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Friday, March 16, 2012

Shockwave treatment for horses: More than just bowed tendons!

Shock-wave treatment has been used in veterinary medicine for over a decade.  Initially, the primary use was for inflamed tendons and ligaments; however, this modality of treatment is now commonly applied to chronic wounds (Figure 1 and 2), bone fractures (Figure 3), navicular disease, back pain, sacro-iliac (SI) pain, muscle pain/inflammation, osteoarthritis, and chronic foot pain. 

Shock-wave treatment consists of exposing a specific area of interest to acoustic waves of varying intensity. There are different size probes which correspond to the depth of tissue penetration. A more shallow probe is used for tendonitis of the superficial digital flexor tendon and the deepest probe is used for chronic pain within the epaxial musculature of the horse's top line. The number of shock waves and intensity is adjusted depending on the specific area being treated. For most conditions, the area is treated with 3 sessions that are separated by 10-14 days. For chronic wound healing, low energy is applied and the sessions are every 5-7 days. 

Generally speaking, shock-wave therapy has its greatest benefit by enhancing the development of new blood vessels and thus increasing the blood supply to a region of interest. This will increase the quality and quantity of "healing". In addition, shock-wave therapy will provide short term pain relief to the soft tissues that are inflamed. 

It is very important to remember that shock-wave therapy is only 1 part of managing the above mentioned conditions. It does not replace time nor the benefits of medical treatment and corrective shoeing. However, it does improve the "quality" of healing which is evident in the final product. 



Chronic wound over elbow which has stopped
shrinking in size 2 months after initial injury.




Chronic wound after 3 shockwave treatments.
The cross sectional area has decreased by nearly 30%

A chronic exostosis or splint bone fracture is treated with
shockwave treatment to stimulate healing

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