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  • Writer's pictureAndria Massie

Rehabbing the Equine SI joint

In my last article, I covered the Sacroiliac joint as a critical component of a horse’s skeletal system. The SI region connects a horse’s hindquarters to its spine and is designed for stability and shock absorption. Your horse is only able to trot, gallop, turn, and move efficiently because the SI joint transfers the propulsion from the hind limbs to the back.

by Andria Massie, Equine Physiotherapist

Massie Veterinary Services

This horse is struggling to use his hindquarters in the canter

Oftentimes, overstraining, trauma, and improper training can cause ligament and soft tissue injuries in the equine sacroiliac joint, which can notably affect the joint's structural integrity. When this joint is injured, it leads to deficient muscle tone in the hindquarter region and may cause movement restrictions, pain, and discomfort. This leads to decreased performance and even lameness if left untreated.

This article will cover some therapies I employ to stabilize and rehabilitate a horse’s SI joint.

Diagnosing SI Joint Injury in Horses

Dr. Massie uses the powerful Butterfly ultrasound to investigate soft tissue structures of the SI Joint.

Horses with SI joint injuries might never give clear lameness signs, and an unobservant owner might keep working the horse and worsen the injury.

Perhaps the most important telltale sign of an SI joint problem is your horse doesn’t seem to want to move forward. It might exhibit stiffness, difficulty lifting the hind feet, bunny hopping, and lack of hind quarter coordination.

Diagnostic tools such as ultrasound, radiography, and bone scans are used to definitively confirm SI joint injuries and pinpoint the exact location and extent of the injury.

Ultrasound image of multidirectional muscle contraction in SI resulting in deviation of the spine

Rehabbing the SI Joint

Treatment of SI pain usually requires a combination of medication, physiotherapy, and a rehabilitation program. A sound rehab program combines rest, laser therapy, physical therapy and conditioning exercises, as the sacroiliac ligament only strengthens and repairs when challenged by exercise.

My rehabilitation programs can range from anywhere between six weeks to six months, depending on the extent of the injury. The first step in the process is allowing the horse ample time to rest and recover. Then I proceed to design a variety of exercises, tailored to each horse, to help improve the flexibility and strength of the lower back. Some of them are explained below:

Core Training

Strengthening the core muscles is essential for developing the support muscles of the back and croup. When a horse engages its belly, it activates its back muscles, which contributes to overall strength. Horse owners can help in this process by working on exercises such as carrot stretches and belly lifts, as well as practicing ground poles, Cavaletti, and gait transitions in succession to improve upper hind limb strength.

Equicore Complete Equiband® Pro System

I also focus on strengthening the topline and gluteal region of the horse through lunging exercises on a long rein (50-65 feet) avoiding circles for a time. Incorporating lunging aids such as the Pessoa or Equi-Ami stretch bands also helps in the development of vital supporting muscles. Using a water treadmill or trotting poles and leg weights can be very beneficial. These exercises encourage the horse to lift its hind feet in a more natural foot arc, which promotes the development of the appropriate muscles in the pelvis and upper hind limb.

Groundwork and Stretching Exercises

Simple and effective strengthening cavaletti exercises

Once stability is maintained, strength is the goal. Active stretching exercises such as walking in circles, leg yielding, serpentines, and shoulder-in can also help improve flexibility. If the horse is strong enough to be ridden, then some of these can be carried out with a rider on its back. Set up poles about 3 feet apart and encourage your horse to walk over them without taking a stride between them. You should do this until you feel your horse maintains a steady cadence over the poles. These exercises can greatly help to loosen up the back muscles around the SI joint.

Additional Strengthening Exercises & Complimentary Therapies

Strengthening exercises might look easy on the eye, but they must be carried out in a specific manner to ensure the cooperation of the horse. One specific exercise we encourage includes making the horse stand still, its neck fully stretched outward, and encouraging it to gently stretch out its hind foot under its body for about 15 seconds. Hill work, backing up, and raised pole work can all be used to help strengthen the muscles surrounding the SI joint to make it more stable and less prone to injury.

Range of motion exercises such as walking the horse at a 45-degree angle in a figure-8 pattern, lateral work, and trot poles/cavaletti can also be used to help improve the joint's range of motion and flexibility. These simple exercises require the horse to move in a variety of directions, flexing the horse’s sacral and pelvic areas, and helping to increase joint mobility.

Finally, massage therapy, soft tissue release, and laser are beneficial for horses with SI joint injuries. Massage therapy can help to relax tight muscles and reduce inflammation around the joint, while soft tissue release can help to release tight tissues around the joint, allowing the spine to realign and improve joint mobility.

After rehab, horse owners should ensure proper warm-up and cool-down routines before and after exercises. You should also use proper saddle fit, give frequent massages, and maintain regular bodywork to keep the horse's muscles and joints in good working order.

Rehabbing a horse with SI joint injuries requires an accurate diagnosis and a customized program tailored to each individual horse. These require the skills of a specialist veterinarian. You shouldn’t go off attempting these exercises on your own if you have no knowledge about them. Contact your veterinarian or equine physiotherapist to help with an effective rehab program. We provide tailored rehabilitation services here at our clinic on our farm and would be happy to help you and your horse.

In my experience, horses have a good prognosis after a proper rehabilitation program. Many horses I’ve treated returned to full fitness with patience and good care.

If you have further questions and would like a customized SI rehab program developed for your horse, reach out to me. I love hearing from you. Feel free to email me or call 541-636-1191.

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