Jo Johnson Equine Physiotherapy

27/02/2026

Electrotherapy Treatments for Horses

Electrotherapy is a safe, non-invasive way to support healing, reduce pain, and improve muscle function in horses.
These therapies use controlled energy — such as light, electrical, or electromagnetic pulses — to target soft tissue, joints, nerves, and cellular function.

As part of a tailored physiotherapy programme, electrotherapy can:
• Accelerate recovery
• Support injury rehabilitation
• Improve comfort and performance
• Complement (or, when needed, reduce reliance on) hands-on therapy

It can be especially helpful for horses that are sensitive, reactive, or nervous of manual handling, as many modalities are gentle, well tolerated, and require minimal physical contact.

☀️ Laser Therapy (Photobiomodulation / Low-Level Laser

Laser therapy uses near-infrared light or red light to stimulate cellular activity and promote tissue healing.

Particularly useful for:
• Reducing pain and inflammation
• Accelerating soft-tissue repair
• Supporting wound, tendon, and ligament healing
• Myofascial pain and trigger points

Laser therapy is painless and usually very well accepted.
With appropriate dosing and regular use, it can support early tendonitis, desmitis, and soft-tissue injuries, particularly in the acute and sub-acute phases.

⚡️Neuromuscular Electrical Stimulation (NMES)

NMES uses controlled electrical impulses to stimulate the nerves that supply muscle.
When activated, the muscle contracts — without the horse needing to voluntarily engage it.

NMES is a valuable adjunct for:
• Activating weak, inhibited, or under-used muscles
• Improving neuromuscular coordination and timing
• Supporting postural retraining and proprioception
• Maintaining or rebuilding muscle strength
• Preventing muscle atrophy during box rest
• Supporting recovery after injury, surgery, or nerve involvement

It is particularly helpful when normal movement or correct muscle recruitment is difficult.

🧲 Pulsed Electromagnetic Field Therapy (PEMF)

PEMF uses low-frequency electromagnetic pulses to influence tissues at a cellular level.
Rather than causing movement or contraction, it supports how cells function, communicate, and recover.

PEMF:
• Stimulates mitochondrial activity, increasing cellular energy (ATP)
• Helps regulate inflammation
• Improves microcirculation and fluid movement
• Enhances oxygen and nutrient delivery
• Supports waste product removal

It has been shown to influence:
• Bone remodelling and repair
• Tendon and ligament healing
• Joint and cartilage he
• Soft tissue health

By supporting normal nerve signalling and reducing inflammatory sensitisation, PEMF can also help reduce pain and improve overall comfort.

Particularly useful for:
• Acute or chronic inflammation
• Tendon and ligament injuries
• Bone stress or fractures
• Supporting recovery between training sessions

🐴 Tailored. Targeted. Effective.

Electrotherapy is never used in isolation.
It forms part of a wider, assessment-based physiotherapy programme and is selected carefully based on:
• Your horse’s condition
• Stage of injury or training
• Rehabilitation goals
• Individual tolerance

All modalities are applied in line with best practice and governing regulations.

Whether your goal is to speed up healing, support rehabilitation, manage pain, or maintain performance, electrotherapy can offer an effective, gentle addition to your horse’s care — especially for those who find hands-on treatment challenging.

24/02/2026

Behavioural change deserves investigation…

Following on from a previous post about behaviour and pain, how interesting is this? A recent paper describes a 14-year-old Welsh competition pony presented for explosive, dangerous behaviour in canter, just three weeks after a change of ownership. She was referred for investigations and later found to have malformed spine and an extra rib!

Previously, the mare had competed in low-level dressage and showjumping. On arrival with her new owners, a mild hindlimb lameness was noted, which didn't resolve with rest - what escalated was her behaviour under saddle. On examination she had:
• Marked epaxial muscle atrophy over the mid-thoracic spine
• Visible right-sided scoliosis
• Severe restriction in thoracic flexion and extension (T9–T12)
• Pain reactions on palpation and mobilisation
• Stiffness and difficulty maintaining canter leads
• No neurological deficits

Radiographs revealed abnormal vertebral bodies, partial fusion between T11–T12, an additional malformed spinous process, and mild kyphosis.

