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Revolutionary EqueStride Boot ~ Georgina Roberts

The key to successful tendon rehabilitation in sport horses lies in good basic understanding of how tendons work. Too often with horses we do things “the way we’ve always done them”, but now South Africa has an opportunity to be up to date with the rest of the world when it comes to diagnostics and treatments.

Local vets, teaming up with an international team, are proud to welcome the Equistride boot to our shores. This is not a fad, and it is not an experiment – the EqueStride boot has been designed by a world-renown European veterinary professor and specialist in equine orthopaedic surgery, and a Formula 1 engineer, based on a thorough understanding of how tendons need to be managed for optimal healing. There are one hundred and fifty of these carbon-fibre, custom sized, padded and specially-fitted “moonboots” in the world, and due to specific interest there are now ten available for use in SA. Combined with a cutting-edge and revolutionary system of diagnostics, moderation, and treatment, leg pathologies now have the chance to heal to pre-injury strength.

With any tendon damage, the body sends a rush of cells to fill the gaps and begin healing. These initial cells, however, are not specific cells, i.e. tendon cells, but an inferior basic skin-type cell. Vets then often use platelet replacement therapy – or increasingly the introduction of IGF (growth hormone) – to speed up the healing process. The problem is that although there is an influx of cells, these cells do not know how to behave. As with an injury to our skin, they become scar tissue in an effort for maximum strength. But scar tissue is not elastic so is considered sub-quality tissue, which leaves the tendon compromised for future sports.

Now think of human athletes – instead of confining them during a process of healing, we give them limited and controlled movement, appropriate to the level of damage. We have seen many a horse rider in a knee-brace, and this operates on the premise of a “lock” being in place so that the joint cannot extend beyond its capability while healing. As the knee strengthens up, the physiotherapist in charge will adjust the mobility to gradually allow more and more movement, and all the while the athlete maintains an appropriate level of exercise. The benefits of this are enormous: the main one being that instead of transforming into tough immobile scar tissue, the cells in the area of healing mimic the tendon / ligament cells, and adopt their properties. The tissue heals with minimal scarring, but appropriate strength and elasticity that we would expect from a leg without trauma.
With the correct monitoring it is literally as good as before, plus the athlete has not suffered atrophy of the surrounding muscle structures, which is liable to cause secondary injury, and a modicum of inherent fitness is maintained. On top of all of this, the mental wellness of the patient remains intact, instead of frustration causing them to possibly forgo correct rehab and reinjuring themselves prematurely.

The EqueStride boot is the equine equivalent, and so essential to an athlete who cannot be asked politely to “take it easy”! The tendons are attached from the back of the knee to the pedal (hoof) bone, and are thus responsible for the flexion of the foot and fetlock. Tendons become injured in hyper-extension, such as in full gallop, landing impact after a jump, or any time that the tension exceeds the current weight-bearing ability – the structure can withstand an incredible 3.5 tonnes of pressure! This is fitness- and strength-appropriate, so an unconditioned or fatigued tendon is more at risk through high-pressure work, but also in accidents. ((pictures))
This boot allows an injured (or “at risk”) tendon to stay weight-bearing while controlling motion. In other words, no more box rest! An injured horse would be fitted with the boot on its most limited setting, allowing the horse to walk, trot, and even canter while allowing only a controlled range of motion – the horse cannot move the joint in a negative way which would further injure the structure. This means that there is no muscular atrophy, no naughty frustrated horses, no scar tissue, and as a bonus it draws tendon rehabilitation time from a year down to just three months.

Already we are seeing the first success stories in SA, where incorporating the EqueStride boot has given life back to both foals and top-level show jumpers. Dr Henk Oefferens, the Dutch vet behind the importation of this technology, works in conjunction with Pretoria-based Dr Ingrid Cilliers – by using the UTC scanner, a mobile tendon scanner that is one of only fifteen in the world (this will be covered in next month’s Equilife), guesswork is removed at identifying “at risk” structures. Whereas regular sonography can pinpoint lesions (already damaged areas), the UTC scanner can monitor healing and identify possible weak points before they are injured; this is usually the point where owners insist that their horse is “off”, but there is not yet a clinical pathology. Thus, an injury could be completely avoided, but the UTC is just a diagnostic support tool – the EqueStride boot can be used safely under any therapy, incorporating the tried-and-tested concept of early exercise.

There is a tale about a woman who cuts the bottom off a chicken every time she roasts it. “Mummy, why do we do it like this?” her daughter asks. “Well because that’s how we’ve always done it,” her mother replies. But mother ponders this, and decides to ask HER mother why they cut the bottom off the chicken – “Well dear,” granny laughs, “I didn’t have a big enough roasting pan when you were growing up!”

In order for scientific advances, we need people who constantly ask “Why” and try to improve on it. When it comes to horses, we find ourselves favouring tradition over progressiveness, often to our, and our horses’, own detriment. We have an opportunity here to step our veterinary care up onto the platform of our international counterparts, increasing the work life of our equine athletes and best friends.


What Nutrients Does Your Horse Need?

With respect to weight management, balancing a horse’s diet while meeting its digestible energy requirements is extremely important. However, a horse requires other nutrients that should be considered when looking at the overall feeding program. Any good feeding program will be based on the following principles: Meets the nutrient needs for the animal, maintains a healthy digestive system, offers feeds of the highest quality.

