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Tendon Injury Rehabilitation in Horses

By Chris Bates, Osteopath, Horse Trainer and Lecturer at London College of Animal Osteopathy

Spend enough time with horses, and no doubt you’ll come across tendon injuries.

Whether mild or serious, many horses will experience pain and lameness stemming from their lower limb in their lifetime.

With equestrian competitions growing more challenging, vets and therapists find themselves facing these problems more frequently.

So why are tendons getting injured? First, let’s take a look at how tendons function.

Horse Tendon Function

The tendons of the horse’s lower leg are made up of strong bands of fibrous tissue that is mostly formed from type 1 collagen.

This densely packed tissue sits in parallel fibers that connect muscle to bone. Tendons and ligaments are the main soft tissues found on the horse’s lower leg.

The angle made by the horse’s fetlocks down to the pedal bone inside the foot creates a tensile structure with the tendons. This structure suspends the weight of the body and holds potential energy like a coiled spring.

This allows for energy efficiency when the horse is in motion as the recoil in those structures supplies some momentum.

What Affects Tendon Health?

Hard ground, temperature, poor nutrition, and trauma will greatly affect tendon health.

Harder ground does not provide enough cushioning and causes extra stretch through tendons.

Another detrimental factor is temperature. The use of boots or bandages while providing impact protection, trap heat in the tendon, putting it at increased risk of injury.

 What Are the Signs and Symptoms of Tendon Injury?

The most noticeable signs of tendon injury are heat and lameness.

Signs vary from very obvious, to subtle changes to the horse’s gait or behaviour. The signs of lameness will differ depending on the leg or legs involved.

Tendon injuries occur most often in the front limbs as they support more weight. However, these injuries can still occur in the hind limbs.

Rehabilitating Tendon Injuries

When rehabilitating any tendon injury, we must be aware of risk factors.

Using softer surfaces, assessing nutrient deficiencies, reducing the risk of trauma, and allowing the horse to regulate its temperature as naturally as possible are all essential parts of the tendon rehabilitation process.

Basic Guide To Rehabilitating Tendons

0-60 days – The horse is either confined to box rest or a small paddock on its own.

 Injury 0-30 days 30-60 days
 MildHand walk 15 minutes twice dailyHand walk 40 minutes daily
 ModerateHand walk 10 minutes twice dailyHand walk 30 minutes daily
 SevereHand walk 5 minutes twice dailyHand walk 20 minutes daily



 Progress 60-90 days 90-120 days
 GoodRide at walk 20-40 minutes     dailyRide at walk 40-60 minutes daily
 FairRide at walk 20-40 minutes dailyRide at walk 40-60 minutes daily
 PoorHand walk 60 minutes dailyRide at walk 20-30 minutes daily


 Progress 120-150 days 150-180 days
 GoodAdd 5 minutes trot every 2 weeks Same
 FairRide at a walk 60 minutes dailyAdd trotting 5 minutes every 2 weeks


 PoorRe-evaluate case and discuss further treatment options 


 Progress180-210 days210-240 days
 GoodAdd 5 minutes canter every 2 weeksSame
 FairAdd trotting 5 minutes every 2 weeksAdd 5 minutes canter every 2 weeks
 PoorRe-evaluate case and discuss further treatment 


 Progress240-270 Days270-300 Days
 GoodBegin work at show speedReturn to competition
 FairAdd 5 minutes canter every 2 weeksFull Flatwork; no show speed
 PoorRe-evaluate case and discuss further treatment 


London College of Animal Osteopathy is an approved ETAA educational provider. For more information on general programs in canine and equine osteopathy, please visit

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