannon MagWrap used for bowed tendons, arthritic conditions, inflammation, splints, etc.; and  FIRST+ICE ® Leg Wraps and Freezer Packs A unique mix of polymers, propylene glycol and water that stays cold for up to 2 hours. A non Gel formula that is soft, on-site cold therapy.

These and other fine alternative horse products can be found at:  www.hoofandpaws.com.

Contact: Margaret Paddock
2118 Eagle View Dr
Cottonwood, Arizona 86326
Phone: 928-649-9817
Email: mmap@commspeed.net
Website: www.hoofandpaws.com

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