How to treat tendonitis in horses?

How to treat tendonitis in horses? How to identify it? The difference between sprain and tendonitis. Understand the causes and identify them in order to relieve your horse and avoid recurrence. What are the treatments to relieve tendonitis? 

In this article, you will find out: 

  • How to treat tendonitis in horses? 
  • What are the treatments for tendonitis? 
  • What is the difference between sprain and tendonitis in the horse? 
  • Rehabilitation protocol 

Tendonitis is caused by inflammation of the tendon and ligament. They mainly affect the horse’s forelimbs. 

How to treat tendonitis in horses?

Tendinitis in horses is inflammation of the tendon.

The tendon is a fibrous tissue connecting muscles to bones.

It allows through the transmission of muscle strength the joint of the limbs.  

The horse has three tendons and a ligament: 

  • The superficial flexor tendon of the finger: called “perforated”; 
  • The deep flexor tendon of the finger: called the “perforator”; 
  • The suspensory ligament of the fetlock: also called interosseous muscle 3 (MIO3). 

The superficial flexor tendon (perforated) is located at the rear of the barrel. 

It is located under the skin. You feel it when palpating your horse’s limbs. 

The deep flexor (perforator) tendon is attached to the knee bone called the carpus. 

It is linked to the carpal bridle and extends into the horse’s foot.

The suspensory ligament divides into two branches halfway up the barrel. 

It is he who allows the ball suspension articulation. 

The horse has a lot of ligaments and tendons. 

There is very little muscle in the limbs of horses. 

The tendon is an early mature tissue. 

It does not have an adaptive response to stress. 

The horse is provided with “accessory ligaments.”

They are very powerful and allow automation of movements. 

They are very elastic and light. 

This feature saves energy and increases the speed of the horse. 

Identify the symptoms of tendonitis

Tendonitis are progressive lesions. 

They gradually degrade over time. 

Tendonitis is divided into 2 phases: 

  • The subclinical phase; 
  • The acute or clinical phase.

During the subclinical phase, the symptoms are mild.

When the symptoms worsen, we talk about the acute phase also called the clinical phase. 

The first mild symptoms that may alert you are: 

  • Lameness; 
  • Heat, and pain on palpation; 
  • Hollow or swollen back pastern. 

What are the causes of tendonitis in horses? 

Tendinitis is the result of a buildup. 

The appearance of tendonitis may be related to: 

  • A fatigue injury;
  • A degenerative lesion; 
  • Defects of plumb. 

The fatigue lesion appears when there is a mismatch between the horse’s work and the tendon’s capacity to deform under the intensity of the effort. 

These lesions heal when the horse is put to rest. 

Degenerative lesions affect adult and older horses.

The tendon loses elasticity. 

This is called “fibrosis”. 

Resting will relieve the horse but will not allow it to heal properly. 

The lack of plumb favors the appearance of chronic tendonitis. 

Sport horses are prone to tendon damage. 

The discipline of the horse influences the affected area. 

Complete horses (CCE) will have lesions on the suspensory ligament (MIO3) or on the perforator (flexor digitorum superficialis).  

Show jumping horses (CSO) will have lesions located more on the carpal band of the perforator (flexor digitorum profundus). 

The most common causes are: 

  • Too deep soil; 
  • Intense training;
  • A fitting (or trimming) poorly adapted. 

Certain intrinsic factors can be a cause of tendonitis, such as: 

  • Legs (especially flat feet); 
  • The weight of the horse (on weight or strong bones); 
  • The age of the horse. 

Tendinitis is a cyclical pathology. 

The tendon fibers weaken and deteriorate over time. 

The older the horses, the higher the risk of tendonitis. 

Recurrences may increase thereafter.  

Acute tendonitis of the perforator is uncommon compared to that of the perforator.  

What are the consequences of tendonitis?

Tendinopathy causes: 

  • A loss of elasticity of the tendons; 
  • Weakening of the tendons; 
  • Tendon disorders. 

This is why the healing phase is essential. 

The degree of ligament rupture in the horse

There are 4 types of tendonitis relating to the degree of collagen fiber breakdown.

  • Type I: partial rupture with possible pain at the start of the horse’s work, which disappears during warm-up;
  • Type II: partial rupture with persistent pain during labor and which may increase with the intensity of the effort;
  • Type III: partial rupture with permanent and intense pain, preventing training; 
  • Type IV: total rupture of fibers, making movement impossible and may require surgery.

What are the differences between sprain and tendonitis in the horse?

Horse sprain

A sprain is a painful injury to a joint following a violent distension of the joint capsule. 

The fetlock area is often the area most affected by a sprain. 

The sprain is associated with: 

  • Heat of the joint;
  • Pain on palpation; 
  • Pain when flexing the affected joint. 

Tendinitis, on the other hand, affects ligaments and tendons. 

What are the treatments for tendonitis?
Veterinary treatment

The advice of a veterinarian remains essential in making the diagnosis. 

Certain examinations will allow the veterinarian’s diagnosis to be adjusted. 

Veterinary examinations in case of tendonitis in horses

Here are the most common exams: 

  • Truncal anesthesias; 
  • Ultrasound; 
  • X-ray.  

