Category Archives: Equine

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Walk into almost any equestrian yard and you will find horses on regular bodywork schedules and riders who have never considered booking a session for themselves. That imbalance sits at the heart of Katie McRory’s research. As a Craniosacral Therapist, Registered Massage Therapist and manual osteopathic practitioner, she noticed that only around ten percent of the riders in her practice received regular bodywork — and set out to understand what that gap might cost the horse.

The study assessed eight horse-and-rider pairs over a four-to-six week period. Riders were evaluated for postural and tissue restrictions while standing and in a supine position. Horses were assessed osteopathically, in free movement, under saddle with their own rider, and then again under saddle with an experienced professional — the latter providing an independent baseline against which rider-specific effects could be measured.

The results are striking in their consistency. Seven of the eight riders weighted the right side of their horse more heavily than the left. Patterns of restriction in the horse — across the shoulder, spine, hip, neck, poll and TMJ — aligned predictably with the specific dysfunction present in the rider. A hip restriction in the rider correlated with increased load on the corresponding side of the horse; a twist through the rider’s torso produced a recognisable signature in the horse’s lateral bend and shoulder mobility.

McRory develops a series of dysfunction statements from the data, grounded in the physics of load and torque and supported by Freyette’s Laws of spinal motion. The professional rider’s horse, notably, showed the least dysfunction of any pair in the study — demonstrating that skill and balance in the saddle can substantially offset the effects.

The conclusion is unambiguous: treating the horse while the rider’s dysfunction remains unaddressed is, at best, a maintenance strategy. For resolution, both partners need care. The data points clearly in that direction, and the thesis makes a compelling case for expanding the conversation around equine health to include the person on top.

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Sacroiliac injury is one of the more elusive diagnoses in equine practice. The region sits deep beneath large muscle masses, the clinical signs are often ambiguous, and the gold-standard diagnostic tool — nuclear scintigraphy — sits behind a cost barrier that many owners cannot cross. The result is that a significant number of horses with chronic hindlimb lameness carry an unconfirmed sacroiliac component, managed as best they can be with the tools available.

Katalin Kincses-Jánosi writes from a dual position of authority — a veterinarian with a PhD who has also trained as an equine osteopath. Her thesis opens with a scholarly review of sacroiliac anatomy, clinical presentation, diagnostic approaches and rehabilitation principles, before narrowing into a case study that brings all of that knowledge to bear on a single patient: a senior chestnut Hungarian halfbred mare with persistent low-to-medium grade left hindlimb lameness.

The mare had already undergone arthroscopy for a separate stifle issue. The lameness remained. A subsequent diagnosis of fibrotic myopathy of the hamstrings added further complexity, and it was into this layered clinical picture that osteopathic manual treatment was introduced. Over a series of sessions spanning several months, Kincses-Jánosi documents her findings in detail — pelvic hypermobility, gluteal sensitivity, lumbar stiffness, asymmetrical rib cage response — and records the specific techniques applied, from whole-body osteoarticular balancing to strain-counterstrain on acupressure points to high-velocity low-amplitude pelvic manipulation.

Woven through the treatment sessions is a progressively evolving exercise programme: dynamic mobilisation of the back, pelvic flexion work, ground pole sequences and lateral movement exercises, each calibrated to the mare’s capacity at each stage and designed to build the deep stabilising musculature that the sacroiliac region depends upon.

What makes this thesis genuinely instructive is its honesty. Progress was not linear — an early introduction of cross-country terrain exercises temporarily worsened the lameness. The author reflects on why, adjusts, and continues. For practitioners working with complex, long-standing cases in older horses, this is an account worth reading in full.

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Poor performance in the sport horse is one of the most commonly encountered problems in equine practice, yet it remains one of the least systematically addressed. The horse that is reluctant to work, loses ground in the final furlongs, stiffens through turns, or simply fails to meet expectations is often passed through multiple treatments before anyone stands back and asks the right questions. Juan Garcia’s thesis is an attempt to provide the framework for doing precisely that.

Garcia structures his approach around Andrew Taylor Still’s four foundational principles of osteopathy and applies them to a clear functional hierarchy of performance problems: pain management, proprioceptive deficits, stiffness, weakness, and neuromuscular control. Each category receives its own clinical logic, its own manual therapy indications, and its own body of supporting evidence. The distinction between mobilisation — controlled movement within physiological range — and manipulation — force taken beyond that range — is carefully drawn, with the clinical reasoning for choosing one over the other made explicit.

