Mischief or Malady? Pain Behaviors in Ridden Horses

Pain behaviors in the ridden horse can range from subtle rhythm irregularities to bucking.

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Hannah Knaebel’s mare Brio wasn’t noticeably lame but displayed 12 of the RHPE behaviors. She was ultimately diagnosed with significant stifle pathology. | Photo Courtesy Hannah Knaebel

A list of pain behaviors in ridden horses becomes an accepted tool for understanding them

Brio wasn’t going particularly well under saddle. The 5-year-old mare trotted up and flexed fine. But Hannah Knaebel knew something wasn’t right.

“I couldn’t get answers from the vets as to why she was behaving the way she was,” recalls Knaebel, who has been in the horse industry in various capacities for 30 years.

Then, in 2018 Knaebel came across the Ridden Horse Pain Ethogram. She knew she was right. Brio was in pain.

Sue Dyson, VetMB, PhD, and other researchers have reported that when a ridden horse exhibits eight or more of the ethogram’s 24 behaviors, there’s a good chance he’s experiencing musculoskeletal pain (TheHorse.com/137071).

In other words, the horse is likely lame.

Brio exhibited 12 of the behaviors, Knaebel says. Her head position was unstable. She kicked out in the canter, cross-fired, and moved on three tracks. Ultimately, nerve blocks and radiographs revealed significant pathologies (disease or damage) in the young mare’s stifles.

Dyson and a small team of researchers released the Ridden Horse Pain Ethogram in 2017. Since then additional studies have validated the ethogram as a useful tool for identifying pain in ridden horses and understanding poor performance.

“I think it is accepted worldwide,” says Dyson, who is a former president of the British Equine Veterinary Association and specializes in equine orthopedics. “I’ve never had as much interest in anything as this,” she says of the ethogram’s popularity.

For Knaebel the ethogram’s implications are dramatic.

“If you really want to do right by your horse, if you want to be the best steward possible for your partner, this is the best thing you can begin to explore,” she says.

The Development of the ­Ethogram

An ethogram is a detailed list of behaviors, explains Renate Larssen, MSc, an equine ethologist working on her PhD in human-animal relations at the University of Leicester School of Archaeology and Ancient History, in the U.K.

Jeannine Berger, DVM, Dipl. ACVB, ACAW, CAWA, CEO of Monticello Veterinary Practice, in Winters, California, and one of Dyson’s partners on the ethogram, explains: “The idea of publishing research that evaluates the subtle behavior changes of horses, especially under saddle, was ‘born’ when (Dyson) and I discussed the issue of horses ‘misbehaving’ when ridden.”

The Ridden Horse Pain Ethogram describes the ridden horse specifically. Researchers looked at the behavior of horses trained to perform flatwork in a frame.

“It’s a strength in terms of the fact that (riding) is the situation most horses find themselves in,” says Larssen. “A problem with (the) Ridden Horse Pain Ethogram is many confounding factors could affect the horse’s behavior under a rider.”

The environment must be a fair place to judge the horse, agrees Erin Contino, MS, DVM, Dipl. ACVSMR, an associate professor of equine sports medicine and rehabilitation at Colorado State University’s (CSU) Equine Orthopaedic Research Center, in Fort Collins.

Ultimately, the ethogram lists 24 behaviors winnowed from 117. Scientists have determined in published research that most of the 24 behaviors were at least 10 times more likely to manifest in lame horses versus nonlame horses.

Rethinking Equine Behavior and What to Look for in Your Horse

The ethogram includes classic signs of major “misbehaviors,” such as bucking, rearing, balking, spooking, resisting rider cues, and breaking gait.

The following behaviors might be less commonly associated with being “naughty” but are indicators of pain nonetheless:

  • One or both ears behind vertical.
  • Mouth and teeth gaping.
  • Tongue out.
  • Change in eye posture and expression.
  • Going above the bit.
  • Head-tossing.
  • Tilting the head.
  • Crookedness.
  • Hurrying.
  • Poor-quality canter.
  • Stumbling and toe-dragging.

See the full ethogram for additional behaviors and details about timing and repetition.

The researchers do make allowances for behaviors that might have other explanations. As an illustration, for some horses an exposed sclera (the white of the eye) is normal. A bit that’s too wide might look like it’s pulled through the mouth on one side. A nonlame horse might drag a toe in deep footing.

“You have to look at the individual in the context of the situation,” says Larssen.

All these sources, however, say they’d like to see veterinarians and horse owners utilize the ethogram and related research. Berger says she’d like veterinarians to go beyond the in-hand trot-up and consider behaviors more closely.

