Ask the Vet: Equine Physical Therapy (Post-Injury Rehabilitation)

Question: I have a horse that is 9 months out from surgery to repair a broken shoulder. What is the best way to help his damaged nerves to recover?  

Answer: Theoretically, damaged nerves do not recover. In practice though, we often see the damaged nerve function return over time to some extent. It would depend on how much damage and where. If there are smaller collateral nerves that could compensate the deficiency, and the other dated tissues scarring and healing. Sometimes the nerve damage is not extensive but the muscles and ligaments around it are scarred and the limb may not function properly regardless, making it look like nerve damage.

The idea is to strengthen the supporting tissues to compensate for the nerve deficiency, and maintain the limb functionality. If any nerve tissue heals, it would take over three (3) months. In the meantime, the muscles and supporting tissues will atrophy if not properly exercised.

Passive range of motion exercises early on are crucial to muscle fitness. Once able to bear some weight, under water treadmill provides buoyancy and resistance to improve muscle, tendon and ligament strength without much impact. TENS has limited range but can also be used, as well as PEMF devices.

Acupuncture is excellent for long-term balancing both the damaged area as well as the contralateral limb compensation. It is thought to be able to help the body regenerate nervous tissues and decrease scarring. It should be started very early on, once swelling goes down even if there’s still fractured bone as it will help it heal faster.

Bear in mind that most of these modalities have not been extensively researched for use in horses or for the specific needs of your horse and you should first consult your veterinarian about what is the best procedure in your case and have him/her accompanying the progress often.

Question: My mare suffered a minor strain of her medial collateral ligament, and was on stall rest for five months. My vet says we need to challenge the ligament without reinjury. What kind exercise would you recommend?

Answer: I would need to know which joint is involved and to what extent is the injury. Other than stall rest, what other treatments were used? Passive range of options can be used for the first few days assuming the injury has healed on ultrasound.

Question: My horse developed a dent in her right hindquarter a few months ago. She did not cut the area, no bleeding, nor did she appear to be sensitive to the area. I started noticing that she would bring that leg down faster than the other when she walked. It was almost as if she couldn’t extend it as far as her left hind leg. What is going on? I had not been riding her when this showed up. She still has the dent, which is about 8 to 10 inches long and seems to run horizontally on her rear right side about 1/4 inch deep.

Answer: It is difficult to know without an examination. She could have ruptured a tendon, ligament or have other muscular damage.  I would recommend a veterinarian exam and likely ultrasound the area to rule out a tumor or abscess.

Silvia Do Valle, DVM, Orlando, Fla.