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Girthy horse = girth pain or discomfort + reactive behaviour.

• the spinal column - the source?
• Symptoms
• Other problems
• Results of Research
• Causes
• How do horses become girthy?
• Diagnosis and Treatment
• Management Options and Self Help
• Conclusion

Bucking on transition from the trot to canter is a very common response to girth pain. Many horses moderately affected horses will look concerned with even light palpation of the tissues underlying the girth.

Girth Pain Syndrome involves the shoulder girdle, upper thoracic vertebrae and the portion of the rib cage that lies under the girth.

Adapted from Denoix and Pailloux, Physical Therapy and Massage for the Horse.1996 Manson Publishing Ltd.

According to the latest research, ribcage trauma is a likely to be a regular feature of birth, both natural and assisted.

Shambourg et al EVJ 2003, 35, (1) 78-81

Girth Pain and Dysfunction

That “Girthy” Horse is Suffering, Not Just Behaving Badly

Girthy horse = girth pain or discomfort + reactive behaviour.

The author’s clinical experience of specific examination and treatment of the spine of over 4000 horses is that girth pain or discomfort is extremely common in horses. It is so common that in most cases the horses’ reactions to discomfort in the girth region are considered by the public, horse trainers and the veterinary profession, to be just bad behaviour. Preliminary scientific investigation of “girthy” horses has helped to more clearly sort out whether horses are suffering pain or other paraesthesia*, or just reacting badly. The sad part is that most “girthy” horses appear to suffer pain or paraesthesia, as well as behave “badly”. Some appear to suffer very mild pain or discomfort, not seeming to be troubled much at all, and some suffer extreme pain, to the point where fastening a girth causes them to collapse on the ground shaking. Very commonly horses appear to suffer moderate pain, and just learn to accept it.

 

The Spinal Column – the source of common Girth Pain and Paraesthesia*?

The origin of girth pain and paraesthesia is unproven. Clinical evidence recorded by the author of over 5000 treatments of girth reactivity supports the view that dysfunction of the spine between the shoulder blades is the source. Treatment, aimed at returning the mobility of the associated part of the spine to normal, is clinically very effective in significantly reducing the symptoms of girth reactivity and associated problems. Quite often symptoms are removed completely.

*Paraesthesia is a medical term that covers abnormal neurological sensations including pain, itching, burning and crawling sensations of the skin which may be associated with irritation of spinal or peripheral nerves.

The combination of behavioural, performance and clinical symptoms associated with girth pain and paraesthesia are grouped together under the title – “Girth Pain Syndrome”.

 

Symptoms that are often clinically associated with Girth Pain Syndrome:

(Note: a number of these symptoms can be associated with saddle soreness and other problems)

On fastening of the girth –

• Attempting to bite the handler. Often repeated at each stage of tightening the girth. This is the most common and most obvious symptom.
• Inflating the chest to fix and splint their ribs. Also prevents the girth being applied very tightly, and may brace the horse to protect from pain.
• Kicking at the girth.
• Slight change in facial expression, often a partial closing or tightening of the eyes or a frown.
• Grunting.
• Lifting the head, swishing the tail.

Once girthed up –

• Short stepping, refusing to move forward freely for 10-20 minutes after being saddled.
• Being one sided, or having difficulty taking one lead. Very common.
• Resisting leg aids.
• Commonly “humping up”, pigrooting or bucking at the start of a ride and especially during the transition from trot to canter on the most affected side, then settling as though nothing had ever been wrong.
• In extreme cases violent bucking and/or pigrooting and /or lying down for a short spell after being girthed up.
• Swishing the tail, laying ears back.
• Grunting while being ridden, especially when going down hill.
• Generally being unhappy and piggy through the ride (While may be happy and a wonderful horse when not ridden.)
• Rushing jumps.
• Resistance to turning sharply.
• Readily developing girth sores.

Signs often seen as a response to touch –

• The skin of the girth area of most horses is ticklish behind the elbow; however, gentle stroking should remove any reaction.  If the skin remains jumpy when touched after gentle stroking then there is probably an active problem.
• When tapping or prodding the skin behind the elbow, the muscles all jump, including the muscles of the leg above the elbow.
• Tightness and tenderness of the muscles under the girth.
• Tightness & tenderness of the muscles above the shoulder blade and under the front of the saddle.
• Uneven shoulders with saddle slipping to the lower shoulder and rider having to correct to the opposite side.

