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Topic:Exercise

Exercise in horses encompasses the physical activities that horses engage in, either through natural behaviors or structured training programs. These activities impact a horse's musculoskeletal, cardiovascular, and respiratory systems, influencing overall health and performance. Exercise can vary in intensity, duration, and frequency, and its effects are studied to understand conditioning, endurance, and recovery processes in equines. Research in this field often focuses on the physiological adaptations to different types of exercise, the prevention of exercise-related injuries, and the optimization of training regimens for various equestrian disciplines. This page compiles peer-reviewed research studies and scholarly articles that explore the physiological, biomechanical, and health-related aspects of exercise in horses.
Impact of Gait and Diameter during Circular Exercise on Front Hoof Area, Vertical Force, and Pressure in Mature Horses.
Animals : an open access journal from MDPI    December 17, 2021   Volume 11, Issue 12 doi: 10.3390/ani11123581
Logan AA, Nielsen BD, Robison CI, Hallock DB, Manfredi JM, Hiney KM, Buskirk DD, Popovich JM.Circular exercise can be used at varying gaits and diameters to exercise horses, with repeated use anecdotally relating to increased lameness. This work sought to characterize mean area, mean vertical force, and mean pressure of the front hooves while exercising in a straight line at the walk and trot, and small (10-m diameter) and large circles (15-m diameter) at the walk, trot, and canter. Nine mature horses wore TekscanTM Hoof Sensors on their forelimbs adhered with a glue-on shoe. Statistical analysis was performed in SAS 9.4 with fixed effects of leg, gait, and exercise type (PROC GLIMMIX...
Interleukin-1Ra (Il-1Ra) and serum cortisol level relationship in horse as dynamic adaptive response during physical exercise.
Veterinary immunology and immunopathology    December 13, 2021   Volume 243 110368 doi: 10.1016/j.vetimm.2021.110368
Arfuso F, Giudice E, Panzera M, Rizzo M, Fazio F, Piccione G, Giannetto C.The monitoring of endocrine and immunologic markers during exercise is of paramount importance to assess and/or maintain the physical well-being of athletes as well as to optimize the athletic performance. This study aimed to investigate the linkage between acute stress response and immune status in Thoroughbred horses competing in an official 1300-m race. From 10 horses blood was collected 1 week before the day of the race (1W-BEFORE), before (REST) and immediately after the race to assess the cortisol, Interleukin-1 receptor antagonist (IL-1Ra), total proteins, white blood cells (WBC), red b...
Moderate-intensity training in hypoxia improves exercise performance and glycolytic capacity of skeletal muscle in horses.
Physiological reports    December 11, 2021   Volume 9, Issue 23 e15145 doi: 10.14814/phy2.15145
Mukai K, Kitaoka Y, Takahashi Y, Takahashi T, Takahashi K, Ohmura H.We investigated whether moderate-intensity training of horses in moderate hypoxia for 4 weeks elicits greater adaptations in exercise performance, aerobic capacity, and glycolytic/oxidative metabolism in skeletal muscle compared to normoxic training. In a randomized crossover study design, seven untrained Thoroughbred horses (5.9 ± 1.1 years, 508 ± 9 kg) completed 4 weeks (3 sessions/week) of two training protocols consisting of 3-min cantering at 70% of maximal oxygen consumption ( ) in hypoxia (HYP; F O  = 14.7%) and normoxia (NOR; F O  = 21.0%) with a 4-month washout period....
Heart rate variability before and after 14 weeks of training in Thoroughbred horses and Standardbred trotters with different training experience.
PloS one    December 9, 2021   Volume 16, Issue 12 e0259933 doi: 10.1371/journal.pone.0259933
Nyerges-Bohák Z, Nagy K, Rózsa L, Póti P, Kovács L.Changes in heart rate and heart rate variabilty (HRV) were investigated in untrained (UT; starting their first racing season) and detrained (DT; with 1-3 years of race experience) racehorses before and after 14-week conventional training. HRV was measured at rest over 1 h between 9:00 and 10:00 AM on the usual rest day of the horses. The smallest worthwhile change (SWC) rate was calculated for all HRV parameters. UT horses had significantly higher heart rate compared to DT (P<0.001). There were no gender- or training-related differences in heart rate. The root-mean-square of successive diff...
Application of an electrocardiography device (iECG) for heart rhythm analysis after exercise in Thoroughbred horses.
