Complementary Therapies for Horses

Five reasons to use these modalities on your equine athlete and the research behind them

Is your equine athlete’s performance a little off? Is he stiff in the hindquarters, choppy in front? Perhaps you find him to be underperforming, sluggish, or sore?

You might consider coupling complementary therapies with conventional treatments to boost your horse’s overall well-being and performance. Once called “alternative” and shunned for lack of scientific support, complementary therapies such as chiropractic care, acupuncture, and massage are rapidly gaining ground in sport horse barns as veritable complements to—not replacements for—­traditional veterinary medicine.

If you’re new to complementary therapies or just want to learn more, here’s the latest information from veterinarians trained in these techniques.

Five Reasons to Use Complementary Therapies

Does your horse need these approaches? He might. Read on to find out whether your performance horse fits into any of these categories.

1. He has orthopedic issues.

Orthopedic problems are often par for the course for any athlete, animal or human. Horses’ musculoskeletal systems, in particular, face the additional strains of carrying a rider’s weight, sometimes over high jumps and difficult terrain. Thus, performance horses often need extra attention to, and therapy for, their bones, muscles, and connective tissues, says Tiffany Snell, DVM, certified veterinary acupuncturist and chiropractor at Old Dominion Equine Associates, in Keswick, Virginia. 

The goal of standard veterinary and complementary therapies for equine orthopedic issues should always be to address pain management, proprioceptive (awareness of body positioning) ­deficits, stiffness, weakness or fatigue, and neuromuscular control issues, explains Kevin Haussler, DVM, DC, PhD, Dipl. ACVSMR, of the Orthopaedic Research Center faculty at Colorado State University’s (CSU) College of Veterinary Medicine and Biomedical Sciences, in Fort Collins.

2. He has gastrointestinal or respiratory issues.

Although therapists carry out their complementary treatments on the horse’s exterior, the inner organs could benefit as well, says Brett Robinson, DVM, an associate veterinarian from San Dieguito Equine Group, in San Marcos, California. “Complementary therapies (particularly acupuncture) can help with a variety of other conditions, such as respiratory illnesses, allergies, neurologic disease, gastrointestinal disorders, and more,” she says.

3. He’s dealing with challenges.

Owners often know their horses well enough to identify when something’s not quite right or when they’re facing “life challenges,” say Snell. Those might be stresses related to travel, learning new things, fighting off illness (even with no clinical signs), adjusting to new management or diet, new (or lost) equine companions, or physical stresses associated with learning new skills.

“Complementary therapies really improve the nervous system function, which connects to everything,” she says. “Any stress on the horse’s body or mind, any kind of challenge—whether physical, emotional, or medical—takes its toll on the body, which can affect their physical well-being, soundness, and performance.” Horses might cope better with such challenges with the help of various kinds of complementary therapies, says Snell. 

4. You’re looking to improve his health and performance from a whole-body perspective.

Even if they seem fine and aren’t facing any obvious challenges, performance horses might benefit from complementary therapies that could bring out their full potential, says Robinson.

Snell agrees. “My clients tell me their horses have more improved performance with treatment,” she says. They seem “more stable in their minds” and potentially easier to manage, and their owners “can feel how much better their horses are able to use their bodies ­biomechanically.”

This has a lot to do with whole-body health, adds Robinson. “Body systems are connected, and inflammation in one body system can move to another,” she explains, a concept called energetics. “Chronic inflammation affects hormones, blood flow, and organ function, and integrating these therapies into the horse’s treatment regimen can be very effective (in addressing that).”

“It’s often many things together complementing each other to make the best performance,” adds Snell.

Improvements can also relate to energetics and balance, Snell says. “Especially with acupuncture, people understand that these modalities really benefit mental balance in addition to the physical body in terms of performance.”

5. Standard Western medical treatments have not been effective.

Certainly when a horse has an illness, injury, or performance issue, standard veterinary care—labeled “Western” for its development in the western world as opposed to Asia, where some of the early complementary therapies come from—is a first step, our sources agree. However, despite quality medication and even surgical intervention, some horses don’t improve. In these cases Eastern therapies might have value.

“Owners, riders, or trainers may consider complementary therapies when the standard therapies or medication regimen fails to improve the horse,” Robinson says.

“Maybe their horse is having some sort of problem that has been correctly worked up and examined by a previous veterinarian, and it just wasn’t really a ‘Western’ type of problem, in that it really needed a more hands-on energetic modality to help resolve the issue,” says Snell. “I think a lot of cases come to me in that way because everyone else is like, ‘I don’t know what else to do!’ And there’s just not another pill to give. Sometimes there are just things that are lingering or challenging that need to be resolved with other types of care.”

Complementary Therapies for Horses

Five Complementary Therapies & the Research Behind Them

Now let’s review popular complementary therapies and which ones researchers have examined most.

1. Chiropractic care

Chiropractors use specific controlled movements to correct and relieve pressure and restore range of motion to spinal column joints, says Robinson. Athletic activity, carrying a rider, a pasture or stall mishap, and even bad posture can adversely affect the movement of joints, potentially putting pressure on nerves and connective tissue. “Relieving this pressure enables the horse’s nervous system to function properly and restores joint range of motion, muscle function, and neurologic reflex pathways,” she says.

