At the walk, healthy horses rely on passive neck motion to support balance and efficient movement. The characteristic figure-8 pattern of the head and neck coordinates with the forelimbs, reveal­ing important clues about biomechanics, soundness, and compensation.

Spooky or resistant behavior under saddle is often an early sign of pain, not a training problem. Facial expression and performance changes can reveal underlying biomechanical dysfunction long before visible lameness appears.

Performance lameness does not always present as a clear head-nod or limp. In many sport horses, discomfort in the neck, back, or pelvis shows up first as subtle performance decline rather than obvious limb lameness.

ECVM cannot be cured, but careful training, rehabilitation, veterinary support, and lifestyle management can greatly improve comfort and long-term soundness.

ECVM diagnosis relies on clinical exams and imaging of the lower neck. While radiographs are common, advanced imaging like CT can be limited by access and risk.

The neck influences balance, stride, shock absorption, and nerve function. When cervical structure is compromised, movement and performance across the whole body are affected.