Australian veterinary journal    December 2, 2021   Volume 100, Issue 3 114-120 doi: 10.1111/avj.13137
Nath LC, Forbes G, Elliott AD, Tomren V, Ryan A, Franklin SH.AliveCor is a smartphone electrocardiography device (iECG) providing automated heart rate (HR) and rhythm determination. Atrial fibrillation (AF) in horses often is paroxysmal and rapid ECG acquisition is needed for diagnostic confirmation. iECGs were collected post-race from 15 horses with AF and 64 horses in sinus rhythm (SR). Results of manual assessment were compared to 3 commercial algorithms for HR and rhythm. Agreement between manually derived HR (HRM ) and HR derived by the AliveECG Vet (HRVET ) and Kardia version-1 (KV1 HR) and Kardia advanced (KADV HR) algorithms was quantified by th...
How Much Energy Vaquejada Horses Spend in a Field Simulation Test?
Animals : an open access journal from MDPI    November 30, 2021   Volume 11, Issue 12 doi: 10.3390/ani11123421
Coelho CS, Sodre TDRP, Sousa LN, Siqueira RF, Manso Filho HC, Aragona F, Fazio F.Vaquejada is a high-intensity and short-duration exercise in which helper horses (HH) are responsible to keep a bull running in a line while pull horses (PH) work to put the bull down after 100 m of running. The purpose of this study was to quantify and compare energy expenditures (EE), transport costs (COT) and metabolic energy requirements (Pmet) of horses used in Vaquejada. Thus, eight Quarter Horses, in randomly formed pairs, performed a vaquejada simulation test (VST), which consisted of three races on a sand track (130-150 m), with a 5-min interval between them. All horses used an integr...
Growth and Bone Development in the Horse: When Is a Horse Skeletally Mature?
Animals : an open access journal from MDPI    November 29, 2021   Volume 11, Issue 12 3402 doi: 10.3390/ani11123402
Rogers CW, Gee EK, Dittmer KE.Within the lay literature, and social media in particular, there is often debate about the age at which a horse should be started and introduced to racing or sport. To optimize the welfare and longevity of horses in racing and sport, it is important to match exercise with musculoskeletal development and the ability of the musculoskeletal system to respond to loading. The justification for not exercising horses at a certain age is often in contrast to the scientific literature and framed, with incorrect generalizations, with human growth. This review provides a relative comparison of the growth...
Multimodal therapy for treatment of equine back pain: a report of 15 cases.
Brazilian journal of veterinary medicine    November 22, 2021   Volume 43 e003321 doi: 10.29374/2527-2179.bjvm003321
de Melo UP, Ferreira C.Back pain and diseases of the spine are considered significant problems in equine sports and veterinary medicine. This article reports a multimodal approach to the treatment of equine back pain using ozonized platelet rich plasma (PRP), dynamic mobilization exercises, and therapeutic shoeing in 15 horses involved in the vaquejada discipline. Fifteen American Quarter Horses of both sexes engaged in vaquejada in the state of Rio Grande do Norte, Brazil, with a mean age of 8.61 ? 1.73 years were examined at a training center for lower performance diagnostics or back pain. A complete clinical exam...
Bone stress injuries and fatigue fractures of the pelvis in endurance horses.
Equine veterinary journal    November 17, 2021   Volume 54, Issue 6 1064-1075 doi: 10.1111/evj.13536
Puccetti M, Beccati F, Denoix JM.Bone stress injuries and fatigue fractures of the pelvis are reported in only a small number of endurance horses. Objective: To describe bone stress injuries and fatigue fracture of the pelvis in endurance horses trained and competing on the deep sand surfaces. Methods: Retrospective case series. Methods: Medical records of horses used for endurance and diagnosed with bone stress injuries and/or fatigue fractures of the pelvis by ultrasound were reviewed. The bone stress injuries and fatigue fractures were classified as affecting the iliac wing, the iliac shaft, the tuber ischiadicum, the rest...
Quantifying Serum Total Lipids and Tryptophan Concentrations by Raman Spectroscopy During Standardized Obstacle Course in Horses.
