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Can you tell when your horse is lame?

“Half of owners cannot identify equine lameness, research finds”, was the headline in a Horse and Hound news article. I found the comments on the article on the Horse and Hound Facebook page particularly interesting. Given that the research findings specifically point out that a person’s confidence in their ability to recognise lameness does not necessarily correlate with their actual ability to recognise lameness (at least in this study), it’s fascinating how many people point out in their comments how confident they are. We know that even a veterinarian’s ability to recognise lameness is not great, especially when the lameness is bilateral, which means that I take with a pinch of salt those comments explaining that it’s just about spending enough time observing enough horses. Sadly, some people have taken the article as shaming owners who are not able to recognise lameness. If we are going to improve equine welfare through improving recognition of lameness and pain behaviours, then we need to somehow stop people feeling as though they don’t know as much as they should. To me, this article is praising those who admit that they aren’t great at recognising lameness, because the study clearly shows that they fit into the majority in the case of recognising hindlimb lameness, and that it’s 50/50 in the case of forelimb lameness.

One thing that stood out to me in the article was the statement from Jade England, the lead researcher, saying, “It’s probably no surprise that horse owners struggle to identify lameness, particularly hindlimb and bilateral lamenesses…Signs such as behavioural changes and pain expressions could really help with this, but we’re finding that owners are rarely using these.”. Having literally written the book on recognising behavioural changes and pain expressions, in conjunction with world-renowned lameness expert Dr Sue Dyson, I’d like to add to this. Lameness is only one element of neuromusculoskeletal pain. Think of this in terms of pain in people. You might limp because your foot hurts. But you might also be in pain in a way that doesn’t make you ‘lame’, perhaps because your back aches or because you have a headache. The Ridden Horse Pain Ethogram is a user-friendly tool backed by solid science that you can use with your horse to check his level of comfort or discomfort. You can learn more about it by reading our book, Harmonious Horsemanship. 

Helping horses, helping humans

This week, I travelled a distance to visit Jen and Magic for the first time. After an online coaching session, we agreed that an in-person visit would be a good idea. Jen and Magic have worked in the past with an equine behaviourist and a veterinary behaviourist, and it was time to bring in some physio. Jen has been lucky enough to have Magic in her life for a few years now, but their journey hasn’t been without its difficulties. It’s fair to say that Jen had to work hard to overcome her nerves around my visit, and that Magic has no qualms about expressing himself. I pulled together my skills as a horse person, a behaviourist, a physio, a coach, a healer, and more, to offer Magic what I felt would most benefit him. We had the loveliest time, and afterwards, Jen sent me a picture that she took during the treatment, with the words, “I never imagined Magic would let you so close, let alone fall asleep on you. You’re a special person.”

Controversy around HRT (hormone replacement therapy)

A few weeks ago, I went to Stafford Gatehouse Theatre to listen to Dr Louise Newson talk about perimenopause and menopause. This is something that half the population will experience, and it can massively affect the lives of the women going through it, as well as those close to her. Research by the Fawcett Society in 2022 found that one in ten women who worked during menopause had left a job due to their symptoms. In my case, as with other mums who were in their thirties when they had children, the hormonal changes of menopause for me are coinciding with the hormonal changes of my son going through his teenage years. You can imagine how much fun that is at times! 

A few days later, Dr Newson was the subject of a Panorama documentary looking into situations where HRT was prescribed above the recommended guidelines. Whilst I absolutely agree that recommended guidelines are there for a reason, I think it’s interesting to look at another area of the discussion around menopause. The same research by the Fawcett Society found that almost half of women haven’t approached their GPs about their symptoms, and three in ten have seen delays in diagnosis, whilst only four in ten women were offered HRT in a timely fashion. That’s six out of ten women who have not been offered HRT when they needed it. And one in two women who aren’t even speaking to their GPs about the difficulties they’re experiencing. Dr Newson has dedicated years of her life to raising awareness of the fact that help is available for those who are suffering.

There has long been fear around the use of HRT, since the now de-bunked early results of the 2002 Womens Health Initiative study that linked it to increased heart disease, breast cancer and more. Since then, other studies, such as one published in the Journal ‘Of Cancer’ in 2022, have found that the use of HRT at the right time and in the right doses reduces the risk of cardiovascular disease, and that the risk of breast cancer is comparable with that of other medications. The use of mare’s urine to make Premarin was enough to put me off going anywhere near it until I discovered that there are better (and kinder!) alternatives. If you’re interested in finding out more about the history of HRT, an interesting article titled The Controversial History of Hormone Replacement Therapy was published in 2019 in the journal Medicina, an open-access peer-reviewed journal owned by the Lithuanian University of Health Sciences.

Ultimately, HRT is a relatively new drug, and any of us using it at this time are, to some degree, guinea pigs. Although it’s been around since the 1960s, the types of HRT offered have changed dramatically, and studies into its safety and effectiveness only began in the 1990s. As with so much in life, we can only do our best in the moment, using the knowledge and experience that we currently have. It’s up to each of us to do our best to gather information and surround ourselves with people we trust, so that we can make the decision that is right for us at this time. Tomorrow, with new knowledge or a new experience, we might make a different decision. 

Sue Palmer MCSP, aka The Horse Physio, is an award-winning author, educator, and Chartered Physiotherapist. 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.

To arrange a phone call or online coaching session with Sue Palmer, The Horse Physio, click here.

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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.

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

Kissing Spines In Horses: Preventive Measures and Long-Term Management Solutions

Harmonious Horsemanship, co-authored with Dr Sue Dyson

Understanding Horse Performance: Brain, Pain or Training?

Horse Massage for Horse Owners

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