Alternative Therapy

Extracorporeal Shock Wave Therapy (ESWT)

Extracorporeal Shock Wave Therapy (ESWT)

ESWT has been used for many years in human medicine to treat many orthopaedic conditions such as tennis elbow, shoulder and heel injuries etc and is now a commonly used and effective treatment in equine medicine.

Some of the conditions commonly treated using ESWT include:

  • Osteoarthritis
  • Wounds and Chronic Wound Care
  • Acupressure Points
  • Non-union or delayed-healing of Fractured Bones
  • Joints
  • Bone
  • Large Muscles
  • Tendon Injuries
  • Chronic Back Pain
  • Ligament Injuries
  • Painful Scar Tissue
  • Trigger Points
  • Connective Tissue
  • Cosmetic Applications

Specific equine pathologies that have successfully been treated with Shock Wave Therapy include:

  • Insertional desmopathies such as proximal suspensory ligament desmitis, suspensory branch desmitis, suspensory avulsion fractures, inferior check ligament desmitis, distal sesamoidean ligament desmitis, nuchal ligament, and other ligament injuries
  • Tendinopathies with & without calcification such as superficial & deep digital flexor tendon injuries, e.g. bowed tendons.
  • Metacarpal Stress Fractures & dorsal metacarpal disease such as bucked shins
  • Fractures & stress fractures of splints, coffin bone fractures
  • Tibial & humeral stress fractures, and Bone Exostosis
  • Angular Limb Deformities (ALD) in Foals
  • Sesamoiditis & Sesamoid fractures
  • Navicular Syndrome (Caudal heel pain)
  • Osteoarthritis such as pastern degenerative joint disease (DJD), Ringbone, and hock degenerative joint disease, Bone Spavin
  • Osteochondrosis lesions (OCD)
  • Soreness/Stiffness in muscles and gluts
  • Sore back problems such as dorsal spinal process, sacroiliac problems, and Kissing Spines

The shock waves are created, emitted and directed onto the injured area. When the shock waves meet different types of tissues with differing make ups (i.e. bone/soft tissue interface) changes within the tissue are created.

Biologic Effects:

  • Vasodilation and new vessel growth
  • Stem cell activation
  • Anti-inflammatory effects
  • Release of growth factors
  • Release of neurotransmitters

Clinical Effects:

  • Increases blood supply
  • Regenerates soft tissue
  • Regenerates bone
  • Reduces pain
  • Promotes faster healing

Essentially, shockwaves work by marshaling the natural healing response and can be applied safely and easily without the risk of any side effects.

The treatment can be useful in cases of chronic pain that have been unresponsive to conventional treatment and typically involves three treatments at two week intervals.


Acupuncture Case Study


This 6 year-old polo pony was presented to us with a very severe left hind lameness. She was found not weight bearing and quite distressed in the stable. After our examination and supportive treatment it was decided to refer her to the Equine Referral Hospital at the RVC for further diagnosis as we suspected a possible fracture.

After a few days in the hospital and a complete diagnostic assessment including “Bone scan??? and ultrasound examination, a rupture of the vastus medialis muscle was identified. A period of rest and anti-inflammatories was advised for some weeks.

The prognosis was fairly good but after a few weeks the owner reported a significant muscle waste above the left stifle. This atrophy was getting worse and worse and the pony was still quite lame.

The client had already been using the services of a physiotherapist but the pony was still quite sore at walk. At that stage, I recommended acupuncture and I was very pleased when the client called me back to update me after the first session. She was already moving more comfortably but still not pain free.

We noticed that the pain was reducing but the muscle waste was not. The lack of muscle above the stifle was getting so severe that the joint was losing stability and becoming also a mechanical lameness. By this time, it was obvious there was a neurological involvement during the muscle rupture. This means that the nerve was also affected and without a healthy and functioning nerve, the muscle was going to keep wasting.

I decided that this polo pony really needed some extra help in the form of electro-acupuncture as horses with nerve damage and muscle waste are the best candidate for this technique.

