The Horse Physio - Delivering care with expertise since 1992

25.3.2022: The Ridden Horse Pain Ethogram – Research and Development

Lame On Both Front Legs?

This study shows just how difficult it is to recognise lameness when it’s in both front legs. The researchers created short term lameness in 11 horses, by causing pressure-induced pain on the sole. They measured the movement of the horses, sound and lame, on a treadmill. There was very little difference in the movement of the bilaterally lame horse compared to the movement of the same horse when it was sound. The most significant changes were that the fetlocks dropped more when the horse was sound compared to when he was lame, and he put the front feet down earlier when he was lame compared to when he was sound. There were no changes in the measured movements in the hind legs, and the slight differences in the movement of the head and body were not statistically significant. The authors suggest that regular measurement of the length of stride and the extension of the fetlock could lead to early detection of bilateral forelimb lameness. This could then be confirmed using nerve blocks.

Buchner HH, Savelberg HH, Schamhardt HC, Barneveld A. Bilateral lameness in horses–a kinematic study. Vet Q. 1995 Sep;17(3):103-5. doi: 10.1080/01652176.1995.9694543. PMID: 8525594

You can access the full article here.


The kinematic pattern of mild bilateral lameness was studied by inducing a supporting limb lameness in both fore-limbs of 11 sound Dutch Warmblood horses. The kinematics of the horses were recorded while they trotted (3.5 m/s) on a treadmill. The locomotion analysis system CODA-3 was used to determine the temporal stride patterns, limb movements as well as head and trunk movement patterns. The transient lameness model, by which pressure-induced pain is evoked on the hoof sole, was used. Differences between left and right limbs as well as between the sound and the lame condition were tested using a paired t-test. Stride and stance duration did not change significantly (p < 0.05) during bilateral lameness compared to the pattern of sound horses. Diagonal advanced placement changed to an earlier placement of both forelimbs. Fetlock hyperextension decreased also in both forelimbs, while the pro- and retraction, hoof impact angle, maximal hoof height, and all hind limb variables remained unchanged. Vertical head and trunk movements tended to decrease, but these changes were not significant. It was concluded that fetlock hyperextension and diagonal advanced placement indicate locomotor disturbances, but that mild bilateral lameness may be difficult to distinguish from individual patterns in single assessments because of the lack of locomotor asymmetries. Evaluation of these variables at regular intervals may allow an early detection of bilateral lameness, which then could be confirmed by diagnostic local anaesthesia.

Dr Sue Dyson and I are in the process of writing a book for horse owners and riders on how to understand and use the Ridden Horse Pain Ethogram with your own horse. The book will be published by J A Allen, and available sometime In 2023. Sign up to my newsletter at for updates.

In the meantime, you can learn more about the Ridden Horse Pain Ethogram through listening to Dr Sue Dyson explaining here it on the Equine Veterinary Education, where you can also listen to her discussing many of the other studies that she has been involved in. You can also take an online course with Equitopia.

© Sue Palmer, The Horse Physio 2021

Treating your horse with care, connection, curiosity and compassion

March 25, 2022
Sue Palmer