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Extracorporeal Shockwave Therapy (ESWT)

Extracorporeal Shockwave Therapy gives our veterinarians an alternate treatment modality for treating common conditions in a horse’s back and extremities, particularly the suspensory ligaments and tendons. Previously we were only able to offer corticosteroid, non-steroidal anti-inflammatory (NSAIDS) medication and corrective shoeing. While these therapies are still effective in some cases combining different modalities including shockwave therapy is far more effective.

Photo: Dr Ross Alexander administering Shockwave Therapy

ESWT is not an electrical shock but rather a sound wave that is directed through a focused beam generated in a transducer. This beam generates a large amount of energy into the tissue or bone as required. The dosage (number of shocks) and amount of energy can be controlled to deliver precise and focused treatment. The shockwave compresses the targeted tissue (bone, ligaments and tendons), these tissues then decompress stimulating an intracellular and extracellular response, causing tissue regeneration.

ESWT has been shown to improve healing and is a particularly useful and non-invasive treatment for the following reasons:

  • Stimulates new bone growth

  • Increases vascularisation (vascularisation improves ability to deliver required nutrients and minerals to a site for healing)

  • Stimulates the release of a cascade of cell-based healing and growth factors to promote tissue/ tendon healing

  • Decrease the expression of high levels of inflammatory mediators (matrix metalloproteinases and interleukins)

  • Relief of pain through hyperstimulation analgesia

  • Recruitment of mesenchymal stem cells

  • Can be effective as an adjunct to intra-articular therapy (additive effect of the combined two therapies)

It is important that your veterinarian does a thorough clinical examination to identify the cause of a lameness or injury so that effective treatment is administered.

ESWT is generally administered three times and at 2-3 week intervals. There is a requirement by Racing Australia that shockwave treatment only be administered by a licensed veterinarian and that it not be administered within 7 clear days of racing or trialling. This is a sensible and considered regulation as shockwave therapy does have a short-term analgesic effect. Our recommendation is that horses treated with shockwave are given at least 5-days before resuming high intensity training.

Horses in training are often referred to veterinarians as having “hamstring” issues. In most cases these horses are sore through the lumbar muscles, down through the extensor musculature of the hind limb which gives rise to the “hamstring” issues. Treating the lumbar muscles in cases of “hamstring” pain with shockwave therapy has been shown to be very effective.

Treating high suspensory disease / pain in both the fore and hind limbs with shockwave therapy is also very effective. Rather than reducing the inflammation with corticosteroid infusion, the shockwave therapy stimulates healing of the suspensory ligament insertions and after a course of treatment recurrence is less common.


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