Every time I think I have a handle on the therapy options that are available to horse owners, new ones pop up. They probably have been around for longer than I realize, but they are new to me nonetheless. Many seem to be adapted from the human physical therapy realm, which I find somewhat comforting because humans can actually testify to their efficacy. Plus, they are likely to be safe if they have been used on humans. Here are a couple that I would like to share with you:
Functional Electrical Stimulation (FES) Therapy
Functional Electrical Stimulation (FES) was originally developed for use in humans with debilitating injuries that prevented them from being able to move. And, of course, muscles that are not used begin to atrophy, or shrink. This phenomenon could occur in patients with neurologic disease, spinal-cord injury, or in those who were bed-ridden. However, FES therapy could be used to maintain muscle mass and function.
Essentially, FES is the application of computer-regulated electrical impulses to the muscles through electrodes affixed to the skin. The therapy invokes a rhythmic contraction and relaxation of muscles. It is like an electronic deep-tissue massage. Results reported among human patients and horse owners alike include pain reduction, increased range of motion, and an all together “good” feeling afterward.
FES can be useful in horses, particularly in the deep pelvic muscles, because machines can generate an electrical signal that can penetrate up to 6 inches into the body. That allows it to reach the deep muscle, tendon and ligament tissues. This ability is of great value when dealing with spinal and pelvic problems such as iliopsoas muscle strains. Horse owners report that horses enjoy the sensation and often start to show extreme relaxation during treatment. Therefore, sedation is seldom needed for this therapy to be applied.
FES is generally used for the following purposes:
- To stimulate muscles, tendons and ligaments so that normal movement is returned to injured tissue.
- To promote edema reduction and tissue healing through increased circulation of blood and lymph due to the movement of muscles.
- To stimulate muscle movement and sensory nerves for the treatment of pain.
- Reversal of the wasting of muscle (used in EPM rehabilitation).
- Reduction of scar tissue.
- Increasing range of motion.
- Wound healing.
Horses with tendon and ligament tears will undoubtedly be laid-up for months, and many owners remain forever timid for fear of injury recurrence. Now, veterinary researchers have developed a therapy to stabilize soft-tissue injuries to halt their advancement and aid in healing. Novobrace is a patented injectable bioadhesive that forms an internal brace using a chemical crosslinking agent that is injected directly into the torn tendon or ligament, immediately adding mechanical support to the injury.
Although flexible (elastic), the brace prevents further advancement of the lesion, which results in improved healing. Novobrace may be used as a standalone therapy and also as an adjunct therapy with other tissue healing therapies including stem cells and growth factors. Over 90% of the horses treated with Novobrace to date have returned to work within seven months with zero percent of re-injury.
Horses with tendon or ligament injuries can receive the injection as soon as 10 days following the injury. A veterinarian will sedate the standing horse, disinfect the injection site, provide local anesthesia to the area being injected using lidocaine, and then inject the agent using ultrasound guidance. The whole process can take less than 30 minutes but can shave months off of lay-up and help ensure strong, healthy healing.
We're always looking for new treatments or modalities that make a positive difference in our horses' lives.
Editor's Note: Read Dr. Miller's article on tendon injuries here.