08/23/2026
Old soft tissue injuries can be frustrating to live with. Fibrotic (scar) tissue does not stretch the same way that normal ligaments and tendons do. Think of a tendon or ligament like a bungee cord made up of a bunch of small rubber bands. All of these rubber bands have approximately the same ability to stretch. Now, if a few of the rubber bands break (tear in a tendon or ligament), they are repaired with rubber cement (fibrosis). Rubber cement is strong, but not very stretchy. If that bungee is then stretched maximally, the rubber cement tears away from the normal rubber bands.
The same thing happens in tendons and ligaments. This means that every time a ligament or tendon with fibrotic tissue is maximally stretched, some degree of reinjury occurs. Pain, edema, and sometimes new tears are the result.
Horses with this type of problem are usually not consistently lame at a trot. They tend to be the horses that have a great run or performance one day, then do slightly worse the next day, and even worse the third day. Or...they are the ones that do fine right after joint injections, but seem to get bad again about 3 weeks after injection.
A standard lameness exam that focuses on watching a horse trot, then uses blocking to localize pain is not a reliable way to find these chronic sources of pain. Because this type of reinjury doesn't generally cause a consistent limp, adequate musculoskeletal palpation is the best way to localize lesions. Finding these old, problematic injuries is a crucial part of managing expectations when it comes to performance.
The suspensory ligament in the pictures has a band of fibrosis (red arrows) surrounded by edema (outlined by yellow).