Sweeney Shoulder in Horses: 2025 Vet Guide to Diagnosis, Treatment & Recovery by Dr Duncan Houston 🐴🩺

Welcome! I’m Dr Duncan Houston, veterinarian and founder of AskAVet.com. In this in-depth 2025 guide, we explore Sweeney shoulder—also known as suprascapular neuropathy—a condition that leads to shoulder muscle wasting in horses. We’ll walk through causes, symptoms, diagnostics, comprehensive treatment plans, rehabilitation strategies, and long-term recovery tips. Let’s restore shoulder strength together! 💪🧠

🔍 What Is Sweeney Shoulder?

Sweeney shoulder occurs when the suprascapular nerve is damaged or compressed, causing the supraspinatus and infraspinatus muscles to atrophy. The result? A hollowed shoulder with a prominent scapular spine, joint looseness, and gait abnormalities :contentReference[oaicite:3]{index=3}.

📌 Causes & Risk Factors

Primary triggers include:

• ⚠️ **Trauma** – hard impacts like fence collisions, kicks, falls over poles :contentReference[oaicite:4]{index=4}
• 🧍 **Chronic nerve compression** – poorly fitting harnesses, collars rubbing over scapula :contentReference[oaicite:5]{index=5}
• 🛌 **Disuse atrophy** – from limb injuries or prolonged recumbency :contentReference[oaicite:6]{index=6}
• 🦴 **Neck/spine disorders** – brachial plexus damage or cervical radiculopathy :contentReference[oaicite:7]{index=7}
• 🧪 **Anesthesia recovery** – poor perfusion after surgeries :contentReference[oaicite:8]{index=8}

👀 Recognizing the Signs

Common clinical features are:

• Wasting of shoulder muscles, leading to a hollowed appearance and visible scapular ridge :contentReference[oaicite:9]{index=9}
• Joint instability—shoulder may subluxate or "pop" forward :contentReference[oaicite:10]{index=10}
• Lameness and reluctance to move the front leg forward :contentReference[oaicite:11]{index=11}
• Pain and reduced range of motion :contentReference[oaicite:12]{index=12}
• Toe-dragging if atrophy extends to upper limb muscles :contentReference[oaicite:13]{index=13}

🧠 How It’s Diagnosed

Veterinary exam includes:

• Observation of gait and palpation to compare muscle mass :contentReference[oaicite:14]{index=14}
• Diagnostic imaging—X-rays to rule out fractures, ultrasound, sometimes nerve blocks :contentReference[oaicite:15]{index=15}
• Exclude spinal or neurologic causes, e.g., cervical radiculopathy :contentReference[oaicite:16]{index=16}

🩺 Treatment Plan Overview

Effective management is staged:

1. Acute Phase – Pain & Inflammation Control

• NSAIDs (e.g., phenylbutazone, firocoxib/Bute) to ease discomfort :contentReference[oaicite:17]{index=17}
• Cold therapy and gentle massage to reduce swelling :contentReference[oaicite:18]{index=18}
• Stall rest transitioning to light turnout :contentReference[oaicite:19]{index=19}

2. Supportive & Regenerative Therapies

• Physical therapy, acupuncture, chiropractic adjustments, electrostimulation (e.g., Faradism) :contentReference[oaicite:20]{index=20}
• Laser or shockwave therapy targeting the nerve/glenohumeral region :contentReference[oaicite:21]{index=21}
• Vitamin E supplementation to support nerve healing :contentReference[oaicite:22]{index=22}

3. Controlled Exercise & Rehabilitation

• Groundwork – controlled lunging, pole work to rebuild muscle control :contentReference[oaicite:23]{index=23}
• Gradual return to under-saddle work once shoulder stabilizes :contentReference[oaicite:24]{index=24}
• Long-term turnout to encourage natural movement patterns

4. Surgical Decompression (Rare Cases)

If medical treatment stalls (3–6 months), surgical removal of scar tissue or part of scapula to decompress the nerve may be considered. Risks include scapular fracture but can restore function in chronic cases :contentReference[oaicite:25]{index=25}.

🕒 Recovery & Prognosis

Recovery varies:

• ~80% recover with conservative therapy within 6–12 months :contentReference[oaicite:26]{index=26}
• Residual atrophy or mild lameness may persist in severe cases :contentReference[oaicite:27]{index=27}
• Surgically managed cases have mixed outcomes depending on severity

📋 Long-Term Management & Prevention

• Ensure well-fitting tack, collars, and harnesses to avoid nerve compression :contentReference[oaicite:28]{index=28}
• Use protective shoulder boots during turnout or high-risk work
• Monitor performance, gait, and shoulder for early signs
• Maintain physiotherapy or conditioning to support muscle tone
• Consult with farrier for limb balance to reduce compensatory strain
• Stay in touch with your vet team via AskAVet.com for recovery tracking

📌 Key Takeaways – 2025 Vet Summary

1. Prompt diagnosis prevents permanent shoulder loss
2. NSAIDs and rest begin recovery early
3. "Regrow" muscles via therapy and exercise
4. Monitor for nerve signs and seek prompt vet advice
5. Surgery is rare but may help persistent nerve compression
6. Most horses return to function within a year
7. Prevent recurrence with good gear fitting and regular checks

📲 Support & Resources Anytime!

Need help with your horse’s rehab or recovery plan? Download the AskAVet.com app to share photos or videos, ask questions, and connect live with vets experienced in orthopedic care. Your horse’s shoulder health matters—and expert help is just a click away! 🐾💙