Does my horse need physiotherapy and key signs you shouldn’t ignore:
Back pain is a common presentation in the equine community and is usually the most common reason referral to veterinary physiotherapy, however often it is the most glaring symptom from other issues, such as poor core engagement, lack of thoracic sling activation, hamstring or neck tension, the list is endless.
So where can you start looking? There are often subtle health signals that can suggest your horse may benefit from early intervention from an equine physiotherapist who looks at the horse not just the back:
• Behavioural change: demeanour change, pinned ears, biting during saddling/mounting, general reluctance to work, new aggression towards other horses or people.
• Gait/movement changes: shortened stride length, tripping, toe dragging, stiffness, difficulty with transitions.
• Ridden resistance: bucking, difficulty with a consistent contact, change in gait without rider instructions
Research shows the face can show many signs of pain: The equine pain face (Gleerup et al., 2015)
• ‘Low’ and/or ‘asymmetrical’ ears
• Angled eye appearance
• Withdrawn/ tense stare
• Dilated nostrils
• Tension of the lips, chin and facial muscles
Whilst symptoms of pain in the ridden horse can include (Dyson, 2022):
• Head and ears: Repeated head position changes, head shaking, head behind or in front of the vertical/ Ears rotated back
• Eyes: closed for 2-5 seconds/ frequent blinking/ Sclera exposed/ Intense stare for greater than 5 seconds
• Mouth: opening repeatedly/ Tongue exposed/ Bit pulled through mouth repeatedly
• Tail: clamped held to one side or swishing repeatedly
• Gait: Rushed or slow gait/ Hindlimbs deviate from tracks of the forelimb/ Repeated canter leg changes/ Stumbles and trips more than once/ Sudden gait changes and direction changes against rider instruction/ Bucking/kicking out/ Reluctance to move forwards
• Tacking up: Biting/ ears pinned/ kicking out while tacking up
Remember horses are prey animals; this mean they hide their pain to protect themselves from vulnerability. This means as equestrians be it owners, riders, coaches, veterinary physiotherapists, grooms and all other professionals in the field we sometimes need to look a little harder to keep our horse in top conditions and keep them happy, healthy and pain free.
Equine physiotherapy takes a holistic whole horse approach considering in depth biomechanical knowledge to help restore mobility, relieve pain, improve global biomechanics and improving performance. Physiotherapy not only reduces areas of tension to allow the horse to move more fluidly and transfer propulsion and power more effectively, but we can also use our knowledge to produce rehabilitation or strengthening plans to help your horse heal and perform their bests.
Why is it so important to spot these early signs and prevent them from occurring at all?
Pain causes compensations, often even before a pathology is diagnosed the compensation patterns have already occurred, this can cause secondary injuries. This is why investing in evidence based equine care can help reduce firstly the risk of injury and secondarily improve the rate of healing following injury (Dianm, 2026).
Why can physiotherapy be useful for healthy horses? To maintain the horses condition, promote strengthening, improve performance and help to reduce the risks of future injury.
Why does pre-injury fitness matter?
• Better circulation = better healing rates
• Muscular compensations – the body is ready to take on this extra strain
• Slower muscle atrophy
• Stronger support system
• May have Higher mental resilience
Remember at Chandler’s Veterinary Physiotherapy we work strictly in accordance with the Veterinary Surgeons Act 1966 & Veterinary Surgeons (Exemptions) Order 2015. We do not diagnose and cannot treat lame animals unless we have a veterinary referral. We love to work closely with your vet and other paraprofessionals to ensure the best treatment for your horses.
You know your animals best, don’t hesitate to get in contact with us if you feel a subtle change, want the best start for your youngster and want to know some exercises to help protect them and remember to consider routine check-ups because sometimes a fresh pair of eyes can really help
Book in with Chandler’s Veterinary Physiotherapy today. If you are out of our area, remember to ensure you veterinary physiotherapist is fully insured, qualified and registered with an appropriate registering body to ensure they use science backed current knowledge such as NAVP (national association of veterinary physiotherapists)/ RAMP (register of animal musculoskeletal practitioners)/IRVAP (Institute of Registered Veterinary and Animal Physiotherapists)/AHPR (animal health professional register).
Some useful reads (scientific)
DIANM, D.M.I., DC, MAS (2026) ‘Exercise as Medicine: How Movement Reduces Inflammation and Promotes Healing’, Kynetex, 21 January. Available at: https://kynetex.com/exercise-as-medicine-how-movement-reduces-inflammation-and-promotes-healing/ (Accessed: 7 September 2026).
Dyson, S. (2022) ‘The Ridden Horse Pain Ethogram’, Equine Veterinary Education, 34(7), pp. 372–380. Available at: https://doi.org/10.1111/eve.13468.
Gleerup, K.B., Forkman, B., Lindegaard, C. and Andersen, P.H. (2015) ‘An equine pain face’, Veterinary Anaesthesia and Analgesia, 42(1), pp. 103–114. Available at: https://doi.org/10.1111/vaa.12212.
Participation, E. (no date) Veterinary Surgeons Act 1966. Available at: https://www.legislation.gov.uk/ukpga/1966/36 (Accessed: 8 September 2026).
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