💧 Vet Guide: Hydrotherapy in Equine Rehab | 2025 Cold Therapy, Treadmills & Recovery Tips 🐴

By Dr Duncan Houston, BVSc

Hydrotherapy has long been a staple in human recovery—and it’s now making waves in equine rehabilitation too. Whether your horse is recovering from injury or just needs low-impact conditioning, water-based therapies offer a range of benefits. But not all hydrotherapy is created equal, and knowing when and how to use it matters. 🧠🐎

This 2025 guide explores cold water therapy, underwater treadmills, alternating heat-cold cycles, and the pros and cons of swimming—so you can make smart decisions about your horse’s recovery. 💧🩺

🧊 Cold Water Hydrotherapy: More Than Just a Hose

Cold water therapy works by cooling the tissues to reduce pain, inflammation, and metabolic activity. But casual hosing won’t cut it—you need **ice** to drop tissue temperatures low enough for a therapeutic effect. ❄️🧪

🧠 Why Cold Therapy Works:

• 🧊 Decreases pain by reducing nerve conduction velocity
• 🧬 Slows tissue metabolism, reducing oxygen and glucose needs
• 🩸 Constricts blood vessels, limiting bleeding and swelling

🔬 Target Tissue Temperature:

• 🌡️ Goal: 10°C (50°F)
• 🚫 Spraying cold water usually doesn’t reach deep enough
• ✅ Use ice wraps or submersion for full effect

This is ideal for **acute injuries**, post-surgical inflammation, or tendon and ligament stress. 📉

🌡️ Contrast Therapy: Alternating Hot and Cold

Using **alternating cold and warm water** can improve blood flow, particularly for soft tissue injuries in their subacute stage. ❄️🔥

💡 Mechanism:

• ❄️ Cold = vasoconstriction (less blood flow)
• 🔥 Heat = vasodilation (more blood flow)

This cycling effect encourages circulation without exercise—but it’s tough to apply consistently in the field.

⚠️ Temperature Targets:

• 🔥 Heat phase: 40°C (104°F)
• ❄️ Cold phase: 15°C (59°F)

Maintaining these temperatures precisely is difficult without professional equipment. Still, this approach has promise for mild to moderate tissue recovery. 🧠🔁

🦵 Cold Saltwater Leg Spas: Trending, But Unproven

Some rehabilitation centers use **cold saltwater leg spas** that spray limbs with chilled, aerated water. The theory is that salt enhances healing and oxygenation—but studies don’t yet confirm their effectiveness. 🧊🌊

These may be helpful as part of a broader recovery program, but should not replace proven methods like icing or underwater treadmills. ⚠️📉

🏃‍♂️ Underwater Treadmills: Controlled, Targeted Therapy

One of the most effective and widely accepted forms of hydrotherapy is the **underwater treadmill**. This equipment allows horses to walk or jog in water, reducing joint strain while increasing range of motion. 🏃‍♂️💦

✅ Proven Benefits:

• 🦵 Improves **limb mobility and joint flexibility**
• 🧬 Promotes **muscle development without concussion**
• 🫀 Provides light **cardiovascular work**

Unlike swimming, treadmills allow for **specific targeting** of joints and gait mechanics, making them ideal for post-injury rehab or early conditioning. 🎯

🏊 Swimming: Great for Fitness, Not for Rehab

Swimming offers full-body exercise—but it’s **not recommended for injured horses**. Why? Horses tend to hold their breath after inhalation while swimming, which can strain the cardiovascular system—especially in horses with respiratory dysfunction. 🫁

In addition, swimming doesn’t isolate or control joint angles—so it may do more harm than good for recovering limbs. 🧠⚠️

📋 When to Use Hydrotherapy

Not every injury or condition calls for hydrotherapy. Here’s a general guide to help: 🧾

✅ Use Hydrotherapy For:

• 🧊 Acute inflammation (cold water or ice)
• 🦵 Soft tissue recovery (contrast therapy or treadmills)
• 💪 Conditioning for overweight or out-of-shape horses (treadmills)
• 🧠 Neurological rehabilitation (treadmills with guidance)

🚫 Avoid Hydrotherapy For:

• 🏥 Open wounds or surgical incisions (unless cleared by vet)
• 💔 Fractures in healing stage (treadmill may be too intense)
• 🫁 Respiratory compromise (avoid swimming)

📲 Use Ask A Vet for Rehab Planning

The Ask A Vet app helps horse owners and rehab professionals create safe, custom recovery plans. You can:

• 📱 Ask about hydrotherapy equipment and techniques
• 📸 Share video of gait abnormalities or swelling
• 📊 Track rehab progress and exercise tolerance
• 🧠 Get second opinions on rehab timelines and protocols

Don’t guess—plan your rehab the right way with support from licensed equine vets. 🐴📲

✅ Hydrotherapy Takeaways

• 🧊 Cold water therapy reduces inflammation—but must drop tissue to 10°C to work
• 🌡️ Alternating hot and cold may improve circulation, but is hard to manage at home
• 🌊 Saltwater leg spas are trendy, but not yet backed by research
• 🏃‍♂️ Underwater treadmills are the gold standard for low-impact rehab and conditioning
• 🏊 Swimming is great for fitness but risky for injured or respiratory-compromised horses

📲 Final Thoughts from Dr Duncan Houston

Hydrotherapy is a powerful addition to equine rehabilitation—but only when used correctly and for the right horse. From chilling inflammation to gently restoring motion, water-based therapies can support recovery and long-term soundness. 🧠💧

Download the Ask A Vet app for personalized rehab planning, hydrotherapy advice, and expert insights—all tailored to your horse’s needs. 🐎📱