Recovering from a tendon injury is a delicate process that demands patience, precision, and a well‑structured exercise program. The goal is to promote proper collagen alignment, restore strength, and gradually return the horse to its previous level of performance without re‑injuring the tendon. Below is a comprehensive guide to the most effective rehabilitation exercises, organized by stage of healing and key principles to keep in mind.
Understanding the Healing Timeline
| Phase | Approx. Duration | Primary Tissue Activity | Exercise Focus |
|---|---|---|---|
| Inflammatory | 0‑7 days | Hemostasis, inflammation, fibroblast influx | Rest, gentle range‑of‑motion, low‑stress circulation |
| Proliferative | 7‑21 days | Collagen type III synthesis, angiogenesis | Controlled stretching, low‑impact muscular work |
| Remodeling | 3‑12 weeks | Replacement of type III with type I collagen, fiber realignment | Progressive loading, proprioceptive drills |
| Maturation | 3‑12 months+ | Collagen cross‑linking, increased tensile strength | High‑intensity conditioning, sport‑specific work |
Every horse is unique---monitor the animal's pain response, swelling, and gait closely, and adjust the program accordingly.
Core Principles for All Stages
- Gradual Progression -- Increase load by no more than 10% per week.
- Pain‑Free Movement -- Any sign of discomfort should halt progression.
- Consistent Warm‑up & Cool‑down -- 10‑15 minutes of light walking or hand‑walking before and after each session.
- Cross‑Training -- Use complementary activities (e.g., swimming, water treadmill) to unload the tendon while maintaining fitness.
- Regular Evaluation -- Weekly lameness exams, ultrasonography, and tendon circumference measurements guide the program.
Stage‑Specific Exercises
1. Inflammatory Phase (Days 0‑7)
| Exercise | Description | Duration/Frequency |
|---|---|---|
| Passive Range‑of‑Motion (ROM) | Gently flex and extend the affected limb through its full safe range. Use a soft pad to support the fetlock. | 2‑3 sets of 20‑30 seconds, 2‑3 times/day |
| Hand‑Walking | Light walking on a soft, even surface keeping the horse relaxed. | 5‑10 minutes, 2‑3 times/day |
| Isometric Contractions | With the horse standing, ask for a "hold" on a lead rope or a low poll pressure to engage the hindquarters without joint movement. | 5‑10 seconds, 5 reps, twice daily |
Goal: Minimize swelling, maintain joint mobility, and stimulate blood flow without stressing the healing tendon.
2. Proliferative Phase (Days 8‑21)
| Exercise | Description | Progression |
|---|---|---|
| Short Walks on Soft Surface | Increase distance gradually, staying on sand or rubberized footing. | Start 15 min, add 5 min each session up to 30 min |
| Passive Stretching with Support | Use a towel or soft bandage to gently stretch the tendon while the horse is standing. Hold at mild tension (no pain). | 15‑30 seconds, 2‑3 sets, twice daily |
| Water Treadmill -- Light Resistance | Set the treadmill at 0‑5 % incline, water depth just up to the hock. Encourages muscle activation while unloading the tendon. | 5‑10 min, 3‑4 times/week |
| Hip Flexion Rolls | While the horse stands, roll a cylinder (e.g., PVC pipe) under the affected hind leg, encouraging flexion of the hip and activation of the gluteals. | 10‑15 rolls per session, twice daily |
Goal: Promote organized collagen deposition and begin building muscular support.
