The Horse Physio - Delivering care with expertise since 1992

Can your horse tell you where it hurts?

Can your horse tell you where it hurts?

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I had a self-care day with an online Somatics session from Nicki Marshall, The Somatics Coach, and an online consultation with Mehmet Gem, The Hip Physio. As you probably know, I believe in regular physiotherapy for maintenance and prevention. Given the physical job I have and the importance of staying sound, I have physio approximately every six weeks with Dave Paling at the Snazell Pain Relief Clinic, and massage, reflexology, or whichever of her therapies takes my fancy, every six weeks or so from Jenny Charlton at Holistic Horizons. The body fascinates me, and I love learning about health. In all these sessions, the practitioner relies on feedback from me, the patient. I’m acutely aware of how much feedback we miss from our horses since they can’t communicate verbally.

Does your horse trust you?

In my Somatics session with Nicki Marshall, The Somatics Coach, we started by talking through the background and theory of somatics. This is an important aspect of treatment, which is impossible when treating horses. I can explain to the owner why I’m doing what I’m doing and how I came to a particular conclusion. I can do my best to explain it to the horse using movement, touch, body language, and energy. But I’d be kidding myself if I thought that the horse could understand the theory of why he hurts, why I want him to move in a certain way, or how physio can help him to heal. Yet again, I’m reminded just how much horses place their trust in their humans.

How a body scan could impact your horse riding

My Somatics session began and ended with a particular type of guided body scan. I do body scans regularly as part of my meditation practice, but the focus in Somatics is different. It’s fascinating how differently I saw things simply by changing my focus. I wonder how much we would benefit from applying that to our ridden work. Take an exercise we do all the time, for example going from walk to trot, but change what we’re focusing on. So, instead of thinking about how responsive your horse was to the transition, perhaps consider how much weight is in your heels or whether one hand is higher or further forward than the other. Give it a go, and let me know how you get on!

Does your horse notice that he has more weight through one foot than another?

Right from the beginning of my Somatics session, I was fascinated. Nicki asked me to stand and focus on my feet. Was my weight more in my heels or my toes, more on the inside or the outside of my foot, more in one foot than the other? I’ve done body scans before, but not for a long time. I remember standing on a Nintendo Wii and being surprised at how my weight was distributed differently between my left and right foot. In this session, I felt the weight in my heel in my right foot and on the inside of my foot in my left foot. The difference felt massive, like when a chip in your tooth feels so much bigger than it really is. By the end of the session, the weight felt evenly distributed throughout both feet. I wonder if a horse feels more weight in one foot than the other and if they notice the difference at the end of a physio treatment?

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Does pain impact your ability to spend time with your horse?

My online consult with Mehmet Gem, The Hip Physio, left me feeling so relieved. It was great to have an in-depth discussion with a specialist about something that’s been bothering me for a long time. I have regular physiotherapy assessment and treatment every six weeks, as well as regular massage and reflexology, and I trust and respect these practitioners. However, my hip has been sore for several months, and I wanted to chat it through with someone specialising in hips. I love treating horses, and I don’t want pain to impact my ability to do this. I knew that my physio and massage therapist would be interested in hearing about the conversation so that it would help all of us. I specialise in the links between pain and behaviour in horses. Message me if you’d like to chat with me about your horse.

How to be less stressed about what to do for your horse

During my online consult with Mehmet Gem, The Hip Physio, he asked me lots of questions about the background of my hip pain. Physiotherapists are trained in asking relevant questions and are practised in figuring out what to do next based on the answers they receive. When I chat with someone online, I ask them to fill in a form before we meet. This allows the owner to write down everything they would like me to know about their horse; the more information they give me, the better! From this information, I will pick up on some things I want to learn more about, and I will ask about them when we meet. All of this enables me to support you on your journey with your horse, whether you’re looking for guidance, don’t know who to turn to, or need reassurance that you’re doing the best you can.

Can your horse tell you where it hurts?

When I see my Physiotherapist, he asks me to perform specific movements. He can see if I struggle to do any of the movements, if I’m stiff or sore, or if I have restrictions in the range of movement. He can watch my body and my face for signs of pain. But as for where that pain is, he will ask me. So if I am, for example, bending forwards to touch my toes (which, by the way, I can’t reach unless I stretch every day), I might tell him that I feel pain in my back, or my hip, or down the back of my legs. Without the ability to speak or point to the area that’s hurting, he would be able to tell that the movement was painful, but he wouldn’t be able to tell precisely where the pain was. Take the time to think about how that concept applies to recognising pain in your horse.

