The Performance Horse’s Therapy Toolkit

Read about some of the trending and emerging treatments for keeping performance horses feeling their best.

ice boots
Icing, be it with a commercial boot, a simple slurry in a bucket or time spent in a cold water spa, helps reduce pain by drawing out inflammation and numbing the area. | Courtesy Travis Burns/Dr. R. Scott Pleasant

These approaches can offer relief from the aches and pains of training and encourage whole-body wellness

Remember the last time you had a stiff neck, an achy joint, or a pulled muscle? Even mild discomfort can interrupt your concentration and impact your ability to perform a task or physical activity. Professional athletes rely on a combination of techniques to relieve soreness from daily training and stimulate the natural healing process.

Increasingly, horses are benefiting from many of the same modalities developed for human athletes to keep them fit and performing their best. Top competitors rely on specific therapies for their equine partners and credit them with helping keep their horses in winning condition. That can feed the fear of missing out as others rush to try similar techniques. Before you know it, you’ve spent thousands on equipment, gear, and appointments.

“Have a discussion with your vet and/or training professional to strategize how to best invest your money,” says Tracy Turner, DVM, MS, Dipl. ACVS, ACVSMR, who owns Turner Equine Sports Medicine and Surgery, in Minneapolis, Minnesota.

It’s important to remember that each horse is an individual. He might not like or respond to every modality, and some therapies might not be suited to his body or conditions. Without an understanding of how these modalities work, you might also do more harm than good.

“Some people think that if 10 minutes is good, then 20 minutes must be better,” Turner says. “Well, that’s not the case. For example, if you use therapeutic ultrasound too long, it can lead to decalcification (of bone and tissues).”

Andris J. Kaneps, DVM, PhD, Dipl. ACVS, ACVSMR, who owns Kaneps Equine Sports Medicine and Surgery LLC, in Beverly, Massachusetts, emphasizes the importance of talking with a veterinarian before starting therapy to ­ensure it doesn’t cause harm or delay healing based on the horse’s medical ­history.

Picking a modality for your horse and your discipline can feel as overwhelming as ordering from a restaurant menu with too many choices. Here we’ve highlighted popular treatments for keeping performance horses feeling their best. Use this article to start a conversation with your veterinarian about options that make the most sense for your horse. 


Practitioners are recommending chiropractic, acupuncture, and massage more than ever as part of regular maintenance for working horses. Each complementary modality is designed stimulate and alleviate muscle tension, soreness, or other irritation. As for massage, many horses appreciate the firm pressure that targets muscle knots and pain. “Who doesn’t like a massage if they’re doing anything athletic?” Turner says.

Ice/Cold Therapy

People have used ice baths since the earliest times of sports medicine for recovery and healing, and doctors and surgeons recommend it for nearly every type of trauma, says Summer Terry, who works with a team of veterinarians to provide rehabilitation, post-surgery, and fitness therapies for performance horses at her Superior Therapy LLC facility, in Guthrie, Oklahoma. Icing, be it with a commercial boot, a simple slurry in a bucket, or time spent in a cold water spa, helps reduce pain by drawing out inflammation and numbing the area. The cold slows blood flow, she explains, but as soon as you remove the ice, the body sends a rush of blood to the area. This surge of freshly oxygenated blood throughout the leg can help injuries heal.

Injections for Joint Pain and Inflammation

It’s not uncommon to hear riders and trainers talk about having their performance horses injected to relieve joint pain. Injections can fall into three categories: intra-articular, intravenous, and intramuscular. A veterinarian makes recommendations based on the horse.

Some owners schedule regular joint injections and consider them routine maintenance for their performance horses. Turner prefers thinking of it differently: “I don’t like the term maintenance because horses are biological organisms and don’t need oil changes or tires rotated,” he says. “Their joints do become inflamed from time to time and need to be treated.”

Joint injections deliver anti-­inflammatories to the administered area. Corticosteroids are the most common medications in injections and often get combined with hyaluronic acid to control inflammation and offer pain relief in sore joints.

“These days there are far more options available with other properties than the anti-inflammatories,” Turner says.

For example, autologous conditioned serum (ACS, used to increase the cellular response to the naturally occurring interleukin-1 receptor antagonist protein, or IRAP, to block the activity of the potent inflammatory mediator ­interleukin-1) is a recently developed treatment that reduces inflammation and abates pain. Other options include synthetic hydrogels, which are lubricants that attach to damaged cartilage and combat inflammation. Turner says the newest developments are α-2 macroglobulins, naturally occurring enzymes in the horse’s blood that counteract cartilage breakdown.

Injections are part of a whole-horse plan that can bring targeted relief to inflamed and achy joints experiencing inevitable wear and tear.

Electrical Stimulation Therapies

Increasing blood flow to an area is critical to healing acute and routine ­performance soreness. Electrical stimulation includes several types of therapeutic treatments veterinarians often pair with physical therapy. Examples include functional electrical stimulation (FES) and transcutaneous electrical nerve stimulation (TENS). These devices deliver electrical waves to targeted areas of the body.