As a member of the Shotter&Byers team I was very proud that the partners were supportive once again considering integrative therapies as an option for restoring and preventing injuries. They purchased an Electroacupuncture machine and therefore this polo pony became my first electroacupuncture patient.

After a couple of sessions, the owner started noticing that the muscle was recovering its volume and the biomechanics of the stifle joint was improving significantly.

Currently, we are just waiting for this young polo pony to start training gradually and she will hopefully be playing this 2017 season.

In conclusion, this is one of the examples of how Acupuncture can help restore your horse´s health.

Please feel free to contact the office on 01 306 627 706 if you would like to discuss or arrange an acupuncture treatment for your horse.

Fran Tirado BVSc MRCVS CertVetACU (IVAS)





Shotter & Byers believes in the use of combined modern Western medicine and Acupunture as a traditional Chinese medicine therapy in the purpose of restoring or mantaining your horse wellbeing and health.

Francisco `Fran´ Tirado has trained in Veterinary Acupuncture since 2013 when he completed the ABVA (Association of British Veterinary Acupuncuture) foundation course and he has also completed the IVAS (International Veterinary Acupuncture Society) Certification course. He is currently a member of the ABVA.

What is Acupuncture?

Acupuncture may be defined as the insertion of needles into specific points on the body to produce a healing response. Each acupuncture point has specific actions when stimulated. This technique has been used in veterinary practice in China for three thousands years to treat many conditions. The Chinese also use acupuncture as preventative medicine.

Traditional Chinese Medicine (TCM) supports the body’s ability to heal and rebalance itself.

In western terms, scientific research has proven the merits of acupuncture for pain relief, anti-inflammatory effects, reproductive and hormonal regulation and gastrointestinal disturbances among many other effects.

What conditions can acupuncture be used for?

Most commonly acupuncture is used for enhancing performance in competition horses.

  • It is an excellent drug-free modality for relieving musculoskeletal pain:
  • Neck and Back pain
  • Sacroiliac pain
  • Myofascial pain syndrome
  • Arthritis
  • Laminitis
  • Navicular disease

Acupuncture can also be very effective for:

  •  Gastrointestinal problems (chronic diarrhoea, frequent spasmodic colics, weight     loss, inappetance).
  •  Hormone/metabolic disease
  •  Behavioral issues
  •  Respiratory problems like heaves (COPD/RAO)
  •  Head-shaking

What does the treatment look like?

The first examination and treatment can take from 45 to 90 minutes and sometimes will include an assesment at walk, trot and canter. Initially a full history will be taken, then a complete inspection of the horse including a careful palpation of diagnostic acupuncture points, examination of the tongue and pulse will take place.

After this, a diagnosis is stablished and an according strategic treatment planned.

Then, very small fine needles are placed in specific points.

Sometimes the needle can be heated with a herb called moxa (Moxibustion) or a small volume of vitamin B12 and blood or homeopathic remedies can be injected on the acupuncture points.

Most horses will accept acupunture treatment very well. Some animals will become sleepy or lethargic for a few hours post treatment. That is why we recommend to exercise the horse before the treatment and resume work on the next day.

The length and frequency of acupuncture treatments depends on the condition of the patient and the method of stimulation that is used by the veterinary acupuncturist. Usually an acute condition may require only one or two treatments, while a chronic condition may require a series of treatments over a period of 4-6 weeks.

It is not uncommon for owners to notice an immediate improvement in their animal. However, more often than not, acupuncture needs to be performed several times over the course of a few weeks in order attain the maximal benefit. At that point, your horse may need monthly or quarterly treatments or he may never need an acupuncture treatment again.

Can I combine Acupuncture with a regular visit?

Acupuncture can be combined with a regular visit, but preferably not with one that will require sedation or the use os steroids as this will decrease its efficacy.

What does it cost?

The initial session costs  £84   (incl. VAT).

Follow up sessions costs £54   (incl. VAT).

Acupuncture stimulates the body’s own healing processes.

Fran Tirado BVSc MRCVS


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