What is shockwave therapy?
Extracorporeal Shock Wave Technology (ESWT) uses a specialized machine to provide a high-energy, focused pressure wave to a specific location on the body. This results in several biological changes in the tissues being treated. It stimulates the release of proteins associated with the healing process, as well as regulating inflammation and providing analgesia (pain relief).
Shockwave is frequently used to address injuries of muscle, tendon, ligament, and bone. It can also be beneficial in alleviating chronic pain in areas such as the back or poll. Wounds that are very large or slow to heal can also benefit from shockwave therapy.
Patient history
Coco in December 2018, several days after initial injury
Coco, a 20 year old thoroughbred mare, presented for evaluation of ongoing head tossing when bridled and resistance to pressure over her nose. Three months prior to examination, Coco was likely kicked by a pasture mate and suffered a small fracture of her frontal bone on the right side of her skull.
Patient evaluation
Upon examination, Coco was mildly painful and reactive to downward pressure over her nose (where a noseband from a halter or bridle might sit), as well as pressure over a swelling on the right side of her skull. Radiographs of this region revealed a bony callus (thickened bone that is part of the normal fracture healing process) on either side of a small frontal bone fracture. Unfortunately, a radiolucent (dark) line remained present at the fracture site, indicating that the fractured bone in this location may not have entirely healed. This slight bony instability could explain Coco’s ongoing discomfort when haltered or bridled.
Radiograph demonstrating incomplete fracture healing prior to shockwave therapy, three months after injury.
Treatment
Shockwave therapy was initiated to help stimulate continued healing of Coco’s fracture and alleviate her discomfort. Three treatments were performed at one- to two-week intervals. She was sedated lightly prior to each treatment.
Results
Coco responded very well to shockwave therapy, becoming significantly less reactive to pressure over her nose and fracture site. Follow-up radiographs were consistent with ongoing fracture healing, with the bony callus becoming slightly smoother and the fracture line becoming less distinct.
Radiograph demonstrating ongoing healing of fracture following three shockwave treatments, taken one month after previous radiograph
Coco has since made a full return to her career as a polo pony. Her riders report that her disposition is as fiery as ever!
Coco in August 2019, nine months after initial injury
