Clinical Experiences with Radial Shock Wave Therapy in Performance Horses

Extracorporeal Shock Wave Therapy (ESWT) is a relatively new treatment for musculoskeletal injury in performance horses. Both high energy focused and low energy radial shock wave devices are becoming popular in Europe and North America. However, there is still a need for documentation of the effects of shockwaves on equine tissue or the efficacy of treatments.

Extracorporeal Shock Wave Therapy has been used in human medicine for the past 17 years.4 Known as lithotripsy, this therapeutic instrument is used primarily for non-surgical disintegration of kidney stones, gall bladder stones and stones in salivary glands. The FDA is currently evaluating the use of ESWT in the United States for orthopedic conditions.5 A growing body of research supports success with heel spurs, calcific tendinitis, lateral epicondylitis (tennis elbow), plantar fasciaitis and non-union fractures.

Many soft tissue and bone injuries in performance horses carry guarded to unfavorable prognoses for future athletic endeavors. Many are slow healers, have a high reoccurrence and are poorly responsive to other forms of medical or surgical treatments. Eleven different conditions, on primarily Standardbred race horses were treated with Radial Shock Wave Therapy (RSWT) using a Swiss DolorClast Vet system (EMS Electro Medical Systems, Dallas, TX, USA) unit, which generates a pressure pulse pneumatically, through the use of an air compressor. The pulse converts a mechanical impulse through a focused tip on a hand held probe in to equine tissue.

The conditions treated were superficial digital flexor (SDF) tendinitis, suspensory desmitis, fractures, sesamoiditis, distal sesamoidean ligament desmitis, inferior check ligament desmitis, exostoses or splints, plantar ligament desmitis, dorsal metacarpal disease (DMD), proliferative synovitis and joint synovitis /degenerative joint disease. The purpose of this retrospective study, was to evaluate the effectiveness of Radial Shock Wave Therapy as a viable treatment option for such lameness problems in 70 performance horses.

Materials and Methods

Seventy performance horses, comprising 68 Standardbreds, 1 Thoroughbred and 1 Arabian, were all included in this study. Ninety five limbs had 98 different conditions involving 11 different problems (diagnoses). Many of these horses therefore, had multiple problems on one leg or multiple problems on multiple legs, which is not an uncommon finding in Standardbred racehorses. All horses were presented for a lameness evaluation of varying degrees (AAEP grades 1 to 5) and many conditions were chronic and recurrent. Over 50%