Chronic Lower Leg Issues

Chronic Lower Leg IssuesChronic Lower Leg Issues

It's difficult enough to support the mass of a horse on a tiny column like the leg if it is a rigid structure.  When it also has a moving part (the fetlock), the problem becomes much more complicated.

How the Lower Leg Works

Exaggerated flexion of the fetlock is an easily seen outward indicator of the force being applied to the leg. This occurs when speed is added to the mass of the horse, as in racing, also in dressage movements requiring suspension, cutting/roping, takeoff and landing from jumps, negotiating hills or uneven ground, and sometimes plain old horseplay. 

The soft tissue structures of the tendon, ligament and dense investing fascia allow the horse's lower leg to function as it does. Damage to the extensor tendons, suspensory ligament, or any of the myriad other supporting and reinforcing structures is very common.

Once damaged, they never completely regain their normal strength and flexibility but with a little extra care, many horses can continue to be athletically active, even at their preinjury level. 

How to Reduce the Risk of Re-injury

Once the healing period from an acute injury has been successfully completed, you need a strategy for reducing the risk of re-injury. Passive stretching as part of the warm-up is a good idea. The flexor tendons are attached to muscle bellies. Increased tension is common when an injury can show contraction that may respond to gentle stretching and massage. 

Absolutely meticulous attention to hoof balance, regardless of barefoot, shod, or type of shoes, is an absolute must. Every effort must be made to ensure that the leg is loaded evenly. 

Physical fitness and good balance (neuromuscular conditioning) are two of the best guardians against reinjury. Introduce work slowly but with steadily increasing increments. Avoid unfavorable ground conditions whenever possible. Do not ask for sudden, sharp movements or speed changes but introduce elements that challenge control and balance, like ground poles. 

Finally, use the best and cheapest therapy there is - heat and cold. 

Like massage and stretching, warmth encourages tissue relaxation. Standard wraps, sweat wraps, and neoprene can all be used to advantage when the horse is stalled. 

It's impossible to overemphasize how important ice can be to the horse coming back from an injury. Apply ice to the previously injured area as soon as possible after exercise stops and maintain it for a 30-minute cooling period. Ice slows excessive blood flow and/or inflammatory enzyme activity that often results in annoying periods of intermittent heat and edema as you bring the horse back into work. I use it faithfully after every work regardless of intensity.

Investing these few extra minutes can mean a smooth uneventful rehab and maximize your chances of avoiding reinjury.

 

- Eleanor Kellon, VMD

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