# tendon injury - box rest v field rest



## wjgfred (5 July 2008)

Hi all,

As my horse has a current DDFT injury I have been an avid reader of all posts to do with tendons since I discovered this site.

It is obvious from some of the postings that some vets prescribe box rest and then field rest and others box rest then walking in hand and then ridden walking.

I just wondered if anyone had any thoughts on this as the injuries in some cases appear to be similar.

Would also be interested in anyones experiences - good or bad - in the different types of management.


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## Madcow (6 July 2008)

One of my horrors damaged his Superficial flexor tendon (I know it's not the same tendon as yours but guess the treatment would be the same) in his right fore just over 2 years ago. He was only on total box rest for 5 days. (the tear was 12 cm long) After 5 days he started being walked out in hand - first for 5 min once a day, for a week, then building up by the end of 3 weeks to twice a day for 5 min, then adding on 3 minutes to each walk per week until we reached 45 (ish) minutes, twice a day, in hand. Then we cut back on the time and he was ridden, in walk for 10 min once a day on flat, firm surfaces for a week, then 2 x 10 minutes in week 2 and adding on 2 minutes every 5th day. Once he was walking out under saddle fo 30 min twice a day his leg was scanned again and he was allowed to start trot work. At first he did 20 min walking and 2 min totting, which we gradually built up. After months of road work, once the trotting was up to 15 minutes, he was allowed back into the school. He was turned out into a stable sized pen 5 months after the initial injury and didn't go into a normal sized field until we he had been trotting for 2 weeks (even then I held my breath every time he had a hoolie) During the initial phase he alternated between cool sport boots on for 3 hours, then bandages for 3 hours during the day and magnet boots on at night. My vet injected him with Cartrophen weekly for a month. He came back perfectly sound, with very little external evidence of the injury, just a very slight thickening.
My advice would be, go with whatever your Vet suggests, mine was brilliant. It all takes a long time, but is worth it.


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## kerilli (6 July 2008)

I have a lot of bitter experience of tendon injuries, ddft and sdft.
If it happens again, I will do the following, at my yard, or elsewhere if necessary. Have the horse in a small concrete floored (essential) crew-yard or similar, about 3-4 times the size of a stable, with a shelter or stable opening into it. then he can mooch about, he won't go doolally because he won't trust himself not to slip over, he won't go stir-crazy and explode the first time he's let out of the stable in hand (had that plenty of times). at least a few months of this, possibly with in-hand (or under saddle if safer) walking out if vet advises. 
Oh, and as much time to repair as possible - 1 year minimum... unless you are having those fancy new stem cell injections, of which i know nothing but hear great things.
i've had one get to a high level eventing after a tendon injury, and stay totally sound (although it was from a bruise, not a pull, initially, which makes a huge difference.)
best of luck with your horse's injury.


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## carthorse (6 July 2008)

I have no recent knowledge but 20 years ago my horse 'did ' a tendon eventing. There was not the knowledge there is now and so we just had to box rest for 4 days and then turn out for 6 months with a quiet horse. He came back into work very slowly. I never evented him again because it worried me that he was not really fast enough and was having to go at his full speed most of the way.
He went on to dressage and worked up to P.St.G within two years and was sold for a lot of money and a full vetting including x rays. He carried on for many years being a fantastic dressage horse.


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## cellie (6 July 2008)

I linked up 6 small stable sized paddocks so my horse could walk about and graze during the day and brought him in at night .When he was better there were no explosions in the field.We only had a mild tear so I would go on the advice of your vet but the small paddocks work Ive had to use them numerous times.Good luck


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## wjgfred (6 July 2008)

Hi,

Thanks very much for all your replies. My horse actually had 2 months of box rest with 2 x 20 min walks per day and cartrophen once a week for 4 weeks and then monthly for a further 3 months.

Following the box rest I was allowed to turn him out and told this would be for 12 months field rest.  He actually comes in during the day for 8 hours and out at night.

He has been sound in walk and trot on the straight for 3 months.  He is trotted up once a week (and untested in anything else).  He is on month 2 of the 12 months field rest.

My vet has actually said that I can walk him out in hand with his tack on  for 20 mins, but that this is not really needed as he is doing his exercise in the field.  I do intend to start doing this shortly though as he is a working horse and I believe to have his tack on will keep him mentally interested and give him a 'job', also it wont come as a huge shock when he has his tack back on in 12 months time (hopefully!!).

I am desperate to do the best for my horse, he has evented to pre-novice level.  I accept he wont do this again, but he was very talented in the dressage phase and my ultimate hope is that we can carry on with this at some stage.