The manual therapy toolkit Garcia presents is broad and practically grounded. Massage therapy, passive stretching, joint mobilisation, and spinal manipulation are all discussed in terms of specific indications rather than general application. Particularly valuable is the section on neuromuscular rehabilitation, which covers exercises rarely discussed in short-form clinical resources: limb circumduction, pelvic flexion reflex work, sternal elevation, and tail traction. Each is presented with clear diagnostic and therapeutic rationale.

Garcia also draws on case data to illustrate the real-world impact of these approaches — a private stable study in Mexico found that 82.5% of horses receiving manual therapy improved their racing times, compared to 30% in the control group. Evidence from show jumping contexts reinforces the pattern: rider satisfaction with movement quality improved universally following structured manipulative therapy.

What makes this thesis particularly useful is its honesty about limits. Manual therapy, Garcia argues, is not a solution to every performance problem. Understanding when it applies — and when it does not — is as important as knowing the techniques themselves. For practitioners working in sport horse practice, this is a clear-eyed, clinically useful piece of work.

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Every time a horse moves — whether walking across a field or landing from a jump — an intricate network of muscles, tendons, ligaments and fascia works to suspend the thorax between the forelimbs and direct that power toward purposeful movement. This network, known as the thoracic sling, is the horse’s core stability system. Unlike humans, the horse has no clavicle, no bony connection between forelimb and trunk. That single anatomical fact has enormous consequences — for movement quality, for soundness, and for how we approach dysfunction when it arises.


This thesis offers a richly detailed account of the thoracic sling’s anatomy and function: the serratus ventralis, the deep and superficial pectorals, the rhomboids, trapezius, and the dorsal scapular ligament that anchors the scapula to the spine. Each structure is examined in terms of what it contributes to the whole — how energy is stored and released, how the ribcage is suspended, how the forelimb lines of protraction, retraction, abduction and adduction operate in a quadruped without a collar bone. The myofascial connections that link these structures to the spiral line, the lateral line, and the deep ventral line are explored with reference to both veterinary and human anatomical research, drawing a picture of connectivity that makes the osteopathic principle of treating the whole body not just a philosophy but a functional necessity.

The consequences of thoracic sling dysfunction are wide-ranging and often misread. Resistance to lateral bend, difficulty in canter, fatigue, asymmetry under saddle, even behavioural changes — all can trace a pathway back to this region. The thoracic outlet, through which the vagus nerve, phrenic nerve, and major vessels pass, means that dysfunction here can ripple into respiratory, digestive, and neurological function. The author makes a persuasive case that this area is significantly under-diagnosed in equine practice.

Osteopathic articular balancing, functional technique, positional release, myofascial release and craniosacral techniques are presented as the tools best suited to restoring thoracic sling function — not because they are gentle, but because they are appropriately matched to the complexity and the sensitivity of the structures involved.

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A few decades ago, ‘kissing spines’ was barely a term in the equine world. Horses with back pain were labelled difficult, disobedient, or simply unsound. Today, overriding dorsal spinous processes (ORDSP) is recognised as the most common cause of primary back pain in horses, with surgical interventions costing upwards of £1,700 per procedure — and the diagnosis appearing with increasing frequency across all disciplines and breeds. The question this thesis poses is not how best to treat the condition, but whether it can be prevented.


The author, writing from within the equine community and drawing on both clinical literature and osteopathic philosophy, maps the biomechanics of the condition with precision. Kissing spine occurs when the dorsal spinous processes of the thoracic vertebrae — most commonly between T13 and T18, the site where the rider sits — come too close together, touching or overlapping where there should be a clear interspinous gap. The causes are genuinely multiple: early training before musculoskeletal maturity, poor rider technique that fails to develop core stabilisation in the horse, ill-fitting tack, compensatory guarding from hind limb lameness, and breeding practices that prioritise aesthetics over conformation. Archaeological evidence shows the condition predates modern equitation, which complicates any single-cause narrative and demands a systemic response.

That systemic response, the author argues, is osteopathic manual therapy delivered consistently throughout the horse’s working life. By maintaining full articulation of the musculoskeletal system, supporting optimal fluid circulation, and identifying somatic dysfunction at its earliest and most reversible stage, the osteopath acts as the body’s early warning system. The TART framework — tissue texture, asymmetry, restriction, tenderness — provides a clinical language for catching minor dysfunctions before they cascade into the structural changes that drive spinous process contact.