When humans are in casts or immobilized, they lose muscle tone. In these scenarios doctors might recommend electrical stimulation to strengthen the muscle not being used. The principles are the same in the horse: FES stimulates muscle contraction to make the tissue work, especially when it has been inactive because of an injury.

“FES has a lot of uses. It can be particularly helpful for horses that need multiple spinal adjustments or skeletal adjustments,” Turner says. “The electrostimulation helps fatigue the muscles so you can better work on an area.” 

While few TENS equine studies exist, the therapy might help control musculoskeletal pain by blocking certain pain signals to the spinal cord and releasing endorphins.

Therapeutic Ultrasound

Veterinarians might recommend therapeutic ultrasound to warm tendons and ligaments and loosen tissues. Kaneps says it has the potential to reduce pain and muscle spasms and increase tissue elasticity. “We often use it in my practice for pre-stretching because it loosens the tissues, making stretching more beneficial,” he says. “It can be used to reduce scar tissue.”

Vibration Plates

The next time you watch a professional sporting event, notice how the athletes jump around in warmups to loosen up and release the tension of anticipation. Turner compares these pregame routines to the benefits of vibration therapy.

Horses treated with this therapy stand on large vibrating platforms. The motion is believed to increase blood flow and reduce joint pain and inflammation. The muscles warm and loosen, relieving tension before a ride.

Turner has anecdotally observed the relaxation and loosening that vibration plates offer the horse’s body before work. One client’s horse walks directly from his stall to stand on the plate on his own.

Researchers have shown that vibration plate therapy can help reduce stress and promote hoof growth, among other positive effects, Kaneps adds. Subjective study findings out of Michigan State University (C Nowlin et al., 2018, noted that vibration therapy did not cause any changes in horses’ flexion, stride length, or heart rate but did result in behavioral changes such as relaxation and reduced stress levels.

Magnetic Therapy

Remember playing with magnets as a kid? You learned if you put two similar poles next to one another, they repel. But when opposite poles come close, they attract. Proponents claim that magnet polarity stimulates blood circulation, which can increase oxygen flow and help promote healing, though scientific studies have not confirmed this.

Two types of magnetic therapy are available: static and pulsed electromagnetic field (PEMF). Static magnetic products are available in different strengths and included in sheets, hoods, leg wraps, hock wraps, saddle pads, and more.

Terry says PEMF products pulse a small electrical current through coils of wire (you might have seen specially designed blankets or big loops draped over standing horses) intended to jump-start and accelerate normal biological cellular reactions—the idea being to encourage circulation and help reduce pain and inflammation to accelerate healing (R Cadossi et al., 2018).

“FEI has a rule that the stronger magnets are not allowed to be used during a competition,” Turner cautions. “You can use less-effective magnets over longer periods of time.”

Emerging Therapies in Horses

Keeping up with newly evolving therapies is a challenge, Kaneps says. Advancements in human medicine and sports rehabilitation inspire the use of new approaches in horses, and technological advancements have increased the speed at which new treatments emerge.

Take compression therapy, for example: Some riders outfit their horses in full-body compression suits to help keep muscles in peak shape and alleviate soreness after exercise. While no scientific studies have proven compression therapy’s benefits in horses, research in humans (J Sear et al., 2010) has shown it mimics massage, which reduces tension in overworked muscles and lowers lactic acid levels. The pressure might also promote blood flow, which helps reduce swelling.

Kinesiology tape is a therapeutic tape strategically applied to muscles for ­support, pain relief, and swelling reduction. Currently, studies investigating the use and efficacy of elastic therapeutic taping methods in horses are limited. “We’re using kinesiology tape to help correct weakness and imbalance in the body,” Kaneps says. “It has been useful in human physical therapy for a while now, but it’s gaining popularity in equine practice, too.”

Making Decisions

Horses are like any other athletes. Those who show up the most physically and mentally fit are going to have the best chance of victory. Horses performing at the highest levels have sports medicine teams made up of veterinarians and therapists to keep them feeling their best. These therapies are not luxuries just for elite horses, though—horse owners of all disciplines and levels can use them to help their horses feel their best.

No one therapy is an instant fix for injury or discomfort, and you should always have your veterinarian rule out and treat underlying issues first. And remember when you’re trying to balance the body or correct a deficiency, it doesn’t happen overnight.

“One massage or PEMF treatment will only help for a short time because a series of treatments is needed to work through the layers of pain and dysfunction in the muscle,” Turner says.

Knowing your horse and the weaknesses he might have is key to success. Turner encourages horse owners to choose an approach that addresses those shortcomings first. It’s also important to remember that every horse is an individual. What works for one might not work for another in the same barn. Not all horses respond positively to all therapies, either.

“If you’re at a place and you can pay for a therapy session, try it and see if your horse likes it,” Turner says. “It’s like in people—some like chiropractic and others don’t want somebody snap, crackle, and popping them. I think horses feel the same way. Find a therapy that feels good to your horse.”


Written by:

Katie Navarra has worked as a freelance writer since 2001. A lifelong horse lover, she owns and enjoys competing a dun Quarter Horse mare.

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