The musculoskeletal system in horses encompasses the bones, muscles, tendons, ligaments, and joints that facilitate movement and provide structural support. This system is essential for locomotion, athletic performance, and overall health in equine species. The equine skeleton consists of approximately 205 bones, which are connected by joints and supported by a network of muscles and connective tissues. Tendons connect muscles to bones, while ligaments link bones to other bones, contributing to joint stability. The musculoskeletal system is subject to various conditions, including injuries, degenerative diseases, and developmental disorders, which can impact a horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, physiology, pathology, and treatment of musculoskeletal conditions in horses.
Science (New York, N.Y.)September 21, 1962
Volume 137, Issue 3534 979-980 doi: 10.1126/science.137.3534.979
STEINBERG S, BOTELHO S.Congenital myotonia, similar to that which has been reported in humans and in goats, is here reported for the first time in another species. Evidence is given to show (i) that the myotonic phenomenon is present despite complete block of neuromuscular transmission; (ii) prior to injection of curare, synchronous activity of muscle fibers may result not only from ephaptic stimulation of neighboring fibers but also from reflex firing; and (iii) water deprivation does not relieve the myotonia.
Bosman LM, Logan MG, Miszewski A, Pepper MS.Translational regenerative medicine, integrating human and veterinary approaches within the "One Health" framework, increasingly uses horses as models for human musculoskeletal conditions due to shared anatomical and functional features. Osteoarthritis and tendon disorders affect both species, often resulting from high-impact or repetitive strain activities. Regenerative medicine offers therapeutic opportunities by promoting tissue repair and modulating inflammation. Cellular orthobiologics such as mesenchymal stromal/stem cells (MSCs) show promise for treating osteoarthritis and tendon injuri...
Hoogelander B, Frippiat T, Bergman HJ, Vanderperren K, van Veggel ECS.Thoracolumbar congenital abnormalities are considered rare in mature, performing horses. This case report describes a 14-year-old Welsh pony presented with marked epaxial muscle atrophy, mid-thoracic spinal pain, and stiffness, most pronounced during canter. The thoracic spine exhibited scoliosis, centered at T9-T10, and kyphosis. Radiography and postmortem computed tomography revealed complex congenital malformations of the thoracic vertebral column, including abnormal morphology of the T10-T12 vertebral bodies, partial vertebral fusion, a malformed spinous process, a malformed rib with assoc...
Balog O, Havanecz K, Csányi T, Ökrös C, Tóth L, Berki T.Equestrian sport is a unique multi-species discipline in which the performance of a horse-rider dyad depends on the harmonious interaction of two athletes with distinct biomechanics and needs. Although the sport contributes substantially to the global economy and is the only Olympic event involving two species, research on rider-centered factors has been fragmented. Current narrative review centered peer-reviewed evidence addressing three questions: (RQ1) how rider biomechanics and posture influence horse performance and welfare; (RQ2) what causes and consequences rider asymmetry has; and (RQ3...
Kim T, Lee S, Seo JP.Foot diseases are common causes of lameness in horses. Computed tomography (CT) is a valuable tool for diagnosing musculoskeletal lesions in horses and providing a detailed evaluation of foot diseases. Objective: The objective of this study was to establish reference ranges related to the feet of normal Jeju horses by measuring the angles and length of the hoof, and the Hounsfield Unit (HU) value of soft tissues in the foot. Methods: Sixteen normal Jeju horses (mean age: 4.25 years; mean body weight: 282.06 kg) without lameness were examined using CT. After CT scanning, the angles and lengths ...
Keller LE, Kelly TN, Chevalier JM, Jung HJ, Pearson GB, Begum L, Beane OS, Bhumiratana S, Fortier LA.Fresh osteochondral allograft (OCA) transplantation effectively repairs cartilage and subchondral bone; however, the persisting shortage of available donor OCAs and their short shelf-life make scheduling surgeries and meeting patient demand challenging. Attempts have been made to develop tissue-engineered solutions to address the limitations of OCA; nonetheless, these have failed to progress beyond the preclinical stage. Objective: To assess the safety and efficacy of a tissue-engineered osteochondral allograft (TE-OCA) as compared with equine OCA in an equine osteochondral defect model. Metho...
Eren G, López-Albors O, López Corbalán M, Latorre R.Digital technologies have improved the visualization of anatomical structures for veterinary education and clinical practice. In this study, a detailed three-dimensional anatomical model of the equine palmar metacarpal region was generated using E12-based epoxy sheet plastination combined with digital reconstruction in Amira V5.6 software. Serial cross-sections of the metacarpal region provided high-resolution visualization of bones, tendons, ligaments, nerves, vessels, fasciae, and synovial structures, with minimal shrinkage or deformation, ensuring improved anatomical accuracy. These section...
