Hartpury University Repository

Sellick, Katherine

Taylor, Sienna

The effects of dogs on the mental health of the general population with consideration to welfare.

Tabor, Gillian

Tabor, G., Routine Equine Physiotherapy 
Routine Equine Physiotherapy 1 
Equine Veterinary Education 2 
Tabor, Gillian; Hartpury College, Equestrian Performance Research Group 3 
This is the peer reviewed version of the following article: Tabor, G. (2018), Routine Equine 4 
Physiotherapy. Equine Veterinary Education, which will be published in final form at 5 
https://onlinelibrary.wiley.com/journal/20423292. This article may be used for non-commercial 6 
purposes in accordance with Wiley Terms and Conditions for Self-Archiving. 7 
 8 
What is equine physiotherapy?  9 
Physiotherapists work with the patient to help those affected by injury or illness through movement 10 
and exercise, manual therapy, electrotherapy, education and advice.  As a science based profession 11 
they take a holistic approach to health, helping patients manage pain and prevent disease (Chartered 12 
Society of Physiotherapy (CSP), 2017a).  Training to become a Chartered Physiotherapist requires a 13 
three year undergraduate degree and to become a veterinary physiotherapist and category A member 14 
of the Association of Chartered Physiotherapists in Animal Therapy (ACPAT), a minimum of two years 15 
post graduate training at UK Higher Education level 7 (Masters degree) is required.  The title ‘Chartered 16 
Physiotherapist’ is protected by law and can only be used by physiotherapists who are members of 17 
the Chartered Society of Physiotherapy.  However in the UK, the term physiotherapist is not a 18 
protected title in relation to the treatment of animals, therefore currently ‘physiotherapy’ for horses 19 
can be provided by any member of the public regardless of their level of training.  As a consequence 20 
a multitude of courses have been developed, with standards varying from minimal to those providing 21 
‘day 1 competencies’ equivalent to human practice at completion.  To ascertain the standard of 22 
training of an individual it is recommended to refer to an independent voluntary register such as the 23 
Register of Animal Musculoskeletal Practitioners (RAMP). 24 
Tabor, G., Routine Equine Physiotherapy 
Equine Physiotherapists work within the team of professionals supporting horses at both the national 25 
and international level of competition. In the non-elite equine population, physiotherapists are also 26 
commonly involved in the management of musculoskeletal injuries in partnership with veterinary 27 
team as well as advising owners on regular assessment and treatment schedules for their horses.  28 
Working with the direction of a veterinary surgeon on a client’s horse fulfils the requirements of the 29 
Veterinary Act (1966) Exemptions order (2015) and whilst there may be a practical difference in the 30 
treatment by physiotherapy for injury or for maintenance, the physiotherapist should always work 31 
within the scope of this legal framework. Communication between the physiotherapist and veterinary 32 
surgeon is crucial to delivering the best possible care to the equine athlete.  33 
Horses with diagnosed injuries are likely to benefit from a programme of physiotherapy at all stages 34 
of rehabilitation (Tabor, 2015).  However, unfortunately there is no evidence to support either the 35 
frequency of physiotherapy treatments or specific protocols for particular diagnoses. Evidence is 36 
emerging for the effectiveness of individual treatment approaches, for instance, the use of spinal 37 
manipulation to reduce epaxial muscle tone (Wakeling et al., 2006), to reduce epaxial muscle pain 38 
(Sullivan et al., 2008) and to increase spinal range of motion (Haussler et al., 2010). More recently 39 
evidence that supports the use of physiotherapy exercises to develop the muscles that provide 40 
intervertebral stability to the spine, called dynamic mobilisation exercises, has been published 41 
(Oliveria et al., 2015; Tabor et al., 2012; Stubbs et al., 2011).  Anecdotal reports from owners reporting 42 
the improved outcomes after treatment are suggestive that, as in human sports medicine, teamwork 43 
between veterinary surgeons and physiotherapists ultimately can be key to treatment selection and 44 
achieving rehabilitation goals. 45 
Benefits of routine physiotherapy  46 
Routine or maintenance physiotherapy has yet to be defined fully for the management of horses but 47 
translation from human rehabilitation would suggest the aims are to prevent objectively measureable 48 
deterioration in a patient’s quality of life and or to optimise the patients’ functional capacity (Flanagan 49 
Tabor, G., Routine Equine Physiotherapy 
