“Football players tear up their knees—it’s what they do. Hunters, jumpers and equitation horses are also athletes and they will get athletic injuries,” says Elizabeth Davidson, DVM, who focuses on equine sports medicine at the University of Pennsylvania’s New Bolton Center. In this article, Davidson explains how some common injuries happen, how they’re treated and how they could affect your horse’s career.

Any horse can get hurt at any time, of course. But hunter, jumper and hunt-seat equitation disciplines include demands that set horses up for certain injuries.

• Jumping stresses tendons and ligaments that support the leg during both push-off and landing. The impact of landing can also damage structures in the front feet. The bigger the jump, the bigger the stress.

• Speed increases the stress of jumping, so risks are higher for jumpers who are against the clock. Tight turns also raise the odds of a misstep that could lead to injury.

• Repetitive stress takes a toll. Many horses in these sports show year-round—and when they’re not showing, they’re schooling. “With repetitive stress, minor damage can build up in ligaments or other structures,” Davidson explains. “Then something tips it over the edge.”

What’s most likely to bench your horse? Hard statistics on injury rates in hunters, jumpers and equitation horses are limited, Davidson notes. “At any horse show you’ll see horses of different ages and breeds in different training programs and with riders at different skill levels. The variables make research difficult,” she says. Still, at a large referral clinic like New Bolton Center, many horses in these sports come in with problems in three areas that we’ll discuss below.

Suspensory Ligament Tears

The suspensory ligament acts like a sling, supporting the ankle joint as it sinks under weight and helping the joint return to normal when the weight is removed. Tucked behind the cannon bone, this ligament starts just below the knee (or hock), splits into two branches that pass around the back of the ankle and ends on the front of the long pastern bone below.

What happens: If the strain is too great, the tough fibers that make up the ligament may tear. “This is an area that undergoes repetitive stress, so it’s a common site for athletic injury,” Davidson says. “In horses that jump, both front and hind injuries occur.” Although fibers can tear at any point on the ligament, proximal (high) injuries are common. The injury may be mild with just a few torn fibers, but in severe cases, the ligament may rupture or even fracture bone as it tears away.

What you see: “Your horse may suddenly be lame, but usually damage has been building up as a result of recurring stress,” Davidson notes. “Identifying the problem as early as possible, before severe injury, gives the horse the best chance of recovery.” Early detection isn’t easy with high suspensory injuries, though. A horse with a mild injury may be barely off and because the top of the ligament is hidden under other structures, you won’t find heat, swelling or sensitivity at the site.

What to do: Your veterinarian can find the problem with local nerve blocks and a hands-on exam. An ultrasound scan will show the exact site and degree of injury to the ligament, and X-rays can show if bone is damaged. Magnetic resonance imaging (MRI) can also identify damage to the ligament. “MRI is often helpful in hind-limb suspensory injuries, when ultrasound can be difficult to interpret,” Davidson says.

Every case is different, so your vet will help you work out a treatment plan that suits your horse’s injury. Treatment usually includes these steps:

• Cool down. To reduce inflammation, your vet may prescribe cold therapy (icing or cold-hosing several times a day) and a nonsteroidal anti-inflammatory drug, such as phenylbutazone or Banamine® (flunixin meglumine).

• Stall rest to let healing begin. Your vet may advise standing wraps for the injured leg and the opposing leg.

• Hand-walking. Once inflammation is down, controlled walking encourages proper healing. Follow your veterinarian’s advice, starting with as little as 10 minutes a day and gradually increasing the time.

• Gradual return to exercise. Working closely with your vet, set up a program that eases your horse back into work over several months, using ultrasound exams to monitor the ligament and adjust the program as needed.

Your vet may suggest other therapies, such as shockwave treatments. Stem cells or platelet-rich plasma can be injected at the injury site with the goal of improving healing. Research into these new regenerative therapies is ongoing.

Surgery—neurectomy of the deep branch of the lateral plantar nerve and fasciotomy—is an option for hind-limb proximal suspensory injuries that are reluctant to heal, Davidson says. In the hind limb, a band of connective tissue traps the top of the ligament in a sort of compartment and swelling within the compartment causes chronic pain. The surgeon cuts the connective tissue (fasciotomy) and the deep branch of the lateral plantar nerve (neurectomy), relieving pressure and pain. This nerve branch serves only the top of the suspensory, so the operation doesn’t otherwise affect the horse. Your veterinarian can help decide if surgery might be the best option for your horse’s case.