Postmortem CT confirmed complex congenital thoracic malformations, including:
• Scoliosis centred at T10
• Partial vertebral fusion
• Abnormally shaped vertebral bodies
• A malformed additional rib with altered rib-to-spine articulations
• Degenerative changes in multiple articular and costovertebral joints

In simple terms: the spine was structurally abnormal from birth. Over time, altered biomechanics likely increased mechanical stress, restricted motion, and contributed to pain, particularly at canter, where spinal motion demands increase significantly.

What makes this case especially important is the timeline: the pony had worked previously - she had competed. The behavioural escalation followed a change in ownership and management which the authors suggest could be due to compensatory mechanisms gradually failing, or that subtle discomfort had previously been attributed just to temperament.

This paper reinforces several key points:
• Not all back pain is kissing spines.
• Not all pain presents with neurological deficits.
• Structural abnormalities can exist in mature, functional horses.
• Behavioural change (especially after changes in rider, workload or management) deserves investigation.

Importantly, the authors stress that severe imaging findings alone are not an automatic indication for euthanasia. Findings should always be interpreted in context and with correlation to clinical symptoms. But when behaviour changes, particularly in a previously “coping” horse, it’s certainly worth asking why. This paper also highlights how sometimes the story starts long before the behaviour becomes impossible to ignore - right back when the horse was developing in the womb!

If you have any concerns about your horse's behaviour or think a work-up is needed, do feel free to contact us to discuss and we can arrange a visit with Emiliano!

Read the full paper here: https://www.sciencedirect.com/science/article/pii/S0737080626000365?dgcid=author

24/02/2026

Following yesterday’s practical day with world-leading riders, vets and clinicians, one message came through consistently: most injuries don’t start suddenly – they develop quietly through asymmetry, poor movement patterns, or unresolved low-grade pain.

Soundness isn’t just about whether a horse looks lame. It’s about how evenly the body is loaded, how well it moves, and how early small issues are recognised and addressed. Rider position, saddle fit, shoeing cycles and training choices all interact. Early intervention improves comfort, performance and longevity.

Good riding is not just about results – it’s about reducing wear and tear. Poor transitions increase strain on joints and soft tissues whilst consistency and repetition of good work builds resilience with rider posture directly affecting how forces travel through the horse.

Thorough hands-on assessment is essential before conclusions are made because, as prey animals, many horses work on despite underlying discomfort. Waiting for “obvious lameness” often means waiting too long!

Posture and muscle shape provide valuable information and re-assessment is just as important as treatment. Lateral saddle slip is usually a symptom of a weakness (or lameness) issue- not poor tack or poor riding. Worth noting that saddle slip can occur even without a rider but that rider asymmetry simply worsens or masks the problem. Temporary shimming may help, but strengthening the horse is essential and ignoring saddle slip means ignoring a physical imbalance.

Importantly, performance should never come at the expense of long-term health. Ask yourself why something feels harder, not just how to push through. Low-grade muscular pain will always limit performance and only worsens over time.

In summary, saddle fit, farriery and physio checks should be built into routine. When the owner nurtures an environment where all professionals- the rider, trainer, vet, farrier, dentist, saddler and physiotherapist are working together and communicating, issues can be addressed, longevity of the horse and the horse’s career and comfort is protected.

A huge thank you to Gillian Higgins and team at Horses Inside Out, to Dr Sue Dyson, Dr Kevin Haussler, Dr Gillian Tabor, Mark Fisher,, Ros Canter, Jeanette Breakwell, Dr Lee Clark, Dr Kirsty Lesniak, Dr Chris Pearce and Dr Clare MacLeod, for such a brilliant day! 🤩

23/02/2026

This weekend I’ve been lucky enough to be at the Soundness & Symmetry conference hosted by Horses Inside Out and it has genuinely been one of the most thought-provoking equine CPD events I’ve attended.

We’ve heard from some truly world-leading names in equine science, performance and welfare, including Dr Sue Dyson and Dr Kevin Haussler, whose work continues to shape how we understand soundness, asymmetry and performance.

A consistent message throughout has been that asymmetry does not automatically equal pain and equally, a horse that looks “straight” is not necessarily pain-free. Horses are naturally lateral, and many asymmetries are normal preferences. The real skill lies in recognising when asymmetry is functional… and when it’s pain-driven.

Dr Haussler reinforced the importance of correlating what we see on imaging with how the horse actually functions, particularly when assessing the cervical spine, to avoid over-diagnosis. Dr Dyson reminded us just how well horses mask pain and how behaviour, ridden performance and subtle gait changes often tell us far more than obvious lameness alone.

