11 Most Common Injuries in English Sport Horses: Risk Factors, Treatment & Prevention

English performance riding has roots in European equestrian traditions linked to military horsemanship and hunting on horseback. ^[1]

These traditions relied on the horse’s agility, disposition and responsiveness – the traits at the heart of modern English equestrian sport disciplines.

From the spectacle of top level show jumping, to the poise of the dressage ring, to the rough and tumble of cross-country eventing, each discipline carries its own set of risks to equine athletes.

English riders can help ensure the health and safety of their mounts in training, travel, and competition by familiarizing themselves with the relationship between their horse’s training and competition demands and the potential for injury.

Read on to learn everything you need to know about the most common injuries and sports-related health conditions in English performance horses.

Impact of English Riding Disciplines on Horses

The life of any competition horse carries a degree of risk and stress, regardless of their level or discipline. Some lifestyle factors contributing to health concerns in English sport horses include:

• Demanding show season: Riding is limited to summer seasons in most regions. This often means horses are competing every week for part of the year, and some shows last for three or more days. In addition, there are often winter circuits where riders can train and prepare in the off season.
• Trailering and travel: Horses can get bumped around in a moving trailer or step on themselves as they jostle for balance, even with protective boots, wraps and bumpers. Horses are often shipped in narrow, side-by-side stalls with limited space to move. This creates additional stress for horses, who are not always well-adapted to long periods of close confinement.
• Previous careers: Some hunters, jumpers and eventing horses participate in these sports after prior careers in racing. Off-the-track horses may show signs of pre-existing stress, including sterotypies or anxiety. They may also have existing sports-related health concerns, like bucked shins.
• Level of difficulty: Competition can be strenuous on the horse’s musculoskeletal system. Eventing courses may present thirty to forty-five fixed obstacles over a distance of 7 km (4  mi) or more. Grand Prix showjumping courses feature jumps as high as 1.60 m (5.2 ft) at elite levels. Course designs may also encourage riders to make tight turns at high speed.

By considering these factors when creating training and competition programs for your horse, you can minimize the long-term impact on their health and help ensure a successful show season.

Risk Factors for Injuries

The specific injury risk factors for English disciplines are related to the mechanical demands placed on the horse’s body by the sport. Generally, the physical demands on English horses by sport include: ^[2]

• Hunter/Jumper: Besides navigating obstacles, these horses must modulate their stride, turn at speed, and make repeated impact with the ground. Like other forms of show jumping, there is also a risk of horses running into or not fully clearing a jump, which can lead to blunt force injuries.
• Dressage: The dressage horse is trained to shift its balance or switch its gait in a precisely coordinated and, in some cases, choreographed manner, with a high degree of collection while rider is continuously seated. These horses are prone to injuries associated with repetitive training, particularly in their back, hind-end and distal limbs.
• Eventing: This discipline requires combined expertise in jumping and dressage and adds a rugged cross-country phase that tests speed and endurance over variable terrain. Further, with solid jumping obstacles fixed in place, the risk of injury to the eventing horse has been high in the past. Recent updates to eventing course designs include collapsible jumps to address this particular risk.

Injury Profile of English Sport Horses

While English sport horse skills overlap with many forms of riding, there is evidence that some injuries are more common according to discipline.

One study evaluated the primary site of injury for horses admitted for orthopedic evaluation and found a significant relationship between the horses’ sporting careers and injury trends. Horses dedicated to a single competitive sport had distinctly different injury profiles compared to horses that were used for general purpose riding. ^[2]

The specialized skills and workload associated with competitive training predispose horses to injury at specific anatomic sites or to particular injuries that are distinct from those of leisure horses. ^[3]

Discipline

Not only are performance horses disposed to unique risks associated with intensity and difficulty of competition, but each discipline carries its own distinct risks. ^[2]

Jumping horses, particularly eventers, tend to suffer from acute injury in the front limbs. The dressage horse, by contrast, is more frequently treated for injuries associated with accumulated stress in the hind end. ^[2]

The specific injuries vary, but the patterns make intuitive sense: horses specializing in one sport repeatedly load specific anatomical structures or load them in a discipline-specific way, which can contribute to the risk of excessive or repetitive strain injuries.

Understanding the common patterns of injury and their underlying risk factors can help owners, riders and trainers take precautions, look for early symptoms and, where possible, work to alleviate avoidable risks.