and Green, 2000).  Examples of maintenance physiotherapy interventions range from ongoing muscle 50 
strengthening programmes in elderly human patients at risk of falls and pain management for 51 
osteoarthritis to the other end of the spectrum when assisting management of the elite athlete during 52 
competition. Continuing treatment using the above definition refers to ongoing conditions that by 53 
their nature will not be fully resolved with a course of physiotherapy.  Therefore in the non-injured 54 
sport horse or those with more chronic pathology such as osteoarthritis there may be a case for the 55 
adoption of maintenance physiotherapy. For a horse in full work, demands on the musculoskeletal 56 
system may predispose the horse to minor tissue injury that left unchecked, could affect quality of 57 
life, welfare and performance capacity.  Some veterinary surgeons are starting to advocate 58 
maintenance physiotherapy to manage conditions and prevent deterioration and ultimately promote 59 
the welfare of the horse.   The importance of a good working relationship between the veterinary 60 
surgeon and physiotherapist, as well as the coach, performance analyst, farrier and saddler is critical 61 
to the success of this team approach to ongoing management of the sport horse. 62 
Regular visits by a physiotherapist, under the direction of a veterinary surgeon, could be included in 63 
the veterinary practice’s health plan for equine clients.  A physiotherapist would likely be able to spend 64 
a considerable amount of time with the client and have very confident knowledge of the particular 65 
horse's normal behaviour, movement pattern and reaction to palpation.  Assessment would be less 66 
geared towards previous history, as this would be known, but focused on assessing and reassessing 67 
key metrics of the health of the musculoskeletal system.  Clinically reasoning the ongoing approach to 68 
the patient by monitoring and evaluating the outcomes of treatments, is crucial to physiotherapy 69 
practice as an evidence informed profession.  Taking into account current workload and any recent 70 
changes to behaviour, observations of gait and function should be included in the assessment. Modern 71 
technology can be used to record and measure movement patterns either in-hand, on the lunge or 72 
performing ridden functional tasks required within their chosen discipline.  Whilst inter-rater reliability 73 
of gait analysis by eye is low, reliability of repeated assessment by a single (experienced) observer is 74 
higher (Fuller et al, 2006).  Systems to objectively measure gait symmetry, for instance inertial 75 
Tabor, G., Routine Equine Physiotherapy 
measurement units, are becoming more affordable and practical and have become available for 76 
routine clinical use.  A mild asymmetrical pelvic movement pattern may be present at each 77 
physiotherapy assessment, however it is important to note that the threshold or the use of a threshold 78 
at which the asymmetry is considered lameness is under debate (Weeran, 2017)..  A subtle gait 79 
asymmetry, when monitored regularly, may be unchanging.  However it may, on subsequent 80 
assessment, have become more apparent to the physiotherapist even if at this stage not felt by the 81 
rider. The presence of asymmetry would be an indication for the physiotherapist to speak to the 82 
veterinary surgeon so a decision can be made whether to further investigate or monitor this finding.  83 
This enables all parties to adhere to BEVA guidelines for working with musculoskeletal therapists, 84 
which state maintenance physiotherapy is appropriate so long as the therapist is sufficiently well 85 
trained to recognise when veterinary intervention is required. 86 
Palpation assessment forms an essential element of the physiotherapy assessment procedure and is 87 
a core skill of a physiotherapist.  With the advent of scoring systems for muscular assessment, this 88 
section of the examination can be made more objective than perhaps considered initially.  Varcoe-89 
Cocks et al. (2006) and Walker et al. (2016) have used objective grading of pain reaction and muscle 90 
tone within groups of horses with and without suspected back pain.  The first study demonstrated 91 
changes in pain and muscle stiffness in horse with sacro-iliac dysfunction and that palpation scores 92 
were correlated with objective measures of mechanical nociceptive threshold and the grade of the 93 
dysfunction.  The second study used an in depth composite grading system to score muscle in dressage 94 
horses and moderate to good agreement was found between scores of five assessors using this 95 
grading system on ten horses.  Using standardised, validated outcome measures in clinical practice is 96 