What to expect: Ligaments heal slowly—anywhere from two to 12 months, depending on the location and extent of the damage. The process can’t be rushed. Re-injury is a risk even after healing because scar tissue that forms isn’t quite as strong as the original ligament tissue.

“Front proximal suspensory ligament injuries tend to heal well with treatment, but hind injuries often don’t respond so well,” Davidson says. “With conservative treatment only, less than 20 percent of horses with hind proximal suspensory ligament injuries return to previous levels. Surgery greatly improves the odds.” Keep in mind, though, that current rules bar horses from FEI competition after any neurectomy.

Sore Feet

The front feet take the brunt of landing after a jump and structures in the hoof capsule work together to handle the shock. The coffin joint—the meeting point of the small pastern bone, the navicular bone in the heel and the coffin bone in the toe—disperses the force. Ligaments that lash the joint together stretch then spring back. So does the deep digital flexor tendon (DDFT), which runs behind the joint and helps support the navicular bone.

What happens: The feet are designed to handle great forces, but jumping fence after fence takes a toll. Common problems include:

• Strains and tears in the DDFT or the ligaments in the foot

• Inflammation in the coffin joint or in the navicular bursa, a fluid-filled sac that helps cushion the navicular bone from the pressure of the DDFT

• Deep bone bruising, which can appear in any of the foot bones

• Inflammation and degeneration of the navicular bone

“Sometimes there are multiple problems,” Davidson says. “Again, these are injuries that occur through wear and tear—damage builds up until it hits the tipping point.”

What you see: “Because the injured structures are hidden by the hoof capsule, you don’t see swelling or other signs,” Davidson explains. “Often these problems are bilateral, involving both front feet, so the horse may not be obviously lame. He may begin to move with shorter strides, but the gait is still symmetrical.” Or the horse may be lame and improve with rest, but be sore again when he goes back to work. He may rest a front foot or shift weight from one foot to the other when standing.

What to do: A lameness exam and diagnostic nerve blocks will help the vet determine the general site of soreness. Often it’s in the heel, or caudal, region, where several key structures come together. But to treat the problem, you need to know which structures are injured.

X-rays can reveal bone damage, but they won’t show soft-tissue injuries. Ultrasound is great for imaging soft tissues in the leg, but it’s hard to get a clear ultrasound image in the hoof capsule. The best tool, Davidson says, is MRI. “With MRI we are able to look inside the hoof capsule and sort out these problems much better than in the past,” she notes. The results will help your veterinarian target treatment to fit the injury.

• A tendon or ligament injury needs a long period of rest, six months to a year. You’ll follow more or less the same program as you would with a suspensory injury with stall rest followed by a gradual return to work. The vet may recommend directed injections of platelet-rich plasma or stem cells.

• Inflammation in the coffin joint or the navicular bursa may respond to directed injections of corticosteroids, which are powerful anti-inflammatories, and hyaluronic acid, which is a natural component of cartilage and joint fluid.

• A bone bruise needs rest. This injury isn’t as serious as a fracture, but there is microscopic damage to the bone and fluid builds up within it. Healing can take three or four months depending on the degree of bruising.

• When the navicular bone is chronically inflamed, it responds by remodeling, losing mineral content in some areas and developing lumps of new growth in others. This pattern of inflammation and degeneration is often called navicular disease, and it doesn’t heal with rest.

What to expect: A horse with a mild injury has the best chance of recovery, but Davidson notes that rehabilitation can be challenging. “In sporthorses, significant pathology in the foot doesn’t have a good outlook. When the horse goes back to work, he stresses the same structures—so reinjury is likely,” she says.

Good trimming and shoeing are essential to keep the horse comfortable, regardless of what structures are involved. It’s important to keep the hoof trimmed at the correct angle, so the bones are properly aligned and the foot breaks over easily. Wedge pads or bar shoes can help take pressure off the heels. When problems persist, though, the horse may have to switch to a lighter work program.

Joint Problems

Elite horses are especially prone to joint problems. “Jumping a lot of big jumps—and jumping every weekend—stresses joints and eventually triggers degenerative joint disease (DJD),” Davidson says. Common sites include the hocks and ankles, but DJD can develop in any joint that comes under stress when the horse works.