There are limitations honestly acknowledged: genetics, birth defects, and certain rider disciplines present challenges that no amount of manual therapy can fully offset. But the core argument holds — a horse maintained in functional health is a horse far less likely to need a surgeon.

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The hands of the osteopath remain the primary diagnostic instrument — palpation, motion testing, and clinical observation form the bedrock of assessment. But in a high-performance equine context, where the margin between subclinical dysfunction and career-ending injury can be measured in days, the question of whether objective imaging tools can add value is worth asking seriously. Isabelle De Smet’s thesis does exactly that, examining medical infrared thermography — MIT — with both enthusiasm and rigour.


Thermography works by recording infrared radiation emitted from the skin surface, which reflects local circulation and tissue metabolism. Because the autonomic nervous system directly controls microcirculation, thermal patterns become a window into vasomotor activity — revealing areas of inflammation, altered blood flow, or sympathetic-mediated vasoconstriction that would be invisible to even the most experienced hand. In clinical terms, MIT is at least ten times more sensitive than manual palpation at detecting skin temperature differences, and a differential of just 1°C is considered clinically significant.

The early detection potential is one of the thesis’s most compelling threads. In racehorses, thermographic changes associated with dorsal metacarpal soreness have been shown to precede radiographic findings by two weeks — a window in which training load adjustments can prevent the injury from becoming structural. Similarly, MIT can identify altered blood flow in the contralateral foot before laminitis becomes irreversible, and it has been used to detect subclinical inflammation associated with lameness well before it manifests as a gait abnormality.

De Smet also addresses treatment monitoring — an area with obvious relevance for osteopaths seeking to objectify their outcomes. A long-term study of 51 horses treated osteopathically for somatic dysfunction found that thermographic abnormalities improved or resolved in all horses that returned to work, with over 90% resuming normal activity. A separate case study documented a 79% reduction in overall thermal asymmetry following joint manipulation, with statistically significant temperature increases in previously hypothermic areas — direct evidence of autonomic nervous system response to manual intervention.

The limitations are handled honestly: artefacts from ambient temperature, hair coat variation, and scar tissue can compromise readings; there is no gold-standard protocol for equine back thermal imaging; and the technique demands experience to interpret correctly. De Smet concludes that MIT is not a replacement for palpatory examination, but a valuable complement to it — one whose potential, particularly for objectifying osteopathic treatment outcomes, has not yet been fully realised.

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A horse grazes for up to sixteen hours a day under natural conditions. That means the temporomandibular joint — the TMJ — is one of the most continuously loaded structures in the equine body, yet it remains one of the least studied. While human TMJ dysfunction has attracted decades of clinical research, the equine equivalent sits in a diagnostic grey zone, where vague and overlapping symptoms make it difficult to distinguish a functional problem from outright pathology.

This thesis by Hanna Musakka sets out to map what is known about the equine TMJ, examine the range of dysfunctions that may arise, and assess whether osteopathic manipulative treatment — so well-established in human TMJ care — can be rationally applied to horses. The investigation draws on equine anatomy, veterinary literature, and a substantial body of human osteopathic research, building a case for cross-species application where direct equine studies remain scarce.

The anatomy alone is revealing. Equine TMJ fibrocartilage shows a unique zoning pattern suggesting higher regenerative capacity than its human counterpart — which may explain why clinical TMJ pathologies appear relatively rare in horses, or simply why they go undetected. The joint’s proximity to the hyoid apparatus, the guttural pouch, and multiple cranial nerves means that dysfunction here can cascade into problems that look nothing like a jaw complaint: headshaking, bit resistance, altered head carriage, even recurrent colic.

Musakka surveys the osteopathic literature on human TMJ treatment — myofascial release, muscle inhibition, balanced ligamentous tension, joint mobilisation — and makes a carefully reasoned argument for adapting these approaches to the horse. The cervicomandibular relationship proves particularly important: manipulation of the upper cervical spine in humans consistently improves mouth-opening range, pointing to a biomechanical link that almost certainly holds across species.

The thesis is candid about the limits of current knowledge. Without equine-specific clinical trials, the transfer of human treatment protocols requires both theoretical grounding and hands-on caution. Musakka, a licensed equine massage therapist turned osteopath, brings both — and shares her own clinical observations from treating horses presenting with hypertonic masticatory muscles and hyoid tension. The results, she notes, have been encouraging.

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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.