Case Study And Protocol’s

Suspensory Ligament

Case history

The patient is a 14 year old Connemara gelding who sustained bilateral trauma to his hind suspensory ligaments. Upon diagnosis of the trauma he was treated with a course of shock wave, however, on re-scan the injury appeared to have worsened with significant tears and holes detected on the scan. In the vets words ‘this is as bad as it gets’.

Horse is bilaterally lame and struggles to balance when one limb is lifted to either have feet picked out or trimmed.


After speaking to the vet and identifying the exact area of damage, treatment began covering the areas directly involved as well as distal to the trauma.

Both hind limbs were treated on each visit

Initially we did a course of 6 treatments, each treatment was one week apart for 6 weeks. Ultrasound scans were taken before treatment and after the course of 6.

Protocols for week 1, 2 and 3

Time: 5 minutes, Power output: 5%

Time: 10 minutes, Power output: 5%

Protocols for weeks 4, 5 and 6

Time: 5 minutes, Power output: Up to 12% but temperature monitored closely

Time: 10 minutes, Power output: Up to 10% but temperature monitored closely

The 6 week scans revealed complete healing of the off hind. Some areas of scarring still showed on the near hind but significant healing had also occurred.

The treating vet advised a further course of 6 treatments with the introduction of exercise from now on.

Protocol for treatments 7 – 12

Time: 5 minutes, Power output: Up to 12%

Time: 10 minutes, Power output: Up to 10 %


Initially in had walking on a hard surface was advised.  10 minutes twice a day to gradually increase every 3 days until 30 minutes was reached.

Scan at 12 weeks showed further healing and sign off was given.  Owner given further exercise rehabilitation and horse now able to be turned out into a small paddock.

NB – due to several compensatory traits developed a full body physiotherapy treatment was performed on the same day as treatment 7 which made a significant improvement to his balance issues.  He now stands easily on 3 legs while being trimmed.

Cotswold horse and hound physiotherapy – Hannah Ashton BSc qualified as a Veterinary Physiotherapist in 2009. Hannah treats animals of all shapes and sizes, specialising in the treatment of race horses, show horses, dressage horses, hunters, eventers and companion horses.

She also works with competition, show and companion dogs and farm animals.

Based near Stow on the Wold, areas covered include parts of Gloucestershire, Oxfordshire and Warwickshire.