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Gifts in Action


Solving Sports Medicine's Trickiest Mysteries

By: Sacha Adorno Date: Nov 6, 2018
A client rides her horse inside New Bolton Center's Equine Performance Evaluation Facility for observation.
A client rides her horse inside New Bolton Center's Equine Performance Evaluation Facility for observation.

Penn Vet’s Dr. Elizabeth Davidson loves a good horse mystery. She and her team of equine Sports Medicine experts at New Bolton Center have solved many cases of ‘just not right’ horses, athletic animals who aren’t performing well but don’t have any obvious clinical complaints.

“These ‘mystery horses’ look fine,” said Davidson, Sports Medicine Service Chief and Associate Professor of Sports Medicine. “They eat and drink. They run around a pasture. In their stalls, they act normal. But when you ask them to do their jobs, for whatever reason they don’t do them properly or at all. Owners or trainers come to us to sort out why.”

Gathering Evidence

Like all great detectives, Davidson and her New Bolton Center peers use their highly-developed powers of observation to find clues. And assessing the horse’s gait while it’s being ridden is one of the tools they use to crack each case.

“We start by taking a detailed history and conducting a physical examination,” said Davidson. “Because the most common problem for an athletic horse that isn’t doing its job is some sort of musculoskeletal abnormality, we then go through a traditional gait assessment without a rider. Sometimes the problem is clear. But often these horses don't have an obvious lameness. What we see when we look at them without a rider is different than when we look at them with a rider.” 

After this preliminary investigation of the horse’s gait, which usually happens outside, the evaluation team moves inside to the Ilona English Equine Performance and Evaluation Facility (EPEF). 

“Many abnormalities happen when a rider rides the horse, and, for a variety of reasons, we can’t replicate them without a rider,” Davidson explained. “Watching horse and rider together allows us to get a much better visualization of how a horse responds to its rider’s direction.”

Closing the Case

Solving the “just not right” horse puzzle is much easier since Penn Vet opened the world-class EPEF nearly six years ago.

The 80-foot by 120-foot indoor arena is impervious to weather, allowing observations year-round. Natural light floods the space, and a specialized all-weather footing offers a consistent, level surface familiar to equine athletes. Inside the facility, the lead clinician can ask horse and rider to perform movements specific to the horse’s discipline, including jumping. And there is enough space for the horse to move at different paces.

The arena is also quiet, which, according to Davidson, helps with evidence gathering, hearing, for example, specific foot-flight patterns or abnormal breathing. 

This perfectly controlled environment enables New Bolton Center clinicians to effectively evaluate horses and provide more accurate diagnoses. And, at any point during a ridden gait assessment, a full array of equine sports medicine and performance specialists can be called in to consult on a case, either during diagnostic sleuthing or once the mystery has been solved and the horse moves on for treatment.

“We have imagers and neurologists, an onsite farrier, regenerative medicine capabilities, and much more,” Davidson said of the group, whose primary goal is to return a horse to peak performance and health.

Training Tomorrow’s Detectives

Students also participate in getting to the bottom of a problem. Every assessment is conducted with a senior clinician, resident, and student in the arena. Davidson sees great value in future veterinarians developing the ability to see subtle abnormalities and understand a diagnostic path when it’s not evident or straightforward.

“When a dog comes in with a sore ear, for example, there’s often a straight forward diagnostic algorithm,” said Davidson. “You ask how long the ear has been sore, if there's been drainage. You pick out your otoscope. You look in the ear. You take a swab and see if it’s fungal or bacterial. Then you treat the condition,” she said.  “Versus a horse that comes in for not doing its job where the diagnostic pathway is unclear What are the signs it’s not performing well? Is it an abnormal gait? Bucking? Rearing? Then does it have a musculoskeletal problem? If yes, do we need to do a lameness assessment? Does it have a neurologic problem? Then maybe we need to do a neurologic assessment. Does it have a respiratory problem? Then maybe we need to go down that pathway. It’s very challenging to figure out the puzzle pieces and connect them.”

Having students walk through the case with Penn Vet’s seasoned sports medicine detectives gets them thinking like investigators. They learn to follow the clues to help close the case of the mystery horse.

Dr. Elizabeth Davidson walks students through a physical evaluation.
Dr. Elizabeth Davidson walks students through a physical evaluation.

Sports Medicine at New Bolton Center

New Bolton Center's Sports Medicine clinical team is a multidisciplinary group consisting of board-certified sports medicine and rehabilitation specialists and surgeons.

This team frequently collaborates with New Bolton Center’s board-certified internists, neurologists, behavior experts, and an internationally renowned farrier all specializing in the evaluation of equine athletes.

The mission of the Sports Medicine program is evaluation, accurate diagnosis and targeted therapeutic plan to get performance horses “back on track.”

Services include:

  • Lameness evaluation
  • Pre-purchase examination
  • Poor performance examination
  • Imaging (Radiography, Ultrasonography, CT, MRI, Nuclear Scintigraphy)
  • High-speed treadmill assessment and endoscopy
  • Overground endoscopy
  • Cardiology
  • Farrier services
  • Regenerative medicine (IRAP, PRP, Stem-cell)
  • Other therapies, including shockwave, joint injections, ultrasound-guided injections, and more
  • Consultation with specialists in surgery, cardiology, internal medicine, neurology, behavior, reproductive, and ophthalmology

Learn more about our Sports Medicine service here.