Journal of equine veterinary science    November 17, 2021   Volume 108 103820 doi: 10.1016/j.jevs.2021.103820
Giannetto C, Acri G, Giudice E, Arfuso F, Testagrossa B, Piccione G.Raman spectroscopy is an inelastic light-scattering phenomenon that provides vibrational spectrum that contains information relative to chemical bonds and symmetry of a specific molecule, allowing the quali-quantitative simultaneous determination of several components in the biological fluids. Raman spectroscopy measurement returns a spectrum over a wavenumber range constituted by several bands representing biomarkers according to investigated biological matrices. In literature, it has been reported that at the frequencies inside the (1,300-1,360) cm total lipids, and tryptophan have been iden...
Effect of exercise on serum neutrophil gelatinase-associated lipocalin concentration in racehorses.
Veterinary clinical pathology    November 14, 2021   Volume 50, Issue 4 551-554 doi: 10.1111/vcp.13027
Flick M, Vinther AML, Jacobsen S, Berg LC, Gimeno M, Verwilghen D, Howden W, Averay K, van Galen G.Serum neutrophil gelatinase-associated lipocalin (sNGAL) is a marker of renal injury, and its concentrations are affected by inflammation. Therefore, it could serve as a useful biomarker of disease or fitness in high-level competition. However, it has not yet been determined if sNGAL concentrations are affected by exercise. The aim of this study was to determine whether concentrations of equine sNGAL were affected by 1000 m galloping as the form of exercise used in the study. Pre- and post-gallop sNGAL, serum amyloid A, and creatinine concentrations were evaluated in 14 healthy Thoroughbred r...
Application of kinesiology taping to equine abdominal musculature in a tension frame for muscle facilitation increases longitudinal activity at the trot.
Equine veterinary journal    November 11, 2021   Volume 54, Issue 5 973-978 doi: 10.1111/evj.13533
Biau S, Burgaud I.Kinesiology taping (KT) has been used on human subjects for many years. More recently, KT has been used in sport horses. The physiological mechanisms involved remain unclear and its benefits are controversial. Objective: To investigate the effects of application of kinesiology taping to abdominal muscles on locomotor parameters before and after lungeing exercise in horses. Methods: Cross-over study. Methods: Eleven horses were tested twice, once with an application of KT without tension on abdominal muscles (condition 1) and once with a facilitation application of KT on abdominal muscles (cond...
Horses’ Use of Lying Halls and Time Budget in Relation to Available Lying Area.
Animals : an open access journal from MDPI    November 10, 2021   Volume 11, Issue 11 3214 doi: 10.3390/ani11113214
Kjellberg L, Yngvesson J, Sassner H, Morgan K.Sleep is crucial to horses' wellbeing, and their lying time can vary according to such factors as climate, exercise, bedding, and housing. This study aimed to analyze behavior and time spent in lying halls of various sizes. We examined the influence of housing systems on total lying time and behavior, and how changes to available lying area can affect lying time. Two open barns were used in this study, with lying areas of 8, 15, and 18 m/horse available in the lying halls. The horses' behavior was video recorded and logged using scan sampling and interval observations. Individual boxes were us...
Variation in insulin response to oral sugar test in a cohort of horses throughout the year and evaluation of risk factors for insulin dysregulation.
Equine veterinary journal    November 8, 2021   Volume 54, Issue 5 905-913 doi: 10.1111/evj.13529
Karikoski NP, Box JR, Mykkänen AK, Kotiranta VV, Raekallio MR.The oral sugar test (OST) is commonly used to diagnose insulin dysregulation (ID) and equine metabolic syndrome; however, possible seasonal changes in OST results have not been evaluated. Objective: To determine the possible variation in insulin response to OST throughout the year and risk factors associated with maximum insulin concentration (InsMax) and ID. Methods: Prospective, longitudinal cohort study. Methods: The OST was performed on 29 Finnhorses every other month six times. Serum total adiponectin concentration and phenotypic variables related to obesity were also measured. Changes in...
Successful application of closed loop stimulation pacemakers with remote monitoring in 3 miniature donkeys with syncope.
Journal of veterinary internal medicine    November 6, 2021   Volume 35, Issue 6 2920-2925 doi: 10.1111/jvim.16305
De Lange L, Van Steenkiste G, Vernemmen I, Vera L, Cromheeke KMC, Walser U, Meert H, Decloedt A, van Loon G.Rate-adaptive single chamber pacemakers with accelerometer, closed loop stimulation (CLS), and remote monitoring functionality (Eluna 8 SR-T, Biotronik, SE & Co, Germany) were implanted in 3 miniature donkeys with third-degree atrioventricular block and syncope. After recovery, different pacemaker programming modes were tested at rest, during stress without physical exercise and during physical exercise. Pacing rates were compared to actual atrial rates and showed that CLS functionality allowed physiological heart rate adaptation. A transmitter installed in the stable provided wireless connect...
