Conservative treatments for musculus interosseus medius injury

The suspensory ligament (musculus interosseous medius) can be divided into three areas that are subject to injury: the proximal part, the body and the branches and may or may not involve the bone at the origin/insertion and/or the fetlock joint. The basis of conservative treatment for any of these areas will be a controlled exercise regime, but the duration of the rehabilitation program, the potential additional treatments and the prognosis will vary significantly.

Connective tissue adapt their appearance and composition to match functional demands and collagen type, cross linking and proteoglycan type and content can all be affected by the type and amount of stress applied to the tissue. Controlled mobilisation is a major part of conservative treatment of suspensory ligament injury as research has shown there to be significantly improved strength, better overall healing, improved orientation and organisation of the collagen fibres and extracellular matrix synthesis compared to box rest alone (‘form follows function’). Little equine literature is available¹ , therefore most of these recommendations are based on common sense and human literature which shows controlled exercise results in better healing of tissues² and is an effective treatment for musculoskeletal disorders³ . The degree of controlled exercise should be adjusted to the stage of tissue healing and regular evaluation (every 6–8 weeks) should be performed both clinically and through advanced imaging modalities to ensure adequate progress. The programme can then be adapted accordingly. In general, an acute injury (week 1) requires complete box rest and additional treatments to reduce inflammation might be required. In the proliferative stage of healing (week 2–3) immature connective tissue is produced, which is fragile and prone for re-injury. [...]