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A Physiotherapist's View: The Dysfunctional Equestrian! Part 1

This incredible blog was written by my wonderful physiotherapist, Denise Thomas. Denise has worked wonders on my poor, battered body for years now, and I truly wouldn't be without her! Anyone local to Wantage/Swindon, who needs their body putting back together should 100% get in touch with Denise. Her contact details are at the end of the blog.

Just a word of warning: This is fabulously detailed and science-y, so make sure you have time to digest it properly. But don't let that put you off - it's a truly fascinating read!


The Dysfunctional Equestrian!

All variants of equestrianism require a harmonious partnership between both the horse and rider, built on clear communication and trust. We train our horses and ourselves to deliver quiet aids and communicate through subtle postural clues that become more refined as the partnership progresses, at least that is the aim for the discerning rider and it takes years to master. Most often it is the rider who is holding the horse back from improving, not the other way around. To ride well, even at a low level we need a combination of strength, suppleness, core stability, flexible hips, ankles and overall fitness, although the ratio of this will vary depending on the discipline. Only when you increase freedom and suppleness through your own hips, pelvis and spine will you stop being a cumbersome hinderance to your horse!

To excel in any area of equestrianism, one needs to work on strengthening, resistance work (including rotational forces), core strength, balance, flexibility, nutrition, hydration, focusing your mind, losing excess weight and having corrective physical therapy followed by maintenance to prevent repetitive strain injury to self and the equine athlete.

If your muscles (postural & phasic) are out of balance the strong postural ones can inhibit the weaker phasic ones (see image below) that subsequently fail to strengthen, which is why it is important to have a good therapist (me) who will help you lengthen before you strengthen and reduce existing niggles while helping to prevent secondary issues from forming by giving you a nice level starting platform.

Figure: Postural-phasic muscles, a) anterior view, b) posterior view. Purple muscles predominantly postural, and green muscles predominantly phasic.

Human beings are naturally one sided and everything we do in life further exacerbates muscle imbalances. Modern living means we spend more time sitting at desks, at the table, on the loo, in our car, curled up in bed for hours or looking at tablets and mobiles thus resulting in a forward flexed position and rolled forward shoulders (known as an upper crossed syndrome as shown by image below) that can lead to impingements and pain in our cervical spine, lower back, hips knees and ankles.

Figure: Upper crossed syndrome (UCS)

We often slouch from the bra line and through the lumbar, while our hip flexors become dominant, inhibiting glutes and altering biomechanics and synergy of muscle sling systems. Add in stable duties, carrying buckets, sweeping, mucking out, handling horses from the left – well, it doesn’t get more crooked and one sided than that and now your altered biomechanics and muscle imbalances are detrimental and could lead to long term pain syndromes (see image below) and pathology in both the horse and rider resulting in disconnect, loss of performance, behavioural problems from your equine buddy and time out!

Figure: Painful areas of compensation

Once the rider has become asymmetrical secondary to pelvic or vertebral malalignment, our equine friend will feel this as confusing weight distribution and signals, sometimes responding to commands the rider is unaware they are giving or not responding to the rider. Likewise, if the horse is out of balance and experiencing muscle loss, pain or weakness, the rider will also compensate both exacerbating existing problems in each other while exerting unnecessary forces through both musculoskeletal systems.

A confused, unbalanced, compensating horse experiencing pain or discomfort in the musculoskeletal system due to rider imbalance may then understandably exhibit any of the following:

⦁ A hollow back

⦁ Shortened stride

⦁ Open mouth, crossing/fixing of the jaw

⦁ Irregular breathing

⦁ Head tossing

⦁ High head carriage and a stiff gait

⦁ No lateral flexion of the neck to one side

⦁ Dropping a shoulder

⦁ Inconsistent contact

⦁ Rearing in frustration

⦁ Unable to execute a circle in one direction

⦁ Refusing to jump

⦁ Lameness/stumbling

⦁ Veering to one side

⦁ Rushing

⦁ Bucking

⦁ A seemingly complete change in ability to work and attitude

A stiff or biomechanically crooked rider may experience the following:

⦁ Inability to sit the movement of the horse anymore

⦁ Sitting crookedly to one side

⦁ Unlevel pelvis

⦁ Unlevel shoulders

⦁ One leg/shoulder forward or back

⦁ Fork seat

⦁ Water skiing position

⦁ Unable to use one leg correctly or independently of the other

⦁ Hands crossing in desperation due to falling in or out

⦁ Neck pain

⦁ Scapular pain

⦁ Painful QL

⦁ Pain at the bra line

⦁ Stiff hips and ankles causing bouncing or landing hard in the saddle

⦁ Unable to sit to the trot or thrown out of the seat in canter – bouncing, rather than absorbing the movement

⦁ Nodding head – a compensation for a stiff lower back and thoracic spine

⦁ Unable to drop the heels naturally

⦁ Knee/hip/ankle/sacral pain

NOTE - Neither list is exhaustive.


⦁ Sometimes a rider may have a right anterior innominate rotation, resulting in the right ischium sitting high and the left ischial tuberosity (seat bone) sitting lower which would put pressure on the equines left paravertebral muscles causing tension so that the right shoulder and hip would then be too far ahead of the movement giving a perched appearance. At the same time the right hip may be in extension and the right leg would sit back farther behind the girth. Sometimes the traps and paraspinal muscles of the horse along the mid-thoracic region respond by shortening the left forelimb causing a veering off to the side.

⦁ A rider may complain of pain, stiffness, spasms and struggle mounting or dismounting. The spasm may be due to the body producing a protective reflex if the pain originates from a joint. Remember pain may refer out so often where the pain is, the problem isn’t. It is merely a weak link in a now dysfunctional chain.

⦁ The foot and ankle complex maybe so stiff that the normal foot position of dorsiflexion (forefoot up/heels down) and slight turnout cannot be maintained resulting in supination of the forefoot (slight rolling out) and plantar flexion (forefoot pushing down), contracting the calf muscles, raising the heels often resulting in a slight tip forward of the torso, lowered hands with either a drop or forward tilt of the chin. In addition, a faulty foot/ankle complex (see image below) can affect leg length and the natural position of the pelvis causing problems on and off the horse leading to cross syndromes.

Figure: Internal tibial rotation of ankle/foot with STJ pronation, commonly found with a right anterior innominate rotation.

⦁ Sacral torsions (see image below) and sacral locking can result in a poor siting posture resulting in asymmetry in thigh position creating rider compensation with unequal use of legs.

Figure: Sacral and pelvis torsion

⦁ The forward seat requires more flexion at the knee and hip while the adductor muscles are now working harder. However, it is kinder to the equine back providing the rider isn’t slapping the saddle with each canter stride; fitness, stamina and balance are key here.



Denise Thomas


Mobile: 07710170838

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