Survival Analysis of Training Methodologies and Other Risk Factors for Musculoskeletal Injury in 2-Year-Old Thoroughbred Racehorses in Queensland, Australia.
Frontiers in veterinary science    November 2, 2021   Volume 8 698298 doi: 10.3389/fvets.2021.698298
Crawford KL, Finnane A, Greer RM, Barnes TS, Phillips CJC, Woldeyohannes SM, Bishop EL, Perkins NR, Ahern BJ.Musculoskeletal injuries remain a global problem for the Thoroughbred racing industry and there is conflicting evidence regarding the effect of age on the incidence of injuries. The ideal time to commence race training is strongly debated, with limited supporting literature. There is also conflicting evidence regarding the effect of high-speed exercise on musculoskeletal injuries. There is a strong interest in developing training and management strategies to reduce the frequency of injuries. The types of musculoskeletal injuries vary between 2-year-old and older horses, with dorsal metacarpal ...
Association of Thoroughbred Racehorse Workloads and Rest Practices with Trainer Success.
Animals : an open access journal from MDPI    November 1, 2021   Volume 11, Issue 11 3130 doi: 10.3390/ani11113130
Morrice-West AV, Hitchens PL, Walmsley EA, Wong ASM, Whitton RC.Understanding the relationship between the training practices of Thoroughbred racehorses and race performance is important to ensure advice given to trainers for injury prevention or management is practical and consistent. We assessed associations between intended volume and speed of gallop training (i.e., typical workloads for horses free of injury or other performance limiting conditions) and rest practices on official trainer career and previous season success rates (rate of wins and places, prizemoney per start). Sixty-six Australian Thoroughbred trainers were surveyed. Multivariable negat...
The Impact of N-Acetyl Cysteine and Coenzyme Q10 Supplementation on Skeletal Muscle Antioxidants and Proteome in Fit Thoroughbred Horses.
Antioxidants (Basel, Switzerland)    October 30, 2021   Volume 10, Issue 11 1739 doi: 10.3390/antiox10111739
Henry ML, Velez-Irizarry D, Pagan JD, Sordillo L, Gandy J, Valberg SJ.Horses have one of the highest skeletal muscle oxidative capacities amongst mammals, which, combined with a high glycolytic capacity, could perturb redox status during maximal exercise. We determined the effect of 30 d of oral coenzyme Q10 and N-acetyl-cysteine supplementation (NACQ) on muscle glutathione (GSH), cysteine, ROS, and coenzyme Q10 concentrations, and the muscle proteome, in seven maximally exercising Thoroughbred horses using a placebo and randomized cross-over design. Gluteal muscle biopsies were obtained the day before and 1 h after maximal exercise. Concentrations of GSH, cyste...
Skeletal Muscle Adaptations to Exercise Training in Young and Aged Horses.
Frontiers in aging    October 27, 2021   Volume 2 708918 doi: 10.3389/fragi.2021.708918
Latham CM, Owen RN, Dickson EC, Guy CP, White-Springer SH.In aged humans, low-intensity exercise increases mitochondrial density, function and oxidative capacity, decreases the prevalence of hybrid fibers, and increases lean muscle mass, but these adaptations have not been studied in aged horses. Effects of age and exercise training on muscle fiber type and size, satellite cell abundance, and mitochondrial volume density (citrate synthase activity; CS), function (cytochrome c oxidase activity; CCO), and integrative (per mg tissue) and intrinsic (per unit CS) oxidative capacities were evaluated in skeletal muscle from aged (n = 9; 22 ± 5 yr) and yea...
Does the type of exercise affect tryptophan catabolism in horses?
Animal : an international journal of animal bioscience    October 5, 2021   Volume 15, Issue 11 100377 doi: 10.1016/j.animal.2021.100377
Kędzierski W, Sadok I, Kowalik S, Janczarek I, Staniszewska M.Tryptophan (Trp) is an essential amino acid which metabolises via the kynurenine pathway to generate a number of bioactive substances referred to as kynurenines. Among those are 3-hydroxykynurenine (3-HKyn) and quinolinic acid, which are neurotoxic, as well as kynurenic acid (Kyna) and xanthurenic acid (XA), which, similarly to nicotinamide (NAm), show neuroprotective and anti-depressive effects. Routine exercise is known to modulate Trp metabolism in skeletal muscle and is thus believed to reduce the risk of depressive states in humans and laboratory animals. Analogously, it was hypothesised ...
