Horses commonly develop wounds on the lower legs and although some heal without a problem, many are difficult to heal due to lack of blood supply and the occurrence of proud flesh. All open wounds that are not sutured heal by filling in with granulation tissue; if granulation tissue becomes excessive and grows too far out of the wound, it is called proud flesh. Wounds cannot heal with proud flesh because the skin cannot cover the wound.

One treatment that has been used in certain orthopedic conditions is extracorporeal shock wave therapy, and this treatment method was also used in a study on healing of lower leg wounds. Shock wave therapy is pulsed high energy waves that cause the release of energy in the tissues that theoretically could decrease healing time. There are many treatments used to decrease healing time in lower leg wounds but very few of them have been actually tested in controlled studies. In this study with shock wave, wounds were created on all four limbs of six horses and some of the wounds were treated with shock wave once weekly for four weeks and lightly bandaged, while others were only lightly bandaged. Results indicated that control wounds were almost twice as inflamed as wounds treated with shock wave. Also, control wounds had a significantly greater amount of proud flesh than wounds treated with shock wave. However, the size of the wound areas was not significantly different between control wounds and those treated with shock wave therapy. So even though shock wave decreased inflammation and proud flesh, it did not decrease healing time. If you have a wound on a horse's leg, use of shock wave to decrease healing time is questionable.