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Level of Competition

Even within a discipline, the level of competition can predict certain injury. ^[2] Horses competing at lower versus higher (‘elite’) levels showed different injury profiles. ^[2]

Table 1. Summary of injury risk by level of competition

SDFT = Superficial digital flexor tendon; DDFT = Deep digital flexor tendon

Top 11 Injuries in English Performance Horses

While this data is helpful to guide training plans, it’s important for riders to be aware of individual risk factors for their horse, such as previous injuries, conformation faults, and underlying health conditions. Further, some of the more common discipline-specific injuries may be correlated to differences in the horse’s age, weight or sex.

With that being said, here are some of the most common performance-related injuries associated with jumping, dressage and eventing horses.

Soft Tissue Injuries

Soft tissue injuries in horse sports primarily involve the tendons and ligaments, particularly in the lower limbs. Internal structures of the hoof may also sustain soft tissue injury, including the:

• Sole
• Frog
• Heel

1. Heel Pain

For the jumping horse, loading on take-off and impact on landing are unavoidable. As expected, bruising, abrasions and soft tissue lesions of the heel or other soft-tissue regions of the foot can arise from friction or impact with hard, abrasive or irregular surfaces encountered in training and on course.

Heel pain is most common in hunter/jumper and eventing horses, and less common in the dressage ring where the risk of excessive concussive impact is lower. ^[4]

Some factors that can affect the quality and integrity of the equine hoof include: ^[5]

• Conformation faults like low heel or other foot imbalances
• Environmental conditions (e.g., wet, muddy paddocks)
• Nutritional status
• Improper shoeing
• Inadequate/irregular farriery

Heel pain may manifest as lameness, particularly on hard surfaces or under saddle. If soreness is suspected, then palpation or careful application of hoof testers to the heel region helps localize a bruise or subcutaneous injury. ^[4]

Heel pain generally responds well to effective management. Corrective shoeing can mediate some risks associated with heel pain, including shoes modified to protect the heel or otherwise re-distribute the load. ^[4]

2. Superficial Digital Flexor Tendon Injuries

Superficial digital flexor tendons (SDFT) provide support to the cannon bone and associated muscle. This tendon acts as a stabilizer and a shock absorber, and it mediates energy and movement throughout the horse’s lower legs. ^[4]

The SDFT is responsible for flexing the digit and is prone to high loading stress during movement, especially in the jumping horse. ^[6][7]

Injury to the superficial digital flexor tendon can range from relatively mild tendonitis to severe acute tendonitis characterized by large lesions. Overstrain is one source of inflammation or tissue damage, but severe cases can also be associated with missteps in deep footing or excessive torque on the lower limb associated with the use of shoe studs. ^[4]

Initial treatment includes: ^[4]

• Stall rest
• Cold therapy
• Anti-inflammatory drugs
• Protective bandaging, casts or boots may further help to stabilize the tissue

Several treatments are available to help English sport horses recover from a tendon injury, including plasma-rich protein injections or other biologic therapies that can improve the quality and speed of recovery. Other treatments may include the use of laser or ultrasound therapy, or surgical intervention. ^[4][6]

If your horse is affected by a tendon injury, consult your veterinarian to determine an individualized treatment plan.

3. Inferior Check Ligament Desmitis

Ligament sprains are a prominent injury in English performance horses that typically presents as heat, soreness and swelling at the site. ^[4]

Mild strains (Type I Lesions) and mild tears (Type II Lesions) may not result in lameness. More severe tears (Type III and IV Lesions) present with moderate to severe lameness and show obvious swelling, heat and soreness. ^[4]

The inferior check ligament (ICL) is also called the accessory ligament of the deep digital flexor tendon (DDFT). It runs along the back of the lower leg below and adjacent to the DDFT, attaching to it approximately one-third of the way down the cannon bone. This ligament absorbs shock and prevents excessive lengthening of the DDFT. ^[4]

ICL injury typically occurs due to: ^[8]

• Overextension due to excessive twisting or pivoting on the leg
• Repetitive strain

Inferior check ligament injuries are common in both jumping and dressage horses. ^[4] They are reported more often in older horses, suggesting that degenerative aging may predispose this ligament to injury. ^[8]

