Category Archives: Equine

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Sacroiliac joint dysfunction sits at the intersection of frustration and complexity in equine practice. Horses are stoic creatures — pain is masked, subtle gait changes are dismissed as training problems, and by the time a diagnosis is confirmed, the damage is often well established. This thesis by Emma Ramanathan asks a question that reframes the conversation entirely: what if we stopped waiting for dysfunction to appear and started preventing it from developing in the first place?

Ramanathan focuses on three distinct causes of sacroiliac joint dysfunction — trauma, repetitive use and conformation — and examines how osteopathic care might reduce both the likelihood and severity of each. The sacroiliac joint, connecting the spine to the pelvis via dense, inelastic ligaments, has remarkably limited movement yet bears enormous force during locomotion. When that system is compromised, the consequences ripple throughout the entire musculoskeletal chain.

The thesis draws on a combination of published research and personal clinical experience, including two horses from Ramanathan’s own yard. These case studies ground the academic argument in lived reality, illustrating what it looks like when osteopathy is integrated as a long-term maintenance strategy rather than a crisis response. One horse, written off at seven years old, went on to compete at elementary dressage following osteopathic intervention.

What emerges is a nuanced picture. Osteopathy cannot prevent a horse from slipping in a field, nor alter the structural facts of straight hocks or a long back. But it can, the thesis argues, build a body better equipped to cope — one where compensatory patterns are caught early, muscle balance is maintained, and recovery from injury is faster and more complete. Ramanathan also draws on a 2025 peer-reviewed study showing measurable improvements in hindlimb movement patterns following a single osteopathic treatment. This is a thesis about prevention as a clinical strategy, and it makes a compelling case for treating the horse before it breaks down rather than after.

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A horse that weaves in its stable, cribs obsessively, or shies at the slightest movement is often labelled simply as ‘difficult’ or ‘nervous’. What is less commonly asked is whether that horse is in pain, and whether the behaviour is a sophisticated survival response rather than a character flaw. In her thesis submitted to the London College of Animal Osteopathy, Emily Ethier examines the physiological underpinnings of equine anxiety and makes a carefully reasoned argument for osteopathic manual therapy as a meaningful part of its management.

Ethier opens by drawing a clear parallel between human and equine anxiety disorders, noting that both share roots in the activation of the sympathetic nervous system and the limbic system’s pain-response pathways. In horses — prey animals hardwired for flight — anxiety is not merely a psychological inconvenience; it is a physiological state with real consequences for musculoskeletal health. A horse in a near-constant state of hypervigilance will develop chronic tension through the topline and cervical spine, disrupted sleep, reduced blood flow to the viscera, and, over time, a nervous system that interprets innocuous stimuli as genuine threats.

The mechanisms behind these changes are explored in depth. Repetitive stress or pain causes specific nerve pathways to become the path of least resistance — a process of central sensitisation that makes the horse increasingly reactive even after the original stimulus is removed. Stereotypic behaviours such as weaving and stall pacing are not simply bad habits; each generates its own pattern of compensatory musculoskeletal tension that, if left unaddressed, will affect the rest of the horse’s body through fascial and myofascial connections.

Ethier draws on a systematic review by Rechberger, Biberschick, and Porthun published in the European Journal of Medical Research to provide evidence that osteopathic manual therapy — including HVLA techniques, cranial osteopathy, and joint mobilisation — produces measurable changes in autonomic nervous system function in humans. High-velocity low-amplitude cervical techniques showed increased parasympathetic activity, while the CV4 cranial technique demonstrated direct influence on parasympathetic tone. Since the mechanisms are shared across mammalian species, Ethier argues that these findings are relevant to the horse. By alleviating joint restrictions, resetting aberrant nerve pathway signalling, and helping the body move toward homeostasis, osteopathic treatment can reduce the physical amplifiers of anxiety and create the neurological conditions in which a calmer, more settled horse becomes possible.

Ethier is careful to position the osteopath not just as a hands-on therapist but as an advocate for the whole animal — one who assesses the horse’s environment, training practices, social needs, and management conditions alongside its musculoskeletal status. Anxiety rarely has a single cause, and treatment rarely has a single answer. What this thoughtful thesis makes clear is that osteopathy has a meaningful role to play in the conversation.

