The 4 Stages of Injury Rehabilitation

Bandaging horse leg injury

Bringing a horse back from injury and lameness can sometimes be a long and arduous road. While advances in equine sports medicine have brought many new treatment options to the fore, some things – like the stages of the rehabilitation process itself – will always remain the same.

As many a horse owner that’s dealt with injury knows, taking the time and appropriate steps necessary is paramount in ensuring a full recovery.

The role of your vet:

It is important to note that the first step in developing an informed rehabilitation plan is having an accurate veterinary diagnosis.

You need to know what you are dealing with in order to address it effectively.  Equally important is re-evaluation, to assess the rate and quality of healing and inform the progression towards increasing workloads.

While other therapists such as REMTs, your farrier, trainer, or barn staff may be called on to help in the rehabilitation process, think of your vet as the Chef d’Equip.

-> Ultimately, when everyone is working together, and on the same page, you are going to get the best results.


The four stages of injury rehabilitation:


1. Reduce pain

cold hosing horse leg

Anti-inflammatory or analgesic (pain relieving) medications may be recommended by your vet during this stage. While inflammation is part of the healing process, an excessive inflammatory response can impede the healing process and contribute to increased pain.

Hydrotherapy offers a convenient and low-tech approach that is also often applied. Cold – applied by hosing or icing – constricts the blood vessels (helping to limit the inflammatory response) and can slow nerve conduction (with a numbing/pain reducing effect).

Beyond the acute stage of injury, warm heat may be used  (usually after 72+ hours) to improve tissue pliability, decrease muscle spasm and reduce pain. Massage therapy may also be appropriate to help reduce pain after the acute stage, with veterinary approval.


2. Restore mobility, range of motion and balance

The goals during this stage are to encourage the proper alignment of fibers in the healing tissues, prevent restrictions from developing, and restore and maintain range of motion of the joints, muscles and connective tissues.

equine massage hind limbThis is often achieved through stretching, manual therapies such as massage and chiropractic, and a controlled exercise program (as per veterinary consult).

Addressing compensatory issues is also key in restoring balance to the musculoskeletal system.  Altered stance and movement due to injury mean that some muscles and structures will be working overtime.


3. Regain Strength

Strengthening supporting structures in the horse’s body is essential to protect against further injury.

The musculoskeletal system in the horse works on the use-it-or-loose-it principle. Time off during an injury will mean a loss in muscle, bone and ligament strength that will need to be addressed through the gradual progression of exercise intensity.

Ligaments that support the horse’s joints, and bones, take longer to adapt to a greater workload than do muscles.


horse jumping4. Return to work at pre-injury level

Brining a horse back to full work after a lay-up requires careful attention. It is during this phase that the horse is often at the highest risk for re-injury.
Depending on the injury, healing tissue may not be as strong or extensible. Tendons, for example, heal with scar tissue, rather than regenerative tendon tissue. This requires careful consideration in the demands that are placed on the horse as they return to previous competitive levels.

Other tissues, like bone and muscle, are better at healing with actual bone and muscle tissue, respectively, given sufficient time and so long as the injury is not too severe.

All in all, it is vitally important during the progressive increase in training to be attentive to any signs of overstrain – heat, swelling, pain, increased sensitivity or change in attitude. When in doubt, consult with your vet.


Where there are horses there will be injury, but good horsemanship and attentive care can make all the difference during the healing and recovery process.


About Lindsay Day, REMT

Lindsay Day is a Registered Equine Massage Therapist and award-winning writer based in Ontario, Canada. She is a graduate of the two-year equine massage therapy program at D'Arcy Lane, and brings to her practice over 20 years experience riding and working with horses. With a strong commitment to promoting the health and welfare of horses through her work, Lindsay uses massage to help horses find ease of movement and comfort in their bodies, so they can feel and perform their best.