 

Other problems that appear to be associated with “Girth Pain Syndrome”

• The hoof of the most affected side is usually narrower and higher in the heel, than its opposite pair. This also changes leg length and shoulder angle. Usually trouble taking the canter lead on this side.
• Restricted vertebrae and restricted ribs appear to make breathing harder (Morrison J. Master of Chiro. Sc research thesis. Undergoing completion.) – possibly reduces performance in racehorses, and possibly increases the chance of horses bleeding from the lungs.
• The triceps muscles of the legs are often tighter. This is likely to reduce the ability of these muscles to cushion the horses stride, which would increase leg concussion, and potentially lead to lower leg injuries.
• The muscles under the tree point of the saddle are tighter and more tender, and thus are more susceptible to saddle damage and more likely to be painful.

 

Results of Girth Pain Syndrome Research

Preliminary experimental work, conducted for the author’s research thesis into the response of girth pain syndrome to Willoughby Veterinary Chiropractic, has illustrated how changes in pain and reactivity scores occur as a result of spinal adjustment of the motion restricted vertebrae of the wither. Over the page is a graph of the changes that occurred over four examinations, including two treatments, with treated horse scores being shown alongside with untreated, or control, horses. Pain scores were generated from the sum of ten different subjective measures.

 

Causes of Girth Pain and Paraesthesia

It is highly likely that the most common cause of this spinal and rib problem is birth trauma. The body of foals, and especially their chests, are severely compressed during their passage through their mother’s pelvis. Recent research into birth trauma in foals revealed a 5% incidence of broken ribs, and a 20% incidence of rib cage trauma in newborn foals. A small portion of foals actually die from trauma to their chest. The most affected area corresponds with the highest part of the wither and overlaps with that of the girth pain and paraesthesia described here. Symptoms of girth pain and paraesthesia are commonly found on examining young foals, weanlings and yearlings that have never seen a saddle or girth.

Horses falling over backwards often damage their wither, including the vertebral processes, bodies and vertebral facet joints. Evidence consistent with the latter is found in around 10% of thoroughbreds appearing to suffer girth pain, paraesthesia and associated vertebral motion dysfunction.

 

How do horses become girthy, sometimes seemingly overnight?

It appears that in many horses girth irritability or pain is there but is low grade. Most, I believe learn to live with it. When you’re broken in, you get a saddle and girth on, and it’s a bit uncomfortable, but it is made clear that you’re not allowed to complain by biting or carrying on, so you don’t – well not unless you’ve got “attitude” and you have to let every one know about it. The horse, with considerable discomfort or pain, has to either put up with the problem, or do things to evade the pain. Behaviour such as biting at the handler or girth, or pigrooting or bucking, can develop. Pain also creates a heightened sense of anxiety or fear, which further feeds the development of abnormal and undesirable behaviour. Our reactions to the undesirable behaviour may actually encourage them, rather than help diminish them.

Uncomfortable girths and saddles are likely to irritate underlying girth pain or paraesthesia and make it less tolerable for the horse.

If the girth pain and paraesthesia is moderate the horse may learn to live with the discomfort but often we will still have other obvious signs of girth pain syndrome remaining – often trouble with one canter lead, anxiety/fear when away from home, hoof unevenness and so on.

When a horse goes over backwards, falls on its shoulder, or trips badly with a saddle on, or is girthed up roughly, the problem that perhaps started at birth, can be irritated. As a result a good horse can quickly or gradually turn sour, something we have all seen time and time again.

 

Diagnosis and Treatment of Girth Pain Syndrome

Combining the expertise of veterinarians and registered human chiropractors and osteopaths who have had special training in the diagnosis of girth pain syndrome, particularly graduates of the RMIT University Graduate Diploma in Animal Chiropractic, and an equine behavioural specialist, is very important in the diagnosis and treatment of girth pain syndrome. In addition to spinal dysfunction, issues of foot pain, leg lameness, saddle fit, and especially behaviour, can all contribute to the syndrome, and thus all need to be dealt with.

