💥 Vet Guide: Shock Wave Therapy for Lower Leg Wounds in Horses | 2025 Effects on Proud Flesh & Inflammation 🐴

By Dr Duncan Houston, BVSc

Wounds on a horse’s lower legs are notoriously tricky to manage. The lack of soft tissue, limited blood flow, and tendency for **excessive granulation tissue (proud flesh)** make healing slow and complicated. But could shock wave therapy help reduce these challenges? 🧠🐎

Extracorporeal Shock Wave Therapy (ESWT) has been used for orthopedic conditions like arthritis and tendon injuries—but a study explored its potential in managing **lower leg wound healing**. In this 2025 guide, we’ll explore the results and what they mean for your horse’s recovery. 📊🩺

🔬 What Is Shock Wave Therapy?

Shock wave therapy delivers **pulsed, high-energy acoustic waves** to the tissue. This energy triggers cellular responses believed to promote **pain relief**, **blood flow**, and **healing**. 💥

It’s commonly used for:

• 🦴 Arthritis and joint pain
• 🔗 Tendon and ligament injuries
• 🧠 Bone healing and navicular syndrome

The theory is that by stimulating local tissue response, ESWT could help **accelerate wound healing** and control granulation tissue in stubborn leg wounds. But does it work? 🧪

📊 The Study: Shock Wave vs. Control Wound Healing

Researchers created **controlled wounds** on the legs of six horses—one on each limb—and compared shock wave treatment to standard bandaging. 📋

Study Design:

• 💥 Shock wave therapy applied once per week for 4 weeks on select wounds
• 🩹 All wounds lightly bandaged
• 📐 Outcomes measured: inflammation, proud flesh, and wound area

Key Findings:

• 🔥 **Shock wave wounds had less inflammation** than controls
• 🧱 **Proud flesh formation was significantly reduced** in treated wounds
• 📏 **Wound size and healing time** showed **no significant difference**

So while ESWT helped reduce **inflammation and proud flesh**, it **did not accelerate closure or healing time**. 🧠

🧱 Understanding Proud Flesh in Horses

When a wound heals by second intention (without sutures), it fills with granulation tissue. But if this tissue **proliferates excessively**, it forms **proud flesh**—a spongy overgrowth that prevents skin from closing over the wound. ⚠️

Why Proud Flesh Happens in Lower Legs:

• 📉 Poor blood supply
• 🚫 Constant movement and tension
• 🧪 Exposure to dirt and bacteria

Reducing proud flesh is key to proper healing. That’s where ESWT showed benefit. 💡

⚖️ Is Shock Wave Worth It for Wounds?

The study suggests that while **shock wave therapy doesn’t speed up healing**, it may still be useful in managing complicated wounds prone to excessive granulation. 🧪

Consider ESWT If:

• 🧱 Your horse consistently develops proud flesh
• 🔥 Wound inflammation remains stubborn despite other treatments
• 🧪 You’re already using shock wave for orthopedic care and want to support local healing

It may be a supportive option—not a miracle cure. 🧠

📲 Use Ask A Vet for Wound Management Advice

The Ask A Vet app helps you monitor and manage leg wounds, proud flesh, and alternative treatments:

• 📸 Upload wound photos for progress tracking
• 🧠 Ask about combining ESWT with antibiotics, dressings, or surgical trimming
• 📋 Log shock wave sessions and response
• 🩹 Get daily care recommendations from wound care veterinarians

Healing support—where and when you need it. 🐴📲

✅ Shock Wave Therapy Takeaways for 2025

• 💥 ESWT reduces **inflammation and proud flesh** in leg wounds
• 📏 It **does not shorten healing time** or reduce wound size significantly
• 🧠 Consider it as **adjunctive therapy** in chronic or recurring wounds
• 🧱 Proud flesh remains the biggest barrier to wound closure in horses
• 📱 Use Ask A Vet to get wound healing advice tailored to your horse

📲 Final Thoughts from Dr Duncan Houston

Shock wave therapy is a useful tool—but not a silver bullet. If your horse struggles with chronic wounds or proud flesh, ESWT may help improve the healing environment—even if it doesn’t speed things up. As always, consistent care, clean bandaging, and professional oversight make the biggest difference. 🧠💙

Download the Ask A Vet app to assess wounds, explore treatment options, and stay on top of healing progress with expert guidance. 🐎📱