Equine Front Limb Tendon Injury Rehabilitation Protocol

Purpose:

To safely rehabilitate a flexor tendon injury (SDFT/DDFT) using structured exercise, rest days, and a collaborative care team.

Key Team Members:

• Veterinarian: Diagnosis, ultrasounds, rehab plan updates

• Farrier/Trimmer: Hoof balance checks at specific phases

• Bodyworker (Optional): Address compensations at key stages

• Owner/Caretaker: Daily monitoring, exercise, rest management

Rehabilitation Phases

Phase 1: Acute Phase (0–2 Weeks)

• Goal: Reduce inflammation, stabilize injury

• Care:

  • Stall rest only (no exercise)

  • Cold therapy 15–20 min, 3-4 times/day (first 3 days), then as needed

  • Bandaging as recommended

  • NSAIDs per vet instruction

  • Veterinary Imaging: Initial ultrasound

  • Farrier Check-In (Week 1–2): Tendon-supportive trim or shoeing

Phase 2: Subacute Phase (2–8 Weeks)

• Goal: Controlled movement to stimulate healing without overloading

• Exercise Plan:

  • Weeks 2–4: Hand-walk 5–10 min/day

  • Weeks 4–8: Hand-walk 15–20 min/day

Rest Day Schedule:

• 3 days on, 1 day off (repeat)

Housing/Turnout:

• Small, confined paddock or rehab pen (12 × 12 metres to 15 × 15 metres)

• Flat, even footing

• Individual turnout only (no group turnout)

• If no safe paddock available: Continue stall housing + controlled hand-walking

• .

Additional Care:

• Monitor for swelling/heat

• Farrier Check-In (Week 6–8): Hoof balance review

• Bodywork (Optional, Week 6–8): Address compensatory patterns

• Veterinary Recheck: Ultrasound at Week 6–8

Phase 3: Early Remodeling Phase (8–16 Weeks)

• Goal: Gradually introduce loading for tendon remodeling

• Exercise Plan:

  • Weeks 8–10: Hand-walk 25–30 min/day

  • Weeks 10–12: Add trot: 1–2 min (straight lines only)

  • Weeks 12–16: Increase trot to 5 min total (in sets)

Rest Day Schedule:

• 2–3 days on, 1 day off

Housing/Turnout:

• Gradually enlarge paddock if horse remains calm

• Still individual turnout

• Avoid free-running, no cantering allowed

• Hand-grazing or calm supervised turnout allowed

.

Additional Care:

• Farrier Check-In (Week 12–14): Adjust hoof care as needed

• Bodywork (Optional, Week 12–14): Prevent muscle imbalance

• Veterinary Recheck: Ultrasound to guide progression

Phase 4: Advanced Remodeling Phase (4–8 Months)

• Goal: Build resilience and prepare for return to sport

• Exercise Plan:

  • Months 4–5: Walk 45 min + Trot 5–10 min

  • Months 5–6: Increase trot, add large circles

  • Months 6–8: Introduce short canter (only if cleared by vet)

Rest Day Schedule:

• 2–3 days on, 1 day off

Housing/Turnout:

• Gradual increase in paddock size if safe

• Individual turnout only until cleared by vet

• Monitor for overexertion or excitement

.

Additional Care:

• Farrier Check-In (Month 6): Support for increased workload

• Bodywork (Optional, Month 6): Address any lingering issues

• Veterinary Imaging: Ultrasound before return to full work

Phase 5: Return to Full Work (8–12+ Months)

• Goal: Safely resume sport-specific activities

• Exercise Plan:

  • Gradually return to prior work level

  • Maintain at least 2 rest days per week

Housing/Turnout:

• Return to normal paddock or pasture turnout if cleared by vet

• Group turnout may be introduced once the horse is fully back in work and tendon ultrasounds confirm readiness

.

Additional Care:

• Ongoing Farrier Care: Every 4–6 weeks

• Bodywork (Optional, Every 2–3 months): Prevent compensation

• Veterinary Maintenance: Consider ultrasound every 6–12 months for high-level sport horses

Summary: Rest & Exercise Rhythm

Owner Daily Checklist

• Check both front legs for heat, swelling, or pain

• Record daily exercise time and intensity

• Observe for any lameness or reluctance to move

• Monitor behaviour during turnout (calmness vs excitement)

• Ensure paddock size and footing remain appropriate

• Schedule and attend all veterinary, farrier, and optional bodywork appointments

• Adhere to rest day schedule strictly

• Communicate promptly with your veterinary team if signs of setback appear

Important Notes:

• Tendon healing typically takes 12–18 months for full strength recovery

• Follow-up imaging is essential to guide safe progressions

• This is a general guideline; adapt to your individual horse in consultation with your veterinary team

Rest Day Philosophy:

Rest days are essential to:

• Allow the tendon to recover between loading periods

• Reduce risk of re-injury

• Support circulation and collagen remodeling without fatigue

Guideline:
🗓️ No more than 3 consecutive days of controlled exercise
🛑 At least 1 rest day (no controlled work, stall rest or light hand-grazing only) after each 2–3 day block

Phase-by-Phase Rehabilitation Plan

Phase 1: Acute Phase (0–2 Weeks)

No changes needed here — stall rest only, no exercise.

Phase 2: Subacute Phase (2–8 Weeks)

Always on firm, straight paths

• If signs of heat/swelling return, return to full rest

Phase 3: Early Remodeling Phase (8–16 Weeks)

Phase 4: Advanced Remodeling Phase (4–8 Months)

Phase 5: Return to Full Work (8–12+ Months)

Rest Day Definition

On a rest day, the horse:

• Stays in the stall or small paddock

• May have hand-grazing

• No controlled walking/trotting, no exercise

Optional supportive care:

• Ice therapy (if swelling noted)

• Light bodywork or stretching

• Quiet time and observation

Rest Day Pattern Example (for 8–16 Week Phase):