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What if the reason a horse’s hoof won’t balance is not a farriery problem — but a whole-body problem rooted in the thoracic sling? That is the provocative and clinically compelling question at the heart of this thesis by David Harrison Schaefer, a practising farrier who undertook equine osteopathy training at LCAO and discovered that the two disciplines are far more intertwined than most practitioners realise.

The thoracic sling — the muscular system that suspends the horse’s forelimb from the thorax — plays a direct role in dictating the forces applied to the hoof. When asymmetry or restriction exists within this complex, one limb effectively becomes “higher” than the other, altering load distribution across the entire distal limb. The hoof, which like bone responds to the forces placed upon it by growing more material in areas of lower stress, compensates accordingly — often producing excessive heel growth, toe stunting, or medial-lateral imbalance that resists conventional farriery.

Schaefer builds his argument through anatomy, biomechanics, and a detailed case study of Shine, a 12-year-old Missouri Fox Trotter whose right forelimb deterioration was traced back to a diagonal compensatory pattern following an old left hind injury. Over three osteopathic sessions across eighteen weeks — combining indirect techniques, Osteopathic Articular Balancing, and visceral work addressing the lung pleura — Shine’s thoracic sling restrictions were progressively cleared, allowing his hoof growth to normalise in a way that farriery alone had been unable to achieve.

Perhaps most striking is Schaefer’s attention to the often-overlooked organ component of sling dysfunction: fascial restrictions in the visceral pleura, the hypothalamic-pituitary-adrenal axis, and the autonomic nervous system all feature in his analysis. His conclusion is clear — treating the hoof without treating the whole horse is an incomplete solution, and the collaboration of osteopath and farrier is essential to achieving lasting change.

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Statistics about equine dental disease are striking. A 1994 survey of 500 equine skulls found evidence of dental disease in 80% of subjects. By 2012, a UK study identified dental irregularities in 95.4% of horses aged fifteen and over — yet only a quarter of owners were aware their horse had a problem requiring attention. Despite decades of routine dentistry, these numbers have barely shifted. Christina Hall, writing for the London College of Animal Osteopathy, asks a provocative question: could the way we approach equine dentistry be part of the problem?

Hall, who practises as both an equine osteopath and a qualified equine dentist in the United States, brings a rare dual perspective to this thesis. Her central argument is that modern equine dentistry operates almost exclusively within an allopathic framework — addressing the visible signs of dental abnormality, from hooks and ramps to ulcerations and malocclusions, without asking why those abnormalities exist in the first place. She contends that the answer almost always lies in immobility somewhere in the body, and that osteopathic assessment is the tool best placed to find it.

The thesis draws on A.T. Still’s four principles of osteopathy to reframe every aspect of dental care. If a horse presents with recurring tongue ulceration, for instance, the standard response is to file the offending tooth surface. But Hall argues the cause is likely restriction at the temporomandibular joint — and that restriction, in turn, may originate in a hoof imbalance, a visceral restriction, or a fascial tension pattern running from the hind limb to the skull. The concept of the ‘six legs’ — the three paired extremities of mandible, forelimbs, and hindlimbs that govern mobility patterns across the horse’s entire body — is introduced as a clinical lens for understanding how restriction in one region cascades throughout the whole.

Hall reserves particular concern for routine dental practices such as prolonged speculum use and head positioning on extended dental stands, arguing that these techniques place the upper cervical spine into hyperextension and impose excessive strain on the apical ligament and the temporomandibular joint disc. With nine of twelve equine myofascial kinetic lines originating or terminating at the skull, the downstream consequences of dental procedures performed in biomechanically unsound positions may be far greater than is currently appreciated. This is a thesis that will challenge the assumptions of every equine professional who reads it.

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The hoof is often treated as a farriery problem — a question of angles, balance, and correct trimming. But what if poor hoof morphology is not just a foot problem, but a whole-body problem? In this thought-provoking and expertly reasoned thesis, Cheryl Hammerson makes the case that osteopathy and farriery are not separate disciplines, but deeply interconnected partners in equine health.

Anchored in the second principle of osteopathy — that structure and function are interrelated — Hammerson walks the reader through a compelling argument: that the body and the hoof shape each other in a continuous, dynamic feedback loop. When a horse develops pathology in the stifle or hip, compensatory loading patterns over time distort hoof morphology. Conversely, poor hoof structure — long toes, low heels, broken hoof-pastern axes — imposes abnormal forces on the entire musculoskeletal system, generating postural dysfunction, back pain, and eventually lameness.

