Two 9-year-old warmblood jumpers came in Monday with proximal suspensory fiber disruption (ultrasound grade 1A) after a schooling show on baked footing; mild lameness on the circle and palpation reactive. Planning 2–3 weeks of reduced loading, ESWT weekly x3, isometric strengthening and minor foot balance adjustments, then a graded return — any colleagues have outcomes comparing ESWT alone versus ESWT + PRP in similar low-grade cases?
I’ve had a couple of grade‑1A hind suspensories after baked footing do best when I swapped the first two weeks of isometrics for power-walk straight lines (add a gentle hill if you’ve got it) and a tiny 2–3 mm heel lift, then weaned it by week 4. I hold circles until they can trot 10–12 min straight without palpation reactivity — ‘no circles till they’re boringly normal’ — and a quick re-scan at about 3 weeks has caught the odd one that needed a fourth ESWT; are yours hind or fore?
I pair your “ESWT weekly x3” with 3–5 mm heel lifts; wean after 14 days; hold off circles.
Baked footing gets me every summer, . For grade‑1A suspensory, I’ve had smoother returns when I swap your first week of isometrics for 5–7 days of straight‑line hand‑walk on forgiving footing plus cold‑compression 15–20 min BID, then re‑scan around day 21 before adding any trot or small circles. Minor foot balance is great, but I’d prioritize quicker breakover rather than lifting heels; if they’re still palpation‑reactive after the second ESWT, I’d stretch the reduced loading another week per @b_washington22’s “hold off circles” point.