How being a horse physio is like being a detective

When I find a particular movement painful for a horse, I can recognise (I hope!) that the movement is painful. Still, it can be difficult to tell where that pain is coming from without further assessment and possibly veterinary investigations and diagnostics such as nerve blocks, X-rays and scans. For example, when I pick up the left hind, the horse resists the movement and exhibits pain behaviour; I can deduce that picking up the left hind is painful. Is that because it’s painful to pick up the left hind, or because it’s more painful to put more weight on the right hind or the left fore? If it’s the left hind, is the pain in the fetlock, hock, stifle, hip, sacroiliac region, or back? Is it sore because of bony changes or soft tissue damage such as a muscle tear, tendinopathy, or ligament strain? Being a physio can be a bit like being a detective; and sometimes, ruling things out is as important as ruling things in.

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How could your horse let you know that his leg hurts?

When a horse is difficult for the farrier on just one leg, the behaviour is likely to be pain-related. In my physio assessment with The Hip Physio and my regular physio assessments at the Snazell Pain Relief Clinic, my legs are moved into certain positions to assess for pain, stiffness, and restriction in movement. Given that I have an ongoing grumble in my right hip, if I were a horse, I would kick and bite when some of these tests are done! No wonder a horse with pain in his hock doesn’t want to hold his leg up for the farrier. It’s no surprise that a horse with a sore knee tries to snatch his leg away. When something isn’t right in a limb, holding it in a particular position can hurt! 

Can you give your horse the benefit of the doubt?

My right hip has been grumbling away for several months now. Having had it assessed and having done lots of reading and learning, it seems likely that I have gluteal tendinopathy. Thankfully, this is slowly getting better. Most days, if you watched me walk or work, you wouldn’t know anything was wrong. It’s mainly when I put the leg into a particular position, for example, putting my right sock on, that it hurts. And when I’ve sat still for too long – so if you’ve seen me walk the first few steps when I get out of the car, you’ve probably noticed me limping. Just because your horse is sound in hand and ridden doesn’t rule out the possibility of pain when the limb is asked to do a specific movement, for example, lateral work or holding the leg bent for the farrier. Can you give your horse the benefit of the doubt?

How stress can impact the physical health of your horse

It’s clear from my investigations into my hip pain that although there is a level of tissue damage, in this case probably gluteal tendinopathy, my pain levels are hugely impacted by my environment and my situation. Feeling stressed or overwhelmed, having too much to do, or being overtired, can all make a difference in how much pain I feel. I had been trying to understand why some days feel so much better or worse than others when there is no obvious trigger for the change. But life changes all the time, and in the grand scheme of things, there is very little that I can control about that. Just knowing that more pain does not always equal more damage is such a relief, and I think it’s important to recognise this for our horses as well as for ourselves. 

How you can use your horse’s mind to help heal his body

I learned long ago that as much as I love acupuncture as a treatment, I cannot tolerate certain needle placements when I am feeling emotional. The link between body and mind cannot be unpicked. In the human field, we can use the mind to help the body and the body to help the mind. I’ve long recognised this and integrated it into my approach as a horse physio. After my initial session with Nicki Marshall, The Somatics Coach, I’m fascinated to learn more about Somatics. There is much we can do to help our horse’s body by focusing on his mind. As a horse physio, I encourage relaxation during my treatment sessions to promote the body’s ability to heal. As an owner, you can help your horse by doing your best to provide the optimal environment for the individual, including diet, space, company, enrichment, and much more. 


I have often said that the horses are my teachers. When it comes to self-care, I’m beginning to realise that if I stop and take the time to notice, perhaps I can be my own teacher. Stopping is not easy. I’m a self-employed single mum with a thriving business and a passion to educate and encourage. You have your own busy life. We all have a reason why we can’t make the time for self-care. Perhaps it’s my version of a mid-life crisis, but with my 50th birthday approaching this year, I’m more determined than ever to look after myself. That includes making time for myself and spending time with friends and family, focusing on being there for my son, continuing to serve my clients in the job I love, and being part of making the world a better place for horses. It’s time to celebrate the wins. Would you like to join me?

Meet Sue Palmer

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Sue Palmer MCSP, aka The Horse Physio, is an award-winning author, educator, and Chartered Physiotherapist offering online courses and consultations throughout the world. Sue specialises in understanding the links between equine pain and behaviour, focusing on prevention, partnership and performance. She promotes the kind and fair treatment of horses through empathetic education, and is registered with the RAMP, the ACPAT, the IHA, the CSP and the HCPC.

You can find The Horse Physio on the web, on Facebook, on Instagram, and on YouTube, book an online consultation, or take a look at Sue’s online courses.

Online courses

Horse Health Check: The 10-Point Plan for Physical Wellness

Head to Hoof: An Introduction to Horse Massage

Horse Massage for Horse Owners

Stretching Your Horse: A Guide to Keeping Your Equine Friend Happy and Healthy


Harmonious Horsemanship, co-authored with Dr Sue Dyson

Understanding Horse Performance: Brain, Pain or Training?

Horse Massage for Horse Owners

Thank you

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