The paper is enriched by real-world case examples, including a detailed account of a show pony whose refusal to jump, aggressive pain response, and postural collapse were traced to severely imbalanced hind hooves. Once the farrier addressed the foot balance and osteopathic treatment restored mobility to the horse’s soft tissues and spine, the pony returned to competition. Three comparative hoof assessment examples — measured with the HoofmApp tool — further illustrate how hoof asymmetry correlates with diagnosed pathology in the opposite limb.

Hammerson also draws on emerging research in human osteopathy and posture science to strengthen the case for equine application. The conclusion is clear: to care effectively for the horse’s hooves, you must care for the whole horse — and that is exactly what osteopathy is designed to do.

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Equine osteopathic manual therapy is widely used to improve biomechanics and support rehabilitation, yet its systemic physiological effects have rarely been rigorously measured. In this thesis, Carla Pujadó analyses the findings of a landmark controlled study involving thirty Thoroughbred horses to examine how a single OMT session — using Pascal’s high-velocity, low-amplitude technique — produces measurable changes across three of the body’s most important regulatory systems: the autonomic nervous system, the immune system, and thehypothalamus-pituitary-adrenal axis.

The results are striking. Blood serum cortisol rose significantly in the experimental group immediately after treatment, then declined toward baseline within an hour — a transient HPA axis activation consistent withpatterns observed in human OMT research. White blood cell counts showed a parallel fluctuation, indicating an acute immune response rather than a sustained inflammatory shift. Body temperature increased significantly in treated horses, pointing to autonomic involvement in thermoregulation, while heart rate trends suggested a shift toward parasympathetic dominance, even when changes fell short of statistical significance.

Pujadó situates these findings within ten clinical cases — horses presenting with neurological deficits, pelvic asymmetry, suspensory desmitis, and chronic thoracolumbar pain — demonstrating how the physiological responses documented in the study map onto real-world presentations. The thesis also confronts an uncomfortable gap: despite OMT’s growing clinical use, only one published study examines its systemic physiological effects in horses. Pujadó identifies the methodological, funding, and standardisation barriers that have slowed this research, and makes a compelling case for why closing that gap matters — not just for science, but for the horses practitioners treat every day.

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Every horse carries its physical history in its body. The old falls, the awkward landings, the years spent compensating for an undiagnosed restriction — these experiences accumulate as somatic dysfunctions that quietly shape how a horse handles, moves, and responds under saddle. In this practical and perceptive thesis, Bethany Rice — drawing on more than a decade as a full-time professional trainer before qualifying as an animal osteopath — explores the physical roots of some of the most common and frustrating problems in horses.

The thesis is structured around three categories: handling issues, behavioural problems, and performance limitations. For each, Rice identifies the likely anatomical origins, walks through the clinical reasoning, and outlines an osteopathic treatment approach. Head shyness is traced to atlanto-occipital dysfunction and compression of the poll nerves. Resistance during farriery maps to joint pain, brachial plexus nerve impingement, or sacral and lumbar lesions, depending on which limb is involved. Girthiness reliably points to rib head and thoracic vertebral dysfunction at segments T8-T12. Bucking at canter, a behaviour often managed through training alone, is reframed here as a probable expression of sacral or lumbar neuralgia that worsens as the horse transitions to a different gait.

Performance limitations receive equally detailed treatment. Bit resistance is examined through the lens of the atlanto-occipital joint, C2 dysfunction, and the hyoid apparatus. Preferred bend patterns are categorised as Type 1 or Type 2 lesions — each with a distinct presentation, origin, and treatment pathway. The concept of diagonal synchrony is used to explain why a restriction in one limb produces a corresponding reduction in the contralateral diagonal.

Throughout, Rice makes a clear and compelling argument: that what trainers often interpret as stubbornness or training failure is often the body communicating a need for restoration rather than correction.

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What separates a well-trained horse from a truly high-performing one? According to Asia Peruzzetto’s thesis, the answer lies not in genetics or training intensity alone, but in the structural harmony that underpins every stride, jump, and transition. Her comprehensive exploration focuses on the role of osteopathy in equine athletic performance. By integrating biomechanical research, breed-specific anatomy, and clinical evidence, the work makes a strong case for incorporating manual therapy as a fundamental component of sport horse management.

