🐴 Tendon Injury Treatments for Horses: Recovery & Rehab in 2025 🧊🧬

By Dr Duncan Houston BVSc

Tendon injuries remain one of the most common—and frustrating—conditions faced by horse owners and equine veterinarians. Whether your horse is a racehorse, sport horse, or recreational partner, tendon damage can sideline performance for months and carry a high risk of recurrence. In 2025, advanced rehab techniques, stem cell therapies, and structured loading exercises are helping us change that prognosis. 🧠🐎

📍 What Are Tendon Injuries?

Tendons are fibrous tissues that connect muscle to bone. In horses, the most frequently injured tendon is the superficial digital flexor tendon (SDFT), particularly in racehorses and high-level performance horses. This tendon supports the limb during loading and is vulnerable to strain, tearing, and rupture. 🦵

Symptoms include:

• 🔥 Heat and swelling along the back of the limb
• ⚠️ Lameness of varying degrees
• 🩺 Palpable pain during tendon examination

📉 Why Tendons Heal Poorly

Unlike bone, tendon tissue doesn’t regenerate—it heals by forming scar tissue, which lacks the elasticity and strength of normal tendon fibers. This contributes to a reinjury rate as high as 82% in some Thoroughbred racehorses. 💔

📊 The Three Phases of Tendon Healing

According to Dr. Sherry Johnson, tendon healing follows a predictable timeline:

1. 📆 Inflammatory Phase (0–3 days): Characterized by swelling, heat, and pain. Treatment = icing, NSAIDs, and rest.
2. 🛠️ Repair Phase (Day 4–30): Fibroblasts begin producing collagen; early tissue formation begins.
3. 🔁 Remodeling Phase (30–90+ days): Scar tissue is remodeled and aligned under stress to rebuild strength.

Each phase requires tailored care to optimize recovery. ⏳🧠

🧊 Early Treatment Strategy

During the inflammatory phase:

• 🧊 Apply cold therapy (ice boots or wraps) for 15–20 minutes multiple times daily
• 💊 Use NSAIDs like phenylbutazone to reduce pain and inflammation
• 🛏️ Stall rest to limit further damage

Monitoring limb swelling and checking tendon heat daily is critical. 📋

🧬 Stem Cell Therapy in 2025

Stem cell therapy continues to evolve and is now more targeted. Typically, bone marrow-derived stem cells are:

1. 🦴 Harvested from the horse
2. 🧪 Cultured in a lab over 2–3 weeks
3. 💉 Injected into the injured tendon

Stem cells may improve tissue quality by reducing scar formation and promoting new, more tendon-like collagen fibers. However, controlled studies are still ongoing, and success varies by case. 🧠📊

🏃‍♂️ Controlled Exercise & Rehab

After the inflammatory phase, controlled exercise becomes the single most important component of recovery:

✅ Eccentric Loading Exercises

These involve lengthening the tendon under load to stimulate better fiber alignment. An example:

• 📍 Withers Pull: Apply gentle pressure to the withers to shift the horse’s weight, hold for 5 seconds, and repeat.

Other activities include straight-line walking, raised pole walking, and gentle hill work (once cleared). These promote remodeling and strength. 💪

📅 Rehab Timeline

Typical tendon rehab spans 6 to 12 months and includes:

• 📆 Months 1–2: Stall rest + hand walking (5–10 min/day)
• 📆 Months 3–4: Increased walking + light trot (if imaging allows)
• 📆 Months 5–6+: Return to flat work, then gradual return to full performance

Ultrasound every 30–60 days helps monitor fiber healing and guide rehab progression. 🩻

⚠️ Risk Factors for Reinjury

High recurrence rates are linked to:

• 🔁 Incomplete rehab
• 📉 Early return to work
• 🦶 Poor hoof balance or conformation

Ongoing support from your vet and farrier is crucial for long-term soundness. 🛠️

📲 Ask A Vet for Rehab Planning

If your horse is dealing with a tendon injury or you need help building a recovery timeline, visit AskAVet.com or use the Ask A Vet App. 📱🐴

Dr Duncan Houston and the team can help assess ultrasound reports, suggest therapeutic exercises, and customize recovery plans. 🧠💬

🏁 Final Thoughts

Tendon injuries demand time, science, and consistency. In 2025, combining targeted therapies like stem cells with eccentric loading and structured rehab gives horses the best chance at full recovery. Trust the process, and never rush healing. ❤️

Rehabbing a tendon injury? Get your custom plan today at AskAVet.com 🐎🧬