Truncal anesthesia will make it possible to target the location of the lameness. 

Ultrasound can identify the lesion. 

The x-ray will reveal if there is any calcification. 

MRI may also be considered. 

Drug treatment for tendonitis in horses 

Drug treatment may be prescribed to relieve the horse. 

Painkillers and anti-inflammatories are the most commonly prescribed for tendonitis in horses. 

Some local treatments may be recommended: 

  • Application of cold decreases pain and inflammation; 
  • The application of a heating product stimulates tendon healing.
An orthopedic shoe adapted after tendonitis in the horse

An orthopedic shoe avoids the risk of recurrence of tendonitis. 

The shape of the shoe changes the support of the horse. 

This helps relieve tension on the tendons. 

Two orthopedic fittings are recommended following tendonitis:

  • The iron upside down; 
  • The oval iron, also called “egg-bar-shoes”.

What are the natural treatments for tendonitis in horses? 

Rest and recovery are the key to avoiding any form of recurrence. 

The durations are variable, it is the veterinarian who determines them. 

Clay to treat tendonitis in horses

Clay has a strong absorption power. It will absorb the inflammatory fluids present in the muscles or tendons. 

Clay is also an antibacterial. Bacteria are trapped and retained upon contact with clay. 

Clay also has astringent properties. That is to say, it tightens the tissues to facilitate their healing.

We advise you to use the Thalasso range from Cavasso  to do your care with clay.

Essential oils to relieve tendonitis

Certain essential oils are recognized for their analgesic properties. That is, they have a calming effect.

They also have draining and anti-inflammatory properties. 

You can use the following essential oils in particular: 

  • Common Cypress : exceptional tonic and circulatory qualities;
  • Java Lemongrass : anti-inflammatory effects when applied directly to the skin;
  • Lemon Eucalyptus : soothing, anti-inflammatory, analgesic and anti-fungal qualities traditionally used for joint comfort.

For example, the CapTend balm from Akhal contains:

  • A neutral aqueous base;
  • Essential oil of common cypress;
  • Java lemongrass essential oil;
  • Essential oil of field mint;
  • Gum arabic to ensure synergy between the oils.
Capsular Gaiters

There are new generation care gaiters. 

They are generally made up of a gaiter and a gaiter. With a washable wipe inside.

This wipe is reusable and allows the formula to be absorbed to slowly release the active ingredients and thus obtain increased efficiency.

For example, you can apply the CapTend balm mentioned above to the wipe to relieve tendonitis in horses.

Capsular gaiters are placed on the forelegs and / or hindquarters of horses during rest periods.

They absorb vibrations in the event of an impact at rest.

In contact with the horse’s skin, the active ingredients penetrate his body.

The active principle touches the tendons to prevent tendonitis, knurls and engorgement. 

The Capsular Recovery Range allows in particular to: 

  • Help to tighten the tendon tissues;
  • Promote the absorption of edemas;
  • Accelerate the drainage of toxins.

Capsular gaiters are made from very light materials.

They weigh 250 grams each.

The Capsular Gaiters are entirely made in France .

Homeopathy to treat tendonitis

Homeopathy can relieve your horse of tendonitis. 

The dosage form, called “granules” is best suited for the horse. 

The dilution adapted to the horse is 9CH with two doses per day. 

For tendonitis that has appeared after intensive training: 

  • Zinc Sarcolactate; 
  • Sportenin are effective. 

In order to avoid recurrence, the use of: 

  • Causticum;
  • Guaiacum can be considered.

Rehabilitation protocol after tendonitis in horses 

Your veterinarian will develop a specific rehabilitation protocol for your horse. 

The duration of rehabilitation varies between horses. 

It is broken down into 4 phases: 

  • Marching in ;
  • Fractional trotting with gradual increase in exercise;
  • Rehabilitation in a canter in a straight line;
  • Gradual return to training. 

Rehabilitation should be done gradually so as not to put too much strain on the weakened tendons. 

Soil management to prevent recurrence of tendonitis.

Soil management is also an element to take into account to avoid recurrence of tendonitis.

The more the tip of the hoof (called the clamp) is driven into the ground, the more the perforator and the carpal bridle are relieved. 

Conversely, the less the point of the hoof sinks into the ground, the less the tensions on the suspensory ligament and the perforated one. 

For tendonitis of the perforator or the carpal bridle, hard floors should be avoided. 

Soils that are too deep for tendonitis of the suspensor or perforator should be avoided. 


To relieve and improve the healing of your horse, certain food supplements can be beneficial. 

They will support the horse’s body during the healing process of tensions or fragile ligaments. 

We advise you to use the DolAway Sport range from Equibao to complement your horse. 

The solution for tendonitis in horses

You now know everything there is to know about tendonitis in horses.

You now know the solutions to treat and relieve tendonitis.

If in doubt, consult your veterinarian. Only the veterinarian will be able to perform a complete diagnosis.

You can check out the full features of Capsular Gaiters here.

To go further, you can read this article on the knurling wheels in the horse. 

Article written by Aurélie Martin , founder of Akhal. 

Photos taken by Studio Flora Charpentier .