The suspensory ligament is a structure in the lower part of the front and hind limbs.

It runs from just below the knee/hock down the back of the cannon bone and branches to attach on the sesamoid bones at the back of the fetlock. The proximal portion is the upper third of the ligament.

Injury to the proximal portion of the suspensory ligament can occur because of a single overloading or traumatic event or as a result of chronic repetitive strain; with the latter most commonly seen in competition/sports horses.

Affected horses will commonly show a mild to moderate degree of lameness, however sometimes the only presenting complaint is poor performance such as, not wanting to go forwards or jump. Typically injury in the forelimbs presents as a sudden onset and in the hind limbs has a slower onset. Other signs may include pain, swelling and heat from the affected area at the back of the cannon bone.

Diagnosis of proximal suspensory injury is made using nerve blocks to localise the source of the lameness and then ultrasonography to visualise the affected area. Treatment can consist of rest and anti-inflammatories but this carries a poorer prognosis for return to athletic activity and often surgery is required; where the nerve supplying the area is removed and some of fascia surrounding the ligament is cut to release the pressure caused by swelling of the injured suspensory ligament.

Veterinary advice in NHT magazine is provided as a general guide and you should always seek your own professional advice.

Swanspool Equine & Farm Vets