It’s a technique that helps improve performance in horses, says Haussler, adding that researchers have shown the modality is beneficial for pain relief, improving flexibility, relieving muscle stiffness, and making motion of the spine more ­symmetrical.

“Chiropractic care has both biomechanical effects on the spinal articulations and neurophysiologic effects on muscles and pain perception,” he says. 

2. Osteopathy

Despite its name (“osteo” meaning bone-related), osteopathy takes chiropractic methods a step beyond the bones, addressing muscle and joint manipulation with a ­concentration on internal organs, says Snell. “A chiropractor really focuses more on the movement of the joints and the spine and the nervous system, but the osteopath will use those movements or deficiencies in the spine to lead them to a more internal structure that needs to be attended or treated additionally,” she says.

Although it’s common practice in stables across Europe and is among frequently recommended complementary therapies for back pain in North America, there’s little scientific evidence that osteopathy is effective in horses, says Haussler. Still, one study on more than 50 horses with chronic lameness or gait abnormalities revealed that osteopathy led to improvement in most cases, even six to 12 months after, he says.

3. Acupuncture

Acupuncturists insert fine hypodermic needles into the skin at precise locations—called the “Shu-xu”—as identified by traditional Chinese medical practices dating back thousands of years. Acupuncture aims to stimulate a kind of bodily energy known as “qi,” which—in theory—­normalizes nervous system function and harmonizes energy in a way that’s foreign to Western science. It might also stimulate blood flow and the release of endorphins—the body’s own analgesic.

In Snell’s experience, acupuncture “helps relax the muscles and reset the equilibrium of the energy in the body,” she says. As such, acupuncture works well in combination with chiropractic care. “They’re synergistic in a way that helps the body then hold on to this new natural state.”

Therapists can stimulate these same areas with similar modalities including acupressure (applying firm manual ­pressure over selected acupuncture points) and electroacupuncture (pulsing a mild electrical current through needles inserted in pairs of acupuncture points), she says.

Even so, science supporting the merits of acupuncture and other modalities in horses is limited, says Khursheed Mama, DVM, Dipl. ACVAA, professor of anesthesiology at CSU’s Veterinary Teaching Hospital. Acupuncture likely alters pain signaling and neurochemical inputs, she says, but efficacy studies are conflicting or inconclusive. Many of the studies lack healthy controls for comparison or don’t include enough horses to make robust conclusions.

Sarah Le Jeune, DVM, Dipl. ACVS, ECVS, ACVSMR, CVA, CertVetChiro, of the University of California, Davis, offers a different perspective. In her published review, she states that the needle insertion creates immune responses that help alleviate pain while healing tissues and improving muscle strength.

Complementary Therapies for Horses

4. Stretching

You might not consider it a complementary therapy, but stretching is certainly one of the more popular modalities, says Snell. And although it necessitates good training, it’s something owners can do themselves to help their horses, she says.

“Therapeutic stretching, body Pilates, and yoga movements are all ways that you can manipulate your horse to improve their spinal mobility,” says Snell, adding that this is a nice complement between scheduled professional therapy sessions.

Stretching’s effects occur through increasing flexibility, stimulating proprioception, and strengthening core musculature, says Haussler. People can encourage horses to stretch their necks and backs by getting them to reach for carrots, and they can pick up and stretch their legs according to professional guidelines, he says. Although randomized controlled trials are few, anecdotal evidence and biomechanical knowledge of horses suggest that “carrot stretches,” at least, are beneficial for core strengthening. Limb stretching is also helpful if applied correctly and not overdone. 

5. Massage

Who doesn’t love a great massage? Horses seem to appreciate massages, as well—and it’s something owners can do themselves, says Snell.

Massaging your horse allows you to familiarize yourself with his body. If you pay attention to his reactions, you can detect tender spots and areas he likes massaged the most, she says.

“Touch therapies” and massage, when carried out by professionals, focus on myofascial tone and connective tissue in their roles supporting muscle, joint, ligament, and tendon function, says Haussler. When massage therapists roll the skin or provide deep massage, they stimulate the connective tissues—especially helpful for horses with pathologies such as fibrosis (scarring) or soft tissue adhesions, he says. Research on equine massage is scarce, but studies have shown it helps reduce stress behavior and relieve pain in the thoracic and lumbar back regions.

Getting Started

Before initiating any complementary treatment, it’s important to keep the complementary part in mind, says Robinson. “The best place to start is by consulting the primary care veterinarian, as far as getting the most educated recommendation for what kinds of therapy may help that particular horse,” she says. “The veterinarian is the professional who makes assessments, diagnoses, and makes informed treatment recommendations. From there, the veterinarian can either provide the service(s) or refer to a trained professional, and then the veterinarian can follow up after treatment to make subsequent recommendations.”

Owners should always ensure professionals have the necessary certifications by checking official websites for each modality, adds Snell. If owners want to try certain therapies on their horses themselves, they should seek professional advice and get appropriate training first.

Take-Home Message

Jumping into the world of complementary therapies can seem daunting, given the number of choices and varying amount of scientific evidence. But their increasing popularity and practitioners’ tales of satisfied horses and owners suggest some are beneficial. With good veterinary guidance and careful observation of your horse’s responses, you can start testing therapies to try to increase your athlete’s health, welfare, and performance.