Injury Care :: Injury Care

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About Injuries

Unfortunately, even when all the correct preparations are made and maximum safety precautions taken, a horse can still sustain an injury. Whether it is due to extremes of weather, physical endurance, or contact (such as a kick), your horse is likely to experience some kind of injury during your ownership. How you deal with that injury will have a significant impact on your horse's recovery time, so we are sharing the following information in order for you to provide the best possible care for your horse in the early stages of injury.

Signs and symptoms of injury
Your horse may experience some or all of the following:

Swelling
Heat
Pain on palpation
Lameness in affected limb

What causes these?
Swelling is caused by damaged blood vessels leaking into the tissues. The first reflex action (lasting a few seconds up to 10 minutes) resulting from damage and pain at the site of injury involves constriction of blood vessels, which helps to reduce blood loss from the damaged vessels. However, the restricted blood supply can starve cells of nourishment and cause them to die. Dying cells release histamine which causes the blood vessels to dilate and flood the injury site with blood in an attempt to repair and rebuild the area. This increased blood flow not only causes swelling but can bring heat into the site of injury.

Muscle spasm may also occur during the early phases of injury as part of the body's protective mechanism. This causes muscles around an injury to contract, involuntarily increasing the tension in the muscle and limiting further movement. This also, however, restricts blood flow, placing more pressure on nerve endings and causing more pain and possible lameness in the horse.

Treatment of injuries

Icing

I cannot stress enough the importance of ICING an acute (new) injury. No matter what the injury is, ice it; it will only ever do good.

Excessive swelling at the site of injury will slow the healing process because it decreases mobility and prevents fresh blood from coming into the area. To promote faster recovery the most important thing to do is to decrease the swelling so that the area can function normally. The most beneficial and quickest way of doing this is by the application of ice.

Even if you can't see any visible sign of swelling there is always increased blood flow to an injury site and possible internal inflammation. Icing also produces an analgesic effect which helps reduce muscle spasm.

How long should you ice for?
10-15 minutes (holding or strapping ice on to the affected area)
Repeat once every hour if possible or as often as you can. It should be done at least 3 times daily.

Never cold hose/ice longer than 15 minutes as the body thinks that it is freezing and so reverses the effect by pumping extra blood back into the site of injury.
It is vital that in the first 48-72 hours the injured sight is iced as frequently as possible. After this time when signs and symptoms improve you can reduce the number of times you ice daily. Depending on the severity of the injury (consult a therapist) you could be icing for anything up to 2 weeks or longer.

What can you use for icing?

Gel packs (the most effective as they mould to an area and are reusable, lasting for years. Get you gel packs click here)
Frozen Peas (mould to an area well but can get expensive as not reusable and not always available)
Ice cubes in a plastic bag (harder to mould to an area but does the job)

Cold hosing is probably the most widely used form of giving cold treatment to injuries. It is not incorrect to apply this technique and the same principles apply as for icing, but using ice is significantly more effective and is to be preferred.

Do not use cooling gels for the skin in the belief that they will be as effective as cold treatment. They often contain alcohol or menthol, which give the impression of cold but without actually cooling the area.

Bandaging

This only applies if there is swelling below the knee or hock. For injuries above this region bandaging the lower leg will be of no benefit unless there is fluid build up in the lower limb. Applying a compression bandage helps to minimise swelling of the damaged tissue promoting healing. Ensure this is applied firmly, but not too tightly. Attach the bandage from the fetlock area and work up towards the knee/hock. This ensures that fluid is flushed upwards, minimising swelling below these joints. Compression, using bandages, helps prevent oedema (abnormally high amount of fluid in the tissue) by increasing the pressure on the tissues and therefore limiting the amount of fluid which can enter the area.

These bandages should be reapplied as often as possible (at least 2x daily), allowing time in between for the horses' legs to breath and blood to flow normally.
They should only be applied whilst there is swelling in the lower leg- usually the first 48-72 hours following injury. After this time if there are no obvious signs of swelling, bandages are no longer required.

Rest

Immediately following an injury, refrain from riding or lunging in order to prevent further damage. It is then advisable to get a therapist's opinion on when to start exercise again. Even though blood vessels will have repaired after 72 hours, damaged muscle fibres and connective tissue will still be weak. Any exercise at this point should be cautious and used only on sound horses. Any pain/lameness is a clear sign that the repairing tissues are being damaged again and the recovery period will be extended.

When being rested from work due to injury your horse is better off remaining slightly mobile so turn out is more beneficial if not severely injured. He may benefit from box rest for the first 24 hours of injury after this time see notes on "Box rest".

Equine Body Workers

You should not allow any therapist to work on your horse in the first 72 hours of injury as the repair stage is still active and you can further damage your horses' tissue. However, after this 3 day period it is in your horse's interest for the injury site (depending on the injury) to be subject to specialised massage and stretching techniques in order to flush fluid out, stretch damaged tissue, remove scar tissue, prevent prolonged damage, and shorten the recovery time. Having your horse treated appropriately following injury is the difference between, for example, a bad muscle strain taking 6 weeks to heal instead of 10-12 weeks.

Failure to follow the procedures above may mean that the recovery period from injury may be considerably extended while the body deals with the swelling and removal of dead tissue and blood cells. If the injury is not properly managed and these waste products are not removed, this may create long-term problems for the horse if the debris and fluid begin to congeal and solidify.

