Monday, July 30, 2012

Red's Rehab Slowly Progresses . . .

Our vet/chiropractor was out today to see how Red's healing from his injuries in coming along.  The answer is that it is coming along, although slowly, as is often the case with soft tissue injuries.  Now that the swelling in his hock is pretty much gone, it's possible to feel (although really not see) that there is a bit of residual swelling along the lower end of the Achilles tendon just above the point of hock, and the point of the hock itself is very slightly swollen to the touch (not visible to the eye).  Here's the anatomy of the hock - the Achilles tendon is part of the structure labeled tendon of gartrocnemius (top right) in the diagram:



He also has just the slightest bit of remaining sensitivity of his inner sesamoid ligament - the very short ligament under the sesamoid bone which attachs it to the pastern bone.  His walking downhill is much improved, although on a steeper hill he will drag the left hind toe and tend to break over at the pastern joint more quickly.  When moving on the level he also tends to preferentially slightly weight the outer side of his left hind hoof.  All of these behaviors, as well as his being more off when trotting to the right on the lunge, are consistent with the remaining areas of slight soreness.  The tightness in his hindquarter muscles is now gone.  It's likely that all this is the result of the original injury when he stepped in a hole in the arena and almost fell with me.  The subsequent kick to the outer hock, while resulting in ugly swelling and cellulitis, probably didn't make anything worse.

Here are two diagrams that shows the location of the sesamoidean ligaments - which run from the underside of the sesamoids - the pair of bones protruding from the back of the pastern joint, to each side, and covered by the suspensory ligaments.  For some reason the first diagram omits the suspensory ligaments.





So we're to continue on track with our rehab - continuing daily turnout, since he's careful to protect the injuries in the way he moves at walk, trot and canter, and the use of the leg should result in stronger (although some slower) healing, some icing of the two remaining slightly sore areas - the rebound of blood to the area after icing should aid healing - rubbing in arnica gel, and what we've come to call "pasture patrol" - hand walking around our pastures and up and down their hills. Every week or so, I'll stick him on the lunge for a few minutes to see how things are coming.  No riding until everything seems to be healed up, which could be several more weeks or perhaps even a month or more.

It's been about 5 1/2 weeks, and I hope to be enjoying riding Red for many years to come, so a couple more weeks, or even longer, won't be too hard for either one of us.  These sorts of injuries can be very persistant and slow to heal, and although to many eyes Red would appear to be only slightly lame, it's advisable to take our rehab slowly.

8 comments:

  1. Poor guy! I am just catching up, I guess :-( But it sounds like you have things well under control, and it's a good thing he's such a sensible guy that he can go out. I also find they do so much better on turnout. When I was doing rehabs at my place, it never ceased to amaze me what wonders good old fashioned cold therapy, structured handwalking, and sensible turnout can do in time. My old jumper Mellon bowed both his front tendons (at different times in the field after he retired) and they looked horrific, but now he's perfectly sound and you can barely see them at all. And the arnica is amazing, isn't it? Best of luck with his recovery :-)

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  2. Wow! I had no idea Red had gotten injured. I hope he's healed up soon.

    ~Lisa

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  3. Patience is a true virtue in this case.

    And, you are lucky to have to other really nice horses to ride in the meantime to keep you occupied.

    I have always found that caring for an injured horse creates an even stronger bond between us. Knowing Red's personality, I have a feeling this will apply to the two of you as well. You are going to have a special partnership.

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  4. I am glad that he is mending. Keep up the careful, slow work and I am sure he will be good as new. He is lucky to have you looking after him. I am sure that he appreciates your efforts and will not forget them.

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  5. I didn't realize he'd been injured either, but I do understand the idea of being "slightly" lame and how difficult it is for others to see it. I was just writing about that myself, but for different reasons. I may be joining the ranks of those with horses affected by EPM, so I came over to read your stories again. I hope I'm wrong and it's just an abscess or something.

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  6. Too often people rush the time frame for soft-tissue injuries and end up with larger problems more difficult to solve later on. I had rotator cuff surgery in '09 and even though I felt ready to get back to riding after six weeks when the doctor cleared me to go back to work (which meant I could DRIVE again), I wasn't given the go-ahead for riding for a full six months. Friends who had horses with anular ligament issues were told they could ride after several weeks, and a Grand Prix dressage rider said, "Don't do it. Give them another couple of months off." They did and have sound horses today. Slow and steady indeed. Fingers crossed Red is 110 percent very soon!

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  7. Your patience with Red's recovery will be rewarded. I hope his recovery stays on track - enjoy the pasture patrolling. :)

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  8. As the owner of a horse with very tricky feet, I can honestly say I never get tired of diagrams of a horse's legs and feet. Endlessly fascinating. And I do believe that by looking at them long enough, you learn a lot. They summon great ideas and provide a look that you just can't get by looking at the actual animal.I agree with all the comments: slow and steady. later you'll be glad for your patience.

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