What happens: Chronic inflammation in the joint from injury or simple wear and tear sets off a destructive chain of events. The viscous fluid that fills the joint becomes thin and watery, so it doesn’t lubricate the cartilage that cushions the working surfaces so well. Under pressure, cartilage starts to wear away and the joint stiffens. There’s more concussion on the bones, which respond by remodeling. Lumps of new bone growth appear in the joint.

What you see: Joint problems often creep up gradually. At first your horse may be mildly sore or stiff or just seem less fluid or less forward, especially at the start of work. The soreness may improve with rest, but it returns. Over time it worsens and begins to affect his performance over jumps. You may find heat or swelling in the affected joint.

What to do: Your vet can perform a lameness exam and other tests to diagnose DJD. X-rays can show damage to bone and cartilage, but by the time this damage shows up the destructive process is well under way. Damage to the joint can’t be reversed, but you may be able to slow the progress of the disease by managing inflammation. Anti-inflammatory medications like phenylbutazone can help the horse weather a flare-up, but for long-term management there are other options.

Management Options

Regardless of which modalities an owner and veterinarian elect to use when approaching equine joint health, it’s important to approach DJD or osteoarthritis (OA) not just as a cartilage or even a joint issue but, rather, a “whole-horse disease.”

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These ubiquitous drugs, such as phenylbutazone (Bute), help keep horses with inflamed joints comfortable and are widely used as part of the approved multimodal treatment approach to OA. In older horses who do little to no work, NSAIDs can help control comfort and maintain quality of life. In performance horses, however, experts agree that NSAIDs should not be the base of your treatment program.

“I think that NSAIDs can have a place in performance horse management,” says José M. García-López, VMD, Dipl. ACVS, ACVSMR, associate professor of large animal surgery at the University of Pennsylvania’s New Bolton Center. “These can safely be used at a low dose and while monitoring the overall health of the horse, either during conditioning or rehabilitation from an injury.”

Intra-Articular Therapies: In lieu of relying on NSAIDs to help maintain joint health, veterinarians often use intermittent intra-articular therapies to control joint discomfort in performance horses. In a recently published survey, 407 equine veterinarians provided information regarding some of the more popular therapies currently being used in performance horses. Based on that survey, corticosteroids—primarily triamcinolone and methylprednisolone—are still one of the first-line, intra-articular therapies. Practitioners frequently co-administer hyaluronic acid with those intra-articular corticosteroids.

Despite these tried-and-true articular therapies, Kyla Ortved, DVM, PhD, Dipl. ACVS, ACVSMR, assistant professor of large animal surgery at New Bolton Center, says the tides are changing.

“I think using orthobiologics early in the disease process is better because they are designed to prevent further damage and promote healing,” she said. “If I have a horse with lameness or pain attributable to a particular joint, I won’t hesitate to use orthobiologics in the early stages of disease. And I feel more comfortable using these before jumping to steroids as I think they are more protective of the cartilage.”

Other Intra-Articular Therapies: Another intra-articular product available for horses is Polyglycan®, which is essentially a synovial fluid replacement product. “I use Polyglycan®, which is made of a patented formulation of hyaluronic acid, chondroitin sulfate and N-acetyl-D-glucosamine, at the end of any elective arthroscopic procedure and also as my hyaluronic acid fluid replacement product of choice,” said García-López, citing a 2009 study out of Colorado State University that showed Polyglycan® to have the potential to have both symptom- and disease-modifying effects.

Polyacrylamide hydrogels are also available for horses with OA and gaining popularity. Polyacrylamide gels are synthetic products, not orthobiologics, injected into the joint to provide lubrication and shock-absorbing properties. In one study of a 2.5% polyacrylamide hydrogel product, researchers reported that 83% of treated horses were lame-free at four, six and 12 weeks following administration.

Despite study findings, García-López believes more unbiased research is needed on these products.

“There is subjective evidence that these gels can create fibrosis of the synovium and granulation tissue formation that, in turn, can affect the composition of the synovial fluid, which is the main source of nutrition to the cartilage in adult articulations,” he said. “This family of gels could be considered in end-stage cases of OA but maybe not in early or moderate cases of OA.”

Intramuscular Therapies: It’s important to keep in mind that OA management is multimodal, and intramuscular (IM) polysulfated glycosaminoglycan (Adequan®) is still recommended by veterinarians.