The legend- Ros Canter brought a rider’s perspective to soundness, training and longevity, reinforcing the value of good horsemanship alongside evidence-based decision making. I loved hearing how Ros creates confidence in each of her horses depending on their very individual personalities.

A particularly powerful and thought-provoking talk came from Roly Owers (Horse Welfare), who challenged us to reflect on welfare, learning culture and how horses experience training and management. His message was clear: if we listen more carefully to what horses tell us through their behaviour and movement, sport can evolve in a way that supports both performance and welfare.

The exhibition space was also a highlight with hands-on learning from full equine skeletons, practical demonstrations and research posters that really helped bring anatomy, biomechanics and rehabilitation principles into three dimensions.

….And I’m still here because today is a practical day! We’ll be working through real-world assessment and decision-making with none other than Dr Sue Dyson, Dr Kevin Haussler, Master Saddler Mark Fisher and more. An incredible opportunity to integrate theory with hands-on application- and hang out with like minded and complementary professionals.

20/02/2026

Too important not to share!

As physios, we see behaviour and movement patterns every day. Emiliano articulates so clearly why behaviour is communication and why careful, structured investigation matters. A really valuable perspective for anyone working with, riding, or caring for horses. Ruling out pain isn’t always straightforward but that’s why a thorough, experienced approach is so important when answers feel elusive.

Behaviour is communication and as equine vets working in the field of lameness and performance medicine, we see this every day. We also see how sometimes the conversation stops too soon. There are hundreds if not thousands of social media posts where people say “It’s not pain, we’ve had the vet out and had all the checks done.” Sometimes that’s true. But sometimes it simply means the source hasn’t been found yet.

There is a significant difference between a general 'once-over' and a structured, focused veterinary work-up. Subtle orthopaedic pain (particularly in horses used for athletic work) rarely presents as dramatic three-legged lameness. More often it shows up as resistance on one rein, reluctance in transitions, difficulty engaging, girthiness, mounting issues, or what’s labelled as an “attitude change.” A horse that can’t circle left may not be evading the rider; it may be protecting a painful stifle or proximal suspensory. A horse that objects to the saddle may not be “cold backed”; it may be compensating for thoracolumbar or sacroiliac discomfort. A horse that becomes explosive under pressure may not be disobedient; it may be responding to chronic orthopaedic pain that has reached threshold. Bilateral hindlimb pain, sacroiliac dysfunction, cervical pathology and kissing spines can all be subtle and compensatory. Without a holistic veterinary approach using things like performance assessments, systematic diagnostics, gait analysis, sequential nerve and joint blocks, or targeted imaging like x-rays/ultrasound or MRI for example, these issues can be easily missed. Horses are good at masking discomfort - and 'compliance' is not proof of comfort. This does not mean every behavioural issue is orthopaedic, but it does mean that ruling out pain properly requires experience, depth of anatomical knowledge, and a structured approach. The absence of an obvious finding is not the same as the absence of pain.

If you have been searching for answers and feel like you’ve reached a dead end, please don’t lose hope. Complex cases often require a different lens. Sometimes the difference isn’t simply whether a horse has 'seen a vet', but whether they have been assessed through an experienced, equine-specific approach.

Within our team, Emiliano dedicates most of his time to exactly these types of complex lameness and performance cases, bringing years of focused experience in his investigations. For challenging or unresolved cases referred to us, he also works collaboratively with primary care vets to review findings and offer an additional experienced perspective. Because at the centre of all of this is the horse - and our responsibility to listen carefully, investigate thoroughly, and do our absolute best to find answers when they need them.

16/02/2026

There’s been a lot of discussion recently about whether we should still be riding horses long and low, particularly as more everyday horses are being found to have compromised or partially absent nuchal ligaments.

Biomechanically, this isn’t an “either/or” question - it’s about how, when, and for how long we use each posture.

🐴 Long & low (when done correctly)
True long-and-low work allows the horse to lengthen the topline, encourages dynamic movement through the thoracolumbar spine, and can support a more relaxed, swinging back. The nuchal and supraspinous ligaments act as elastic structures, helping to reduce muscular effort from muscles such as longissimus dorsi and distribute forces along the spine. This can support back health, circulation, relaxation, and overall longevity.