There are several nutrients a horse requires such as water, protein, vitamins, and minerals. Specific amounts for each of these nutrients will depend largely on your horse’s weight and activity level or physiologic status (such as if an animal is growing or lactating).

Nutrient Requirements of Horses at Maintenance


Water is by far the most important nutrient, and is most often overlooked. All horses should have access to fresh, clean water at all times. Without it, colic, dehydration, and even death could result. Horses’ water requirements depend greatly on their physiologic state—as a lactating horse will require significantly more water than a horse at “maintenance.” In general, a 500 kg horse will drink approximately 30–45 liters per day. However, how much horses actually drink will largely depend on diet; for example, a horse at pasture likely won’t drink as much as a horse eating hay because the pastured horse takes in water with each blade of grass.


Protein’s main function as a nutrient is to provide the building blocks for tissues, muscle, hormones, and enzymes. With respect to equine diets, we often classify protein requirements based on quantity and quality. Quantity refers to grams of protein required in the diet. Most horse owners think in terms of percentage of protein in a given feed, but how much the horse actually gets would depend on how much of that feed it gets. (Example: Feeding 5 kg of a 10% protein diet would give a horse 500 grams of protein [5,000 grams x 0.10]; feeding 2.5 kg of a 20% protein diet would also give a horse 500 grams of protein [2,500 grams x 0.20 = 500 grams].)

Horse owners should consider the total grams of protein intake per day, not the percentage. In addition to being aware of the quantity of protein a horse is getting, being aware of the quality of the protein is equally important. Protein quality refers to the amino acid make up of a feed. Some amino acids can actually be made by the body and are not essential from a dietary standpoint. Amino acids that cannot be produced by the body, such as lysine, are considered essential and must be provided for in the diet.

A high-quality protein should provide these essential amino acids. Good-quality sources of protein include the seed meals (such as linseed or flaxseed meal) and legume (alfalfa) hays. The essential amino acid lysine is of particular importance because of its requirements for growth. Some equine feeds are relatively low in one or more of the key amino acids, with lysine being considered the first limiting amino acid (meaning that if insufficient quantities of lysine are present, the body’s protein synthesis abilities are limited ). Thus, if a horse were easily meeting its protein quantity requirements but wasn’t getting enough lysine, the diet wouldn’t be suitable.

Fats and Carbohydrates

The main nutritional property of fats and carbohydrates is their ability to generate energy through being metabolized. However, specific types of carbohydrates and fats serve additional important functions for the horse. For example, complex carbohydrates such as fiber are extremely important for digestive tract health; the microbial ecosystem is highly sensitive to an insufficiency of fiber.

Furthermore, in humans it is now recognized that some types of fats are essential parts of the diet; namely the omega fatty acid group, including , omega-3 and omega-6. These fats are important for their anti-inflammatory properties and their roles in immune function. Horses also likely benefit from these omega fatty acids and research is ongoing, though these fats are not considered essential nutrients.


Equines require several minerals to meet a variety of functional needs, including skeletal integrity and cellular communication. The macro minerals (those needed in relatively high amounts) include calcium, phosphorus, sodium, potassium, chloride, magnesium, and sulfur.

Trace minerals (those needed in relatively small amounts) include cobalt, copper, zinc, selenium, iron, iodine, etc. Horse feeds tend to be variable in many minerals, and as they are usually low in sodium and chloride (salt), it is recommended all horses be offered some kind of salt source, such as a salt block.

Another important point about minerals is the significance of several ratios among these minerals, as the amount of one mineral in the diet may affect the use of another. For example, there should always be more calcium in the diet than phosphorus, ideally in the ratio of approximately 2:1. If this ratio is imbalanced, the horse may not be able to use the calcium in its diet and may develop bone problems.

The only way to know how many minerals are present in your feeds (particularly hay and/or pasture) is to have them analyzed at a local agriculture lab. Most commercially available feeds will have minerals added in quantities to meet the needs of the type of horse the feed is designed for.


Vitamins are classified as water-soluble or fat-soluble. The fat-soluble vitamins (they can dissolve in fat) include A, D, E, and K while the water-soluble vitamins include the B complex (niacin, thiamin, etc.) and vitamin C. The horse is unique with respect to some of its vitamin requirements in that the microbes located within the large intestine have the ability to synthesize the B complex vitamins and vitamin K. The microbes do so in quantities sufficient to meet most horses’ needs such that deficiencies of these vitamins are very rare and even difficult to induce experimentally.

Horses, unlike humans (and fruit bats, primates, or guinea pigs), can synthesize their own vitamin C and therefore generally do not require it in their diet. Vitamin D, synthesized upon the skin’s exposure to sunlight, is found in good amounts in sun-cured forages. Therefore, providing you feed good-quality hay (i.e., not last year’s batch) and your horse gets some outdoor exposure, it should be getting plenty of vitamin D.

Vitamins A and E are found in variable amounts in pasture and hay, with higher amounts found in pasture during the spring months and in hay that hasn’t been stored for too long. Most of the fat-soluble vitamins will degrade over time in stored hay.