Treatment Options

Using Willoughby Veterinary Chiropractic to free up the motion of the upper chest & ribcage, with the aim of returning the function of the nervous system to normal, is very effective in alleviating girth pain and paraesthesia.

Many therapies can be used to ease the pain and dysfunction associated with girth pain syndrome. Below are just some of the therapies that can help.

• Willoughby Veterinary Chiropractic. The most effective and long lasting treatment that I have seen is Willoughby* veterinary chiropractic adjustment of the joints between the affected vertebra, and of the vertebrae and rib.  It appears to work at the heart of the problem, not just the symptoms. (Using true bony chiropractic to “adjust” only the affected joints, and not leg pulling or massage “chiropractic”).  Improvement is usually immediate, and at times the results are nothing short of spectacular.  See Chart 1 for experimental results.
• Osteopathic techniques that gently improve the flexibility of the ribcage by inducing relaxation of the tight muscles and joints can work very well.
• Acupuncture is very effective in settling down the affected joints and muscle knots, and so the combination of these therapies gives a much-enhanced result.  
• Massage of the girth and wither area is helpful and will, where tolerated, at least give temporary relief.  Some skilled massage therapists claim to produce long- term alleviation of the signs of girth pain.
• Postural adjustment via rider balance, and training under lunge and on the arena, can also reduce the twist of the ribcage, and thus alleviate the problem.  Usually one lead, or foreleg, is favoured when there is girth pain.
• “Shoulder in” exercise is one of the most useful exercises that can be used to get horses to better flex their rib cage, and can help to maintain ribcage flexibility once the spinal mobility faults and pain have been resolved.
• Behavioural modification. Pain leads to avoidance behaviour, such as biting when girthed up, stiffening with leg pressure, resistance to adopting one lead, inflating the chest and refusing to go forward. Pain also increases anxiety and fear, which often lead to other undesirable behaviour. Our reaction to the different abnormal or undesirable behaviour may in fact feed their development. The result is often the growth of a complex set of behavioural patterns, which need to be re-trained, once the pain has been resolved. Making use of the services of a professional equine behaviour specialist can thus be an invaluable part of resolving the broader behavioural issues involved with girth pain syndrome.

Note: Chronic foot problems, hoof imbalance or favouring one leg, pelvic twists and falls, bad teeth, girths, saddles, bits, riders etc may cause the problem to return.

 

Management Options and Self Help

• TENS or Faradic machines may be used to break the pain cycle associated with the affected nerves.  These often give considerable relief if used under appropriate instruction.  The results, however, are removal of the obvious symptoms, rather than the cause. 
• Mounting from a block, or some other support, is mandatory for the health of the wither area, no matter how light the rider is.  Where a block cannot be used, it is best to practice getting on from each side.
• Saddles that are too narrow or too wide at the wither and saddles that grip high in the wither should be avoided – they make the wither component of the problem worse, as well as crippling the wither of the horse.
• Using a broad, cushioned girth, that has 10-15cm of elastic at each end, can increase you horse’s comfort and reduce the chance that an underlying problem will be aggravated if the horse has a fall when being ridden. (Avoid over tightening the girth – easy to do with elastic or western cinch systems.)
• Stretches:  encouraging your horse to stretch its topline with exercises that ask the horse to pick up the front of its chest and bend its neck around out wide can help a great deal. These ease the tension that contributes to the pain and dysfunction. The neck exercise that involves the horse nibbing a carrot between its legs also helps to ease this tension. Stretching out each foreleg is useful for the foreleg component of the syndrome. Stretches should not be attempted until your horse is warmed up and should be done gently.
• Use of “Mirotec” bibs can help warm up the affected area, reducing the initial stiffness associated with the vertebral dysfunction.

 

Conclusion

“Girthy” behaviour is only the tip of the iceberg. This is a major problem of horses. Horses are suffering pain, their performance is reduced, and their behaviour is often adversely affected, and at times, dangerous. For the sake of both the horse and rider, this problem needs treatment that is aimed at the cause, rather than just being managed.

*Dr Sharon Willoughby DVM, DC is the founder of the American Veterinary Chiropractic Association, and a pioneering developer and teacher of veterinary chiropractic.

To find a university trained veterinary chiropractic practitioner check the practitioner lists of the Australian Veterinary Chiropractic Association at www.chirovet.com.au