Kirsten Johnson
Owner, KESMARC

General Information about Tendonitis

 

Tendonitis or bowed tendon is the inflammation of a tendon; usually it includes the disruption of the tendon fibers.  Tendons are made up of thousands of collagen fibers that are arranged length wise along the tendon.  When excessive stretching of the tendon occurs the result can be fiber damage.  Strenuous exercise required in the conditioning of a Thoroughbred racehorse can potentially generate a loading force that cause the fetlock and knee to overextend.  This particular type of overextension can lead to overstretching of the flexor tendons, which can cause individual tendon fibers to break.  In most cases tendonitis occurs in the middle third of the superficial digital flexor tendon (SDFT) because the tendon is thinnest at that point, making this the weakest area of the tendon and more susceptible to injury.  Tendon tissue is less vascular than most other tissue, which is a main reason why bowed tendons are slow to heal and require a long slow recovery process, unless you have the benefit of sending your horse to the Kentucky Equine Sports Medicine and Rehabilitation Center more commonly known as KESMARC, Kentucky. 

 

The following case is that of a 5-year-old Thoroughbred racehorse stallion with a bowed tendon in the right front leg. 

 

Case Study Using the WeHealPlus MV-102 device

 

On the 12th of May 2011 a 5yr Thoroughbred (TB) stallion was presented to KESMARC, Kentucky from Churchill Downs with a right front bowed tendon.  Upon arrival the plan for rehabilitation was to use the MV-102 device daily, the vibrating platform daily, swimming therapy, daily walking and the daily application of poultice to the afflicted leg.

 

On the 19th of May Dr. Johanna M Reimer Sonologist and Cardiologist came to KESMARC to ultrasound the right front leg.  Her findings were as follows:

 

“15% Hypo echoic tear to anechoic core type lesion in distal half of the superficial digital flexor tendon (SDFT) with minimal tendon swelling to 1.3 cmsq (15% of the tendon fibers were damaged)”

 

Dr. Reimer’s recommendations for the TB stallion were as follows:

           

            “Stall rest for one week, then walk, repeat ultrasound in 2 months”

 

            “Amenable to intralesional therapy but no proven efficacy over rest to date”

 

Dr. Reimer’s prognosis of the horse’s injury was as follows:

 

“50-50 chance to return to the racetrack with long rehab- generally one year before return to racing with a slow gradual return to training about 6 months from now”

After Dr. Reimer’s visit on the 19th of May KESMARC, Kentucky proceeded with aggressive therapy applying the MV-102 device to the mid tendon for 4 hours everyday until the 24th of May after that date the MV-102 device was applied for 4 hours on Tuesday, Thursday, and Saturday (for a more complete schedule of the application please see the attached calendar).  In addition to the use of the MV-102 device the stallion was also put on the vibrating platform for 20 minutes everyday.  The horse was put on the walker for 30-45 minutes everyday and returned to the pool on the 24th of May and swam 6 days a week at varying intervals (see calendar).  Poultice continued to be applied to the right front leg daily.

 

On the 10th of June Dr. Reimer returned to re-ultrasound the right front SDFT.  Her findings were as follows:

 

“The previous lesion is barely discernable-mild decrease echogenicity and nonparallel fibers at the previous injury site”

 

Dr. Reimer’s interpretation was that the horse has a “healing bowed tendon” and her recommendations were as follows:

           

“Can try adding jogging any time but watch carefully for any heat or

Filling – If put back into work too soon this may re-tear very easily”

 

After the re-check KESMARC’s plan of action for rehabilitation remained the same.  The MV-102 device was applied to the mid tendon for 4 hours on Tuesday, Thursday, and Saturday.  The horse continued to be put on the vibrating platform daily for 20 minutes, swam 6 days a week and walked for 30-45 minutes everyday.  Poultice was still applied daily to the right front leg.  On the 7th of July the KESMARC staff added jogging to the animals schedule.  He jogged 6 days a week for a distance of 1.5 miles (see calendar).

 

On the 13th of July Dr. Reimer returned to ultrasound the TB stallions leg one last time.  Her findings were as follows:

 

The previous lesion is barely discernable – mild decrease echogenicity and nonparrell fibers at previous injury site, the tendon at the injury site is also smaller than initially (initially 1.3cmsq, now 1cmsq)”

 

Dr. Reimer’s interpretation was that “the stallion’s bowed tendon was healing” and her recommendations were as follows:

           

            “Can continue on with caution- Watch carefully for any heat or filling – If put

Back into fast work too soon this may re-tear very easily”

 

The MV-102 device was administered to the middle portions of the tendon in the right front leg 5 more times.  The horse continued to stand on the vibrating platform for 20 minutes daily, swam for 6 days a week and jogged 1.5 miles 6 days a week (see calendar) until he departed from KESMARC, Kentucky on the 26th of July 2011.