“I like to use Adequan® in performance horses,” Ortved said. “I generally recommend 500 milligrams IM every four days for seven treatments every six months or at time of injury.”

García-López agrees with Ortved, adding, “In horses that have either early signs of joint inflammation or OA without significant morphologic changes, I like to place them on a course of IM Adequan® for the one dose every four days for seven treatments. This has shown good objective evidence for helping restore the ‘steady state’ between production and destruction of cartilage components. Basically, it is quite helpful to keep what is good, good.”

Physical and Alternative Therapies: Many other therapies can help round out a performance horse’s joint management plan. “Physical therapy is a huge part of management and something we need more data on and help from specialists integrating into practice,” Ortved noted.

Examples of such physical therapies include postural exercises and exercises designed to improve coordination and proprioception, target muscle atrophy/weak muscles (potentially secondary to joint discomfort and disuse) and increase joint stability through conditioning. Additional therapies you might consider to help keep your performance horses’ joints comfortable include extracorporeal shock wave therapy (ESWT), laser and acupuncture/electroacupuncture.

Oral Joint Health Supplements: Many owners give their horses joint supplements, making these products one of the most popular types of equine supplement on the market. Of the studies performed in horses, evidence does support the use of some ingredients, such as (but not limited to), glucosamine hydrochloride, chondroitin sulfate and avocado-soybean unsaponifiables (ASU). Glucosamine is believed to play a role in the formation and repair of cartilage, chondroitin sulfate helps give cartilage its elasticity, and hyaluronan helps lubricate joints and form the matrix of articular cartilage. Some studies also suggest that ASU may reduce inflammation and protect cartilage.

But García-López cautions that data regarding the use of oral nutraceuticals in horses is lacking. “Nutraceuticals should not replace treatment with other products such as Adequan®, Legend®, Polyglycan® or intra-articular therapy, whether it is with an orthobiologic or corticosteroid,” he noted.

Nutraceuticals are not required to meet the same standard for Food and Drug Administration approval as drugs are, and so their efficacy has not been studied as extensively. However, equine and human research suggests that some of these substances have protective effects. Your veterinarian can help you decide what’s best for your horse.

Appropriate Conditioning: Adjusted work levels can help. Moderate exercise is good for joint health, but too much can trigger inflammation. Increase the horse’s turnout, give him longer warm-ups and let him be your guide in how much work you do. As long as he stays comfortable, you’re probably on the right track.

“Conditioning cannot be overlooked,” adds García-López. “Equine athletes have their entire weight, which biomechanically increases exponentially during exercise, transferred through one or two limbs at a time. They need to be properly conditioned in order for all musculoskeletal components, including muscle, tendon, ligament, bone and cartilage, to share the load adequately.”

No matter which strategies you and your veterinarian ultimately integrate into an athletic horse’s joint-health plan, as a team you must critically evaluate and reevaluate that plan regularly to make sure you’re optimizing each individual horse’s treatment to his particular needs, balancing equine ability with fragility.

Keep Him Sound

“Injuries happen because of what these horses do,” Davidson says. You can’t eliminate the risk entirely and you can’t stop the clock when it comes to aging. “Most of us have one horse and we invest a lot of time, energy and money in that horse,” she notes. “We ask horses to be athletes, but we forget sometimes that they can’t keep performing at the same level forever.”

Still, many factors that increase the risk of injuries are in your control. Take these steps to help your horse stay sound for many years to come:

• Don’t overtrain or overface him. Keep his work within his ability and be sure he’s in shape for what he’s asked to do. “Fitness—respiratory, cardiovascular, muscle, tendon, ligaments and bone fitness—helps avoid injuries,” Dr. Davidson says.

• Keep up with shoeing. Long toes and low heels put stress on the feet and on the joints, ligaments and tendons in the legs. Be sure feet are trimmed regularly so toes are kept short and use shoes with rolled toes to ease breakover if necessary.

• Use good sense on bad footing. If horses are sliding around in the ring, ask yourself: Is this class or this schooling session worth the risk?

• Stay alert for subtle trouble signs. Do a daily hands-on leg check, comparing opposite legs to detect heat, swelling or sensitivity. Watch for shortened strides and other markers of soreness. Give the horse a few days off if you suspect a problem. If the signs return when he goes back to work, ask the vet to check him out. A mild problem can blossom into a career-limiting condition if it’s ignored.

