Tendons in horses are fibrous connective tissues that attach muscles to bones, facilitating movement and providing stability to the musculoskeletal system. They are composed primarily of collagen fibers, which confer strength and flexibility, allowing horses to perform various physical activities. Equine tendons are subject to significant mechanical stress during locomotion, making them susceptible to injury, particularly in performance horses. Common tendon injuries include strains, tears, and tendinitis, which can impact a horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the structure, function, and pathology of tendons in horses, as well as advancements in diagnostic and therapeutic approaches for tendon injuries.
Robinson RC.Most practitioners will have experienced the
frustration encountered in the treatment of sprains
of the flexor tendons and suspensory ligaments
of racehorses. After apparent recovery, the
damaged structure will often break down again
when the horse returns to hard training. Milne
(1960), Reed (1962), Jubb and Kennedy (1963)
and Hickman (1964) have written detailed ac-
counts of the pathology of tendon injuries and the
mechanism of repair of tendon tissue. These
writers substantiate that when a tendon is
sprained, there is a tearing or rupture of some of
the tendon fibres, varying i...
Abrahams M.The mechanical behaviour of horse and human tendon, as characterised by the stress-strain curve, has been examined with respect to load-strain cycling and strain rate. It was found that the tendon stress-strain curve for successive cycles was reporducible provided that strain on the specimen did not exceed 2·0–4·0%. If this strain level was exceeded, a permanent deformation occurred. This phenomenon was verified by histological studies on strained tendon which showed that some of the collagen fibres did not return to their original orientation. Variation in the rate of strain was found to ...
To investigate predictors of survival and athletic function in adult horses with infection of a synovial structure. Objective: Increasing duration from contamination to referral, bone or tendon involvement and positive microbial culture decreases short-term survival. Synovitis and/or sepsis at 5 days post-admission and involvement of Staphylococcus spp. decreases long-term athletic function. Methods: Retrospective study. Methods: Records over 4 years of adult horses with synovial sepsis were reviewed. A two-tailed Fisher's exact test, Mann-Whitney U test or t-test was used to examine whether v...
Clarke EJ, Jensen A, Gillen AM, Bardell D, Senior M, Anderson JR, Peffers MJ.To determine the protein composition of equine platelet-rich plasma (PRP) and PRP-derived extracellular vesicles (EVs) and evaluate their effects on tendon inflammation in vitro. As tendon injuries are common in horses and treatment with PRP derived from the horse's own blood shows promise, but outcomes vary due to inconsistent composition. PRP contains EVs that facilitate cell communication. Unassigned: From December 2022 through May 2023, equine plasma (n = 3, adult) was isolated via double centrifugation and PRP produced using a commercial kit. Extracellular vesicles were isolated using dif...
Beaumont A, Emond AL, Pourcelot P, Fayaubot L, Ravary-Plumioen B, Dupays AG, Desquilbet L, Denoix JM, Crevier-Denoix N.To quantify changes in the cross-sectional area (CSA) of the midmetacarpal superficial digital flexor tendon (SDFT) in young Trotters during training. Unassigned: In this experimental study, 12 healthy 3-year-old French Trotters, assigned to either a soft-track or a hard-track group, were trained for 4 months (June through September of 2012 and 2013). Both groups followed the same exercise program of increasing intensity. Ultrasonographic examinations of both forelimb SDFTs of each horse were performed before the beginning of training (D0), after 2 months of training (M2), and after 4 months o...
Ellis K, Van Zeeland EM, Ashton L, Wist S, Broeckling C, Harris M, Frisbie DD, Sikes KJ.To (1) identify tissue-specific metabolic profiles of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), and suspensory ligament (SL) and (2) evaluate metabolic profile differences in the SDFT, DDFT, and SL between the equine forelimb and hindlimb. Unassigned: 2 SDFT, DDFT, and SL specimens were collected from the forelimbs and hindlimbs of 10 horses of mixed breed, age, and sex that were euthanized for other reasons. One specimen was processed for histology to confirm that there were no underlying soft-tissue pathologies. One specimen was processed for 2 forms of...
Pluim M, Reynolds A, McClure S.High-power laser therapy and extracorporeal shock wave therapy (ESWT) can be safely used to treat tendon and ligament injuries in horses, and the potential beneficial effects have been described. The power of low level lasers is not sufficient for treatment of tendon and ligament injuries in horses. ESWT is used more often to treat tendon and ligament injuries than it is for any other type of condition in horses, but there is limited supporting scientific evidence. Further research should focus on establishing dosage and treatment protocols for both laser therapy and ESWT in horses with clinic...
Connard SS, Schnabel LV.This review explores the use of biologics in the treatment of tendon and ligament injuries in horses, focusing on current and emerging therapies aimed at enhancing tissue repair and regeneration. It discusses the role of scaffold-based therapies, growth factors, blood-derived and tissue-derived biologics, and gene therapy as biologic regenerative therapies for improving healing outcomes. The review evaluates the mechanisms, efficacy, and challenges of biologics in clinical applications, highlighting recent advances and clinical studies. It provides an overview of current trends and future dire...
Tay A, McMaster M.Equine tendon lacerations are not uncommon secondary to traumatic wounds and degloving lacerations. These wounds are often contaminated and, therefore, basic principles of wound assessment and management are critical to identify the extent of an injury. Ancillary tools to aid physical examination include radiography, ultrasonography, and synoviocentesis (eg, if involving a joint and/or tendon sheath). Prolonged convalescence period, continued external coaptation, and controlled exercise are mainstays of treatment following tenorrhaphy. A poor prognosis for return to full athletic function is e...
