A horse that's been laid-up to recuperate from an injury needs slow and steady reconditioning before returning to work, which is part of accepted veterinary management. But methodologies beyond that vary among experts. Here are some suggestions for getting your horse in shape.
Take It Slow and Easy
Carol Gillis, DVM, PhD (equine tendon pathobiology) and an equine ultrasound specialist in California, advocates gradual, controlled conditioning exercises that begin during the rehabilitation process in the form of stall rest combined with hand walking.
In the case of reconditioning after a tendon or ligament injury, Dr. Gillis usually recommends a basic regimen consisting of gradual advances. Before moving onto each new step an ultrasound is performed to check for inflammation and evaluate healing. That program consists of:
Drug therapy usually is restricted to the rehabilitation rather than the reconditioning phase per veterinary recommendation, although vitamin C supplementation may sometimes be recommended. "There is some evidence that additional vitamin C in the diet of stressed, injured, or ill horses can aid in healing of musculoskeletal injury," Dr. Gillis notes.
To assess progress in conditioning, Dr. Gillis suggests clinical examination and diagnostic imaging – radiographs for hard tissues and ultrasound for soft tissues.
"Exercise is probably one of the most important elements of rehabilitation," notes Joyce Harman, DVM, MRCVS, an equine acupuncturist and chiropractor. Dr. Harman, president of the American Holistic Veterinary Medical Association, believes a little exercise generally should be introduced during the rehabilitation phase. Most horses on the mend can benefit from either having their joints or injured limbs stretched while in the stall, or twice-daily hand-walked for 10 minutes, with increases as they begin to make further recovery.
For the rehabilitated but unconditioned horse, Dr. Harman begins with 5 minutes of hand-walking. "Add about 5 minutes to the exercise program every 3 or 4 days. For the horse that has literally done nothing for 6 months, five minutes of walking two or three times a day is plenty for the first few days. For horses that are somewhat fit, you may add 5 minutes a day, but add part of that doing some trotting."
As the horse progresses, add interval training. "Start out with three sessions of 30 to 60 seconds at the trot, with a walk in between; three short trots are less stressful than one long trot. As the horse gets fitter, canter with a trot in between." Recondition by walking the horse down a trail or walking or trotting around the ring in a big circle, not through longing.
Turnout, where a rehabilitated but unconditioned horse can self-exercise, also is beneficial. "The faster the horse can get into a full day turnout, the easier your job is going to be," Dr. Harman says. "For some horses, that means sedating them, sometimes fairly heavily, so they don't get crazy in their first week or 10 days out and injure themselves because their muscles aren't fit and they're doing something strenuous." She recommends a 2- or 3-hour turnout under a drug such as acepromazine.
Rehabilitate, Then Recondition
Ben Martin, VMD, Diplomate American College of Veterinary Surgeons, and assistant professor of sports medicine at New Bolton Center, University of Pennsylvania, prefers to see a horse make a full recovery prior to starting in a reconditioning program. "Whatever the injury or illness happens to be – bowed tendon, bad heart, surgery – the process of recuperation should be accomplished before the horse begins the process of getting physically fit."
Reconditioning begins with self-exercise via turnout in a small paddock, then turnout in a big paddock. Dr. Martin opts for graduated turnouts in order to minimize risk of injury. "If you take a horse that's been locked up in a stall for eight weeks and put him into a big paddock, the first thing he's going to do is buck and wheel and run around like a maniac. So we start them in a small area where they are less likely to hurt themselves."
After the horse has been allowed out in a big paddock for about 4 weeks, they can start a walking/trotting reconditioning program. "Usually I have the horse walking 5 minutes and trotting 5 minutes each day for a week. The second week he does 10 minutes a day and so on, until he's up to about 30 minutes a day of walking and trotting. This is a good, basic routine to get any horse of any discipline relatively fit in 60 days."
Depending upon the problem from which the horse is recovering, Dr. Martin may use a Holter monitor, ultrasound, nuclear scintography, or radiographs to monitor the horse 4 to 6 weeks after it begins its exercise program.
From there, the horse can move into its training program. "About 4 months of reconditioning is kind of a ball park figure for a horse that's ready to do some concentrated exercise such as racing or competing in a cross-country course," says Dr. Martin.
Sometimes drugs may be part of the rehabilitation and/reconditioning program. "Most of the drugs we recommend are pharmaceuticals," Dr. Martin says. "Commonly, phenylbutazone for inflammation, or Adequan (polysulfated glycosaminoglycan) or Legend (hyaluronate sodium) for anti-inflammatory properties and improvement of synovial fluid in the joint. The nutraceuticals I most commonly recommend for middle-aged to older horses coming back from an injury or lameness are Cosequin and generic chondroitin sulfate and/or glucosamine (the major ingredients in Cosequin)."
When Is Reconditioning Achieved?
Dr. Martin says there are a few ways to access a horse's progress. "One is the general, overall appearance of the horse. Second is how quickly the horse recovers from exercise: The fitter they get, the quicker they recover. You also can tell by how much the horse is sweating or how they are breathing." Excessive sweating or a high respiratory rate could be an indication of too much stress and exercise. Some people use heart monitors to record how fast the horse's heart is beating. "But basically, you can tell a horse is becoming conditioned when he starts going from being a blubber ball to something more muscular."
In the late phase of conditioning, one can assess aerobic capacity objectively. On a treadmill, with sophisticated equipment, one can non-invasively measureVO2 (oxygen consumption) or lactate levels at specific exercise intensities, and if the horse can hold up to a stress test (running to fatigue), VO2max can be measured. Measurement of VO2max gives one an accurate index of fitness, to compare to future tests." says Andrew Hoffman, Head of the Lung Function Testing Laboratory, Tufts University School of Veterinary Medicine.