Boger B, Naraian M, Hernandez E, Eaton A, Rockburn R, Tillman I, Payne S, Yob C, Panek C, Manfredi JM.Resistance bands used while horses are exercised with their handlers have shown benefits, but it is unknown if whole-body resistance bands used independently have therapeutic benefits. This study hypothesized that horses with varying gait asymmetries would experience improvements in lameness, muscular function, range of motion, posture, and cortisol following short-term use of a whole-body resistance band wrap (RBW). In this study, nine lame adult horses were evaluated with and without the RBW. The assessment included: objective gait analysis, acoustic myography, postural analysis, gait kinema...
Hall NP, Sweeney DM, Holmströem M, Kim W, Wang Y, Donahue KD, Palmer SE, Lambert DH, Bayly WM.To determine whether targeted lesion-specific algorithms developed from data collected with accelerometer-based inertial measurement units worn by racing Thoroughbreds could retrospectively identify horses at high risk of incurring forelimb condylar or proximal sesamoid fractures. Unassigned: Fracture-specific algorithms were generated from July 2021 to December 2024 with accelerometer data from 42,623 races by 15,755 horses, including 54 races by 23 horses that subsequently suffered condylar fractures and 90 races by 31 horses that later sustained proximal sesamoid fractures. Fracture-specifi...
Folgmann MS, Stock KF, Feige K, Delling U.Current studies on the health status of young German Warmblood stallions are lacking. Objective: To evaluate the prevalence of radiographic findings at licensing examinations of Warmblood candidate stallions and quantify the environmental influences on the distribution of recorded findings. Methods: In this retrospective observational study, records of 1693 radiographic examinations performed on 1678 German Warmblood stallions presented for licensing in 2018-2020 were reviewed. Data were provided by all German Warmblood horse-breeding associations and their official veterinarians. The collecti...
Zimmerman-Cameron SR, Colbath AC, Caruso MA, Hoffman RM, Logan AA.Navicular syndrome is characterized by palmar foot pain and is a common cause of lameness in horses. Palmar digital neurectomy (nerving) removes sensation to the heel region of the hoof and may serve as a treatment for navicular-afflicted horses, while analgesia (blocking) results in temporary loss of sensation. Objective: The purpose of this pilot study was to examine the effect of loss of sensation in the heel on the forelimb area and force while tracking on soft and hard ground at the walk and trot. Methods: Three horses that scored a 0 or 1 on the AAEP lameness scale were fitted to Tekscan...
Mazzucco L, Marcatili M, Withers J, Cantatore F.Superficial digital flexor tendinopathy is a common cause of forelimb lameness in Thoroughbred racehorses and sports horses; however, this condition is rarely observed in the hindlimb. A 16-year-old Irish sports horse gelding was presented with bilateral swelling in the plantar metatarsal region and severe bilateral hindlimb lameness visible at the walk. The lameness occurred after the cross-country phase of an eventing competition. The clinical suspicion of superficial digital flexor tendon (SDFT) injury was confirmed after ultrasonographic examination, which revealed an extensive core lesion...
Chan ZYS, Ho W, Slobodova A, Parkes RSV, Forbes B, Pfau T.To investigate associations between contralateral (left-right) hoof width asymmetry and vertical movement asymmetry in racing Thoroughbreds. We hypothesized that forehoof differences would be associated with poll and withers movement asymmetry and hind hoof differences with pelvis movement asymmetry. Unassigned: This observational cross-sectional study included 169 Thoroughbred racehorses recently retired from clockwise racing and assessed the day of scheduled farriery work. Contralateral hoof width differences were quantified and movement asymmetry during trot measured using inertial sensors ...
Skierbiszewska K, Turek B, Jasiński T, Kaczorowski M, Kozłowska N, Higuchi J, Domino M.Bone grafting in equine medicine offers a promising contribution to treating orthopaedic developmental diseases and chondral, osteochondral and segmental bone defects. Among grafts, synthetic bone substitutes-alloplastics-show favourable biological properties addressing numerous limitations presented by autografts, xenografts and allografts. Objective: To compile and disseminate clinical data and research findings from existing publications on the use of alloplastics in horses. Methods: Systematic review. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-analysis 202...
McCosh KK, Selberg KT, Platt LA, Seabaugh KA.To compare effusion scores obtained via ultrasound (US) and computed tomography (CT) in equine cervical articular process joints (CAPJs). Unassigned: Cadaveric cervical specimens (skull through C7) from 6 horses were used. One specimen was used to establish maximal joint distension volume. In the main study phase, 50 CAPJs were randomly assigned to receive 0, 2, or 4 mL of positive contrast solution. The CAPJs were imaged via US and CT before and after injection. Effusion was subjectively graded on a scale of 0 to 4 for both modalities. Statistical analyses compared pre- and post-injection eff...
