Tendonitis in horses | Symptoms, Causes and Treatments

Tendonitis in horses is a condition which relates to the horses tendons and should not be mistaken for a specific DDFT tendon injury.

In many cases tendonitis in horses is actually created by an initial trauma or strain to the tendon when the horse is exercising, known as intrinsic tendonitis. Tendonitis as a condition then develops over a period of time and is often referred to as 'a repetitive strain injury' created through bruising or penetration, known as extrinsic tendonitis.

Tendonitis is thought to develop from overworking the horse regularly on uneven ground and is more commonly found with active horses. It only takes one bad step!

As with many long term degenerative conditions (such as equine arthritis) spotting the condition early is often the best way to manage the condition and avoid further complications.

A sports horse with tendonitis is likely to result in them being retired as the tendon is unlikely to fully heal and will effect the overall mobility and performance of the horse. 

In this article we look at the symptoms of horse tendonitis, the most common causes of the condition and various treatments available to you if your horse is diagnosed with tendonitis.

Symptoms of Tendonitis in horses

The most obvious symptom of your horse developing tendonitis is lameness, either severe or intermittently. The level of the horses lameness directly associates to how much inflammation is within the damaged tendon.

As with any lame horse, they will likely show signs of fatigue. A horse with chronic tendonitis may go sound while walking or trotting but lameness will return under hard work. Your horses levels of fatigue are often an early indicator.

Swelling or inflammation around the area of the tendon will sometimes cause a large lump running down one or both sides of the tendon, often effecting the digital flexor tendons and lead to varying levels of pain.

Your horse will probably be tender to touch in the effected area and not bear their full weight on the effected leg.

In the majority of cases tendonitis is found in the forelimbs rather than the hind limbs. 

Bowed tendon, a serious condition for an active sports horse, is a serious and severe version of tendonitis and requires immediate medical attention. A race horse or jumping horse with bowed tendons is likely to never compete again.

Tendonitis is best treated in the early, acute stages so catching the condition early and providing the correct diagnosis and treatment plan will be key to a full recovery. 

Diagnosis of Tendonitis in horses

Establishing that your horse has developed a tendon injury is one thing. Understanding whether your horse is developing tendonitis is another - both require immediate medical diagnosis.

Using ultrasound technology to diagnose the extend of the soft tissue injury is now widely used and is carried out around 5 to 7 days after the injury occurred. Whilst waiting for this many owners now adopt a variety of complementary techniques to support the horses pain levels and provide anti inflammatory support.

Although not cheap, normally between £250 and £300, Ultrasound technology does provide accurate diagnosis of the damage and is also used throughout the recovery process the establish how the tendon is healing. Many vets now use mobile ultrasound technology and will bring the imaging technology to your yard.

Thermal imaging techniques can also be a useful diagnosis tool as the image can show the exact location of the inquiry and where it’s effecting the horse.

Once the vet has diagnosed the condition treatment can begin.

Treatment of Tendonitis in horses

First and foremost, your horse must rest.

During the acute stage, within the first 3 days of the injury occurring, many provide complementary support and medication to help reduce any inflammation.

NSAID anti inflammatory medication is commonly administered to help with inflammation levels. In many sports horses this is not possible and many now look for more natural approaches than NSAID medication. It remains an important part of treating horse with tendonitis and particularly within the acute stages.

Advancements in magnetic therapy introduce ‘resonance technology’ to the equine tack market; unlike traditional magnetic therapy this advanced form of therapy does not lead to an increase in heat and thus is suitable for horses with tendon swelling. Advanced magnetism can be used long term and can be fitted to the horses legs immediately after the injury with a view to reducing inflammation and pain levels. Endorsed by many professional yards and vets across the world, advanced magnetism is now widely used as a preventative measure as well as a treatment aid.

Cold therapy such ice-boots, compress-bandaging and cold-hosing are also common treatments in supporting a reduction in inflammation and thus pain levels.

Various medications are available which can be injected directly into the injured tendon including hyaluronic acid and even organic compounds and in some more sever cases operations to cut the tendon has proven effective.

More recently, stem cell therapy and platelet rich plasma therapy are being spoken about with particular interest. Tendons are unable to regenerate new fibres after a trauma and in many cases will heal through the development of scar tissue. Scar tissue is more prone to re injury so the use of stem cells to target the damaged tendon can keep your horse sound moving forward. Be wary though, stem cell therapy is incredibly expensive as the vet must first sedate the horse and collect the cells using specialised equipment.

Regular cold-hosing is a common treatment in supporting a reduction  in inflammation and helps to reduce pain levels. 

Recovery of Tendonitis in Horses

Once your hours has been diagnosed a rest and rehabilitation program will be created. This is aimed at ensuring the most optimum recovery processes and time period to ensure the horse has the best possible chance of a full recovery. 

In the majority of cases, the initial treatment following the injury will be for 10-14 days. Within this period the horse will require full box rest and have regular cold therapy to support any inflammation. Many will administer ongoing anti inflammatory pain relief throughout this first healing stage and look towards complementary and alternative therapies to keep their horse comfortable and pain free. Remember, the main purpose of this first 10-14 day recovery process is to provide pain relief for your horse.

Following a bout of treatment above, stage 2 of the horses recovery process will be to support the horses regeneration. This second stage of healing will take place as the cells begin to regenerate and will normally take another 10-14 days. The horse should remain on box rest throughout this second stage of healing. 

Once the horse has begun to strengthen the fibres within the tendon, stage 3 of the healing process will begin, normally between 21-30 days after the injury. This period of recovery can take up to 12 months and during this time the fibres within the tendon will begin to rearrange themselves into normal patterns. Within this period of recovery the horse will require regular and controlled light exercise work and several vet inspections.

During the early weeks of recovery, your vet will recommend that your horse be turned out in a small,  private paddock under supervision, and possibly even lightly sedated, in order to minimise re-injury.

Controlled exercise is a vital aspect of recovery following tendonitis. Your vet will provide you an individual plan to help your horse which will likely start with hand-walking whilst on box rest with gradual increases over a period of 6-9 months.

The over all fitness of your horse will be carefully managed to ensure that re injury or further complications do not develop over time

Ultrasound and thermal imaging techniques can provide valuable insight into the horses recovery stage and provide an educated recommendation as to whether to introduce trot work and more steady canter exercises.

Whatever the situation, having a horse with tendonitis is a medical emergency and requires the support of a medical professional. 

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