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Castration is the most commonly performed surgical procedure in equine practice. It is also one of the most routinely dismissed when it comes to long-term consequences. The scar heals, the horse goes back to work, and the surgical site is rarely examined again. Yet equine osteopaths have long observed that geldings sometimes present with unexplained movement asymmetries, hindlimb stiffness, and pelvic dysfunction that conventional diagnostics cannot explain — and that often improve when the castration site is addressed. Pauline Bürgermeister decided to put that clinical intuition to the test.

This thesis presents an original study of 25 geldings — a mix of Standardbred trotters and riding school horses — in which castration scars were systematically assessed for five clinical signs: depression of the scar tissue, fibrotic scarring, pain on palpation, discharge, and oedema. Gait asymmetry was evaluated using Sleip AI, a validated markerless motion analysis system, capturing head, pelvic, and total asymmetry scores. The results are striking.

The composite clinical score showed a strong positive correlation with pelvic asymmetry (ρ = 0.71, p < 0.001) and a moderate correlation with total asymmetry (ρ = 0.53, p = 0.007). Tissue depression, fibrotic scarring, and oedema were the most influential individual signs. Pain alone did not reach significance — suggesting that the most clinically relevant changes are structural and chronic rather than acutely painful. Discharge appeared to dilute the composite score, highlighting the importance of weighting variables appropriately in future work.

The thesis contextualises these findings within osteopathic anatomy, examining how fascial restriction, impaired lymphatic drainage, and the well-documented formation of neuromas in spermatic cord remnants might mechanically and neurologically contribute to pelvic dysfunction. The study is honest about its limitations — small sample, no blinded assessment, heterogeneous population — and frames its findings as a call to action rather than a conclusion. For any practitioner encountering unexplained hindlimb asymmetry in a gelding, this work offers a compelling reason to look further down the leg.

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The demands placed on an elite sport horse are extraordinary. Whether jumping combinations at speed, performing collected dressage movements, or racing under load, these animals are required to operate at the edge of their physical capacity — often day after day, season after season. It is no surprise that managing their health requires more than a single discipline. Josephine Jansen’s thesis makes a careful and well-supported argument for why Osteopathic Manual Therapy should occupy a central role in that broader care picture.

Jansen opens with a clear articulation of what osteopathic treatment actually means in the equine context — not symptom management, but whole-body assessment aimed at identifying the primary cause of dysfunction and restoring homeostasis. She draws on Still’s founding principles to frame OAB (Osteopathic Articular Balancing) not as a technique in isolation, but as a neurophysiological intervention: one that alters signals within the central nervous system, influences sensory processing, and can interrupt chronic pain cycles that persist long after the clinical signs of injury have resolved. The concept of ‘traumatic muscle memory’ — neural activity that continues reverberating in the CNS even when tissue has healed — is introduced with precision and practical relevance.

Two significant studies form the evidentiary backbone of Jansen’s argument. A French study of 26 sport horses found measurable improvements in propulsion, symmetry, and regularity of gait following a single osteopathic treatment, with younger horses showing the most immediate response and older horses benefiting from repeated sessions. A larger study by Thoresen, examining 374 horses with suspected sacroiliac, hip, and back dysfunction, found positive outcomes in approximately 80% of cases — including horses that had not responded to intra-articular injections.

The final section on integrative medicine is where the thesis becomes most forward-looking. Jansen draws on research from equine sports medicine to argue that the best outcomes for performance horses emerge not from any single modality but from a coordinated team — veterinarian, osteopath, farrier — each contributing their specialist lens to the same problem. The hoof’s relationship to upper musculoskeletal health, the limitations of traditional diagnostics in subclinical cases, the role of preventive care in extending a horse’s competitive career: all are addressed with clarity and practical grounding.

This is a thoughtful, well-researched thesis with a strong clinical voice. It neither overclaims nor undersells, and for practitioners working in or adjacent to performance horse care, it provides both the evidence and the rationale to advocate for OMT as a serious, integrated tool in sport horse practice.

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For horses affected by trigeminal-mediated headshaking, the prognosis is sobering. The condition — characterised by violent, involuntary vertical flicking of the head, nasal irritation, and profound distress, often triggered by exercise, light, or wind — has no confirmed cause and no reliably curative treatment. When EquiPENS, supplementation, and pharmacological options fail to bring meaningful relief, euthanasia is frequently the outcome.

Sadie Pearce’s thesis does not offer a clinical trial or a treatment protocol. What it offers is something arguably more valuable at this stage: a carefully constructed hypothesis. Through a systematic narrative review of the available literature, she maps the anatomy and neurophysiology associated with TMHS and asks whether the physiological changes described in osteopathic somatic dysfunction could illuminate — and potentially address — the underlying pathology.

The trigeminal nerve is the largest cranial nerve, with extensive sensory coverage across the head. Research has confirmed hyperexcitability of its maxillary branch in affected horses, with measurable reductions in the threshold at which the infraorbital nerve fires. What has not been established is why. Pearce traces the anatomical connections between the occipitoatlantal joint, the superior cervical ganglia, and the trigeminal nerve’s origin in the brainstem — a pathway where osteopathic lesioning, she argues, could plausibly contribute to the dysfunction observed.

The review draws on spinal lesion research, fascial mechanics, neurological signalling, and even the emerging evidence around gut microbiota differences in TMHS horses, building a layered picture of a condition that may be systemic in origin rather than localised to the nerve itself. The role of calcium and magnesium in neural excitability, and the known therapeutic effect of magnesium supplementation, adds further texture to the hypothesis.

Whether OMT could offer these horses a meaningful pathway to relief remains an open question — but this thesis makes a compelling case that it deserves serious investigation. The full paper is worth reading for anyone working with horses for whom current treatment options have run out.

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Touch a vertebra, and you are not just touching a bone. You are entering a neurological network that extends outward to skin, organs, muscles, and the brain itself. This is the central insight of Frouke-tea Friedhoff’s thesis, which argues that equine osteopaths who understand neurological segmentation can address the underlying cause of dysfunction rather than managing only its visible symptoms.

The paper moves methodically through the architecture of the equine nervous system — central and peripheral, motor and sensory, somatic and autonomic — before arriving at the heart of its subject: the ways in which spinal segments, somatotopic maps, referred pain patterns, and dermatome regions can each guide more precise osteopathic diagnosis and treatment.

Particularly compelling is the discussion of spinal segmentation in practice. Working on the thoracic region at Th1–Th3, for example, carries implications not only for the vertebrae themselves but for the lungs, the heart, and the brachial plexus. The practitioner who knows these connections treats with intention rather than by location alone.

The thesis also explores somatotopic mapping — the idea that each region of the body corresponds to a specific point in the nervous system and in the cortex. Drawing on both human research and emerging equine-specific auricular acupuncture maps, Friedhoff suggests these tools could significantly enhance osteopathic diagnosis, helping distinguish whether a spinal lesion originates from the vertebral column or from organ dysfunction.

Referred pain in the horse is examined with appropriate caution — it is difficult to detect and often overlooked — but the author makes a persuasive case that ignoring it risks misattributing lameness to the wrong source. A dull coat, an unusual hair pattern, a subtle asymmetry: Friedhoff shows us how to read these as neurological signals. The thesis ultimately invites practitioners to look past the surface and ask: what is the body actually telling us?