A Word on Bute
Bute, a well known painkiller and anti-inflammatory for horses, should always be used cautiously, not because it is inherently bad for your horse but because its misuse can have serious consequences for your horse. Although Bute can reduce symptoms of pain and lameness it does NOT necessarily mean that the injury is cured but rather that the effects of the injury are being masked. A horse's body will need at least 24-48 hours free from Bute in order to establish the true status of his recovery eg through trot up.

The use of Bute can be appropriate in order to reduce inflammation and to make your horse more comfortable if he is in obvious pain but it should not be used for long periods.

Under no circumstances should a horse be given Bute in order to be able to ride him at an event or socially. Lameness means your horse is in pain and pain is a response to damage that has not healed fully. If you choose to exercise your horse when being supplemented with this drug you risk further injury to your horse and prolonging his recovery by weeks or even months.

It should be noted, however, that Bute is sometimes used to manage non-traumatic injuries and certain diseases such as chronic joint problems etc. In these situations the above does not apply.

Free Advice Service

If you are waiting for a diagnosis from a vet or therapist to determine the nature of your horse's injury, you can still follow the guidelines above. This will normally reduce your horse's recovery time and can make it easier for vets to assess the injury site. Once you have a diagnosis or if you are already aware of what the problem is, you may find my free advice service of some use. This can be accessed by clicking on the "contact us" icon, where I can provide helpful information on many of the injuries that can afflict your horse, including:

Arthritis/Degenerative Joint Disease (DJD)/Bone spavin/Bog spavin
Shin splints
Navicular syndrome
Bursitis
Muscle strains
Overuse injuries
Impact injuries (falls, kicks etc)
And much more

Please don't hesitate to contact me with any concerns you may have about your horse, no matter how big or small. I will be only too pleased to help.

Equine behaviour and the relationship to injuries

A sudden onset of undesirable or uncharacteristic behaviour in your horse is usually a response to pain as his only way to communicate with you is through body language. For this reason, any change in behaviour could indicate that there is something wrong with your horse which, if not addressed, could lead to serious injury.

For free information and advice on any behavioural issues your horse has, such as head shaking, bucking, shortened stride, biting when doing girth up, unwillingness to perform particular movements etc, please don't hesitate to contact me using the "contact us" icon and providing me with as much information as possible. I will be pleased to provide you with as much help as possible.

A Word on Box Rest
My experience suggests that box rest is too often prescribed when it is not strictly necessary, largely through fear of not being able to control what the horse does when turned out into the field or paddock. However, many injuries heal far more quickly and more effectively when a degree of mobility is maintained through turn out.

When treating my human clients for muscular injuries I would by no means suggest 6 weeks bed rest as this would prolong recovery and I would not propose it for horses either. On the other hand, unlike a human patient who is able to follow therapeutic instructions, a horse relies on its owner to do what is best for it. As a horse owner you have to make an educated decision based on your knowledge of him and what he is likely/unlikely to do.

Prolonged box rest (1wk+) will cause a degree of some or all of the following:

Prolonged healing of injuries
Stiff joints
Swelling of joints
Muscle tension
Muscle wastage
Complete loss of muscular and cardiovascular fitness
Depression

It is not natural for a horse to stand still all day and night in a confined space and this can affect him mentally as well as physically. If your horse is allowed to graze naturally his muscles and joints will be kept mobile keeping him supple and maintaining at least some of his muscular strength and fitness. Moving around will keep any swelling to a minimum, aid relaxation of muscles, and he is less likely to develop a depressed state when grazing naturally.

Some simple questions to ask yourself before deciding what is best for your horse?

Does your horse only have access to a shared field?
Is your turn out field larger than an acre?
Does your horse usually run around and play regularly in the field?

If the answer to any of these questions is yes, there is a strong possibility that turning out an injured horse would only risk aggravating the problem. Other horses may cause him further injury, a large paddock is more encouraging for horses to run around in, and if he does run around he is likely to do further damage.

You can, however, overcome these problems using a simple method:

Section off a small area in your field so that your horse cannot run around. Even if it is barely bigger than the size of his stable he will be happier outside grazing and will move around more than if in the stable. A happier horse is also a healthier horse.

There are occasions when your horse will absolutely need complete box rest for a period of time but these are times of serious injury or illness, where you should always seek a vet's advice.

Example of an injury situation and how to make your decision
My adorable Hanoverian horse was at his fittest 6 weeks ago ready to compete in his first three-day event. 2 weeks before the competition he was cantering around his field, stopped abruptly and subsequently obtained a 3rd degree muscle strain to his shoulder. Since his injury would take anything from 4-8 weeks to fully heal with no riding in that period I continued to turn him out in his paddock as normal but, confused by his sudden lack of regular exercise, he started to pace the field and canter around. (This will only aggravate his injury and prolong his recovery by several weeks). As a result he was immediately put on box rest for 2 days whilst a solution was found. My solution was a small paddock closer to the yard where he could see everything going on. He settled in there grazing quietly with no adverse affects on his injury. As such he can stay out all day as normal without aggravating his injury.

A horse sustained a kick to his shoulder in the field, which he was lame on immediately. There was a considerable amount of swelling and the horse was obviously in discomfort. He was box rested overnight in order to monitor him. In the morning he was still lame but was turned out in his normal routine. After half an hour of walking around and grazing he was sound and the swelling had reduced significantly.

All information is provided by a qualified therapist in good faith and without guarantee. Any advice given is for guidance only and should not be considered as a substitute for veterinary advice and care.

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