How can Extracorporeal Shockwave Therapy (ESWT) help your horse? First, let's look at the name: extracorporeal means outside the body, indicating that this is a non-invasive therapy, and shockwaves are high-intensity pressure waves delivered to a certain depth by the machine. Shockwave therapy stimulates and accelerates healing by immediately relieving pain (analgesia), reducing inflammation, improving blood flow to the area, and stimulating bone repair. This means that shockwaves can be used to treat a wide variety of conditions, including suspensory ligament desmitis and other tendon/soft tissue injuries, navicular syndrome, stress fractures, kissing spines (overriding dorsal spinous processes), etc.
The shockwaves do produce a very loud noise and intense pressure, which startles most horses, so light sedation is usually required for each session. To achieve good penetration of shockwaves into the tissues the injured region should be shaved, and contact gel applied, then the shockwaves are delivered by a handheld "trode" placed on the skin. Depending on the number of shocks to be delivered to the specific area, each treatment session requires between 5-15 minutes, and usually 3 treatments 10-14 days apart are recommended.
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This treatment can only legally be used by veterinarians (or trained, supervised assistants) after a diagnosis has been made, because using an excess amount or strength of shocks can result in tendon damage and too few or too low energy shocks will not achieve the benefits described above.
Because a mild amount of inflammation immediately after shockwave therapy is common, it is recommended that shockwave be started about 10-14 days after an acute injury (such as a bowed tendon) has occurred, after the tendon has been treated with icing, topical, and systemic anti-inflammatory medications to reduce swelling.
USEF does not allow shockwave therapy within 3 days of competition (5 days for FEI competition) due to the analgesic effect increasing the risk of catastrophic injury. If you have any questions about shockwave therapy, don't hesitate to ask your veterinarian!
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