an explicit requirement of the CSP’s standards (CSP, 2017b).  Whilst muscle soreness can be as a result 97 
of training at loads pushing the threshold of muscular strength, certain patterns of pain in the tissues 98 
could be indicative of an underlying sub-clinical issue that could progress to compromise performance 99 
(Hesse et al., 2010). If training soreness does occur, treatment approaches can be used to prevent 100 
mild tension becoming problematic and compensatory movement patterns being adopted by the 101 
Tabor, G., Routine Equine Physiotherapy 
horse. Therefore the physiotherapist, working closely with the veterinary surgeon, can help manage 102 
in effect not only welfare but performance of the horse. 103 
As well as offering treatments such as manual treatment and electrotherapy, with their knowledge of 104 
muscular physiology and principles of cardiovascular, strength and neuromuscular proprioceptive 105 
training physiotherapists are also well placed to take part in the design of exercise training 106 
programmes for their clients (Crook et al, 2010; Clayton et al., 2011; Stubbs et al, 2011; Kopec et al, 107 
2018). Structuring weekly training levels alongside their coach should be part of this process. 108 
Recording work levels and even calculating training loads can make this element of the assessment 109 
valuable if it prevent either under or over training, which can limit performance development and 110 
increase the risk of injury (Castejon-Riber et al., 2016; Gabbett, 2016). A considerable benefit from 111 
working with a Chartered Physiotherapist is that they can manage the rider as part of the performance 112 
analysis and work with them to reduce any negative impact from their own musculoskeletal injury, 113 
weakness or imbalances. 114 
How frequently maintenance visits occur would depend on the level of the competition, horses were 115 
involved in and the individual characteristics of the horse, such as breed, age and discipline. If the 116 
horse is in a stage of training where upward progression of the level of work is expected then less time 117 
between assessments would be recommended. In this instance 3 to 6 weekly visits may be required.  118 
This is in-line with both cardiovascular and hypertrophic muscle changes expected with a training 119 
programme with increasing demands (Rivero, 2007).  This is particularly relevant to the ridden horse 120 
in terms of changing thoracolumbar epaxial muscle size and subsequent saddle fit (Dyson & Greve, 121 
2016). However if the horse is at a lower performance/competitive level and with little history of pre-122 
existing conditions a visit every six months perhaps in the spring and autumn would suffice. Ultimately, 123 
visit frequency may be influenced by the financial circumstances of the clients therefore a 124 
physiotherapist would be working unethically if they suggested re-visiting more frequently than would 125 
be based on sound clinical reasoning. 126 
Tabor, G., Routine Equine Physiotherapy 
Recommendations 127 
Adopting good practice from contemporary musculoskeletal injury management in human medicine 128 
is crucial to the development of physiotherapy for the equine athlete.  Being able to select treatment 129 
choices based on good quality research is the ideal for the evidence based practitioner.  Clinicians 130 
need to draw ideas together and discuss best practice with the consideration that evidence based 131 
practice is not only about clinical trials but about the clinical experience and the patient (Djulbegovic 132 
& Guyatt, 2017). 133 
One major difficulty is that the process of evaluating effect is currently limited due to limited validated 134 
and reliable outcome measures, which are able to report on the success or failures of physiotherapy 135 
intervention beyond anecdote.  Consideration to the knowledge and understanding of the owner / 136 
trainer / rider as well as their judgement and emotion surrounding the expectation of physiotherapy 137 
would also have to be taken into account to limit false reporting of outcome. 138 
To support the increasing demands of equine clients to manage their horse’s health and welfare, as 139 
well as supporting rehabilitation cases a close working relationship between the veterinary surgeon 140 
and physiotherapist can be recommended.  Successful management of the performance horse 141 
requires input from a range of professionals, working as an inter-disciplinary team.  This is ultimately 142 
beneficial to the horse. 143 
 144 
References 145 
Castejon-Riber, C., Riber, C., Rubio, M.D., Agüera, E. and Muñoz, A., 2017. Objectives, Principles, and 146 
Methods of Strength Training for Horses. Journal of Equine Veterinary Science, 56, pp.93-103. 147 
