Leon is a 12-year-old hunter who stepped on a nail and became severely lame a few days later.  He was taken to surgery and it was determined that the nail had damaged his deep digital flexor tendon, his navicular bursa and the back of his navicular bone. After careful surgical debridement and cleaning, he was sent to VRSVA to recover.

Management of this type of injury is extremely critical. Infection in these structures is life threatening.  Too little movement can cause adhesions and severe, permanent lameness. Too much movement can further injure the damaged structures within the foot.

A removable metal plate was attached to the bottom of Leon’s shoe to keep his sole clean and to allow treatment of the surgical site. His initial rehab plan included very short, careful hand walks up to fifteen times per day, cross frictional tendon massage to prevent adhesions, ice therapy to decrease inflammation and Class IV laser therapy to increase cellular metabolism and speed healing.  His tendon sheath was injected with IRAP every 2 weeks in the first 6 weeks to aid in healing.  Vibration Plate therapy and core exercises were incorporated to help maintain muscle tone and to keep him mentally calm and engaged during a long period without the freedom of turnout.

Very gradually, the length of Leon’s hand walks were increased until he was able to begin work under saddle. Hill work and raised cavalettis were incorporated to improve strength and range of motion.   Laser therapy, icing and massage was continued.  Proprioceptive pads were added to improve his balance, proprioception and stretching in all directions.  After each ride, Leon stood on a small toe wedge to continue to stretch his flexor tendons and prevent adhesions.

As expected, it was a long, slow recovery with setbacks along the way. Leon’s treatment plan was adjusted frequently and he was able to keep moving slowly forward.  Finally, after seven months of hard rehabilitation work, Leon was able to go home with detailed instructions to continue his recovery. He has progressed well at home and is back is back in the show ring doing the hunters!