Extracorporeal Shockwave Therapy in Competition Horses

Extracorporeal shockwave therapy (ESWT) reportedly helps horses with a variety of musculoskeletal conditions, such as tendinitis, navicular syndrome, stress fractures, back pain, and osteoarthritis. Like other pain-relieving treatments (think medications), strict rules exist regarding application of ESWT near competition.

“ESWT stimulates tissue healing and regeneration, and can reduce pain in horses with musculoskeletal disorders. With the potential to mask pain, ESWT could contribute to worsening of the condition or even catastrophic breakdown if asked to work too soon after treatment,” said Catherine Whitehouse, M.S., a nutrition advisor for Kentucky Equine Research.

Because ESWT alters the expression of various pro- and anti-inflammatory mediators, researchers from the New Bolton Center at the University of Pennsylvania School of Veterinary Medicine proposed that measuring these mediators could identify horses that had received ESWT too close to competition.

To test this theory, blood samples were sequentially and frequently collected from 11 horses starting from seven days prior to ESWT and continuing until 21 days after treatment. Only a single session of ESWT was performed, simulating treatment of dorsal metacarpal disease (bucked shins).

Researchers found that five of the 10 inflammatory mediators tested were altered following ESWT. These included a decrease in the pro-inflammatory mediators interleukin-1β and interleukin-6, tumor necrosis factor-α, as well as an increase in interleukin 1 receptor agonist that exerts anti-inflammatory effects.

Based on these results, the researchers indicated “these mediators may represent biomarkers that could be used to develop a simple blood test to detect the illegal use of ESWT in equine athletes.”

Certain joint supplements, such as glucosamine, chondroitin sulfate, and omega-3 fatty acids, also exert anti-inflammatory effects but have no limit on their use prior to competition. Further, these products can be used prophylactically in horses to prevent the development and/or worsening of various musculoskeletal disorders prior to any injury or insult, particularly those involving joints.

“Kentucky Equine Research offers these supplement ingredients in KER-Flex and EO-3. Australian horse owners should look to Glucos-A-Flex, a blend of glucosamine hydrochloride, vitamins, minerals, and amino acids,” advised Whitehouse.

^*Chen, J.W., D. Stefanovski, J. Haughan, et al. Inflammatory mediators are potential biomarkers for extracorporeal shockwave therapy in horses. Equine Veterinary Journal. In press.