Bowed tendons in horses

  • Bowed tendon refers to tendon swelling that appears as a bow in the leg.

  • Chronic stress or an injury can cause a bowed tendon.

  • Treatment includes complete rest, antiinflammatory drugs and gradual return to exercise.

  • Full recovery can take 8 to 11 months.

  • Premature work or stress can re-injure the tendon.

Anatomy
Figure 1. Anatomy of front limb lower horse leg.

What is a bowed tendon?

Bowed tendon refers to swelling in the superficial or deep digital flexor tendon, Figure 1. When either of these tendons swell it causes the leg to look "bowed." The bow can appear anywhere from the knee or hock to the pastern region. The superficial digital flexor tendon is much more commonly affected than the deep digital flexor tendon.

Causes

Bowed tendons can occur from chronic stress on the tendons or from an injury. Horses at higher risk of bowed tendons include:

  • Racehorses

  • Polo ponies

  • Jumpers

Placing bandages on the lower leg that puts uneven pressure on the tendons can also cause swelling.

Treatment

Treatment generally includes:

  • Complete rest

  • Controlled, gradual return to exercise

  • Anti-inflammatory drugs

  • Sometimes surgery

Bowed tendons vary in severity, but complete healing takes a long time. Clinical signs may resolve within days if you rest the horse and give anti-inflammatory drugs (i.e. Bute). Generally, the swelling returns with premature work or stress. It can take 8 to 11 months for the tendon to repair itself completely.

Repeat ultrasounds are useful to monitor healing and allow return to exercise as fast as possible without re-injury.

If you want to pursue a newer treatment option such as cell injections or shockwave therapy, make sure to evaluate the pros and cons. Most treatments have shown to be useless or even damaging. Your horse’s rehabilitation period may also be longer.

Annette McCoy, DVM, former graduate student, College of Veterinary Medicine

Reviewed in 2018

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