As with other soft tissue injuries, the approach to treatment varies with severity of the lesion. Options may include: ^[8]

• Stall rest
• Controlled exercise
• Cold therapy
• Anti-inflammatory medications
• Bandaging to immobilize the limb
• Shockwave therapy
• Platelet-rich plasma (PRP) injections
• Stem cell therapy

4. Suspensory Desmitis

Suspensory desmitis involves injury and inflammation to the suspensory ligament, typically from repetitive strain or overuse. ^[4]

It is common in the hind end of dressage horses, where collected gaits place high loads on the suspensory ligament. In the jumping horse, suspensory desmitis is more likely associated with over-extension of the fetlock joint upon landing in deep, soft footing. ^[9]

Distinguishing a suspensory ligament injury from nearby tissue damage to structures such as tendons can be challenging. Diagnostics may include: ^[4]

• Systemic palpation
• Flexion tests
• Diagnostic imaging
• Nerve blocks

Treatment of mild suspensory desmitis includes rest and a controlled exercise regimen. More serious injuries that involve partial or complete tearing of the ligament require rehabilitation therapies, where recovery is measured over months. ^[4]

5. Collateral Desmitis of the DIP Joint & Navicular Bone

Damage to the ligaments that stabilize the distal interphalangeal (DIP) joint and navicular bone apparatus can be difficult to distinguish as they are within the foot. Analgesic nerve blocks combined with diagnostic imaging can help to localize the injury. ^[4]

This injury may be associated with: ^[4][10]

• Trauma from sudden injury or repetitive stress to the foot
• Uneven footing or lateral stress
• Conformational issues
• Overuse

Initial treatment may include rest, controlled exercise, and corrective shoeing to improve balance or re-distribute load away from the affected ligaments. ^[11]

Further treatment may involve:

• Anti-inflammatory medications
• Intra-articular injections to promote healing
• Gradual return to work with careful monitoring

The prognosis for horses with collateral desmitis of the DIP joint is generally favorable. ^[4] Early diagnosis and appropriate management are key to achieving the best possible outcome.

Osteoarthritis

Osteoarthritis (OA) refers to degenerative inflammation of the joints. While it is not an injury by definition, sport horses are at higher risk of arthritis due to the intensity of performing and training.

In addition, traumatic injuries have been directly correlated to development of osteoarthritis in horses. ^[12]

English sport horses are prone to specific patterns of arthritis, including:

• Ringbone
• Bone spavin (distal hock)
• Cervical (neck) arthritis
• Osselets

Horses with arthritis require ongoing management, and most eventually have to retire from competition. Working with qualified trainers, maintaining an ideal body condition, and ensuring robust medical care in cases of traumatic injury can help prevent or delay the onset of arthritis, and limit the strain on joints in working horses.

Providing balanced nutrition is important for supporting joint health, as many vitamins and minerals are required to maintain healthy joint tissue.

Supportive supplements can also be beneficial for horses suffering from OA. For example, the omega-3 fatty acids docosahexaenoic Acid (DHA) and eicosapentaenoic acid (EPA) may help to alleviate joint inflammation and symptoms associated with OA. ^[13]

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Methylsulfonylmethane (MSM) is another joint supplement that may hold promise for performance horses with OA. MSM is a readily available form of sulfur that can support healthy connective tissue such as joint cartilage, tendons, and ligaments.

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Research in horses suggests that MSM has anti-inflammatory and antioxidant effects that can help combat oxidative damage and inflammation associated with exercise in performance horses. ^[14]

6. Ringbone

Equine ringbone is a serious degenerative condition that can affect a horse’s career. Performance horses in English riding disciplines involving high impact or sharp turns, like jumpers and eventers, are at increased risk. ^[4]

High and low ringbone are forms of osteoarthritis that affect the bones and joints of the horse’s lower limbs. ^[15][16] Overuse or conformational inadequacies can predispose an athletic horse to this disease.

Low ringbone specifically afflicts the distal interphalangeal (DIP) joint of both front and hind limbs, particularly of older horses. Like all forms of OA, low ringbone is progressive and clinical signs generally worsen as the horse ages.

