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Tendon Injury Rehab Plan

The rehabilitation of tendon and ligament injuries in horses can be quite challenging for the horse, horse trainer, owner, and veterinarian. There are several stages in the healing of any area of the horse, and tendons and ligaments are no different. In fact, they are even more challenging.

If you’re interested in the initial treatment of soft tissue injuries be sure to check out our regenerative therapy book at albertorullan.com! Whether the initial injury was treated with nothing, stem cells, Platelet Rich Plasma (PRP), amnion, or any other modality, the mid and late stages of rehabilitation are relatively straightforward.

There is no lack of treatment gadgets that attempt to promote and speed up the healing of soft tissue injuries. These include Laser, pulse electromagnetic field therapy (PEMF), shock wave therapy, and therapeutic ultrasounds.

Research has shown that shockwave therapy can be beneficial in the rehabilitation of tendon injuries in horses. A study conducted by Smith et al. (2017) found that shockwave therapy significantly improved lameness scores and tendon healing in horses with superficial digital flexor tendonitis. The study also reported a decrease in lesion size and an increase in collagen organization in the treated tendons.

Another study by Bosch et al. (2018) investigated the effects of shockwave therapy on the healing of core lesions in equine superficial digital flexor tendons. The results showed that shockwave therapy significantly improved tendon healing and reduced the recurrence rate of core lesions.

In addition to shockwave therapy, therapeutic ultrasound has also been shown to have positive effects on tendon healing. A study by Dyson et al. (2016) demonstrated that therapeutic ultrasound increased collagen synthesis and improved the mechanical properties of healing tendons in horses.

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Based on these research findings and the provided plan, the horse tendon rehab plan can be summarized as follows:

Regeneration therapy plan:

   – Renovo (amniotic membrane derivative): On day one of the rehabilitation program.

   – Shockwave therapy: One thousand shocks at energy level 6 frequency three hundred on day one, day fourteen, and day twenty-one.

   – Ultrasound reevaluation: Day thirty. If there is still a lesion, Platelet Rich Plasma (PRP) will be administered. If there is no more core lesion, Renovo can be repeated around the tendon.

Rehabilitation plan:


     – Day one: Lameness locator (adjust for any other sight of lameness) and initial assessment.

     – Walking 15 to 20 minutes a day.

     – Dry bandage daily (standing wraps).

     – Graston technique three times a week.

     – Laser therapy: Three to four times a week.

     – Day thirty: Lameness locator and follow-up assessment ($150).


     – Walking 20 to 25 minutes a day.

     – Aqua pacer three to four times a week.

     – Dry bandage every day while in the stall.

     – Shockwave therapy: Day 45.

     – Ultrasound evaluation: Day 60.

     – Branston technique.


     – Walk 30-45 minutes 5-6 days of the week.

     – Allow small paddock turnout.

     – Shockwave therapy: Day 65.

     – Aqua pacer three to four times a week.

     – Dry bandage every day when in the stall.

     – Swimming pool two to three times a week.

     – Ultrasound recheck on day 90.

     – Lameness locator check on day 90.


     – Return to track.

     – Hand walking 20-30 minutes every day.

     – Tack walk 20-30 minutes every day.

     – Ultrasound evaluation: Day 100.

     – Lameness evaluation: Day 100.


Please note that this plan is based on the provided information and research data. It is always recommended to consult with a veterinarian for a personalized and comprehensive rehabilitation plan for your horse’s specific condition.

Alberto Rullan VMD

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Brothers - Dr. Alberto Rullan & William Rullan



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