This article originally appeared in the June 2016 issue of Practical Horseman, but was updated in 2025.

How is a sporthorse like an NBA basketball star? Injuries—anything from bumps and bruises to torn tendons and damaged joints—can put him on the sidelines. While any horse can get hurt, the demands of eventing, dressage and hunter/jumper competition increase the risk of suspensory ligament injuries, deep digital flexor tendon tears, sore muscles and more.

This article explains how five common types of sporthorse injuries happen, how they’re treated and how they may affect your horse’s career. These injuries occur across the disciplines, but some types are more common in certain sports.

• Jumping, speed, uneven ground and fatigue put eventers and jumpers at greater risk for injuries that are sudden and severe. Your horse lands awkwardly from a jump or sets his foot down badly on rough ground, and the result is a torn tendon or ligament.
• Dressage horses may be less prone to “bad-step” injuries, but repetitive stress is a big factor for them. They’re prone to muscle soreness, microscopic tears in ligaments and joint problems—injuries that can become chronic and limit what the horse can do.

Bringing your horse back from any injury can be frustrating. The damage may be hard to diagnose, and there are no cookbook formulas for recovery because no two injuries are exactly the same. Ideally, you’ll keep your horse off the injured list. 

Suspensory Ligament Injuries

The suspensory ligament runs down the back of the cannon bone from just below the knee (or hock), splitting into two branches that pass around the back of the ankle and end on the front of the long pastern bone below. Its job is to support the ankle joint as it sinks under weight and returns to normal when the weight comes off.

If your horse overloads the leg, the suspensory may give way. The injury may be mild, a few of the ligament’s tough collagen fibers tear but repeated stress will make it worse. In a severe injury, the ligament may rupture or even fracture bone as it tears away.

Most at risk: Acute front suspensory tears are a particular danger for eventers and jumpers because speed and jumping increase the load on the forelimbs and the chances of a misstep. Hind suspensory injuries may be more common in dressage horses because these horses work more off their hind ends. Many are also heavy, which puts added strain on the ligament. Risk for all horses increases with work level and intensity, poor footing and lack of fitness.

Signs: Suspensory injuries can be tricky to spot. Lameness ranges from severe to barely noticeable, depending on how bad the damage is. If the tear is in the main body or the branches, the leg may be warm, swollen and sensitive at the site. But the top of the ligament is hidden by other structures, so you may not see those signs if the tear is high.

Local nerve blocks and a hands-on exam will help your veterinarian find the problem. An ultrasound scan may help pinpoint the exact location and reveal the extent of damage to the ligament, and X-rays will show if bone is involved.

Action: Your veterinarian will help you work out a treatment plan that suits your horse’s specific injury. Treatment usually includes these steps:

• Cool down. Your vet may prescribe cold therapy (icing or cold-hosing several times a day) and a nonsteroidal anti-inflammatory drug, such as phenylbutazone or Banamine (flunixin meglumine), to reduce inflammation.
• Stall rest to give the ligament time to heal. Your vet may advise standing wraps for the injured leg and the opposing leg.
• Hand-walking, to encourage healing. Follow your vet’s advice, starting with as little as 10 minutes a day and gradually increasing the time.
• Gradual return to exercise. With your vet, set up a program that eases your horse back into work over several months, using ultrasound exams to monitor the ligament and adjust the program as needed.

Depending on the case, your vet may suggest other therapies like shockwave treatment; new regenerative therapies, such as stem cells and platelet-rich plasma; or surgery.

How long will all this take? Ligaments heal slowly. A mild strain may take six to eight weeks, but a tear can take eight to 12 months. High hind suspensory injuries can be especially frustrating because your horse’s anatomy makes it hard to follow healing there and harder to know when your horse is ready to return to work. Keep in mind that he may trot sound long before the ligament is healed, and rushing his rehab is likely to cause a setback.

Outlook: Ligaments tend to heal poorly, with fibrous scar tissue that’s prone to reinjury. While many horses make full recoveries, chronic suspensory problems require careful management. This can be a limiting factor for your horse, and it’s hard to judge where the limit is. Even a sensitive rider won’t pick up on the moment when her horse feels the first twinge of pain.

