Dr. Marcos Würschmidt: "EPI is the latest technique to treat acute and chronic tendon injuries".

Dr. Marcos Würschmidt: "EPI is the latest technique to treat acute and chronic tendon injuries".

Electrolysis percutaneous intratissue (EPI), a widely used technique in human sports medicine, it is making its way into the world of equines. The pr-axis confirms its efficacy in the treatment of tendinitis, desmitis and muscular injuries in sport horses.  The treatment of tendinopathies and desmopathies is a clinical challenge that some authors describe as one of the greatest problems in equine sports medicine. Tendon and ligament injuries are usually present with localized heat, inflammation, tenderness, lameness, etc.

Chronic tenopathies represent a very high percentage of the incidence of injuries in sport horses. The edema of the peritendon that is observed in MRI tendinitis is not typical of an inflammatory fluid but rather of the degradation of the collagen tissue of the tendon, that is to say of a “tendinosis” with a high incidence in jumping horses. "Tendinosis" is the degradation of the tendon in the absence of an inflammatory response, and the chronicity of many tendon processes is not due to chronic inflammation (tendin-itis) but to a degenerative process of the tendon (tendin-osis); Thus, it can be understood why many tendinitis are not solved by applying a hypothetically correct treatment with anti-inflammatory drugs, simply because it is not the appropriate treatment.

For its treatment, EPI, combined with a rehabilitation program, offers excellent results in terms of clinical and functional improvement, in a short period of time. It is a minimally invasive technique that consists in the application of a high intensity galvanic current through an ultrasound-guided acupuncture needle, until reaching the exact point of the injury to stimulate a local inflammatory process in the soft tissue. This makes reabsorption possible and repair of the affected tissue.

Treatment with EPI causes an organic reaction with dissociation of water, salts and amino acids from the extracellular matrix, creating new molecules through ionic instability that produces localized acute inflammation, exclusively in the area of treatment . All this leads to the rapid regeneration of the injured tendon or ligament in horses.

The technique has broad scientific support in terms of its effectiveness and with respect to the physiological process that seeks to provoke a non-inflammatory, electrochemical thermal reaction, using a current flow directed directly towards the injury of the muscle, tendon or ligament. Galvanic electricity aggression triggers the repair and phagocytosis processes that will resolve the injury, and seeks to modify the structure of the treated tissue and return it to a functional framework.

The objective and scientific contribution that EPI makes through the use of the ultrasound device is that it guarantees accurate diagnosis and meticulous follow-up of the lesion, as well as the gain of precision in placing the current exactly where it is needed. In this way, the horse's own chronic injuries have a new treatment option, especially in those more degenerative injuries, since its effect on the tissue structure is the key to its benefits in the medium and long term.

This technique affects the mediators of inflammation in the damaged muscle tissue and influences the new vascularization of the injured area. The diagnosis of all these lesions in horses is based on the clinical examination and an ultrasound study with a linear probe (6-15MHz). The use of anti-inflammatories or corticosteroids is restricted during percutaneous electrolysis treatment. "The results showed that EPI represents a useful new therapy for the treatment of muscle injuries in horses, " says Dr. Marcos Würschmidt, owner of Sport Horses Vet at Opglabeek in Belgium, in Equnews, where he has successfully applied this technique.

1. Applied to sports horses, EPI proves its efficacy in the treatment of tendonitis, desmitis and muscle injuries.

2. Very small diameter needles and a modified electric scalpel are used to transmit the current to the treatment area.

3. It is a minimally invasive technique, which involves the application of a high intensity

Treatment protocol

Before treatment, a full ultrasonic inspection is performed with a linear probe to determine the exact spot, severity, and wich phase it is in, and size of the lesion. In addition, through ultrasound, medical details such as neovascularization and scar tissue, among others, are evaluated, which are very important when defining the PPE treatment methodology that varies for each particular case. Preparation of the horse requires cleaning of the skin with isopropyl alcohol before puncture, despite the bacteriostatic action of the device. Subsequently, ultrasound-guided punctures are performed with the device to obtain a controlled debridement of the injured ligament or tendon. Debridement is evaluated with ultrasound images.

The EPI technique produces an adjustable galvanic current through a negative flow cathode electrode. Very small diameter needles and a modified electric scalpel are used to transmit the current to the treatment area. The intensity can be adjusted by changing both the duration and the milliamps delivered.

Treatment consists of three to five EPI sessions every 10 or 15 days, combined with specific rehabilitation training, depending on the type of injury and the type and level of work of each horse.


Dr. Marcos Würschmidt tells us that “the average duration of the injury and the pain symptoms before this technique were of considerable time, even more than a year in some horses, but the treatment with EPI reduces these times by half, or even less. ", he decrees." Reducing the risk of recurrence of injuries "and highlights that during the treatment or monitoring of horses treated with EPI that we have done so far in Sporthorses.vet in no case adverse effects occurred.

Dr. Marcos Würschmidt's experience with EPI at Sporthorses.vet dates back to 2013 and his satisfaction with the application of this human medicine technique to veterinary medicine in sport horses for the treatment of tenopathy and desmopathy is complete."The electrolysis has given rise to a notable improvement that, depending on the case, allows the resumption of sporting activity in a short recovery period and allowing the horses to return to the same level in their sporting activity", he concludes