Lenarz J, Smit IH, Rhodin M, Lischer C, Fugazzola MC.Intramuscular vaccination is a routine component of equine medicine, but local muscle soreness may transiently affect gait symmetry. Objective data on vaccination-associated gait changes in horses are lacking. Objective: To investigate whether intramuscular vaccination induces measurable gait asymmetries depending on injection site, to inform recommendations on vaccination site selection and short-term exercise management. Methods: In this prospective, randomised, blinded, placebo-controlled study, eighteen clinically sound Warmblood horses were enrolled and received an intramuscular vaccinati...
Barreira AP, Moreira T, Silva R, Nunes L, Lioi A, Kraus E, Altheman V, Ribeiro M, Leite C, Silva A, Almeida F, Santos Junior G, Lessa D, Alves AL.Osteoarthritis (OA) is a degenerative joint disease that affects humans and animals worldwide. Its early diagnosis remains challenging due to subtle clinical signs and late radiographic changes. This study aimed to explore candidate biomarkers associated with spontaneous OA and to investigate their correlation with ultrasonographic scores to support early diagnosis. Clinical, radiographic, and ultrasonographic evaluations were performed on 52 equine metacarpophalangeal joints, with and without OA, allowing joint scoring and classification into osteoarthritis (OAG) and control groups. Synovial ...
Slavik K, Underwood C, Lowndes C, Skelton G, van Eps A.To examine the effects of botulinum toxin inoculation into the deep digital flexor (DDF) muscle on foot biomechanics. Unassigned: 6 healthy horses were injected with botulinum toxin in the DDF of 1 forelimb. The opposite forelimb was untreated. Ground reaction forces (GRF) were measured using a pressure sensor in regions of interest, including the dorsal hoof wall (toe). The location of the center of pressure (COP) was measured relative to the dorsal hoof wall during static standing and at peak stance during walking. Repeat measurements 3, 7, 14, 28, and 42 days after injection were compared t...
Nout-Lomas YS, Story MR.Equine head and neck disorders can present with a wide range of clinical manifestations, depending on the structures involved and disease process. Important components of the gastrointestinal, respiratory, ophthalmological, neurological, and musculoskeletal systems are contained within the head and neck, and clinical signs of disorders will result in expected clinical signs. However, clinical manifestations of disease are sometimes subtle, and when not recognized can lead to behavioral changes including undesired behaviors and poor sleep. Recognizing behavioral phenotypes of horses with proble...
Kwon YS, Jeong H, Kim J, Kim J, Chun K, Yang SK, Kim B.Osteoarthritis is a leading cause of equine lameness, yet pragmatic evidence for nutraceuticals in horses remains limited. Unassigned: We prospectively evaluated 12 weeks of daily natural eggshell membrane (NEM; 12 mg/kg, orally) supplementation in Warmblood horses with chronic lameness using a single-arm before-after design. Ten horses were enrolled and prespecified paired contrasts compared visit 3 (V3, week 12) with baseline (V1). Outcomes included rider-reported under-saddle function (walk and trot), examiner-graded lameness (rest and walk-trot composite), simple joint-angle kinematics...
Pezzanite LM, Nelson BB, Downey AC, Gadomski B, McGilvray K, Baer K, Kappel SM, Nout-Lomas Y, Seim HB, Easley JT.To determine the biomechanical properties of pedicle screw and rod (PSR) constructs alone and with an interbody fusion device (PSRIFD) for equine ventral cervical vertebral stabilization. Methods: Cadaveric ex vivo biomechanical analysis. Methods: A total of 14 (n = 14) adult equine cervical vertebral columns. Methods: Cervical vertebral columns were stabilized by PSR alone (n = 6) or PSRIFD (n = 5). Three columns were left unaltered as controls. Non-destructive biomechanical testing showed the kinematic range of motion (ROM), compliance, and neutral zone of each spinal unit in the...
Urion R, Lustgarten M, Hostnik ET.Technological developments in imaging modalities have advanced the diagnostic capabilities for equine tendon and ligament injuries beyond the traditional methods. This review examines elastography techniques in ultrasonography that assess tissue stiffness and strain properties, computed tomography (CT) innovations including PET/CT fusion and dual-energy CT, and emerging applications of diffusion-weighted MRI for evaluating fiber microstructure and functionality. These complementary approaches offer veterinarians improved means to detect early injuries, assess structural integrity, monitor heal...
Moreno C, Rice H.Diagnostic and treatment strategies for infectious equine tendon and ligament disorders are continually evolving where recent progress is focused on advanced imaging and evidence supporting endoscopic lavage and regional antimicrobial therapy.