DDFT Damage

The deep digital flexor tendon runs down the back of the leg and behind the heel to attach to the bottom of the coffin bone (the bone that underlies the hoof wall at the front). Its main job is to flex the leg, but it also plays a support role at the heel, where the tendon fibers fan out to pass over the navicular bone.

Injuries in the lower section of this tendon, from midpastern into the foot, are common for sporthorses. The tendon stretches taut when your horse weights his foot and at the moment of breakover, when his weight passes over the toe and the heel begins to lift. If the stress is too great, fibers may tear or pull away from the coffin bone. This section of the tendon may also become chronically inflamed and thickened from repeated stress, a condition called tendinitis.

Most at risk: Jumping and work at speed can overload the tendon because the DDFT stretches to the max as your horse pushes off at the gallop or after landing from a jump. Mechanics of conformation or poor shoeing may contribute—a horse who has long toes and low heels puts extra stress on the lower part of this tendon during breakover.

Signs: Lameness varies. Sometimes there’s heat, swelling and sensitivity at the back of the pastern or above the heel, but you may not see these signs if the injury is down in the foot.

Tendon injuries can be hard to pinpoint in the foot. Local nerve blocks will tell your vet that your horse is sore in his heel but not whether the problem is the tendon, the navicular bone or some other structure. Ultrasound scans will reveal tendon damage higher up but are not so helpful within the hoof capsule. Magnetic resonance imaging, available at some major clinics, shows these injuries well.

Action: Tendons are a lot like ligaments and heal in the same way—that is, slowly.

• Follow the steps outlined in the suspensory section: cool down, rest, hand-walking and a gradual return to work, based on the program your veterinarian sets out.
• Shoeing changes (such as rolled or rockered toes to ease breakover) may be part of the program.
• If the problem is tendinitis, your veterinarian may suggest an injection of anti-inflammatory medications into the tendon sheath (covering).

Regenerative therapies, such as stem cells and platelet-rich plasma, are being used to improve healing in torn tendons and ligaments alike. These treatments theoretically help the tissues heal stronger, but they don’t shorten the layup and rehab time.

Outlook: DDFT injuries can sideline horses for varying amounts of time. If your horse has a very mild strain, he may be back in work in six to eight weeks. For a tear, think months—it’s not uncommon for horses to be laid up eight months or more. Doing too much, too soon, is a recipe for reinjury.

A healed tendon, like a healed ligament, is never quite as strong as it was before the injury. The question is always: Will it hold up? The answer depends on how severe your horse’s injury was to begin with, how well it healed and what your expectations are for his future performance.

Bone Bruise

Sporthorses can bruise bones in the foot and ankle joints—the coffin bone, the ends of the short and long pastern bones and the lower end of the cannon bone. The foot and ankle come under tremendous force, and that force is focused on the small areas where these bones meet.

Although a bone bruise isn’t as serious as a fracture, there is microscopic damage to the bone. And as with any bruise, there’s internal bleeding and swelling; but in this case the fluid builds up within the bone.

Most at risk: Bruising is caused by impact landing off a jump or working on hard ground?so jumpers and eventers are most at risk.

Signs: Bone bruises are painful, so your horse will be sore. Your vet can isolate the sore zone with nerve blocks, but it may take sophisticated imaging techniques to identify the cause. X-rays won’t show the microscopic bone damage, but a bruise may show up as a “hot spot” on a nuclear bone scan. MRI is a good diagnostic technology to delineate the bruise.

Action: Your horse will need time off, perhaps three or four months, depending on the degree of bruising. He may benefit from an extended course of anti-inflammatory medication. An NSAID such as Equioxx (firocoxib), which belongs to a class of drugs called cox-2 inhibitors, may be a good choice. These drugs tend to have fewer side effects than other NSAIDs when given for extended periods.

Outlook: Injured bones heal slowly, but they’re typically good as new once healing is done. Good shoeing (sometimes with pads) and good footing can help prevent reinjury as your horse starts back into regular work.

Inflamed Joints

Acute synovitis is inflammation that appears suddenly in a joint, often the ankle, coffin or hock. These joints are enclosed in a capsule of soft tissue; the capsule lining (synovial membrane) produces a thick fluid that lubricates the joint. Stress on the joint can trigger inflammation in the lining and the capsule, causing fluid to turn watery and build up. Over time, repeated joint stress can set off a destructive chain of events that lead to osteoarthritis.

