Abstract
Objective: This paper investigates the impact of a single radial extracorporeal shock wave therapy (radial ESWT) on vascularization of injured tendons and/or ligaments in horses.
Materials and Methods: Twenty-nine horses aged 5–24 years, with ligament (n = 25) or tendon (n = 4) injuries, attending participating veterinary clinics, were recruited into the study. Each horse was scanned before and after the initial radial ESWT treatment using the ultrasound Doppler function. A semi-quantitative grading scale ranging from 0 (no vascularization) to 4 (diffuse vascularization) was employed to quantify blood flow in the area. Data were analyzed using the Wilcoxon signed-rank, Kruskal–Wallis, and Mann–Whitney tests.
Results: A significant (p-value < 0.05) increase in blood supply to the tendon and ligaments as a unit was observed after a single radial ESWT treatment. However, when tendons and ligaments were assessed separately, a significant difference (p-value < 0.05) in vascularization before (Median 0.44) and after (Median 2.44) treatment was observed in ligaments, but no difference (p-value > 0.05) in vascularization before (Median 0.28) and after (Median 1.28) treatment in tendons was observed. Age and breed were significantly associated (p-value < 0.05) with changes in vascularization following a single treatment.
Conclusion: Radial ESWT enhances blood supply to treatment sites, with a more pronounced vascularization effect observed in ligaments compared to tendons. As a result, radial ESWT has the potential to promote healing of soft tissues. However, given the limited scope of this study, findings reported here should be interpreted with caution. Larger investigations are recommended to validate these findings.

Key words: Equine sports injury; blood supply; non-invasive treatment; horses; tendon and ligament injuries.