Chartered Society of Physiotherapy (2017a) What is Physiotherapy? Available from: 148 
http://www.csp.org.uk/your-health/what-physiotherapy 149 
Tabor, G., Routine Equine Physiotherapy 
Chartered Society of Physiotherapy (2017b) Outcome and experience measures Available from: 150 
http://www.csp.org.uk/professional-union/practice/evidence-base/outcome-measures-experience-151 
measures 152 
Clayton, H.M., Lavagnino, M., Kaiser, L.J. and Stubbs, N.C., 2011. Evaluation of biomechanical effects 153 
of four stimulation devices placed on the hind feet of trotting horses. American Journal of Veterinary 154 
Research, 72(11), pp.1489-1495. 155 
Crook, T.C., Wilson, A. and Hodson-Tole, E., 2010. The effect of treadmill speed and gradient on 156 
equine hindlimb muscle activity. Equine Veterinary Journal, 42(s38), pp.412-416 157 
Djulbegovic, B. and Guyatt, G.H., 2017. Progress in evidence-based medicine: a quarter century 158 
on. The Lancet, 390(10092), pp.415-423. 159 
Dyson, S. and Greve, L., 2016. Saddles and girths: what is new? The Veterinary Journal, 207, pp.73-160 
79. 161 
Flanagan, T. and Green, S., 2000. The concept of maintenance physiotherapy. Australian Journal of 162 
Physiotherapy, 46(4), pp.271-278. 163 
Fuller, C.J., Bladon, B.M., Driver, A.J. and Barr, A.R., 2006. The intra-and inter-assessor reliability of 164 
measurement of functional outcome by lameness scoring in horses. The Veterinary Journal, 171(2), 165 
pp.281-286. 166 
Gabbett, T.J., 2016. The training-injury prevention paradox: should athletes be training smarter and 167 
harder?. Br J Sports Med, pp.bjsports-2015. 168 
Haussler, K.K., Martin, C.E. and Hill, A.E., 2010. Efficacy of spinal manipulation and mobilisation on 169 
trunk flexibility and stiffness in horses: a randomised clinical trial. Equine Veterinary Journal, 42(s38), 170 
pp.695-702. 171 
Hesse, K.L. and Verheyen, K.L.P., 2010. Associations between physiotherapy findings and subsequent 172 
diagnosis of pelvic or hindlimb fracture in racing Thoroughbreds. Equine Veterinary Journal, 42(3), 173 
pp.234-239. 174 
Tabor, G., Routine Equine Physiotherapy 
Kopec, N.L., Williams, J.M. and Tabor, G.F., 2018. Kinematic analysis of the thoracic limb of healthy 175 
dogs during descending stair and ramp exercises. American Journal of Veterinary Research, 79(1), 176 
pp.33-41. 177 
de Oliveira, K., Soutello, R.V., da Fonseca, R., Costa, C., Paulo, R.D.L., Fachiolli, D.F. and Clayton, 178 
H.M., 2015. Gymnastic training and dynamic mobilization exercises improve stride quality and increase 179 
epaxial muscle size in therapy horses. Journal of Equine Veterinary Science, 35(11), pp.888-893. 180 
Rivero, J.L., 2007. A scientific background for skeletal muscle conditioning in equine practice. 181 
Transboundary and Emerging Diseases, 54(6), pp.321-332. 182 
Stubbs, N.C., Kaiser, L.J., Hauptman, J. and Clayton, H.M., 2011. Dynamic mobilisation exercises 183 
increase cross sectional area of musculus multifidus. Equine Veterinary Journal, 43(5), pp.522-529. 184 
Sullivan, K.A., Hill, A.E. and Haussler, K.K., 2008. The effects of chiropractic, massage and 185 
phenylbutazone on spinal mechanical nociceptive thresholds in horses without clinical signs. Equine 186 
Veterinary Journal, 40(1), pp.14-20. 187 
Tabor, G.F., Johansson, C. and Randle, H., 2012. The effects of dynamic mobilization exercises on the 188 
multifidus muscle in thoroughbred racehorses. In: Randle, H., Waran, N. and Williams, J. (eds.) The 189 
road ahead, proceedings 8th international equitation science conference, Edinburgh, UK, pp. 64. 190 
Available at: http://www.equitationscience. 191 
com/documents/Conferences/ISESConferenceProceedings2012.pdf. 192 
Tabor, G. (2015) Physiotherapy Management of the Equine Athlete. In: Williams, J. and Evans, D., ed., 193 
(2015) Training for equestrian performance. Wageningen: Wageningen Academic Publishers, pp.325-194 
342 195 
Varcoe-cocks, K., Sagar, K.N., Jeffcott, L.B. and McGowan, C.M., 2006. Pressure algometry to quantify 196 
muscle pain in racehorses with suspected sacroiliac dysfunction. Equine Veterinary Journal, 38(6), 197 
pp.558-562. 198 
Wakeling, J.M., Barnett, K., Price, S. and Nankervis, K., 2006. Effects of manipulative therapy on the 199 
longissimus dorsi in the equine back. Equine and Comparative Exercise Physiology, 3(3), pp.153-160. 200 
Tabor, G., Routine Equine Physiotherapy 
Walker, V.A., Tranquille, C.A., Dyson, S.J., Spear, J. and Murray, R.C., 2016. Association of a 201 
subjective muscle score with increased angles of flexion during sitting trot in dressage horses. Journal 202 
of Equine Veterinary Science, 40, pp.6-15. 203 
Weeren, P.R., Pfau, T., Rhodin, M., Roepstorff, L., Serra Bragança, F. and Weishaupt, M.A., 2017. Do 204 
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pp.567-569. 206 


