Returning to Exercise After Laminitis

Key Message

Exercise is an important part of recovery, particularly for horses with EMS.

After laminitis, exercise needs to be introduced slowly and according to the horse's comfort and hoof recovery. Start with voluntary movement, progress to short periods of hand walking, and only increase the workload when the horse remains completely comfortable.

At a Glance

• Never force a painful laminitic horse to exercise.
• Begin with voluntary movement in a small area once the horse is comfortable.
• Progress to short hand walks, initially around 2 to 5 minutes.
• Use a soft, level surface and hoof protection where needed.
• Straight lines are preferable during early rehabilitation.
• The horse should finish exercise moving as well as, or better than, when it started.
• Increase duration gradually rather than increasing speed or difficulty.
• If comfort deteriorates, stop and return to the previous level.
• Avoid lunging, tight circles and other work that places large forces on the recovering hoof.
• Mounted exercise should wait until there is strong, well connected hoof growth.
• Consider repeat radiographs before returning to ridden work.

The Full Lesson

When can movement begin?

The first step back towards exercise is simply allowing the horse to move voluntarily.
Once the horse is comfortable, off pain medication and willing to move, ECIR recommends allowing access to a small area where the horse can wander at its own pace. Hay and water can be placed in different locations to gently encourage movement without forcing it.

At this stage, watch how the horse moves rather than how far it travels.

Start with very short hand walks

Once the horse is comfortably moving around its turnout area, ECIR suggests beginning with 2 to 5 minutes of hand walking each day, ideally in boots on a soft surface.

Look for:
• Willingness to move
• A relaxed, preferably heel first landing
• An even stride
• Comfortable tracking up
• Relaxed movement through the body
• A comfortable expression

Most importantly, the horse should finish the walk moving at least as comfortably as it did at the beginning.

If it doesn't, you have asked for too much.
Build slowly
There is no need to rush.

Gradually increase the length of the hand walks while continuing to monitor the horse's movement and comfort.

ECIR describes building towards a brisk 30 minute hand walk before the work really begins to qualify as meaningful metabolic exercise.

The early walks are therefore less about fitness and more about restoring normal movement and gradually increasing what the feet can comfortably tolerate.

Let the horse tell you when to progress

A useful principle throughout the return to exercise is:

The horse should remain comfortable and steadily improve.

If the horse becomes less willing to move, develops a shorter stride, begins landing differently or becomes less comfortable during or after exercise, reduce the workload and reassess.

Do not increase exercise simply because a certain number of days or weeks has passed.

Progress according to the horse.

Avoid circles in the early stage.

Straight lines are preferable during early rehabilitation.

Be specifically cautious with lunging and circle work because turning places considerably greater forces on the hoof wall, which may still have a compromised laminar connection.

For that reason, lunging, tight circles and round pen work should not be part of the early return to exercise.

When can I ride again?

Mounted work should not begin simply because the horse appears sound.

ECIR recommends waiting until the hoof wall has grown down with a strong, tight connection to nearly the ground. Repeat radiographs can be useful before beginning mounted work to assess the internal structures and hoof alignment.

Depending on the severity of the original laminitis, this can take many months.

Some ECIR guidance is deliberately very conservative, with at least six months after the laminitic episode has resolved, and preferably closer to a complete hoof growth cycle, before returning to ridden work.

The important point is that the decision should be based on hoof recovery, not simply the absence of obvious lameness.

Returning to ridden work

When the horse is ready for mounted exercise, ECIR recommends starting simply.

Begin with approximately 10 to 15 minutes of walking, preferably in straight lines on a soft surface, with appropriate hoof protection where needed.

Gradually increase the duration of walking.

Once the horse can comfortably walk for around 30 minutes, trot work can begin gradually.

Canter and more demanding work should come later, once normal hoof growth and strength have returned.

What if the horse isn't ready to be ridden?

There are other ways to gradually increase activity without putting a rider's weight on the recovering feet.

The ECIR material suggests options such as:
• Long lining
• Driving
• Ponying from another horse

These can help increase the intensity of exercise while delaying ridden work where appropriate.

Why exercise matters for the metabolic horse

Once the horse is physically ready, exercise becomes particularly valuable for horses with EMS.

Exercise increases glucose uptake by muscle and improves insulin sensitivity. Dr Eleanor Kellon's 2017 NO Laminitis! presentation describes exercise as the best insulin resistance "buster" available, with measurable improvements in insulin sensitivity continuing after exercise.

So the goal is eventually to move beyond rehabilitation walking and establish regular, meaningful exercise.

The Most Important Thing to Remember

Don't exercise according to the calendar. Exercise according to the horse.

Start with voluntary movement.

Progress to a few minutes of hand walking.

Gradually increase duration.

Delay circles and demanding work.

Return to ridden exercise only when the hoof has regained sufficient strength and connection.

And throughout the process, use the same simple test:

Is my horse still moving as comfortably at the end as it was at the beginning?

If the answer is no, go back a step.

Slow, steady progression gives the recovering hoof time to adapt while eventually allowing exercise to become one of the most valuable tools for maintaining the metabolic horse long term.