Why your clients' rehab fails (and how you can fix it)

It’s a story we all hear too often:

“My horse had a (insert soft tissue) injury 12 months ago. We did the box rest, followed the walking and return to riding plan, everything looked good… then I brought him back into work and he’s lame again.”

Sound familiar?
​
Despite good intentions, many equine rehab plans fall short. This is not necessarily because they’re wrong, but because they’re incomplete. Here's how we can do better.

The Real Problem: Lack of Structure and Individualisation
Many rehab journeys follow the same loose structure:

• Box rest
• ​Graduated walking and trotting program
• Scans look clear
• ​Owner told to gradually return to full work
• Re-injury ?

In theory this should work, so why does it so often fail? It's because it's missing structured progression, exercise specificity, measurable outcomes, and individualisation to the horse in front of you. What works on paper doesn’t always work in practice, especially when owner time or experience constraints, co-morbidities, and horse behaviour are involved.

There Is No “Recipe”
Rehab isn’t prescriptive by injury type. A superficial SDFT disruption in a 20 year old low-level pleasure horse requires a completely different approach than the same injury in a young high-level showjumper.

Each plan needs to consider:

• The horse’s job and functional demands
• ​Owner capacity (time, skill, environment)
• Response to previous training loads
• Comorbidities or past compensation patterns
• ​Baseline strength and symmetry
  
  

Think of Exercise like Medication
It helps to reframe exercise prescription in a similar way to medication dosing:

• Too little = no tissue adaptation, delayed healing 
• Too much = overload to tissues, risk of re-injury
• ​Just right = positive adaptation (i.e. things get better!)

If we can get more precise about exercise dosage — frequency, intensity, type, time, and progression, we can move away from “one-size-fits-most” protocols and start getting better results for our clients and their horses.

Practice What You Preach
As rehab professionals, we need to lead the process, this means actually showing our clients what to do, not just giving a handout and hoping for the best! That means:

• Completing the program with the horse and handler during consults
• ​Teaching correct execution of exercises
• Tracking meaningful, objective markers
• ​Adjusting programs based on the horse's response, not a calendar
  
  

Rehab isn’t linear. But with structure, strategy, and data-driven decisions, we can significantly reduce the re-injury cycle and give our clients a better shot at long-term soundness.

If you want to improve how you deliver your exercise programs, check out our software, EQ Active.

If you want to learn more about how to best structure and design rehab programs, we've created some resources to help. These include our popular book, and webinar series.