Diagnostic imaging features, cytological examination, and treatment of lymphocytic tenosynovitis of the common digital extensor tendon sheath in an eventing horse.
Veterinary and animal science    September 26, 2021   Volume 14 100209 doi: 10.1016/j.vas.2021.100209
Chanda M, Klinphayom C, Sungsuwan T, Senarat W, Thongkham E, Kamlangdee A, Senarat N.In horses, the structures at the dorsal aspect of the carpus, including the digital extensor tendons, their related tendon sheaths, and bones, are vulnerable to injury because of their superficial location. Injuries to these structures may result in lameness of the affected limb(s) and reduce a horse's athletic performance. A 13-year-old eventing horse that routinely underwent regular exercise exhibited dorsolateral distension of the right carpus. An effusion insensitive to compression was observed in the affected area. No lameness was detected, and the horse exhibited a negative response to t...
A Double-Blinded Positive Control Study Comparing the Relative Efficacy of 2.5% Polyacrylamide Hydrogel (PAAG) Against Triamcinolone Acetonide (TA) And Sodium Hyaluronate (HA) in the Management of Middle Carpal Joint Lameness in Racing Thoroughbreds.
Journal of equine veterinary science    September 24, 2021   Volume 107 103780 doi: 10.1016/j.jevs.2021.103780
de Clifford LT, Lowe JN, McKellar CD, McGowan C, David F.The purpose of this prospective double-blinded positive control study was to compare the efficacy of 2.5% polyacrylamide hydrogel (2.5% PAAG) in the management of middle carpal joint lameness in Thoroughbreds against treatments of triamcinolone acetonide (TA) or sodium hyaluronate (HA). A total of 31 flat-racing Thoroughbreds with lameness (grade 1-3/5) localized to the carpus by intra-articular analgesia were selected. Following a radiological assessment of the carpi confirming the absence of fragment/fracture, the horses were randomly assigned for intra-articular treatment with either 2 ml o...
The Effect of Ground Poles and Elastic Resistance Bands on Longissimus Dorsi and Rectus Abdominus Muscle Activity During Equine Walk and Trot.
Journal of equine veterinary science    September 17, 2021   Volume 107 103772 doi: 10.1016/j.jevs.2021.103772
Shaw K, Ursini T, Levine D, Richards J, Adair S.Core strengthening and postural stability are desired outcomes of certain therapeutic exercises performed in horses. This study aimed to quantify changes in muscle activation at a walk and trot in horses traveling over eight consecutive ground poles evenly spaced (at 30 inches for walk and 48 inches for trot) in parallel fashion in a straight line, and with hindquarter and abdominal elastic resistance bands applied at 25% stretch. Surface electromyography (sEMG) data were collected for the longissimus dorsi and rectus abdominus muscles in six horses. A 2 × 2 repeated measures ANOVA was perf...
Osteochondrosis dissecans (OCD) in horses: hormonal and biochemical study (19 cases).
Veterinary research forum : an international quarterly journal    September 15, 2021   Volume 12, Issue 3 325-331 doi: 10.30466/vrf.2020.104046.2495
Ahmadi F, Mirshahi A, Mohri M, Sardari K, Sharifi K.To investigate the hormonal and biochemical profiles of horses with osteochondrosis dissecans (OCD), serum insulin, cortisol, triiodothyronine, thyroxine, fasting blood glucose (FBG), cholesterol, triglyceride (TG), high- and low-density lipoproteins, albumin and uric acid were measured in horses definitely diagnosed with OCD (n=19) as well as clinically normal horses (n=18). Proxies representing insulin sensitivity [reciprocal of square root of insulin concentration (RISQI)] and beta cell responsiveness [modified insulin to glucose ratio (MIRG)] were calculated. Body fat percent (BF%) was est...
Exercise-induced airflow changes in horses with asthma measured by electrical impedance tomography.
