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New ideas for tendon treatment

by Robert McDowell

I love listening to the Scientists and I had the privilege this week to hear two of Australia's foremost experts on the equine tendon, present papers to a Conference on Nov 15th.

These were Dr Katherine Gibson who is a Vet, Surgeon, Scientist and Educator and Dr Andrew Dart who is both a practicing Veterinary Surgeon and a Research Scientist with the University of Sydney. Both Katherine and Andrew impressed me as practical and caring people who were also independent thinkers and sympathetic to the alternative therapies movement.

What I learned was a great deal more about the actual mechanics of the functioning and healing processes involved in the tendon at work in the horses legs in general and in particular for the tendon at work under full load as in racing conditions.

As usual one is left in absolute awe as to the design and strength of such structures and as to the body's in-built healing mechanisms at work in age, work and stress related situations.

We learned that tendons are designed with a crimp running along the length of their fibres which is the first stage of elasticity and acts like a shock absorber to soften the buildup of tension on a tendon at the beginning of a load situation. Rather like taking up the slack before coming under load. We learned that this crimping decreases with age, and is lost in any areas of tendon, which has been over stretched and then healed.

It turns out that in full work the tendons of a Racehorse are working at very near to their design limits. That is to say there is almost no safety margin left in the tendon at full stretch. Tendons have been tested and shown to begin to fail at around 15% stretch for example in the laboratory. Tests on racehorses in full work show that they are subjected to stretch very close indeed to these absolute limits. We are not talking Endurance horses or Jumpers or even Eventers and we were not told if Pacers either are asked to perform so close to their physical limits, but that Gallopers certainly are.

We also learned how much the tendons heat up during work and the mechanics of the blood flow within them and how these blood vessels rupture when the tendons begin to fail how this causes the tendon to swell and to bow.

I was fascinated to learn that the horse's body has two stages of healing when repairing damage to tendons.

The first emergency stage is to rapidly grow links between individual strands of tendon fibres, which have been damaged, to give some emergency support almost immediately to the area after injury. Also that this cross-linking does, over time, reduce as the repair work on the longitudinal fibres proceeds during the second stage which begins around 30 days after the original injury.

However cross-linking never reduces to its original level and that many months are involved until it is minimised.

The significant conclusions that I can draw from this research are as follows;

My main disappointment I suppose, in the 'Scientific Approach', was that one of the areas of current research is trialing a substance which slows the emergency cross linking process in an attempt to bypass some of the cross linking stage. This sort of clever interventionist, big business supported, approach is where science so often lets us down. Since funding for research comes from big business it is not surprising, but really, all simple natural techniques should be exhausted in a logical and humane world, before we go to an approach like the one above.

The price to paid for this cross link interference strategy is not just big dollars but that we would have to manage the fact that the animal will be significantly weaker and prone to more severe damage early in the recuperation stage. It would involve a dramatic reduction of the animal's freedom to move during months of treatment, which would amount to cruelty in my book not to mention truly massive amounts of money to manage all this intervention.

As a Herbalist and an Engineer however, I am excited by my new knowledge and am very anxious to add to my existing Tendon and Bone treatment programs some further assistance to improve the prospects facing Gallopers simply and cheaply.

My mission as a Herbalist is to educate owners and trainers to the fact that high tech and science is a great tool to describe, to measure and to understand processes but that to go high tech automatically in search of a solution is ridiculous, expensive and restrictive.

All of the simple, traditional, humane, holistic, supportive and practical avenues should be first exhausted before resorting to expensive, high tech and dangerous approaches to all health problems in both man and beast.

My new herbal initiatives are going to be a pre-warmup cream and a post training spray along with a few management suggestions as follows.

Pre Warmup Strategy:

I will prepare a cream with extracts of Arnica, Rosemary, Maritime Pine, and Wintergreen to be lightly massaged into the legs before warm up for all training and racing sessions.

I will also suggest that neoprene type boots should be left off during warmup and heavy work and replaced if necessary, for support or for protection, with a material, which can breathe and facilitate cooling. Not being a trainer I don't know, but it seems logical to me that using such insulating non-porous materials as neoprene must severely reduce heat dissipation from ligaments under work. It seems to me that it is fine to keep the heat into the legs with such materials when not in work, but detrimental in any situation when cooling is required. It is a basic mechanical principal, as stressed by Andrew Dart in his presentation, that elastic movement in tissues or any other substance dissipates the energy by releasing heat.

The buildup of heat and the reduction of internal blood supply within the ligament while in heavy work, as explained by Katherine Gibson, compromises cooling so why would you risk further reduction in cooling by insulating the leg. Porous bandages if required for support and pads maybe to prevent knocking particular areas but nothing to trap heat.

It seems logical to me that any interference with cooling at all must push the ligaments closer to their limits and make them more prone to injury or failure.

The choice of herbs is mostly built around this premise. If we can maximise the circulation and thereby cooling within the ligament and surrounding tissues while at the same time supplying healing herbs topically and internally on a routine basis during maturity and training we can easily improve the safety margin between the design limits and demand load. Any tiny improvement will substantially reduce the damage and the cumulative 'ageing' of tendons occurring during every single training and racing session.

I am confident we can do better than tiny improvements all simply, safely and cheaply.

Post Work Strategy

I will make a concentrated extract mix which is to be mixed into water and sprayed on the horse's legs after a proper warm-down and they have been cooled by hosing down and are beginning to dry. These herbs will be carried down the hairs to the skin and form a healing residue there which will last at least until the next work session or until the legs are hosed down again when, for a racehorse in full work, the spray should be reapplied.

The herbs involved in this mixture are to be Arnica and Maritime Pine again, along with Comfrey and Equisetum. At this stage of the process of recovery and repair I am aiming to speed up and normalise all the minute and quite normal wear and tear occurring during training and athletic performance and provide topically, direct and immediate support to healing within both the bones and the ligaments.

The recommendations would include warm down, during which time the pre work treatment would be still doing its job, and then on to cooling and hosing down the legs. After hosing and before the animal was chilled the spray would be applied and the legs then allowed to dry and then covered up in cool weather.

Internal Treatments:

My basic Tendon and Bone Maturity/Healing supplement consisting of Millet, Linseed, Comfrey, Equisetum and Yarrow which is now being given to yearlings right through to breaking and racing would be continued throughout the whole racing career in the case of a valuable racer. This will continually supply the extra nutrients required to speed maturity and development and support internally all healing processes during work, strain and injury.

Pre Training and Preparation:

The same herbal and nutritional program as above would be particularly useful during pre-training programs as suggested by Andrew and Katherine to sponsor crimp development and extra strength in tendons during the later part of growth and before race training begins.

This whole area of pre-training and support for maximising the development tendon quality before maturity is a fertile area for further improving the safety margins and should be pursued by those genuinely seeking a more competitive and durable long term product in heir racers.

I will develop and trial the pre and post work applications over the next few weeks with some of my professional trainers and then make them available to all my customers. I caution you not to try experimenting with these herbs however in the meantime as I do have experience with Arnica and Wintergreen in particular and it is very easy indeed to blow a horses legs up with creams with too much of either of these two.



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