Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications.
Authors: Qiu Zhongsheng, Wang Jiaqi, Zhang Yukun, Liu Xiaxin, Wei Chengwei, Ma Tianwen
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Extracorporeal Shock Wave Therapy for Equine Musculoskeletal Disorders Musculoskeletal injuries remain the leading impediment to equine athletic performance and career longevity, prompting ongoing investigation into more efficacious and safer treatment modalities. Zhongsheng and colleagues conducted a comprehensive literature review synthesising current evidence on extracorporeal shock wave therapy (ESWT), examining both the underlying biological mechanisms—including pain modulation, inflammatory suppression, and tissue regeneration via multiple signalling cascades—and clinical applications across common equine conditions including suspensory desmitis, superficial digital flexor tendinitis, osteoarthritis, navicular syndrome, and back pain syndrome. The review identifies key findings that ESWT operates through diverse mechanistic pathways affecting cellular responses and tissue healing, with treatment parameters varying according to injury type and anatomical location. Practising equine veterinarians, physiotherapists, and farriers will find the synthesised protocol recommendations particularly valuable for standardising ESWT deployment in clinical settings, whilst physiotherapists and coaches can better understand realistic timelines and outcomes when integrating shock wave therapy into rehabilitation programmes. Given ESWT's emerging evidence base, this systematic analysis provides a much-needed reference framework to inform evidence-based decision-making regarding its application as an adjunctive or primary intervention for performance-limiting musculoskeletal pathology.
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Practical Takeaways
- •ESWT is a viable non-invasive therapeutic option for common performance-limiting musculoskeletal injuries in equine athletes, with established biological mechanisms supporting its use
- •Treatment protocols should be tailored to the specific condition (tendinitis vs. desmitis vs. osteoarthritis vs. navicular syndrome) with optimized shock wave parameters
- •Consider ESWT as part of a comprehensive injury management strategy to potentially reduce early retirement and improve return to performance
Key Findings
- •ESWT produces analgesia, anti-inflammatory effects, and autologous repair responses through multiple signaling pathways and biological factors
- •ESWT is clinically effective for managing major equine musculoskeletal injuries including tendon, ligament, joint, and soft tissue conditions
- •Specific ESWT parameters vary depending on the type of musculoskeletal injury being treated