Adjunct Therapies for Tendon/Ligament Healing
Authors: Pluim Mathilde, Reynolds Angela, McClure Scott
Journal: Veterinary Clinics of North America: Equine Practice
Summary
# Editorial Summary Tendon and ligament injuries represent a significant clinical challenge in equine practice, yet many adjunctive therapies used to accelerate healing lack robust evidence bases. Pluim, Reynolds and McClure conducted a comprehensive review of high-power laser therapy and extracorporeal shock wave therapy (ESWT) as treatment modalities, distinguishing between low-level lasers—which appear insufficient for these deeper tissue injuries—and high-power systems that demonstrate safety and theoretical benefit. Whilst ESWT has become the most frequently applied adjunctive therapy for equine tendon and ligament conditions, the authors highlight a concerning gap: clinical uptake substantially outpaces the supporting scientific literature, with particular uncertainty around optimal dosing, treatment intervals, and long-term outcomes. The profession would benefit significantly from prospective trials establishing evidence-based protocols for both modalities, as current practice often relies on extrapolation from other species or anecdotal success rather than equine-specific data. For practitioners considering these interventions, understanding that safety has been established should not be conflated with efficacy—further rigorous investigation remains essential before definitive clinical recommendations can be made.
Read the full abstract on PubMed
Practical Takeaways
- •High-power lasers and ESWT are safe treatment options for tendon/ligament injuries, but practitioners should recognize that clinical evidence is still developing—use cautiously as adjuncts to proven rehabilitation protocols
- •Low-level laser therapy (cold laser) is not recommended for tendon/ligament healing in horses due to insufficient therapeutic power
- •Request specific treatment protocols from vendors or practitioners offering ESWT, as standardized evidence-based dosing has not yet been established—ask about long-term outcome data before committing to treatment
Key Findings
- •High-power laser therapy and ESWT can be safely used for equine tendon and ligament injuries with potential beneficial effects
- •Low-level laser therapy has insufficient power for treating equine tendon and ligament injuries
- •ESWT is the most commonly used adjunct therapy for equine tendon/ligament conditions despite limited scientific evidence supporting its efficacy
- •Standardized dosage and treatment protocols for laser therapy and ESWT remain undefined, limiting evidence-based clinical application