Most at risk: Inflamed joints occur across the board, typically when there’s a sudden change in work level or intensity—a dressage horse is asked to move up a level too quickly, say, or a hunter does more at a show than he’s used to. Actions such as jumping, work at collected gaits, tight turns and small circles are especially hard on the joints. Unfamiliar footing is another risk factor.

Signs: Your horse will be sore or stiff, especially at the start of work. In a mild case he may just seem less fluid or less forward in his gaits. You may find heat, pain and swelling caused by the inflammation in the joint.

Your veterinarian can identify the problem with a physical exam. X-rays can rule out damage to the bones and cartilage, and synovial fluid can be collected and analyzed to rule out infection.

Action: Reducing the inflammation will ease the pain and risk of joint degeneration.

• Give him some time off. Depending on the case, this may be stall rest, hand-walking or controlled turnout in a small paddock, for as little as seven to 10 days to as long as a month.
• Cold therapy can help in the early stages when there’s heat in the joint. Your vet may prescribe a short course of anti-inflammatory medication. Topical treatments—poultices, DMSO or Surpass (diclofenac sodium) may help reduce inflammation.
• Joint injections can help horses with severe or recurrent synovitis. The injections deliver anti-inflammatory agents,usually a corticosteroid alone or in combination with hyaluronic acid, which is a natural component of cartilage and joint fluid directly into the joint.

IRAP therapy is a new approach in which the joint is injected with interleukin-1 receptor antagonist protein, a substance derived from the horse’s own blood. It targets a specific inflammatory pathway involved in joint degeneration.

Outlook: Most horses with acute synovitis respond well to rest and steps to reduce inflammation. It’s important to prevent repeat episodes that could lead to osteoarthritis, so increase your horse’s work level gradually, be sure he’s in shape for what you ask and space out demanding work sessions and shows to give him time to recover.

Sore Muscles

Work strengthens muscles, but overwork leads to strain and pain. The large muscles of the back and hindquarters make up a sporthorse’s drive train, and they can be strained if they’re asked to work too hard for too long. Most muscle strains are mild, and the amount of damage is small but this is a common injury, and it can be enough to keep your horse from performing his best.

Most at risk: Dressage horses who are asked to collect and maintain a frame as they work often become sore in the back, hindquarters and gaskins. Heavy muscling and general heaviness seem to add to the problem. Hunters and jumpers may develop similar problems if they’re forced into draw reins or longed in a training rig for long periods; the horse has no chance to stretch and relax his back and neck, so the muscles get sore.

Signs: Signs of back pain can be mild and frustratingly vague. Your horse may move off stiffly when you mount and he feels your weight on his back. His hind legs may not really step up under his body, so he doesn’t really carry himself. He may resist bending, rounding and collecting. His ears and the way he carries his head tell you that he’s tense and worried. Most of these signs may improve as he warms up.

Action: Give your horse a few days off to see if the mild signs disappear. If they don’t, or if they recur when he goes back to work, ask your veterinarian to check him. Any underlying causes will have to be addressed for his back to improve:

• The pain may stem from a poorly fitting saddle.
• It may be below the muscles, perhaps in the sacroiliac joint, the meeting place of the pelvis and the spine. (Jumping, galloping and tight turns and circles put a lot of stress on this joint.)
• It may originate someplace else entirely. A horse with hock problems may develop sore back muscles if those muscles work overtime in an effort to spare the hocks.

When the problem is simple muscle strain, most horses get better with rest and turnout. Your veterinarian can help determine how much rest and what type of exercise is best for your horse.

• Some horses improve with a short course of muscle relaxants or with acupuncture or chiropractic treatments.
• Massage also can help.

Don’t overlook the benefits of a thorough currying, which is a massage in itself.

Outlook: Good management helps most sore backs. Give your horse a chance to warm up before you ask him to do collected work. Let him stretch his back and neck muscles by riding “long and low” (on a long rein) or walking up and down hills. Vary his work—ring work one day, a hack in the field the next—and avoid repeating the same maneuvers over and over. And give him plenty of turnout time, which will help keep his back limber.

An FEI-certified veterinarian, Duncan Peters, DVM, MS, heads the Sporthorse Program at Hagyard Equine Medical Center in Lexington, Kentucky.

This article originally appeared in the October 2011 issue of Practical Horseman.