Santo's rehabilitation program
Posted by Irina Yastrebova on Thursday, December 14, 2023 07:28 PM
History In June of 2022 Santo started showing signs of shortness of stride in left hind. The vet's investigation showed positive response in upper joints flexion but with some swelling and heat present it was pointing to the left stifle. After x-rays and ultrasound the vet decided to inject the joint with a standard cocktail of steroids + HA. She said after 3 days of rest continue training as usual. We showed in July and August riding Intermediare II, with a highlight score of 60% at EC Gold Level. I did feel that collected work was hard for him but thought it is very high level and it is expected...???
In September I signed up for a clinic with Jamey Irvin, the day before I gave him routine lunge and noticed shortness again. I was lucky to take another horse to the clinic and scheduled another vet appointment for Santo. The vet thought there is some ligament tear and lots of fluid so we were put to 3 months of walk only, 30 min, small personal paddock.
At the onset of winter we were cleared to start building fitness again and also Santo received PAAG (synthetic joint lubricant) injection into the stifle. Slowly working up trot minutes, then starting canter minutes. By the end of February he showed signs of being uncomfortable. Another vet check made my vet refer us to the stifle specialist at the big equine clinic in Calgary.
Well, after very thorough investigation with dozens x-ray pictures and 30 min of ultrasound she concluded he has lateral meniscus tear! :'( Any treatment option had very guarded prognosis. I decided on stem cell therapy. Stem cells were derived from his breast bone and sent to Denver to get cultivated, at the time of injection we also added PRP (palleted rich plasma) that was created on site in minutes from Santo's blood. That happened on April 13th, 2023. And that started one year strict rehab program that I will describe to you below. By now we are 8 months into it. July and October check ups were very promising. The tear is filling up with fiber tissue, the lameness got down from 3 to 0.5. The vet said she wants to give him up to a year time to heal. The research shows that after one year there is no point of resting longer, it will not heal more. This means in spring he will be checked and started on a careful fitness program to get him back in shape. Fingers crossed...
Santo's rehabilitation work consists of several components - riding: walk only, balancing pads, carrot and assisted stretches, resistance band work
Riding is the main component of our program, 4 times per week. walk 30-40 min which was gradually built from 15 min. The pole work was allowed from the start. However, moderate hills and lateral work has been added at 6 months. Even though I couldn't do much work in walk I still would ride him round, on the bit, doing a few steps of tiny shoulder-fore, leg-yield or a half-pass, then a stretch. I also play with neck position - longer, lower, rounder, higher; walk tempo - slow, faster, shorter, longer steps. Recently, we were allowed to start half-steps. Gradually, I have built to 5-10 steps, 3-5 sets, with walk breaks in between sets. The focus is not on power but rhythm, relaxation, simplicity and ease.
Around 3 months into rehabilitation I also added resistance band work. I created a saddle pad with an elastic band attached to it that can be wrapped around his haunches. I built riding time with it from 5 to 20 min including lateral work and half-steps. I use that saddle pad twice a week.
Balancing Pads are big almost square pads made of firm foam, 2 inches thick. They are human exercise equipment, I bought from Amazon :) I bought 4, one for each leg. Santo learned to stand on them all. I put him on prior to grooming and saddling. I alternate which leg goes first, what sequence of legs follows (two fronts or two backs first, the other sequence is left pair or right pair first). Before I saddle I do belly lifts and small pelvic tilt while he stands on the pads. Carrots after are the must! :) I saddle and remove pads following the same sequence I put him on them. After lifting a leg to remove the pad I keep the leg in the air doing a few circles with it while he balances on other 2-3 pads.
Stretches I do after riding. That is his favorite time. :) He can truly turn himself into a pretzel for a cookie! :) I do 3-4 stretches, repeated couple times on each side. I did stretches with Santo all his life, but only once a week. Clearly, now I see how that was not effective. He is so much better at them doing it 4 times a week. The stretches are standard, you can easily find them on the Internet. I also really like Dr. Hilary Clayton book on stretches.
From start to finish, all the work amounts to over an hour time dedicated to Santo. I improvise with different trails, road, arena work, different sequences of lateral exercises, poles, hills, work in hand. I take my two-year-old with me to brighten our walks and give him a chance to run around and have fun. Despite it is boring sometimes I do not skip the rides. The vet pointed out last time that Santo built muscles between July and October just by doing walk work. That was music to my ears! Another 3 months and hopefully Santo will be sound enough to return to work!
Happy riding...
 
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