By Eve van den Bol From Cayman islands Equestrian Federation

RVC Rehab Services, Dr. Samantha Dorman of the Cayman Islands Agriculture Department, and Dr. Dan Carter, a veterinarian from the US who specializes in the equine lameness, were recently brought together by the Cayman Islands Equestrian Federation (CIEF) to provide cutting-edge rehabilitation therapies to valuable sport horses in the Cayman Islands. Thanks to the team, the horses are on their way to recovery. While each received tailor-made treatments and rehab plans based on their specific injuries, Dr. Carter was insistent that all three horses needed shockwave therapy to ensure their return to competition.

Shockwave Therapy, also known as ESWT (extra-corporeal shock wave therapy), is a relatively recent technology that uses shockwaves to treat chronic musculoskeletal conditions, particularly those involving injuries where connective tissues attach to bone. A shockwave is an intense, short wave of energy that travels faster than the speed of sound. Shockwave therapy works by stimulating certain components within the body to enhance healing and is even able to accomplish this in chronic cases when the injury has not healed on its own. When the shockwave is focused on injured tissue, it produces pressure and force that has been shown to increase cell membrane permeability, which, in turn, improves circulation to the damaged tissue and promotes healing. More specifically, these pressure waves temporarily decrease blood flow and then cause a reflexive increase in blood flow that is particularly beneficial in areas such as tendons and ligaments that are poorly vascularized. The relief in pain experienced by patients receiving shockwave therapy results from both decreased inflammation and decreased conduction of sensory pain receptors. Shockwaves also help to break down calcification that can occur in soft tissue. This calcification is often the source of chronic pain in old injuries.

Common uses of shockwave therapy in humans include treatment of tennis elbow, rotator cuff injuries, and plantar fasciitis. However, it can be used to treat a wide variety of connective tissue injuries. It also encourages bone healing and is useful for treating stress fractures, as well as slow or non-healing bone. What makes shockwave therapy unique is that it seems to work best when an injury has reached the chronic, non-healing state.

RVC Rehab Services, located at the Chrissie Tomlinson Hospital is the only provider of shockwave therapy in the Cayman Islands, as the equipment is rather expensive. When contacted by a representative of the CIEF, which coordinates visits by equine veterinarians to the island, Jacqui Smith, owner of RVC Rehab Services, was eager to help. Fortunately RVC Rehab Services had recently purchased a new state-of-the-art shockwave machine, and were able to loan their older machine to the CIEF for use on site at the two major horse stables on island. Tenson Edmonds, a physiotherapist with RVC Rehab, was assigned as the RVC point person, as he has a keen interest in sports medicine and is well-versed in the use of shockwave therapy.

Trained by Dr. Carter, Dr. Dorman of the CI Agriculture Department, has been providing the therapy to her equine patients on a specified schedule, usually on a weekly, or bi-monthly basis for each horse. “It’s a game changer in terms of these horses’ recovery,” says Dr. Carter. “While shockwave therapy won’t speed healing, it greatly enhances the quality of the healing to the point where it’s possible to get 95%+ return to normal, versus 60% – 75% with conventional therapies. In a sport horse, this can make a huge difference in its ability to return to high levels of competition, and greatly minimizes the chances of re-injury.” The sentiment is echoed by Edmonds, “The benefits of shockwave therapy apply to both humans and horses, it’s just a matter of understanding the physiology. Shockwave therapy is an invaluable tool we have at RVC Rehab Services for placing our clients on the road to recovery and we were happy to help.”

With this recent experience, Edmonds, who is also a certified instructor in kinesio taping, is planning to take a course on its application in sport horses, and is excited to expand his client base from the two-legged to the four.

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