I trust my vet who is extremely experienced and very supportive.  However I find it strange that people with similar injuries seem to be riding their horses as walk alot sooner than the plan is for me.  It may be that he is just being very cautious.  Also he is due to be reviewed in 3 weeks time so maybe things will change then.  I should add that I have no intention of doing anything without the full support of my vet and I am following his instructions to the letter.

I am interested in everyones experiences - there seems to be loads of us with tendon and ligament problems - maybe we need a support group !!

Thanks again


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## carthorse (6 July 2008)

If your dressage was good then I hope you were reassured by my tale. It is worth taking the time for it to heal. Just turn him away and he will come back better for it. good luck


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## wjgfred (6 July 2008)

Hi,

Yes your posting has made me feel much better, and I will give him all the time in the world, but I have to say it is so frustrating.  

Its just that some of the papers I have read say that the ridden walking horse program is more sucessful that turnout and I want the best for Freddie.

Think I will discuss it with the vets when he is reviewed.  Having said that I think he is happier out and it does seem that the ridden walking is accompanied by a full time stabled program.

Thanks for all your advice, I think I will try to keep the postings with the management programs for bringing back into work so I have some further advice when the time comes


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## hellybelly6 (6 July 2008)

I rode my horse at about 3 months post tenoscopy because it was a lot safer than being on the ground and the vet gave the ok for this as well.

When I was riding it was only in walk building up from 10 to 15 to 20 minutes etc.

Regular gentle exercise is vital to reduce any adhesions in the healing tendon.  The new tendon fibres are randomly placed during healing, but the gentle exercise encourages the tendon fibres to lay vertically as the tendon is moved up and down through the tendon sheath, in other words it smooths then straight.

I think it will help your horse to be walked in hand with his tack on, it will help him mentally and when it comes to ride him again, he will be used to the sensation and it will improve the bond you have with him.

My horse was turned out during the day (I couldnt trust him over night) and had his walks in hand/ridden.

Obviously, discuss any questions you have with your vet and see what he/she recommends.

I hope your horse recovers soon.  It took my horse about 14 months and it was worth it.

x


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## brea2006 (6 July 2008)

hi ya my friends horse had just recovered from deep flexor tendon injury.
she had to stay in for 4 weeks solid. prior to this she had her put in the field doing more harm.
at 4 weeks she was allowed to walk her in hand for 10 mins every day then slowly building it up to 20-  by this time she used the horse walker which had concrete base on which built the muscles around her tendon back up.
she has just turned her out which is 6 months since the injury and the vet was really surprised that it had healed that quickly- she was having the tendon scanned every month £150 a go!! but just shows that someties you have to be really vigilant with vets instructions.


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## Gooby (6 July 2008)

My horse did his superficial flexor tendon in his left fore on his first day of summer turnout! He started with 2 weeks box rest then could start to be walked out in hand for 5 mins twice a day for a week then inc. to 10 mins etc. Fin being the pain he is sometimes decided this wasnt exciting enough so did his bucking bronco act and kicked me over! After this we then tried 20 mins turnout everyday. He was quiet calm in the field spending most of his time grooming but it was just too much for his tendon and became lame on turns. He had a weeks box rest and is now walking out again building it up slowly but this time hes in the walker so his speed is controlled and he doesn't go too nuts! Its 8 weeks today since he got injured. I think it will be about a month before he can go out in the field again and then another couple of months before he can be ridden. I would follow your vets advice the best you can but dont forget you know your horse best. When my vet told me he would have to be walked in hand I knew it wasnt going to have a happy ending! Hope the recovery goes well!


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## RachelB (6 July 2008)

The reason there are so many different ways of dealing with tendon injuries (well, and many other types of injury) is that there are so many variables involved. You heard the full extent of my story - my horse was turned away because she is laid-back, has a severe DDFT injury, and also has other problems in her foot. Another horse who may be highly-strung with a mild SDFT injury may only need six months of box rest before it can start being walked out, then turned out at a later date. The main thing is that the horse gets some form of light exercise - mine has wandered around in a field for the last year (literally 365 days today 
	
	
		
		
	


	




 ) whereas others have had to keep on box rest and provide exercise by walking work (ridden or in-hand). Some vets suggest a mixture of the two; it depends entirely on the horse, owner, circumstances, injury, etc. etc.
Obviously the other key thing is that you can trust your vet and that you follow his/her instructions as he/she will be able to review the true extent of the injury and the horse's circumstances to be able to suggest the appropriate programme.
I agree with kerilli though - if total box rest is avoidable it should be avoided as long as the horse is unlikely to re-injure itself. My horse was turned out in a small pen for two hours a day throughout her box rest and this kept her sane. When she was turned away she wasn't half as mad as I expected (she wandered off to eat and didn't bother doing much running about!)