Beasley B.The overall objective of therapeutic farriery for equine tendon and ligament injuries is to provide a biomechanical environment conducive to healing by limiting excessive strain on the injured structure. With an understanding of equine limb anatomy and the pathophysiology of tendon/ligament injuries, the rationale used in therapeutic farriery for soft tissue injuries of the distal limb is quite logical. Through therapeutic farriery, foot manipulation is used to reduce the tension on the injured tendon(s) or ligament(s).
Zamboulis DE, Thorpe CT.The high stresses and strains experienced by the superficial digital flexor tendon (SDFT) make it prone to age-related injury. The SDFT exhibits cellular and structural specializations, localized to the interfascicular matrix (IFM), enabling it to resist its extreme mechanical environment. With aging, these specializations are lost, impacting the ability of the tendon to withstand repeated loading. Within the IFM, there is loss of mechanical properties and organization accompanying cell senescence and a decreased resolution of inflammation. Developing therapeutics to reverse these changes may,...
Giessen EJM, Stas EKL, Grinwis GCM, Veraa S.A 3-month-old Friesian colt presented with severe, progressive distal limb lameness in two limbs. Radiographic and postmortem full-body CT imaging revealed severe articular deforming osteolysis and osteoproliferation at the dorsodistal navicular bone margin and the adjacent distal phalanx proximo-palmar/proximo-plantar margin in two limbs, with the remainder of the distal interphalangeal joint being unaffected. Multiple other joints showed small osteolytic subchondral defects. Postmortem histopathological examination confirmed focal joint disease of both distal interphalangeal joints, without ...
Amari M, Brioschi FA, Auletta L, Ravasio G.Radiofrequency ablation (RFA) and pulsed radiofrequency (PRF) are non-pharmacological techniques employed in humans for chronic pain, but their veterinary application is unexplored. This pilot study evaluated clinical effects of RFA and PRF in twenty-four horses with chronic distal forelimb lameness. Ultrasound-guided RFA (N = 8; 60-90 °C, 2-8 min) or PRF (N = 16; 42 °C; 12 min) was applied to palmar digital nerves. Lameness was scored (American Association of Equine Practitioners scale) at baseline and monthly for six months (T1-T6). At T2, partial- and non-responders in both groups receive...
Tranquille C, Nankervis K, Tacey J, Hopkins E, Deckers I, Walker V, MacKechnie-Guire R, Newton R, Murray R.Water treadmill (WT) exercise has become a popular tool for equine training and rehabilitation. However, few studies describe the long-term effects of WT exercise in low water on muscle development (MD). This study's objectives were to compare MD changes over a 40-week period in sport horses that regularly used WT in low water within training (Group WTH, = 55) and a control group that did not (control, = 28). Subjective MD assessments were undertaken using an adaptation of a previously published method at weeks 0, 20 and 40. For Group WTH, MD significantly increased in the neck, pelvis and h...
Dörner C, Lagos N, Oyaneder L, Menarim BC, Ramírez-Toloza G.Osteoarthritis (OA) is an inflammatory joint disease and the leading cause of musculoskeletal disability affecting human and veterinary patients. New therapeutics halting inflammation while preserving joint homeostasis remain a critical need. Voltage-gated sodium (NaV) channels regulate the pro-inflammatory response of macrophages in the synovium, the central driver of joint homeostasis. Neosaxitoxin (NeoSTX) is a phycotoxin that blocks NaV channels, conferring a unique potential to regulate joint inflammation. This study evaluated the safety of intra-articular administration of NeoSTX in hors...
Gutierrez SO, Garcia-Lopez JM, Chope KB, Levine DG, Ortved K, Brown KA.To describe the clinical and ultrasonographic findings in horses with desmopathy of the abaxial palmar/plantar ligament (APL) of the proximal interphalangeal joint and the prevalence of concurrent musculoskeletal injuries in the pastern and foot. Unassigned: Horses presenting to New Bolton Center between March 2017 and November 2022 with an age ranging from 5 to 20 years that underwent lameness evaluation in which lameness was localized to the distal limb and had an ultrasonographic diagnosis of APL desmopathy. Unassigned: Horses included were those that (1) presented for a lameness examinatio...
Aarts RM, Siegers EW, Serra Braganca FM, van Weeren PR.The need for comprehensive equine welfare assessments has become particularly evident amid ongoing debates about the social licence to operate in equestrian sports. During exercise, multiple physiological systems, principally the cardiovascular, respiratory, muscular, thermoregulatory, endocrine, and locomotory systems, undergo complex adaptations. To monitor and determine equine welfare, an approach that focuses on the quantitative monitoring of both physiological and psychological parameters to determine and understand the impact of equestrian sports on horses is essential. Existing and emer...
