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Extracorporeal Shock Wave Therapy (ESWT) is a non-invasive orthopedic treatment modality that uses high pressure waves that penetrate through the skin to deeper tissues including ligaments, tendons, their attachments, bones, and joints. These shock waves have been shown to stimulate new cell growth, improve circulation, reduce inflammation and pain while promoting healing. Common uses that have been proven successful include bowed tendons, suspensory ligament injuries, and osteoarthritis. The procedure can be done in the clinic or in the field. The horse will be lightly sedated, and transmission gel will be applied to the horse’s skin. The number of treatments and the interval at which these treatments are performed will be determined by the degree of injury.