Check Ligament Injury in Horses

Posted on March 31, 2022 by Categories: Cryochaps
Cryochaps Equine Ice Wraps

The inferior check ligament is also known as the accessory ligament of the deep digital flexor tendon. It is an interesting and important soft-tissue structure in the equine athlete. The inferior check ligament runs from the carpus (knee) on the back of the leg and attaches to the DDFT approximately one-third of the way down on the third metacarpal (cannon) bone. Its function is to help the DDFT with shock absorption and prevent excessive lengthening of the tendon. This blog outlines how check ligament injury occurs, as well as how ice and compression can help treat and manage this type of injury in horses.

Causes of Check Ligament Injury in Horses

Injury to the check ligament usually occurs in the front limbs from overextension because of excessive twisting or pivoting on the leg. Injuries to the inferior check ligament do not get the same attention as other injuries, such as those to the suspensory ligament and flexor tendons. This may be because they occur less often. However, for a dressage horse an injured inferior check ligament can be performance-limiting. 


A horse who has a tear of the inferior check ligament will show a variable degree of lameness. However, if the ligament is only mildly strained or inflamed, lameness will often not be present. Careful regular examination and palpation of the back of the cannon bone, including the tendons and ligaments, will reveal a focal area of swelling laterally and/or medially in the upper third of the cannon bone. You should always have the leg examined if you notice swelling in that area. This applies even without the presence of visible lameness. 


In some cases, there is only fluid buildup or edema. In that case, you can manage the swelling with Cryochaps cooling wraps for horses and possibly box rest. This is to help avoid developing a real tear. Once you have a real tear, the horse will become lame, though the duration of lameness is variable. If the tear is severe enough, the horse will become severely lame.

Managing a horse with a torn inferior check ligament can be tricky as the ligament is short, wide and snug between the DDFT and suspensory ligament. Based on its location, a tear of the inferior check ligament can also affect both the deep and superficial digital flexor tendons in the short and long term. 

If the swelling persists after the ice and compression treatments with horse leg cooling boots, the horse should get an ultrasound done. The check ligament is structured in a way that can make it look normal although it is damaged and vice versa. In addition, it is important to compare the injured check ligament to that of the other leg to have an objective measure. 

Some vets recommend cutting the inferior check ligament to release it when there is a significant enough tear. Unfortunately, this is often unrewarding, resulting in chronic lameness.

Rehabilitating a Horse with a Check Ligament Injury

Within four to six weeks, a horse with only fluid buildup in the inferior check ligament will be fine. If you have a real tear, rehabilitation takes about six to eight months. The ligament’s condition should be monitored via ultrasound every six to eight weeks. 

Management options of tears within this ligament are similar to those in others. Options may include box rest, icing, controlled rehabilitation exercise, the use veterinary prescribed PRP (platelet rich plasma) and stem cells, shockwave and therapeutic ultrasound. These therapies allow new fibres to grow within the lesion that are as similar as possible to those prior to the injury. 

Cryochaps Cooling Wraps for Horses

Cryochaps cooling wraps for horses are ideal for helping to treat and manage tendon and ligament injuries in horses. Whether your horse has been kicked in the field, knocked himself in the stable or sustained an injury during exercise, Cryochaps cooling boots bring the power of cryotherapy to your horse. Our horse leg cooling boots can also be used as part of the post-injury rehabilitation process. Always seek veterinary help and advice.