Factors that can contribute to low ring bone in performance horses include: ^[5]

• Repetitive trauma and concussion on the DIP joint and foot
• Injuries to DIP joint cartilage or supporting ligaments
• Conformational issues
• Excessive strain on the joint

There are several options to mitigate the onset of equine ringbone, including: ^[15]

• Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like phenylbutazone (“bute”) or firocoxib (Equioxx®) can help reduce pain and inflammation. It’s best to work with a veterinarian to manage ongoing arthritis pain, as prolonged use of NSAIDs can lead to right dorsal colitis and other issues.
• Joint injections: Corticosteroids can be injected directly into the affected joint for targeted anti-inflammatory effects. Hyaluronic acid and polysulfated glycosaminoglycans (PSGAGs) may also be injected to protect cartilage and reduce inflammation.
• Platelet-rich plasma (PRP): Involves injecting concentrated platelets from the horse’s own blood to promote healing.
• Interleukin-1 receptor antagonist protein (IRAP): An anti-inflammatory therapy derived from the horse’s blood that reduces the inflammatory response.

Unfortunately, the prognosis for performance horses with advanced low ringbone is generally poor. There is limited space within the hoof for arthritic bone growth or swelling, which increases pressure and pain as the disease progresses. ^[4]

7. Bone Spavin

Osteoarthritis (OA) of the distal hock (tarsus), also known as bone spavin, is a common cause of lameness in performance horses. Wear and tear on these joints through occupation and athleticism are the primary cause of this degenerative condition. ^[17]

Bone spavin is common in older horses, particularly jumpers and eventers, due to: ^[4]

• Repetitive stress and compression on the distal tarsal joints
• Excessive rotation of the tarsal bones
• Tension on the attachment of ligaments

This form of arthritis is also associated with conformational abnormalities such as: ^[4]

• Straight hind limbs
• Sickle hocks
• Cow hocks

Initial symptoms can include: ^[4][17]

• Lack of engagement
• Reduced stride length
• Poor impulsion

Eventually bone spavin progresses to lameness. ^[4][17]

Treatment options for hock arthritis are similar to other forms of arthritis, with pain and weight management as primary strategies. Some horses benefit from regenerative and alternate therapies to maintain soundness. ^[4]

Performance horses living with chronic osteoarthritis may continue competing at a lower level, but as with other forms of degenerative joint disease, they are expected to retire once the condition limits their soundness.

8. Cervical Arthritis

Cervical arthritis describes arthritis in the spinal column of the neck. It can develop in English sport horses from several factors, including: ^[18]

• Degenerative changes associated with aging
• Trauma or injury to the neck
• Congenital malformations of the cervical vertebrae
• Repetitive stress from athletic activities

This performance limiting condition is reported most often in older eventers and jumpers. Initial symptoms may include loss of jumping scope and a general reluctance to lateral flexion, as is required for making sharp turns. ^[18]

Dressage horses with cervical arthritis may likewise show a reluctance to lateral flexion, particularly in advanced maneuvers like the canter pirouette.

In this condition, the cervical articulate facet joint, which connects a vertebra (spinal bone) to its neighboring vertebrae, becomes enlarged, leading to neck pain, lameness or an uncoordinated gait in the hind-end. More subtle symptoms can include resistance to working in a frame, resisting the bit, and stiffness. ^[19]

The precise location of degenerative changes to specific inter-cervical facets (joints) can be difficult to determine. Diagnostic imaging, including bone scans, may aid in diagnosis and guide treatment. ^[4]

Horses with cervical pain may respond to physical therapy and chiropractic care. Medical treatment of cervical OA may involve local injection of corticosteroids and anti-inflammatory medications. Some cases may require surgery. ^[4]

It’s important to note that degenerative changes in the joint are irreversible. ^[20] Most treatments aim to slow the progression of disease and provide pain relief and return to basic function.

Given this, the long-term return to performance for horses with advanced cervical arthritis is limited. ^[21]

9. Fetlock Arthritis

Fetlock arthritis, also known as osselets, is a common condition in older performance horses, especially hunter/jumpers and eventers due to the intense loading of the fetlock joint associated with jumping. ^[4]

Osselets is associated with an accumulation of small injuries over time, which is why it is commonly observed in older horses. ^[4]

Like other forms of arthritis, the symptoms include: ^[4]

• Lameness
• Joint swelling
• Fetlock pain
• Reduced performance

While fetlock arthritis can significantly impact a horse’s athletic career, effective management and treatment can help many horses continue performing, albeit sometimes at a lower level or in a different discipline. ^[16]

Other Musculoskeletal Injuries

Musculoskeletal injuries encompass a broad range of conditions impacting the bones, joints, and soft tissues.

