Don't Just Rest—Rehab: The Smarter Way to Heal Equine Tendons

Don't Just Rest—Rehab: The Smarter Way to Heal Equine Tendons.

Don't Just Rest—Rehab: The Smarter Way to Heal Equine Tendons.

Tendinopathy—an umbrella term for tendon inflammation and degeneration—is a frustratingly common injury in horses, especially those in demanding disciplines like eventing, show jumping, or racing. While treatment is crucial, prevention and proper rehabilitation are what truly determine whether a horse can return to work—and stay there.

Let’s break down practical, evidence-informed strategies for preventing re-injury and promoting long-term tendon health.

🐎 Understanding Tendon Injuries: Why Prevention Matters

Tendons have a poor blood supply and heal slowly. Even after they "look" better on ultrasound, the remodeled tendon is often weaker and more prone to future injury. That’s why a structured, cautious rehab plan is just as important as the initial treatment.

🧘‍♀️ Controlled Exercise: The Gold Standard

The cornerstone of tendon rehabilitation and prevention is controlled, progressive exercise. This helps the tendon fibres realign properly and regain strength. Now, a typical exercise programme will look like something shown below. However, this will vary massively case by case because of age, diet, biomechanics, conformation, behaviour, facilities, general health, etc. Personally, I have had cases that might reach week 5 and relapse to week 2 and we have to repeat previous steps to build things back up again. It's common and you need your team around you to help with navigating this difficult process.

Typical exercise progression:

1. Weeks 1–4: Strict box rest with short, in-hand walking (5–10 minutes/day).

2. Weeks 5–8: Gradually increase walking time; introduce harder surfaces like tarmac for brief periods to stimulate tendon loading.

3. Weeks 9–12: Begin trotting in straight lines on firm, level ground.

4. Months 4–6+: Introduce cantering, small hills, and eventually schooling or turnout depending on progress and vet advice.

Stick to flat, straight lines early on. Avoid tight circles, deep footing, and uneven terrain until much later in the program.

🪄 Supportive Therapies

While exercise is key, these additional tools can support tendon strength and reduce re-injury risk:

- Pole work and cavaletti: Once trotting is well established, low poles encourage proprioception and controlled movement.

- Walking up gentle inclines: This helps build hindlimb strength and reduces stress on the suspensory and flexor tendons.

- Balance and core work: Using unstable surfaces (like pads or mats) to encourage proprioception and muscle recruitment.

🧊 Cooling & Compression

After any significant exercise, especially early in rehab:

- Cold hosing or ice therapy can reduce post-exercise inflammation.

- Compression bandages may help with mild swelling but should be used with care and proper technique. This is an entire topic in it's self!

🥕 Nutrition & Management

- Maintain a healthy weight: Excess weight puts more strain on tendons.

- Hydrolysed collagen (with Vitamin C) may increase collagen synthesis in tendons (Shaw et al., 2017). Omega-3 fatty acids reduce inflammatory markers and may enhance healing in soft tissues. MSM (methylsulfonylmethane) and glucosamine have shown mild anti-inflammatory benefits in equine models.

- Consistent footing: Avoid riding in deep or muddy surfaces, which increase tendon strain.

📌 Takeaway: High-quality tendon supplements can support healing—look for those containing Type I collagen, MSM, Vitamin C, and Omega-3s.

🔁 Vet Check-Ins: Your Roadmap

Regular ultrasound scans are essential during rehab. Tendons can "feel" fine long before they’re structurally sound. Vets will guide changes in the exercise plan based on healing progress.

⚠️ Final Thought

Tendinopathy doesn’t have to be the end of a horse’s career—but rehabilitation is a marathon, not a sprint. By sticking to a gradual program, embracing strengthening exercises, and making smart management choices, you can give your horse the best chance at a safe, sustainable return to work.