Q: I am an equine sports massage therapist and have been treating a 10-year-old Icelandic gelding that has a tendency to hold his head to the right while at a walk. He doesn’t do this at any other gait, and he will do it both under saddle and while being led. He has been examined several times by a veterinarian (although no X rays have been taken) who has determined no cause for this behavior. I have located several stress points on both sides of his neck and right shoulder, and he is extremely sore on the right and often tries to bite when I treat these areas. Could there be some underlying physical problem causing him to hold his head and neck to the right, which, in turn, is causing muscle tightening and soreness?

Kathleen, via e-mail

A: There could be several possibilities causing this behavior, and some would depend on exactly how the horse is carrying his head and neck. One possibility is that there are bony changes in the cervical vertebrae. These could be causing pain by impinging on the nerves exiting between the vertebrae. It would require a radiograph to determine if that is the case. Since the horse has been examined previously without radiographs, it might be time to consult your veterinarian about taking them. Another possibility is that there is a decrease in the range of movement of the cervical vertebrae, causing pain. This could possibly be corrected through manual therapy/chiropractic. The formation of myofascial trigger points in the neck, causing pain, could be considered and might benefit from veterinary acupuncture. A veterinarian educated in these complementary medicine techniques might be able to assist you.