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## hussar (6 July 2008)

My experience of my horse's recent DDFT injury is very much in its early stages - he was diagnosed 3 weeks ago after 4 weeks off with a suspicious swelling, although no heat and no lameness. A scan showed a small tear of the DDFT above the fetlock. Although the vets initially recommended box rest, they softened that when I said he was a box walker, and he's been in a small paddock with 24/7 access to the stable and a donkey for companionship. Thanks to midges and awful weather he's spent the greater part of that time inside anyway, but at least it's voluntary.

We go back for a rescan in 2 weeks. I have been using a hired hand-held cold laser therapy unit and will be very interested to see if it's produced any results beyond what might be expected normally.


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## SOB (7 July 2008)

My lad did his SDFT on the 8th of May 
	
	
		
		
	


	




 No tear or hole just serious strain which had caused the fibres to being to break down. We are on week 9 of 12 "box rest" the first 2 weeks were in a stable but due to his COPD and not settling he has been turned out on stable sized patch during the day and in at night which nicely coincides with the 2 x 10 min walk outs and also makes him safer to handle.

We are 3 weeks from our next scan and I am hoping he will be allowed turnout at this point. The vet suggested a further 3 - 6 months of field rest which will nicely take me up until next year 
	
	
		
		
	


	




 I am just hoping for recovery. We are only happy hackers with a bit of light schooling and jumping thrown in so hopefully a full recovery will be made.


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## wjgfred (8 July 2008)

Thanks again for everyone who shared their experiences, it has been very interesting and informative.

Whilst I can see that the seriousness of the injury has some bearing on things, it does seem that different vets have different opinions on the best program to follow.

Having said that the main theme seems to be that they have some exercise in order that they do not get adhesion formation and the tendon fibrils heal in the right direction.

Thanks again and maybe I will put another posting on in a month and we can see how we are all getting on!!

But most of all GOOD LUCK TO EVERYONE.


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## monstermunch (10 July 2008)

Penning off a small area about 4 times the size of a satble is far more beneficial I think than box rest. Obviously there will be times when box rest is absolutely nesesary. but for tendon injury like this you will keep the horse far happier by letting it mooch round in a good space but too small to be stupid. You then avoid the scenario of the horse going mad when it is first let out which just un does all the box rest anyway. If it is a bad injury he will need a good year to get over it and thefore for his own sanity a small pen is much better. My boy is 9 months into field rest for same injury. he is ding well and isn't stupid as he hasn't been restricted to staring at 4 walls. Good luck


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## Doublethyme (10 July 2008)

My mare has an SDFT injury in the same area as she has injured her annular ligament (impact injury we think).     Her treatment has been :

2 weeks full box rest
Scan
8 weeks box rest with 10 mins in hand walking a day after the first week
Scan
3 months small paddock rest on her own
Scan
4 months small paddock rest on her own

9 months in total and during her box rest I pretty much did just that apart from the walking, she literally didn't come out of the box even for mucking out.

We now have three weeks to go till her next scan when I am hoping it will be good news and the go ahead to start reintroducing something (anything!!!)


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## frostie1 (10 July 2008)

We had a top flight jumping pony that ruptured a tendon, we spent a fortune at Newmarket on stem cell treatment as well as the box rest for three months then the field for a year, then another six months road work light then full work, spent weeks gradually building the jumping back up only for the other leg to give out as soon as we jumped big again! so as hard as it is to except I think horses with serious tendon injuries very rarely make it back to anything other than a hack


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## wjgfred (10 July 2008)

Hi,

Doublethyme - will be wishing for good luck for you on the next scan.  Please let us know how you get on.  

Freddie is due to be reviewed the first week of August and it will be interested to see what the vets think !!

Unfortunately his injuries are in the hoof and they cant get at it other than with MRI which is how he was diagnosed.  Obviously I cant have MRI very regularly due to cost so it is difficult to monitor how he is doing other than checking if he remains sound.

I took him out for 10 minute walk today with his tack on, he seemed to enjoy it and be glad he had a job - all be it this was only walking in hand !!


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## lucemoose (24 July 2008)

My horse did his DDFT a year ago on Sunday 
	
	
		
		
	


	




He spent Aug til Sept kept in and t/o in a little pen, then Sept -Nov out in a larger field , then he was in from Dec til March on proper box rest and he was walkied out in hand and under saddle all this time building up to an hour each day walking ridden. He was so bloody fit he nearly killed me! He has now been turned away and has been since April, I will leave him out for as long as it takes, he is my pride and joy and he will not be sold nor left to rot but I am desperate to see a jump on him again
xx


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