 

Update

 

On October 9, 2011 this 5yr old TB stallion placed 2nd at Keenland in Lexington, Kentucky.  This was his first race since he returned to training.  In 3 months the team at KESMAR, Kentucky was able to rehabilitate this horse in less than half the time it would usually take for an injury the SDFT.  The success of this horse is primarily contributed to the application of the MV-102 device, the vibrating platform and therapy in the equine pool. Swimming the horse maintained the animal’s fitness, which helped the trainer return him to racing condition faster.  KESMARC rehabilitated an injury that should have been career ending. 

TREATMENT

LEGEND:

MV= MV-102 DEVICE APPLIED  TO THE MID TENDON OF THE RIGHT FRONT LEG FOR 4 HOURS
VP= VIBRATING PLATFORM FOR 20 MINUTES
W= WALKING (ON WALKER) FOR 30-45 MINUTES
S= SWIMMING IN THE EQUINE POOL (# OF LAPS X # OF LAPS)
JOG= JOGGING FOR 1.5 MILES)
P= POULTICE APPLIED TO THE RIGHT FRONT LEG
ULTRASOUND BY DR. REIMER

MAY 2011

MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY






1
2
3
4
5
6
7
8
9
10
11
12
Arrived
MV,VP,W,P
13
MV,VP,W,P
14
MV,VP,W,P
15
MV,VP,W,P
16
MV,VP,P
S 3X3
17
MV,VP,W,P
S 4X3
18
MV,VP,W,P
S 4X3
19
Ultrasound
MV,VP,W,P
20
MV,VP,W,P
21
MV,VP,W,P
22
MV,VP,W,P
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MV,VP,W,P
24
MV,VP,W,P
S 1X1
25
VP,W,P
S 1X1
26
MV,VP,W,P
S 2X1
27
VP,W,P
S 2X2
28
MV,VP,W,P
S 2X2
29
VP,W,P
30
VP,W,P
S 2X3
31
MV,VP,W,P
S 3X2






JUNE 2011
MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY SUNDAY


1
MV,VP,W,P
2
MV,VP,W,P
S 3X3
3
VP,W,P
S 4X3
4
MV,VP,W,P
S 4X3
5
VP,W,P
6
VP,W,P
S 4X4
7
MV,VP,W,P
S 4X4
8
VP,W,P
S 5X4
9
MV,VP,W,P
S 5X5
10
VP,W,P
Ultrasound
S 5X5
11
MV,VP,W,P
12
VP,W,P
13
VP,W,P
S 5X5
14
MV,VP,W,P
S 5X5
15
VP,W,P
S 6X6
16
MV,VP,W,P
S 6X6
17
VP,W,P
S 6X6
18
MV,VP,W,P
S 6X6
19
VP,W,P
20
VP,W,P
S 6X6
21
MV,VP,W,P
S 6X6
22
VP,W,P
S 6X6
23
MV,VP,W,P
S 6X6
24
VP,W,P
S 6X6
25
MV,VP,W,P
S 6X6
26
VP,W,P
27
VP,W,P
S 6X6
28
MV,VP,W,P
S 6X7
29
VP,W,P
S 6X7
30
MV,VP,W,P
S 6X7




JULY 2011
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SAUURDAY
SUNDAY




1
VP,W,P
S 7X7
2
MV,VP,W,P
S 7X7
3
VP,W,P
4
VP,W,P
5
MV,VP,W,P
S 6X6
6
VP,W,P
S 6X6
7
MV,VP,W,P
S 6X6
8
VP,W,P
S 6X6
9
MV,VP,W,P
S 6X6
10
VP,W,P
11
VP,W,P
S 6X6
12
MV,VP,W,P
J
S 3X3
13 Ultrasound
VP,W,P
J
S 6X6
14
MV,VP,W,P
J
S 6X6
15
VP,W,P
J
S 6X6
16
MV,VP,W,P
J
S 6X6
17
VP,W,P
18
VP,W,P
J
S 6X6
19
MV,VP,W,P
J
S 6X6
20
VP,W,P
J
S 6X6
21
MV,VP,W,P
J
S 6X6
22
VP,W,P
J
S 3X3
23
MV,VP,W,P
J
S 3X3
24
VP,P
25
VP,W,P
J
S 6X6
26 DEPARTED
VP,W,P
J
S6X6
27
28
29
30
31


For more information about the WeHealPlus device, see WeHealPlus device

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