Peruzzetto begins by mapping the diverse physical demands placed on horses across disciplines — from the torsional hock stress of reining to the thoracolumbar strain of dressage collection, the tendon load of flat racing, and the metabolic demands of endurance. The study analyzes how breed morphology influences both athletic capability and injury risk. Specifically, it notes that Thoroughbreds are prone to suspensory inflammation during intense training; European Warmbloods require diligent management of their sacroiliac region; and Arabians competing over long distances need structured, gradual conditioning to safeguard their flexor tendons.

This thesis provides a compelling argument for the multidimensional effects of osteopathy on athletic horses. The evidence presented goes beyond improved joint mobility, drawing on studies that demonstrate osteopathic treatment induces changes in autonomic tone, cortisol regulation, and immune markers. This highlights how manual therapy contributes to the horse’s overall physiological resilience, not just its musculoskeletal health. Key areas where osteopathy offers measurable value include: enhancing post-competition recovery, improving proprioception, and facilitating the early detection of compensatory movement patterns.

The thesis closes with a call for larger, inter-breed comparative studies to consolidate osteopathy’s place within evidence-based equine sports medicine — a field the author clearly intends to shape professionally.

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When a horse resists the aids, tosses its head, or suddenly loses rhythm through a transition, the instinct is often to look at the training. But what if the problem isn’t in the schooling — what if it’s in the body? This is the central question explored in Anne Éfféré’s thoughtful and well-structured thesis, which makes a compelling case that many of the most common riding problems are not behavioural in origin, but physical — and that equine osteopathy offers a meaningful path to resolving them.

Drawing on current research and established osteopathic principles, Éfféré systematically maps the links between specific physical dysfunctions — including musculoskeletal imbalances, joint restrictions in the sacroiliac and cervical spine, and compensatory movement patterns — and the riding problems they cause. A horse labelled stubborn for refusing to bend may simply have cervical spine restrictions. A horse that bucks during transitions
may be communicating discomfort in the sacroiliac region. Without understanding the physical root cause, training corrections not only fail to resolve the problem — they can make it worse.

The thesis also introduces key osteopathic techniques, including structural mobilisation, soft tissue manipulation, Osteopathic Articular Balancing (OAB), and craniosacral therapy, exploring how each addresses specific dysfunctions. Importantly, Éfféré emphasises that osteopathy works best as part of a collaborative approach — one that brings together the practitioner, trainer, and rider to observe, respond, and adapt. A valuable read for anyone working with horses who don’t quite feel right under saddle.

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Alexandra Jones’s comprehensive thesis highlights a critical issue in veterinary practice: the equine sacropelvic region, despite its immense biomechanical significance, remains clinically underserved. This area is vital as the pivot point for transferring propulsive force from the hindlimbs to the spine, a key stabiliser during stance, and a frequent source of performance issues in sport horses. However, Jones argues that current traditional veterinary methods face considerable limitations in accurately diagnosing and effectively treating pathologies in this crucial region.
Jones’s work systematically examines the sacropelvic complex, starting with a detailed anatomical description of the ilium, sacrum, hip joint, stifle, and related musculature. She then correlates this anatomy with the clinical presentation of somatic dysfunction in the area. Drawing heavily on Thoresen’s seminal 2006–2007 study of 374 horses with suspected sacroiliac or hip issues, Jones identifies the primary clinical signs: restricted femoral extension and abduction, gluteal syndrome, dorsal ilial displacement, and spasm of the thoracolumbar epaxial muscles.

Evidence strongly supports the efficacy of osteopathic manipulative treatment (OMT). For instance, Thoresen’s research on horses with sacroiliac joint restrictions documented a 79% positive outcome rate following OMT. Furthermore, OMT’s effects extend beyond local mechanics, demonstrating measurable systemic changes. A study conducted in Lithuania showed that OMT influenced the autonomic, immune, and HPA systems, evidenced by changes in heart rate, respiratory rate, cortisol levels, and white blood cell counts. This systemic impact is corroborated by infrared thermography data, which revealed significant gluteal temperature shifts post-treatment, consistent with improved sympathetic nervous system regulation.

Jones’s conclusion is that OMT provides both immediate and lasting advantages for horses suffering from sacropelvic dysfunction. The implications of this treatment are significant, reaching far beyond the specific area treated.