In addition to soft tissue and arthritis-related concerns, back pain and osteochondrosis can limit soundness in performance horses.

10. Sacroiliac & Back Pain

Back pain is common in performance horses and tends to be more common in eventers and jumpers. ^[4] It can result from strain or injuries to muscles, joints, and other structures.

Riders and grooms can identify back pain using gentle palpation, particularly around the saddle area, while monitoring the horse’s reaction.

If you suspect your horse is experiencing back pain, contact your veterinarian for definitive diagnosis and treatment.

The sacroiliac joint connects the pelvis to the spine, so its health and function is critical for horse performance and welfare.

Horses affected by sacroiliac pain may show signs of pain when pressure is applied to the highest point on the haunches (where the joint is located), or when the hindleg is picked up and raised to tilt the pelvis. For this later reason, SI pain is sometimes recognized first by farriers. ^[4]

Back pain is often managed with relatively simple changes such as: ^[4]

• Tack fitting
• Optimizing rider body weight/training/positioning
• Training adjustments

Horses with back pain may also respond well to physical therapy, chiropractic work or acupuncture.

Acute cases with significant pain, swelling or muscle spasm may require more intense veterinary intervention. Treatments may include anti-inflammatory drugs, corticosteroids or muscle relaxants. ^[4]

In addition to treatments common to other joint conditions, SI pain may be partially mitigated through physical therapies that include:

• Exercises to strengthen core muscles
• Stretching
• Walking or trotting over poles to encourage pelvic action
• Underwater treadmills

It’s important to work with a veterinarian before exploring alternate or adjunct therapies for your horse. Some modalities can actually make back pain worse if not performed correctly and within the context of the horse’s wider training regimen.

11. Osteochondrosis of the stifle

Osteochondrosis dissecans (OCD) is a developmental disorder that affects cartilage and bone development within the first six months to two years of a horse’s life. ^[22]

In this condition, the bones do not ossify (harden) properly. This results in separation between the bones and cartilage, leading to reduced function in affected joints. ^[22][23]

Some breeds may have a genetic predisposition to OCD, including Swedish warmbloods, which are increasingly popular in the hunter/jumper rings. ^[23]

Several factors may contribute to the onset of OCD, including: ^[23]

• Rapid growth of foals
• High calorie diets
• Mineral imbalances
• Hormone imbalances
• Trauma or mechanical stress on developing joints

Stifle OCD commonly affects the lateral trochlear ridge of the femur but may also occur on the medial trochlear ridge, in the intertrochlear groove, or on the patella. ^[22]

In less severe cases, clinical signs may not become evident until the horse starts athletic work. In severe cases, lameness can be acute and noticeable before a training program begins

OCD of the complex stifle joint can be treated surgically with debridement using arthroscopy, and prognosis is relatively good if the lesions are small enough for effective debridement. ^[22]

Prevention

All equestrian sports carry some risk of horse injury, including English disciplines. By working with qualified trainers and staying up to date with routine veterinary and farrier care, riders can help prevent injuries related to overtraining.

Other strategies to minimize the risk of injuries in English sport horses include:

• Allow time for recovery: For horses in heavy work, rest is as important as training. Give your horse enough time between workouts to recover so they can perform at their best next time they are in the ring.
• Match competition to skill: Developing alongside your equine companion is exciting and rewarding. Make sure your horse is competing at the right level for their (and your) degree of experience, fitness and training.
• Diversify training: Work with your horse to give them a well-rounded skill set, even if some tasks are not directly required by your sport. By developing your horse’s fitness holistically, they are less likely to over-exert under-conditioned structures.

Finally, no matter the discipline, one of the simplest ways to support your horse’s athletic performance and prevent injury to provide balanced, forage-based nutrition. Ensuring your horse meets essential nutrient requirements is key to supporting their training, recovery, and soundness.

If you’re unsure whether your English sport horse is receiving the nutrients they need to perform at their best, consult a qualified equine nutritionist. They can assess your horse’s feeding program to ensure it meets their needs, regardless of age, health status, or sport.