3. Remodeling Phase (Weeks 3‑12)
| Exercise | Description | Load/Intensity |
|---|---|---|
| Longer Walks / Light Trotting | Transition to 5‑10 min of light trot on a warm‑up strip. Keep heartbeat under 120 bpm. | 2‑3 times/week |
| Hill Work -- Gentle Slope | Walk up a low grade (≤5 %). The incline encourages eccentric loading of the tendon. | 5‑8 min, 2‑3 times/week |
| Cavaletti Work -- Low Height | Place low (5‑10 cm) cavaletti spaced 1.5 m apart. Encourage the horse to step over, focusing on a soft landing. | 4‑6 repetitions, 2‑3 sessions/week |
| Proprioceptive Surfaces | Use a balance pad or wobble board for brief (30‑45 seconds) stance work, improving neuromuscular control. | 3‑5 sets, 2‑3 times/week |
| Controlled Lunging -- Small Circles | Lunging at a walk or light trot on a 15‑m circle, allowing the horse to use its core and hindquarters evenly. | 5‑8 min, 2‑3 times/week |
| Therapeutic Ultrasound + Stretch | Combine therapeutic ultrasound (1 MHz, 1 W/cm²) for 5 min then perform a gentle stretch. | 2‑3 sessions/week |
Goal: Align collagen fibers along the line of stress, increase tensile strength, and re‑establish dynamic stability.
4. Maturation Phase (Months 3‑12+)
| Exercise | Description | Target Outcome |
|---|---|---|
| Progressive Trot / Canter Work | Gradually introduce trotting, then cantering on a straight line. Monitor heart rate and gait for any asymmetry. | Build aerobic capacity and tendon resilience |
| Increasing Hill Grade | Shift to steeper hills (up to 10 %) for short bursts of uphill work. | Strengthen eccentric contraction capabilities |
| Higher Cavaletti & Poles | Elevate cavaletti height (10‑15 cm) and vary spacing to encourage a longer stride and greater limb loading. | Enhance muscular power and tendon strain tolerance |
| Lateral Flexion Drills -- "Shoulder‑In/Shoulder‑Out" | While lunging, ask for controlled lateral flexion of the neck, prompting subtle hind‑limb adjustments. | Refine proprioception and core stability |
| Sport‑Specific Simulations | For dressage, jumping, or racing horses, introduce the relevant movements at a reduced intensity, progressively building to full workload. | Transition back to competition readiness |
| Interval Training on Water Treadmill | Alternating 1‑minute high‑resistance bursts with 2‑minute low‑resistance recovery. | Improve tendon elasticity and cardiovascular fitness |
Goal: Reach full functional strength, elasticity, and confidence for the horse's intended discipline.
Monitoring Tools & Red Flags
- Ultrasound Scans -- Perform at weeks 2, 4, 8, and then monthly. Look for decreasing lesion size and organized fiber pattern.
- Circumference Measurements -- Take at the mid‑cannon region; >2 cm increase may indicate swelling.
- Palpation & Flexion Tests -- Persistent heat, pain, or thickening warrants re‑evaluation.
- Gait Analysis -- Use video or pressure‑plate systems to detect subtle asymmetries.
Red Flags: sudden increase in swelling, heat, lameness >2/5, or refusal to bear weight on the injured limb. If any appear, reduce load immediately and consult your veterinarian.
Sample 8‑Week Progressive Plan
| Week | Daily Routine | Weekly Highlights |
|---|---|---|
| 1‑2 | Hand‑walk 5 min → passive ROM → hand‑walk 5 min | Rest, anti‑inflammatory meds as prescribed |
| 3‑4 | Hand‑walk 10 min → water treadmill 5 min (low resistance) → passive stretch | Add short hill walks (5 min) |
| 5‑6 | Walk 20 min → light trot 5 min → cavaletti 4‑5 low heights | Introduce hill work (6 % grade) |
| 7‑8 | Walk 30 min → trot 10 min → lunging at walk (15 m circles) → proprioceptive pad 30 sec | Begin controlled canter on straight line (if pain‑free) |
Adjust based on each horse's response; the timeline is a framework, not a strict schedule.
Final Thoughts
Rehabilitating a tendon injury in a horse is a marathon, not a sprint. The best outcomes arise from:
- Structured, incremental loading that respects the biological healing phases.
- Balanced conditioning , including cardiovascular work, muscular strengthening, and proprioceptive training.
- Close collaboration among veterinarians, physiotherapists, and trainers, using objective data to guide decisions.
When executed thoughtfully, these exercises can restore the tendon's integrity, reduce the risk of re‑injury, and bring the horse back to peak performance---ready to gallop, jump, or dressage with confidence.
Stay patient, keep the horse's comfort first, and celebrate each small milestone along the road to full recovery.