Miles S, McCauley C, Carossino M, Del Piero F, Liu CC, Gaschen L.Manica flexoria tears are increasingly recognized as a cause of lameness in horses resulting in a need for improved pre-operative diagnosis. Partial tears are difficult to pre-operatively diagnose and thus research for diagnostics of manica flexoria tears has been seen in increasing frequency over the past decade, though a deficit of information exists for the features of this structure on MRI, which is best suited for evaluation of soft tissues. The goal is to perform an observational study on the morphometry of the normal manica flexoria prospectively and describe it retrospectively on MRI. ...
Durgam S.The mid-metacarpal SDFT, intrasynovial DDFT and suspensory ligament are frequently injured soft tissues in the equine athlete. The mid-metacarpal SDFT exhibits a hierarchical structure and encounters repetitive strains at its functional limit. The intrasynovial DDFT possesses fibrocartilage where opposing bony surfaces to facilitate resistance-free gliding and contains chondrocyte-like cells embedded in a proteoglycan-rich ECM. While suspensory ligament enthesis injuries are common, collagen and non-collagen ECM structure-function specializations at the bone-ligament interface are understudied...
Aßmann AD, Sànchez-Andrade JS, Argüelles D, Bischofberger AS.Diagnosing digital flexor tendon sheath (DFTS) pathologies, particularly manica flexoria (MF) tears, can be challenging with standard imaging modalities. Standing low-field MRI tenography (MRIt) may improve the detection rate of MF tears. This study aimed to compare ultrasonography, contrast radiography, pre-contrast MRI, and MRIt to detect naturally occurring MF lesions in horses undergoing tenoscopy. Ten horses with a positive DFTS block, which underwent contrast radiography, ultrasonography, MRI, MRIt, and tenoscopy were included. Two radiologists evaluated the images and recorded whether a...
Bosman LM, Logan MG, Miszewski A, Pepper MS.Translational regenerative medicine, integrating human and veterinary approaches within the "One Health" framework, increasingly uses horses as models for human musculoskeletal conditions due to shared anatomical and functional features. Osteoarthritis and tendon disorders affect both species, often resulting from high-impact or repetitive strain activities. Regenerative medicine offers therapeutic opportunities by promoting tissue repair and modulating inflammation. Cellular orthobiologics such as mesenchymal stromal/stem cells (MSCs) show promise for treating osteoarthritis and tendon injuri...
Eren G, López-Albors O, López Corbalán M, Latorre R.Digital technologies have improved the visualization of anatomical structures for veterinary education and clinical practice. In this study, a detailed three-dimensional anatomical model of the equine palmar metacarpal region was generated using E12-based epoxy sheet plastination combined with digital reconstruction in Amira V5.6 software. Serial cross-sections of the metacarpal region provided high-resolution visualization of bones, tendons, ligaments, nerves, vessels, fasciae, and synovial structures, with minimal shrinkage or deformation, ensuring improved anatomical accuracy. These section...
Mazzucco L, Marcatili M, Withers J, Cantatore F.Superficial digital flexor tendinopathy is a common cause of forelimb lameness in Thoroughbred racehorses and sports horses; however, this condition is rarely observed in the hindlimb. A 16-year-old Irish sports horse gelding was presented with bilateral swelling in the plantar metatarsal region and severe bilateral hindlimb lameness visible at the walk. The lameness occurred after the cross-country phase of an eventing competition. The clinical suspicion of superficial digital flexor tendon (SDFT) injury was confirmed after ultrasonographic examination, which revealed an extensive core lesion...
Urion R, Lustgarten M, Hostnik ET.Technological developments in imaging modalities have advanced the diagnostic capabilities for equine tendon and ligament injuries beyond the traditional methods. This review examines elastography techniques in ultrasonography that assess tissue stiffness and strain properties, computed tomography (CT) innovations including PET/CT fusion and dual-energy CT, and emerging applications of diffusion-weighted MRI for evaluating fiber microstructure and functionality. These complementary approaches offer veterinarians improved means to detect early injuries, assess structural integrity, monitor heal...
Moreno C, Rice H.Diagnostic and treatment strategies for infectious equine tendon and ligament disorders are continually evolving where recent progress is focused on advanced imaging and evidence supporting endoscopic lavage and regional antimicrobial therapy.
Beasley B.The overall objective of therapeutic farriery for equine tendon and ligament injuries is to provide a biomechanical environment conducive to healing by limiting excessive strain on the injured structure. With an understanding of equine limb anatomy and the pathophysiology of tendon/ligament injuries, the rationale used in therapeutic farriery for soft tissue injuries of the distal limb is quite logical. Through therapeutic farriery, foot manipulation is used to reduce the tension on the injured tendon(s) or ligament(s).
Zamboulis DE, Thorpe CT.The high stresses and strains experienced by the superficial digital flexor tendon (SDFT) make it prone to age-related injury. The SDFT exhibits cellular and structural specializations, localized to the interfascicular matrix (IFM), enabling it to resist its extreme mechanical environment. With aging, these specializations are lost, impacting the ability of the tendon to withstand repeated loading. Within the IFM, there is loss of mechanical properties and organization accompanying cell senescence and a decreased resolution of inflammation. Developing therapeutics to reverse these changes may,...