However, when the nuchal ligament is compromised, the horse loses part of this passive support system, increasing reliance on muscular control.

🐴 Uphill frame work
Correct uphill posture encourages elevation of the withers, engagement of the thoracic sling, and increased activity of muscles such as the thoracic trapezius, rhomboids, and the deep lower neck muscles. These structures provide active support of the neck and shoulder girdle and therefore play an increasingly important role when ligament integrity is reduced.

✨The key point
When done correctly, long-and-low work and uphill work complement each other in developing healthy posture. The soundest horses are produced by strategically alternating postures:

• Stretch (long and low) to maintain spinal health and tissue elasticity
• Lift (uphill) to develop active postural support
• Transition between frequently to build coordination and load-sharing capacity

07/02/2026

05/02/2026

Until now, there hasn’t been a clear way to spot reliably, using standard X-rays, congenital (present at birth) bone variation in the sixth cervical vertebra (C6) of horses- specifically, where the back part of a bone structure called the lamina ventralis is absent.

Now, thanks to research carried out by Dr Sharon May-Davis, Diane Dzingle, Elle Saber and Pamela Blades Eckelbarger, there is a method.

In their study, the missing bone portion in most horses was associated with a shift of that bone segment onto the next vertebra (C7). This shift often changed how neck muscles (like the longus colli) attached and developed, which could affect neck function. In many cases, the vertebral artery’s path was altered due to these bone changes, sometimes entering the spinal column in an unusual spot.

The abnormalities can be found across many common breeds and disciplines, not just one type of horse or job, with the abnormality strongly linked to neck pain and dysfunction. The findings may help explain why certain horses develop performance issues, behavioural problems, or neurological signs despite good management.

The average age for euthanasia of the horses in the study was just 9 years old and euthanasia followed serious issues such as dangerous behaviour, poor performance, neurological signs, chronic pain, lameness, or declining health— often after only a few years of being rideable.

Many of these horses didn’t need to be euthanised because they were broken — they were euthanised because their pain went unrecognised, their expectations stayed too high, and intervention came after safety was already lost.

When horses:
• Fail to respond to good training
• Break down early
• Show escalating behavioural issues
Or
• Have short ridden careers despite normal management

There has to be a question of “why?”. We owe it to our horses to discover that “why”.

Whilst classic CVSM (Cervical Vertebral Stenotic Myelopathy) or “Wobblers” is about spinal cord compression and true neurological disease; non-CVSM C6–C7 conditions are about pain, altered mechanics, and dysfunction — and confusing the two can lead to misdiagnosis, mistreatment, and unfair outcomes for horses.

How can we help our horses whilst we investigate symptoms?:

🐴Early assumption of pain-based behaviour
🐴Standing down from ridden work sooner
🐴Removing performance expectations earlier

https://mdpi-res.com/d_attachment/animals/animals-16-00482/article_deploy/animals-16-00482.pdf?version=1770205862&fbclid=IwVERDUAPxQH1leHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeP2bSjgS2fj-Sz_KKXLz4KttNf9YWgOXk9urwjJUILaHENkyjw1heGFpWf10_aem_8UCARtxwmia2LE9 oyQ-CiQ

03/02/2026

While her rider Hannah was away, I spent a consecutive 5-day physio and groundwork block with gorgeous Tatti to consolidate progress, listen to what her body was telling us, and fine-tune her rehab as she heads into the eventing season.

Tatti has a history of a right hind injury when she was very young, which was never fully investigated at the time. Over the years, that led to compensatory patterns through her pelvis, back, and neck — not because she’s “naughty” or unwilling, but because her body learned to protect itself.

Hannah has already improved Tatti so much since we started back in September (right hind stride length is now equal to the left, hindquarter muscle symmetry is now symmetrical, Tatti pushes off form both hind limbs when jumping…), but we know we haven’t yet reached her full performance potential.

During this block I focused on:
• Reducing residual pelvic and SI soreness
• Improving right hind alignment and rotational control
• Building strength without provoking fatigue or defensive behaviours
• Removing exercises that looked good on paper but weren’t actually right for her now
• Using groundwork, poles, targeted strengthening, NMES, PEMF and manual therapy to support change

One of the most interesting findings was how right hind alignment improved with kinesiology taping, while some commonly used rehab tools (like bum/belly bands) actually encouraged compensation rather than correcting it — a great reminder that the exercise isn’t the goal, the response is.

