A physical therapist and veterinarian discuss potential applications of blood-flow-restriction training, compression therapy, and more in horses. Equine rehabilitation is a dynamic field that’s advancing constantly. Owners, trainers, and veterinarians are often willing to experiment with new technologies and modalities to keep their valuable elite equine athletes performing at their best. During the 2021 American Association of Equine Practitioners (AAEP) Convention, held in Nashville, Tennessee, sports medicine specialists compared notes on rehabilitation techniques for humans and horses. “The objective of this outline is to discuss emerging rehabilitative approaches used in elite human athletes, provide an overview of the research supporting their translational use, and discuss how their incorporation may apply to the equine athlete,” said Sherry A. Johnson, DVM, MS, Dipl. ACVSMR, a PhD candidate at Colorado State University and partner at Equine Sports Medicine LLC, in Fort Collins. Here are some of the strategies they discussed.

Blood flow restriction (BFR) training is a technique human physical therapists are using increasingly for controlled exercise post-orthopedic injury. With blood flow restriction training, however, the occlusion of the blood vessels traps lactate in the muscle, triggering natural growth hormone release, Bell said. The question, then, is whether we can use BFR as a rehab tool for horses on stall rest or reduced exercise. One of the only studies (Abe 2004) assessing vascular occlusion’s effects on horses’ muscle size and blood flow showed increased skeletal muscle thickness and a 40% increase in serum growth hormone concentration post-BFR. In Johnson’s preliminary assessment of this therapy, she said she’s seen no negative side effects such as chafing, thrombosis (blood clots), or laminitis in treated horses. “For me, this is a very exciting modality—a medication-free bio-hack solution to improve patients’ comfort during rehab,”. In human sports medicine, athletes use GPS and sensors to collect data about their biomechanics during exercise. Many wearable tracking systems exist to assess workloads, detect fatigue and injury risks, and evaluate athletes’ return to play post-injury. On the equine side, she said, you can find about 30 wearable tracking devices on the market to assess horses’ workloads. While baseline equine metrics for interpreting these data are lacking, veterinarians and trainers might be able to use them to identify training fatigue and make workload adjustments before injury occurs.