Hot and Cold Therapies for Horses

Updated March 29, 2024 | By: Andris J. Kaneps, DVM, PhD, DACVS, DACVSR

A building block of almost all other therapeutic treatments is the use of either hot or cold temperatures, called thermal therapy. Thermal therapies, each through different methods, limit tissue damage and improve or speed up healing. The goal is to restore the affected area to full function.

Hot and cold options are generally very accessible in barns by simply turning up the temperature on the water hose or by using ice.

Cold Therapy for Horses

Cold therapy is one of the safest ways to relieve the aches and pains of hardworking equine athletes. Cold therapy (cryotherapy) is most effective during the acute stage – the first one to three days after an injury or surgery—and as a recovery treatment after intense work.

Treatments with cold temperatures reduce the sensation of pain (analgesic) and decrease local circulation by constricting blood vessels. The cool temperatures within treated tissues result in lower levels of inflammation and swelling.

Cold therapy has been shown to be one of the most effective ways to prevent or treat laminitis. Another benefit of cold therapy is the rebound increase in blood circulation that follows treatment. Think of the pangs you feel in your very cold fingers in the wintertime as they warm up. The shift from reduced to increased blood flow has significant benefits for the reduction of swelling and enhanced healing.

Benefits of Cold Therapy for Horses

• Reduces edema (swelling) and pain
• Slows the inflammatory response to prevent secondary damage
• Decreases local circulation (blood flow at/around the treated area)
• Reduces cellular metabolism

How to Use Cold Therapy on Horses

• Cold hosing (hydrotherapy)
• Although this is the most accessible cold therapy, most water sources aren’t cold enough to provide optimal effects
• Immersion of the hoof or leg in an ice water-filled bucket or large plastic bag
• Cold compression boots and wraps

Examples of Cold Therapy from the Barn

• Cold hosing the horse’s legs after training sessions to aid in recovery
• Regular icing sessions incorporated into a rehabilitation program
• Immersing the horse’s foot in an ice bath to prevent or reduce the severity of acute laminitis
• Using cold/compression boots to treat limb swelling or lymphangitis

Heat Therapy for Horses

Chronic or long-term injuries are best suited for heat therapy. These injuries have passed the acute stage, typically 72 hours to a week after an injury.

Hot therapies are used to help promote the body’s natural healing mechanisms. When heat therapies are applied to the skin, it causes blood vessels to dilate. This vasodilation increases blood flow to the injured or affected area.

Enhanced circulation allows for more oxygen and nutrients to reach the damaged cells and cellular metabolism is increased, therefore promoting healing. Excess fluid and cellular waste buildup can also be flushed out with the increase in blood flow.

Pain is lessened not only by the direct action of heat on pain receptors, but also by interrupting the pain-spasm-pain cycle. This makes heat therapy especially useful for muscle issues. Using warm temperatures helps to relax muscles and enhances the tissue’s ability to stretch (also referred to as tissue extensibility), which is why it is recommended athletes stretch once they’re warmed up and blood is flowing.

Benefits of Heat Therapy for Horses

• Increases circulation and metabolic activity at the cellular level
• Increases tissue elasticity
• May enhance the mobility of joints and tendons
• Pain relief and relaxation
• Reduces muscle spasms

How to Use Hot Therapy on Horses

• Warm water hosing (another form of hydrotherapy)
• Warm blankets
• Hot packs
• Leg sweat wrap

Examples of Heat Therapy from the Barn

• Wound healing
• Tendon or muscular injuries
• To relax a horse’s muscles before riding

Differences Between Hot and Cold Therapies for Horses

You should always ask your veterinarian for advice before using hot or cold therapies. General differences between hot and cold therapies include:

• Cold – Used during the acute phase of an injury (first 72 hours), post-surgery, or when rehabbing an injury. Use cold therapy when you want to keep swelling down, help with pain relief, and make the horse more comfortable.
• Heat – Used for chronic or long-term injuries. Heat opens up the blood vessels and gets the blood flowing to improve healing. You can use heat to ease muscle tightness as it helps the tissue relax.

Cold and Hot Timing and Temperature Protocols

The goal of cold therapy is to cool the tissue below 66° F to achieve the most benefits. Ice mixed with water cannot drop below 32°, so frostbite is not a concern. In fact, immersion in ice water has been found to be the most effective form of cold therapy. Researchers have used ice water immersion in laminitis studies for 48 hours continuously without damaging tissues. Remember that horses can safely stand in the snow all day without issues.

For hot therapies, the goal is to warm the tissue between 104° to 113° F, being careful not to go above that threshold as too hot can be painful and damage tissue. The rule of thumb is to only apply water, soaked cloths, or hot packs that you can comfortably tolerate with your bare hand. If it’s too hot for your skin, it’s too hot for your horse and could burn him.

Starting cold therapy as soon as it’s indicated will lead to the best results. For most conditions, veterinarians recommend using hot and cold therapies, like ice, on a horse in 20-minute intervals 2-4 times a day.

Using Compression for Hot and Cold Therapies

Compression therapy is a technique we are all familiar with – as simple as applying a bandage on a limb. The use of controlled, gentle pressure on the outside of the body can reduce swelling and provides some support.

The wrap on a leg warms the tissue, thereby increasing circulation. The pressure distributes excess tissue fluid (such as in a ‘stocked up’ limb) allowing the body to reabsorb the fluid more easily.