From the Research
For dressage horses with suspensory ligament injuries related to ring footing, I recommend a combination of proper footing management, appropriate rehabilitation, and medical intervention, prioritizing a sand and rubber surface as it is associated with less detrimental surface properties 1. The ideal footing for recovery should be consistent, not too deep or too shallow, with appropriate cushioning and stability—typically a sand-fiber mix with 1.5-2 inches of depth that allows slight hoof penetration without excessive sinking. Key considerations for managing suspensory ligament injuries include:
- Implementing stall rest for 2-4 weeks followed by a controlled rehabilitation program spanning 6-12 months, gradually increasing hand-walking from 5 minutes to 30 minutes daily.
- Medical management typically includes NSAIDs like phenylbutazone (1-2 g daily for 5-7 days) or flunixin meglumine (500 mg twice daily for 3-5 days) for acute inflammation, followed by regenerative therapies such as PRP or stem cell treatments administered via ultrasound-guided injection.
- Cold therapy (15-20 minutes, 2-3 times daily) helps manage inflammation, while supportive bandaging provides stability. Prevention measures are crucial and include:
- Proper warm-up (10-15 minutes of walking before work)
- Gradual conditioning
- Regular footing maintenance, ensuring the surface has a base, with limestone recommended, and avoiding crushed concrete 1. Suspensory injuries occur because this ligament supports the fetlock during weight-bearing, and improper footing creates uneven loading that strains this critical structure, particularly during the collected movements required in dressage.