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Horse viewed from behind showing the neck, withers, and topline

Recognizing The Signs of Pain

Understanding body lameness in horses

​Not all pain looks like a limp. Many horses experience discomfort that originates in the back, pelvis, neck, or supporting soft tissues—often referred to as body lameness. These issues commonly present as subtle changes in movement, posture, behavior, or performance, particularly under saddle.

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Because these signs don’t fit the traditional definition of limb lameness, they are frequently misinterpreted as training challenges, behavioral issues, or poor attitude.

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At Kinetic Equine Medicine, we focus on identifying these less obvious indicators of pain through comprehensive, evidence-based sports medicine evaluation.

Back & Pelvis Pain

Signs of hind-end or core dysfunction

Pain or restriction in the back and pelvis can affect balance, impulsion, and straightness. Common signs include:

  • Toe dragging in one or both hind limbs

  • Reluctance to move forward or maintain impulsion

  • Difficulty picking up or holding a correct canter lead

  • Late or inconsistent lead changes

  • A noticeably different feel between directions

  • Crooked tail carriage

  • Jumping to one side of a fence or landing on the wrong lead

  • Weak topline or reduced gluteal development

  • “Pot-bellied” appearance from poor core engagement

  • Uneven front or hind foot size

  • Feeling unbalanced or pulled to one side under saddle

  • Resistance or difficulty lifting hind feet for the farrier

Neck & Shoulder Girdle Pain

When contact or frame makes things worse

  • Difficulty flexing or bending the neck left or right

  • Hopping into trot or irregular transitions

  • Uneven or patchy sweat patterns on the neck or withers

  • Becoming resistant or lame when brought into a frame (rein lameness)

  • Muscle loss or asymmetry along the neck

  • Difficulty bridling

  • Stumbling or tripping

  • Base-wide stance

  • Toe ticking or dragging of the front feet

  • Unequal bend or inconsistent contact

  • Head or neck tilt when ridden or lunged

  • Head tossing in cross ties if the head is too high or low

  • Idiopathic hopping

  • Throwing the head and neck over fences

Cervical and shoulder-girdle pain often becomes more apparent with rein contact, bending, or collection. Watch for:

Equipment-Related Pain Signals

When tack reveals an underlying issue

Equipment doesn’t usually cause pain, but it can highlight it. Signs that appear only when the horse is tacked or ridden are important clues. This can include:

  • Resistance to grooming

  • Irritability during tacking or girth tightening

  • Movement that changes noticeably once tack is applied

  • Hair loss, rubs, sores, or white hairs where equipment sits

  • Prominent “sharkfin” withers or ewe-neck posture

  • Clumsiness or tripping under saddle

  • Forelimb lameness that cannot be localized or blocked

  • Abnormally high or low neck carriage

  • Difficulty maintaining steady contact

  • Wide or narrow forelimb stance

  • Throwing the neck up before or over fences

  • Lameness that appears under saddle but not on the lunge line

When to Seek an Evaluation

If your horse is showing one or more of these signs and especially patterns that:

  • Change with direction

  • Appear primarily under saddle

  • Worsen with contact, collection, or rider influence

…it’s worth pursuing a deeper evaluation.

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Kinetic Equine Medicine provides targeted sports medicine assessments to identify the source of pain, guide diagnosis, and develop an appropriate treatment plan so issues are addressed early, before they become limiting or chronic.

Sports massage on a horse as treatment of equine body lameness
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