Sports Medicine

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Lameness

Lameness or unsoundness can range from the extreme to the very subtle and is the number one cause of performance related issues. Some problems are obvious at first, while others may present only under certain circumstances. It is important to do a proper physical exam involving palpation as well as evaluating the horse’s gait under various conditions. The exam may involve nerve blocks, radiographs and/or diagnostic ultrasound. There are some conditions that may require more advanced diagnostic procedures such as an MRI or Nuclear Scintigraphy. Depending on the problem, there are various treatment regimes that may be offered.

Our facility is set up for primary exams as well as consultations and/or second opinions. As some exams can be very time consuming, for your convenience, you are able to drop off your horse in the morning for a complete exam and diagnostic evaluation.

Lameness is the number one cause of performance problems in horses. From the more traditional to the latest advancements, we are equipped to offer you the best treatments available. These include, but are not limited to:

Platelet Rich Plasma (PRP)

PRP is a product obtained from your horse’s own blood that corresponds to the platelet-rich fraction of blood which is also rich in growth factors. For tissue regeneration to occur, three components are needed: Growth factors, cells capable of becoming the desired tissue (stem cells) and scaffold, which is usually the damaged tissue. Growth factors by themselves may accelerate the healing and promote better quality tissue. In addition, they have potent anti-inflammatory properties and have been used successfully in joint and tendon/ligament therapy. This treatment is available in our hospital and it is done on an outpatient basis.

IRAP

IRAP stands for Interleukin-1 Receptor Antagonist Protein, and is a therapy aimed to block the main inflammatory mediator in joint disease. It is used at different stages of joint disease to stop the inflammation and prevent degeneration. It is obtained from your horse’s own blood in combination with a proprietary product which remains an industrial secret. This treatment is offered in our hospital and requires overnight hospitalization.

STEM CELL THERAPY 
- bone marrow mesenchymal derived

Stem cell therapy is at the forefront of tissue regeneration. It is based on the existence of cells in adult tissue that can become whatever tissue they are implanted into. Although the development of stem cell therapy is still in its infancy, some clinical results are encouraging and we offer this modality for selected cases. Please call our office for further information.

CHIROPRACTIC ACUPUNCTURE

Dr. Martin is a certified chiropractor and acupuncturist and has an integrative approach to traditional lameness/soundness exams. These complementary modalities are offered in conjunction with traditional veterinary treatments to help your horse feel and perform at his best. The two forms of therapy utilize neurophysiology and musculoskeletal physiology to aid in the prevention and treatment of an injury or chronic lameness issues.

EXTRACORPOREAL SHOCK WAVE THERAPY (ESWT)

ESWT is a non-invasive therapy used to stimulate healing and to return horses to a level of fully sound, useful activity without recurrence of disease. This treatment modality is used for a variety of soft tissue (e.g. bowed tendons, suspensory ligament desmitis, sore backs, etc…), bone (e.g. fractures, sesamoiditis, buck shins, navicular disease or heel pain) and joint (e.g. spavin, osselets, arthritis) injuries. From outside the body (extracorporeal), the machine generates high-intensity shock or pressure waves, which pulse to a specific site within the injured tissue.

Though its actual mode of action is still in dispute, it stimulates and accelerates the healing process, essentially combining an immediate analgesic (pain killing) effect with a reduction in inflammation, neovascularization (new blood vessels) in soft tissue and osteogenesis (new bone formation) in bone. It is this new blood flow that promotes tissue healing. Electrical energy is used to initiate the pressure wave. The energy settings and the number of pulses are important. Too low energy or too few pulses might not create the desired therapeutic effect. Excessive energy or pulses may result in tendon damage. The pressure waves penetrate fluid and soft tissue, and their effects occur at sites at the bone/soft tissue interface. Pressure waves might help physically break down or move a hematoma or fluid from the lesion to allow the fibroblasts to more rapidly fill the defect. According to some research, ESWT is an effective method of decreasing clinical signs of lameness associated with osteoarthritis. In a study comparing horses treated with a common non-steroidal anti-inflammatory drug, ESWT performed better, promoting improvement in clinical lameness and increased synovial fluid total protein, and increased amount of glycosaminoglycan released into the bloodstream.

ESWT treatment reduced the clinical signs of pain measured by lameness evaluation 42 days after the final treatment. The results of the study suggested that ESWT is an effective method of reducing clinical lameness and synovitis, but it does not improve gross or histologic progression of arthritis significantly; thus, it would be best considered in combination with a chondroprotective agent. The handheld wand of the unit attaches to an energy source. For the simplest shock wave procedure, the horse is lightly sedated; the area to be treated is shaved to provide for good contact; a contact gel is placed on the horse’s skin, and the hand unit is applied to the horse to deliver the shock wave pulses. The treatment takes minutes. The horse does not experience pain. Sedation is recommended so that the horse remains still and so that ESWT is applied accurately to the specific treatment location. If the horse is fractious, the veterinarian is also protected.

Among possible concerns surrounding ESWT for horses is potential local analgesia (pain killing) after treatment, and for bone micro-lesions, micro-fractures. Some studies have found slight skin analgesia for three to five days, but no bone lesions have been produced. Data indicates that a horse should not be subjected to strenuous activities where local analgesia pre-disposes the horse to injury for at least four days after ESWT.

CRYOTHERAPY (Freeze Firing)

This time-honored treatment modality is used primarily in racehorses. Cryotherapy provides counter-irritation to an area where the healing process has stalled and become chronic. The low temperature produces a new inflammatory reaction that re-ignites the body’s effort to heal a lesion. This technique is very safe and is very well tolerated by the horse. This modality is used particularly in splints, buck shins, curbs, tendon and ligament injuries. It is usually applied with the horse standing under light sedation. The procedure takes minutes to complete and the lay-out period is minimal. The region that has been “freezed” usually develops a characteristic white spot appearance.

Rehabilitation

Back problems, gastrointestinal disturbances such as ulcers, heart conditions, respiratory problems and lameness are just a few of the conditions that can present as poor performance.

After evaluating these performance problems and assessing the strength of each organ, our Veterinarians can design highly specific rehabilitation and physical therapy programs. Conditioning programs are tailored to your horse’s needs and include dietary strategies for optimal performance.