Evidence-based rehabilitation of the competition horse
Authors: Katherine Hanousek
Journal: UK-Vet Equine
Summary
# Editorial Summary: Evidence-based rehabilitation of the competition horse Successful rehabilitation of competition horses demands a structured, individualised approach that evolves across distinct recovery phases, with treatment selection grounded in current evidence and informed by each horse's health status, behaviour and the owner's practical capacity to comply with protocols. Hanousek identifies four core rehabilitation objectives—pain mitigation, inflammatory resolution, tissue healing promotion and restoration of strength and proprioceptive range of motion—which should be sequenced and prioritised according to injury type and healing stage. The cornerstone of any programme remains controlled exercise with precise limb-loading management; by systematically varying exercise frequency, modality and environmental conditions, practitioners can optimise tissue remodelling without precipitating re-injury, whilst complementary modalities including therapeutic laser and extracorporeal shockwave therapy accelerate pain resolution and cellular repair, and targeted injectables such as bisphosphonates and orthobiologic preparations offer disease-modifying benefits for degenerative and traumatic conditions. Collaborative multidisciplinary management involving equine physiotherapists, veterinarians and farriers produces superior outcomes by ensuring rehabilitation programmes remain personalised, progressive and responsive to measurable changes in lameness, joint mobility and performance capacity. For practitioners, this framework underscores the importance of moving beyond single-intervention protocols towards systematic, evidence-informed programmes that harness controlled loading, physical modalities and regenerative therapies in concert.
Read the full abstract on the publisher's site
Practical Takeaways
- •Build rehabilitation around controlled exercise with careful progression of limb loading—avoid the temptation to rest completely or return to work too quickly
- •Consider combining modalities (exercise + electrophysical therapy + injectables) based on individual horse presentation rather than relying on any single treatment
- •Work with an equine physiotherapist to develop a structured, evidence-based plan that accounts for your horse's temperament and your realistic capacity to manage the programme
Key Findings
- •Rehabilitation requires multifaceted, phase-specific approach tailored to individual horse needs and owner capacity
- •Controlled exercise forms the foundation of rehabilitation, with careful limb loading management to promote tissue repair without exacerbation
- •Electrophysical therapies (shockwave, LASER) provide additional benefits for pain management and healing alongside exercise
- •Integration of injectables (bisphosphonates, orthobiologics) with exercise and electrophysical therapies supports tissue repair and disease modification