What are tendons?

Tendons are strong, flexible bands of fibrous connective tissue that connect muscles to bones. Tendons are primarily composed of collagen, a protein with a fibre like structure. Tendons play a very important role in movement, absorbing shock through the limbs and maintaining joint integrity.

What are Ligaments?

Ligaments are strong, fibrous bands of connective tissue that connect bones to other bones within a joint. Ligaments stabilise and support the joints by holding the bones together and preventing excessive or abnormal movement.

Unfortunately the tendons and ligaments, particularly those in the horses lower leg are very susceptible to injury. Tendon and Ligaments have a very limited blood supply, this means that injuries can take extensive periods of time to heal.

Signs of tendon and ligament injuries in horses:

• Heat in the limb
• Swelling in the limb
• Lameness
• Pain
• Reluctance to bear weight on affected leg

What to do if you suspect a tendon or ligament injury:

If you suspect that your horse has sustained a tendon or ligament injury it is important to call your vet as soon as possible. A vet will normally examine and palpate the limb to confirm a diagnosis. Once the initial swelling from the injury has subsided they may wish to carry out an ultrasound to determine the extent of the damage to the structure.

Treatment will depend on the extent of the injury, vets may recommend a period of box rest followed by controlled exercise to help strengthen the affected structure. A combination of ice therapy, cold hosing, bandaging and use of anti-inflammatory drugs such as Bute may also be prescribed to help manage pain and swelling.

Managing & Preventing Tendon and Ligament Injuries

Weight Management

Not surprisingly, when a horse is overweight more strain is put on the sensitive structures within the limb. When placed under strain, the tendons and ligaments are much more susceptible to injury. Maintaining an appropriate body weight is essential for minimising the risk of tendon and ligament injuries. If your horse is overweight it is important to take measures to promote weight loss through dietary and lifestyle changes.

Keeping Cool

Several studies have shown that tendons become more susceptible to injury as their core temperature increases. The core temperature of tendons typically increases during exercise, this can be accelerated by the use of protective boots and bandages. After an exercise session all boots and bandages should be removed to allow for cooling of the limb, if exercise has been intense and the surface temperature of the limb is relatively high, cold hosing or the application of ice therapy boots should help bring this down

Exercise

Always warm up your horse before any exercise or strenuous activity. A proper warm-up helps increase blood flow, raise muscle temperature, and improve elasticity in tendons and ligaments. Similarly, ensure a thorough cool-down session to gradually reduce heart rate and allow muscles, tendons, and ligaments to recover.

Horses are more likely to develop tendon or ligament injuries when ridden on unsuitable surfaces. Uneven, poached or overly hard surfaces can increase the risk of tendon and ligament injuries. Whenever possible, choose soft or well-maintained footing for workouts or training and ensure that arenas have adequate drainage to prevent them from becoming waterlogged during rain.

Conditioning

Gradually introduce exercise routines to build strength and flexibility in tendons and ligaments. Avoid excessive strain or stress on these structures, especially during high-impact activities or on hard surfaces. Regular exercise helps to improve blood flow, oxygenation, and overall tissue health. Vary the exercise routine to work different muscle groups and reduce repetitive strain on specific tendons or ligaments.

Avoid sudden increases in training intensity, duration, or workload. Gradually build up your horse's fitness level and allow adequate time for tissues to adapt and strengthen as sudden or excessive stress on tendons and ligaments can lead to injuries.

Protect the Limbs

A wide range of exercise boots are available for horses and are commonly used in jumping disciplines to protect the sensitive structures within the legs. When exercising at speed or jumping fences, horses are much more likely to strike or damage a tendon. Specially designed boots limit the impact of such strikes and reduce the likelihood of injury.

Tendon and fetlock boots are normally favoured in showjumping whilst brushing boots are more commonly used in cross country to protect the legs from impacts on solid fences. More recently, air vented boots have become increasingly popular. These provide the legs with the same level of protection as standard boots, however increased air circulation minimises the risk of the limb overheating thus reducing the likelihood of injury. 

Owners of young horses may use boots whilst schooling as unbalanced horses are more likely to brush or overreach. When lunging horses it is also a good idea to make use of boots as horses are much more likely to brush or overreach when on a circle.

When using boots and bandages, it is important that these are applied to the leg correctly otherwise they could be doing more harm than good. Bandages should be wrapped from the front of the limb to the back of the limb with the velcro secured on the outside of the leg. If bandages are creased or wrinkled they must be redone as this can cause a pressure point. Boots are normally fastened from the front of the limb to the back of the limb with fastenings being located on the outside of the leg. Before applying any boots or bandages always ensure the legs are clean and the hair is lying flat.

Preventative Care

It is important that all horses receive routine farriery care as a balanced hoof is essential for minimising the stress put on the structures within the leg. An unbalanced hoof can affect your horse's posture and movement, putting abnormal strain on tendons and ligaments. Depending on their individual requirements, horses should see a farrier at least every 4-8 weeks.

Reoccurrence of Tendons & Ligament Injuries 

Tendons and ligament injuries have a very high reoccurrence rate as their structures are usually weakened following injury. If your horse has suffered from a tendon or ligament injury in the past, it is extremely important to take extra precautions to reduce the likelihood of reoccurrence in the future. When bringing a horse back into work following a tendon or ligament injury it is important to think realistically in regards to rehabilitation. Whilst some horses will make a full recovery, in many cases returning to the level of work that your horse was at pre-injury may not be possible. Despite this your horse can still live a completely normal and comfortable life even if they do have to take things a little easier.

Treatment for Injury 

In recent years more and more treatment options have become available for horses with tendon and ligament injuries. Whilst still in early days, the use of stem cell therapy has shown positive results in accelerating healing times post injury and improving prognosis for a full return to work.