English

Routine Equine Physiotherapy

Casgrain, I.

Porter, Catherine

Media Outlets Utilised by Equine Enthusiasts

Oxley, James Andrew

Montrose, V. Tamara

Restraint of dogs in vehicles in the UK

Tranquille, Carolyne A.

Tacey, Jack B.

Walker, Vicki A.

Nankervis, Kathryn

Murray, Rachel C.

International Survey of Equine Water Treadmills - Why, when and How?

Guscott, J.

Evans, Brian

An investigation into the effects of mastitis on fertility in a commercial dairy herd

Wright, Coralie

Carroll, Aisling

Microbiological Assessment of Canine Drinking Water and the Impact of Bowl Construction Material

Gheorghiev, Maria D.

Hosseini, Farzad

Moran, Jason

Cooper, Chris E.

Effects of pseudoephedrine on parameters affecting exercise performance: a meta-analysis

Marlin, David

Williams, Jane

ANALYSIS OF FAULTS IN INTERNATIONAL 
SHOWJUMPING COMPETITION
David. Marlin,1* Gillian. Tabor2 and Jane Williams2
1 Cambridge, UK; 2Hartpury University, Hartpury, Gloucestershire, United Kingdom, GL19 3BE, 
*Corresponding author:  dm@davidmarlin.co.uk
INTRODUCTION
Performance analysis (PA) involves the systematic observation and analysis of factors identified to enhance performance in a specific
sport to improve athlete decision-making (Williams, 2015). PA is commonplace in human sports, yet despite potential competitive
advantages, its application in equestrianism, including showjumping, has been minimal to date. It is commonly believed by riders and
trainers that faults in showjumping are not random, but are associated with particular types and / or locations of fences.
This study aimed to characterise faults and to establish if any relationship existed between fault accumulation and fence 
related factors in International showjumping competition.
METHOD
• Sample: horses and riders competing in the 2nd round of the
FEI Nations Cup competition, European Division, 2017 (n=170
combinations; n=8 events)
• FEI definition of faults: knocking down a pole/plank, displacing an
obstacle, a foot landing in water jump, a refusal or run out.
• Recorded faults: number and location, and fence related
variables: jumping effort (incremental), type, approach and
direction (Fig. 1) for 2550 jumping efforts
• Frequency analysis classified the type of faults that were
accrued
• A series of correlations and logistic regression (dichotomous
variable: faults vs. no-faults) multivariable analyses examined if
relationships existed between fault accumulation and fence
related variables (alpha: p <0.05)
REFERENCES: Williams, J.M. Defining performance and measuring success, in Williams, J.M. and Evans, D. (Eds) (2015) Training for Equestrian Performance, 
Holland: Wageningen Press, pp. 25-35.
Fig. 1: Classification of A) fence type, B) approach  
RESULTS
• Most faults were due to knocking down a pole (Fig. 2.)
• A linear increase in risk occurs with increasing number of
efforts with 70% of variance due to jumping effort
number (Fig. 3)
• 2.8 times more knock-downs occurred in the 2nd half of
the course (efforts 9-15) compared to the 1st half (efforts
107; p < 0.05)
• Increased faults occurred when horses approached fences
straight (7.9%), compared to a slight (<45º from previous
fence) left / right approach (6.2%) or on the left or right
rein (>45º from previous fence; 3.8%; p < 0.001)
DISCUSSION AND CONCLUSIONS
This analysis suggests that for International Nations Cup competition, faults were not randomly distributed, showcasing the potential
for PA to be used within equestrian sport. The application of PA could objectively evaluate competitive performances to identify key
factors which are influencing success, such as factors which are related to gaining faults during showjumping. This information can then
be used by riders, coaches, physiotherapists and veterinary surgeons to inform training regimens, and within competition strategy to
enable riders and teams to gain a competitive advantage.
Fig. 3:  Relationship between sequential jumping efforts and fault accumulation.
y = 1.0464x + 0.9619
R² = 0.6947
0
2
4
6
8
10
12
14
16
18
0 2 4 6 8 10 12 14 16
N
u
m
b
er
 o
f 
fa
u
lt
s
Jumping effort 
0
1
2
3
4
5
6
Knock down Time penalties Water jump Refusal / run out
Pe
rc
en
ta
g
e 
o
f 
fa
u
lt
s 
Type of fault
Fig. 2:  Distribution of faults in FEI European Nation Cup competitions.


Analysis of faults in international showjumping competition

Carr-Taylor, Jessica

Non-commercial approaches to mare and stallion selection for breeding

Not a member yet