By the end of the block:
✔️ Hamstring pain had fully resolved
✔️ Thoracolumbar and lumbosacral mobility had improved
✔️ She was moving straighter, freer, and more comfortably
✔️ Remaining work is now about endurance, not injury

Tatti is strong, athletic, and talented — and like many horses with an old injury, progress hasn’t been linear. But this block of physio gave us clarity, confidence, and a clear plan moving forward as Hannah looks forward to the event season.

These cases are why I love what I do. Rehab results are a team effort and I’m the luckiest physio to have such a conscientious and caring owner as Hannah and such sweet natured, generous horse as Tatti to work with. ✨

03/02/2026

Comparative Anatomy: The Shoulder – Horse vs Human

At first glance, the horse and human shoulder appear anatomically similar. In reality, they function in fundamentally different ways.

No shoulder girdle in the horse
Humans have a true shoulder girdle, where the scapula is connected to the axial skeleton via the clavicle (collar bone) and articulates at the glenohumeral joint—a classic ball-and-socket joint that allows a wide range of motion.

Horses, however, do not have a clavicle. Their scapula is not attached to the ribcage by a bony joint at all.

Instead of a bony connection, the equine forelimb is suspended from the trunk entirely by muscle—the system we know as the thoracic sling.

The primary components include:
• Serratus ventralis cervicis and thoracis (key weight-bearing and shock-absorbing muscles)
• Pectoral muscles, assisting in stabilisation and adduction of the limb
• Additional support from surrounding musculature that controls scapular position and motion

This muscular suspension allows the trunk to be carried between the forelimbs and plays a major role in posture, balance, and load management.

Along the lateral border of the scapula, the supraspinatus and infraspinatus muscles act functionally like collateral ligaments, stabilising the shoulder joint during stance and movement. Unlike humans, horses rely far more on active muscular control than passive ligamentous support.

While horses can abduct and adduct the forelimb to a degree, this movement is highly limited compared to the human shoulder. The equine shoulder prioritises:
• Stability over mobility
• Efficient forward propulsion
• Load-bearing and energy conservation

In contrast, the human glenohumeral joint sacrifices stability to allow extensive multi-directional movement.

Because the horse’s shoulder is muscularly suspended:
• Weakness or dysfunction in the thoracic sling will affect posture and movement
• Forelimb lameness, asymmetry, and “heavy on the forehand” way of going are often linked to poor shoulder–trunk integration
• Training and rehabilitation must focus on strength, coordination, and postural control, not just joint range

In summary:
Humans arms hang from bones.
Horses carry their bodies between their forelimbs using muscle.

Quite different!

01/02/2026

Shoulder Conformation in Horses: Why It Matters for Discipline

Shoulder conformation plays a very important role in gait quality, soundness, and discipline-specific performance.

📐 Scapula (shoulder blade) angle
The spine of the scapula ideally sits at around 65° to the horizontal. A more sloping shoulder (smaller angle) is consistently associated with:

•Higher walk and overall gait scores
•Greater stride length and freedom of the forelimb
•Improved shock absorption and long-term soundness

This is because a sloping scapula allows a larger arc of movement of the forelimb and reduces concussive forces through the distal limb.

🦄Discipline matters: the jumper exception

In jumping horses, a slightly more upright scapula can be advantageous. Here, the shoulder acts more as a supportive strut, allowing the forelimb to:

•Transmit force efficiently during take-off
•Push the body mass upwards and forwards over the fence

And so “ideal” conformation is always relative to function.

The humerus:

The orientation of the humerus (upper arm) is just as important as the scapula. A more vertical humerus improves biomechanical efficiency by:

•Keeping the forelimb plumb line underneath the horse
•Reducing braking forces and wasted energy
•Supporting better balance, straightness, and load distribution

When the humerus is too horizontal, the limb is more likely to sit out in front or trail behind, increasing strain on the shoulder, elbow and distal limb structures.

🏋️ Training can influence appearance, not anatomy

While conformation is innate, correct conditioning of the thoracic sling and core musculature can improve posture, stability, and movement quality- allowing the horse to use its shoulder anatomy to best effect.

And so it’s worth noting when looking for your next horse; shoulder conformation should always be assessed in the context of discipline, biomechanics, and long-term soundness- not aesthetics alone.