Journal of veterinary internal medicine    September 10, 2021   Volume 35, Issue 5 2500-2510 doi: 10.1111/jvim.16260
Herteman N, Mosing M, Waldmann AD, Gerber V, Schoster A.Equine asthma (EA) causes airflow impairment, which increases in severity with exercise. Electrical impedance tomography (EIT) is an imaging technique that can detect airflow changes in standing healthy horses during a histamine provocation test. Objective: To explore EIT-calculated flow variables before and after exercise in healthy horses and horses with mild-to-moderate (MEA) and severe equine asthma (SEA). Methods: Nine healthy horses 9 horses diagnosed with MEA and 5 with SEA were prospectively included. Methods: Recordings were performed before and after 15 minutes of lunging. Absolute...
A Preliminary Investigation into Ridden Water Submersion Training as an Adjunct to Current Condition Training Protocols in Performance Horses.
Animals : an open access journal from MDPI    September 7, 2021   Volume 11, Issue 9 2629 doi: 10.3390/ani11092629
O' Brien C, Pegg J.This observational study aimed to elucidate the effects of RWST on the cardiovascular and musculoskeletal systems of horses and concurrently determine whether RWST limits distal limb temperature increases previously reported during gallop training on land. A group of 15 clinically sound international event horses were recruited, and heart rate (HR), speed (km/h) and thermal images of the distal limb were analysed at set intervals during RWST training. Intervals of RWST produced a total mean HR value of 65.18 ± 3.76%, which is within the parameters for increased aerobic stamina. Mean HR increa...
Musculoskeletal injuries in Standardbred racehorses on Prince Edward Island.
The Canadian veterinary journal = La revue veterinaire canadienne    September 4, 2021   Volume 62, Issue 9 987-993 
Rouette J, Cockram MS, Sanchez J, MacMillan KM.A study of musculoskeletal injuries in Standardbred racehorses on Prince Edward Island was conducted to determine the incidence and risk factors for injury. Monthly information was collected from 10 trainers and 153 Standardbred horses over a 12-month period. Seventeen new injuries were identified in pacers, representing a horse level incidence risk of 23% and an incidence rate of injury of 2.19 per horse-month at risk. Forty-one percent of the injuries occurred during a race, 53% during training and 6% during jogging. Fourteen horses had experienced a previous injury and 3 of these horses exp...
Total Carbon Dioxide in Adult Standardbred and Thoroughbred Horses.
Journal of equine veterinary science    August 12, 2021   Volume 106 103730 doi: 10.1016/j.jevs.2021.103730
Lindinger MI.The TCO2 (total carbon dioxide) test is performed on the blood of racehorses as a means of combatting the practice of administering alkalizing agents for the purpose of enhancing performance. The purposes of this review are to present an overview of the factors contributing to TCO2 and to review the literature regarding TCO2 in adult Standardbred and Thoroughbred horses to demonstrate the range of variability of TCO2 in horses. Most of the research published on the topic of TCO2 or bicarbonate measurement in racehorses was accessed and reviewed. PubMed and Google Scholar were the primary sear...
An investigation into environmental variables influencing post-race exertional heat illness in thoroughbred racehorses in temperate eastern Australia.
Australian veterinary journal    August 5, 2021   Volume 99, Issue 11 473-481 doi: 10.1111/avj.13108
Brownlow MA, Brotherhood JR.Exertional heat illness (EHI) is a syndrome that occurs when metabolic heat production from muscular contraction exceeds the rate at which it can be dissipated. Core body temperature rises to critical levels, causing hyperthermia and central nervous system dysfunction. Best practice for the prevention of EHI centres around early detection, rapid response and aggressive cooling. Advance planning enables risk mitigation measures. The more that is known about EHI in horses, the better prepared those in the positions of responsibility can be to anticipate events in which the risk of EHI may be ele...
Distal Gracilis Tear in an Equestrian.
American journal of physical medicine & rehabilitation    July 29, 2021   Volume 101, Issue 1 e8-e10 doi: 10.1097/PHM.0000000000001854
Chen YT, Mills C, von Rickenbach KJ, McInnis KC.A 61-yr-old female equestrian presented after 2 wks of left medial thigh pain, which developed suddenly while exiting a car. She denied any history of recent trauma or falls. On examination, she was found to have tenderness at the left distal medial thigh with a palpable region of decreased tissue volume at the gracilis myotendinous junction. Point-of-care ultrasound and magnetic resonance imaging confirmed a high-grade partial thickness tear of the left distal gracilis at the myotendinous junction, as well as pes anserine bursal distention. She received physical therapy and underwent a 1-time...
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