“That is a very crude way to assess lameness,” she says of the in-hand jog. “As a rider and equine practitioner, I am very aware that behavior changes are much more subtle than (bobbing head or hips).”

Using the Ridden Horse Pain Ethogram as a Screening Tool

To evaluate a ridden horse for pain behaviors, Dyson suggests working the horse for five to 10 minutes at the walk, trot, and canter in both directions, as well as on a 10-meter circle at the rising trot. Because some horses show pain only during higher level movements (e.g., shoulder-in, collected trot, half-pass, canter flying changes), the rider should also ask the horse to perform those movements, if applicable (and capable).

Rider skill doesn’t make much difference in pain scores. Even though more skilled riders can improve gait quality, says Dyson, other pain behaviors might emerge, making the total score similar.

Though the “magic number,” based on the research, was eight pain behaviors, consult your veterinarian if you’re worried your horse might be in pain. Some horses with lower scores did end up being lame, says Dyson.

Nerve Blocks: Critical to ­Understanding Pain Behaviors

None of our sources want horse owners to go on an expensive radiographic fishing expedition based on a horse’s ethogram score. Nerve blocks (diagnostic analgesia), however, might be in order. The use of nerve blocks validated the ethogram as a tool. Pain behaviors waned when vets performed nerve blocks, demonstrating the behaviors weren’t just how particular horses go.

Knaebel describes her experience with Brio’s nerve blocks as transcendent. “(It) was like a lightning bolt,” she says. “The horse went from difficult and mareish and sassy to willing and forward and happy and uphill and soft. And all it took was identifying where she was hurting and taking the pain away.”

It was the best 10 minutes of her riding career, says Knaebel, who has ridden at the FEI level and now works as a saddle fitter.

Nerve blocks can also be significantly cheaper than radiographs, Contino and Dyson say.

Moreover, while imaging can reveal pathology, the pictures won’t tell you exactly what the horse is experiencing, Knaebel points out. It’s possible the horse’s pain is elsewhere in the body because they’ve been compensating for the pathology the imaging revealed, she says.

The downside to nerve blocks is they’re time-consuming, Contino says: “I think a lot of people fear getting into the weeds.”

Preventing Human Injury

Understanding ridden horse pain behaviors might save your neck. Dyson and others found that pain behaviors in dressage warmup at a three-day event were linked to horses that failed to complete the cross-country phase. Given the risks of riding cross-country, Knaebel finds that significant.

There’s also the psychological pain for riders who believe or are told their poor riding is to blame for the horse’s behavior, Knaebel says. “People are left losing money and losing time and losing sleep, maybe even getting injured themselves,” she says. “However, the horses are communicating very clearly what they’re experiencing. It’s our job to begin to listen.”

Dyson says she hopes if riders can identify pain sooner, the horse can get help before a problem worsens and becomes unfixable.

Brio, the young mare with the problem stifles, was ultimately retired from riding, but Knaebel acknowledges worse things could have happened. The mare could have thrown her in reaction to the pain, resulting in injuries. They could have spent thousands on show entry fees only to be eliminated from competition. The mare could have continued suffering.

“I would much rather be able to stop the suffering and reach a resolution that may not be according to my riding dreams,” Knaebel says. “That saves me money and heartache in the long run.”

Could Artificial Intelligence Tell Us More About Equine Pain?

Dyson has more plans for pain behavior ethogram research, such as conducting studies of Western and jumping horses. Technology will play a part in the future of equine pain behavior research as well. For instance, Dyson and researchers from CSU recently received grant funds to investigate the use of artificial intelligence (AI) to help horse welfare. Visual AI techniques can discern small, discreet changes in movement and facial expression, says Chris Kawcak DVM, PhD, Dipl. ACVS, ACVSMR, a professor at CSU.

“We see this as part of a health management system that could easily include other modalities, such as wearable data,” he says.

Wearable data might come in the form of body-mounted sensors or sensors placed on boots or saddle pads, Contino adds.

Take-Home Message

By familiarizing yourself with the pain behaviors of the ridden horse, you can save time and money and prevent further injury to your horse.

When you think your horse is lame but can’t find an obvious reason, ask your veterinarian about performing nerve blocks.

Pain behaviors for the ridden horse include classic signs of naughtiness as well as subtle rhythm irregularities. “Horses that ‘misbehave’ could be in pain and need our medical attention and not the whip,” Berger says.


Written by:

Karen Hopper Usher has a Master’s degree in journalism from Michigan State University, where she reported for Great Lakes Echo. She previously worked in local news and is a lifelong equestrian.

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