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How To Deal With Sacroiliac Joint Problems In Horses



The SI joint is on the horse's croup and helps engage the hindquarters, as in this horse's jump

Sacroiliac joint (or SI joint for short) problems are not just limiting for horses’ performance, they also cause pain and distress. In this article, we’ll explore ways to identify and deal with a sacroiliac disease.

How To Deal With Sacroiliac Joint Problems In Horses

Domestic horses are real athletes. Like human athletes, they can come down with all sorts of illnesses and problems, especially in their joints. This is because joints, as a rule, do wear out with time, and they do so faster when you use it often. This doesn’t mean a horse must be a sports horse to have it, of course. Quite the opposite: accidents happen. Sometimes, all it takes is a fall to mess with the fragile balance of a joint.

But what is the sacroiliac disease? Well, it’s the damage to the sacroiliac joint.

What is the sacroiliac joint?

The horse’s spine is rather long and divided into different sections. One of these sections is the sacrum, the vertebrae at your horse’s croup. They are five in total and, unlike the others, they fuse together. This connects the tail to the lumbar region of your horse. It also connects your horse’s pelvis to its body.

The sacroiliac joint (SI joint)

Source: Pinterest.

The sacroiliac joint is what connects the ilia (the flat, wide parts of your horse’s pelvis) to the sacrum. The so-called jumper’s bump (or hunter’s bump) is, in fact, the widest part of the ilia. In a fit horse, these might be quite visible, which doesn’t necessarily mean there is a problem.

These joints don’t move much. They don’t even have much fluid in them. But they’re incredibly important. Ligaments and muscles support them, to keep them in place. The whole ensemble, together, help your horse to transfer power from its hindquarters to the front of their body. This is what gives your horse impulsion, that is, what propels it forward so effectively, especially in gaits such as the canter and gallop. The sacroiliac joint stabilizes the hindquarters of the horse, acting as an anchor point between them and the lumbar.

From there, it’s pretty easy to see why an issue in this region could be a huge problem for any horse. This is essential for your horse to move forward properly. Damage, whether from exercise or an accident, will put a damper on the whole biomechanics of the horse.

Where does sacroiliac disease come from?

Damage to any joint can appear due to different reasons, including accidents. In the case of the SI joint, it might come from a fall or anything that affects or ruptures the muscle and ligaments that support this joint. This will often destabilize the horse’s hindquarters, which will cause pain and low-grade performance loss.

Fractures to the ilia may happen, especially in young racehorses, due to persistent stress. These can be seen through ultrasounds, in special at the topmost part of the ilia. Most fractures, especially microfractures, will heal normally, but some might happen near the joint and cause future problems in the region.

Dressage horses are more prone to sacroiliac disease.

Another possibility is osteoarthritis in the SI joint. This happens due to frequent, repetitive movements and the usual wearing of the joint, as it happens to any other sort of osteoarthritis. Subluxations and ligament wear and tear also affect this joint.

Showjumpers and dressage horses seem to be more prone to SI joint issues. This may be due to the high engagement of the hindquarters necessary to jump, and the collection in dressage where weight rests heavily on the hindquarters. There is no clear evidence whether breed influences this. Many horses with the sacroiliac disease are warmbloods, but as many horses in these two sports are warmbloods, it’s not clear whether the breed influences it or whether it’s only the sport itself that does. Taller, heavier and older horses are also more affected.

How do I know whether my horse has an SI joint problem?

Short answer: you don’t, not really.

Sacroiliac joint problems are notoriously hard to identify. This is because of the thick layer of muscle and fat that coat it. Usually, you can assess a joint problem by moving it and watching out for pain. Because the SI joint doesn’t move much and is inaccessible, this method does not apply in this case.

Even worse, the sacroiliac disease doesn’t cause extreme lameness. Rather, it may cause low-grade pain and performance issues, but these are not necessarily obvious. Many times, the issues are only observable when under saddle, if the horse’s canter feels off or if the rider perceives lack of impulsion from the hindquarters.

Horse undergoing longeing. This action helps to identify sacroiliac disease.

Longeing a horse may help to show sacroiliac issues. Source: Wikicommons.

To complicate matters further, it isn’t unusual for horses to have more than one sort of injury to their hindquarters. In fact, the symptoms of SI joint issues also overlap with many other possible problems, such as hock arthritis. Sometimes, the sacroiliac disease might coexist with lower hind limb issues, or even issues elsewhere, which affects diagnosis. Vets might try to inject the sacroiliac with an anaesthetic and see if there is an improvement in the horse’s symptoms.

Signs of (possible) sacroiliac pain

There are, however, some symptoms that might help to identify this condition. These are:

  • The horse’s hindquarters have a slight slump.
  • There’s a tilt to the pelvis or asymmetry in the hindquarters. Asymmetry does not necessarily mean there is something wrong, but if it’s relatively recent, it might be worth checking out.
  • The horse refuses to collect or jump when it did before.
  • Hesitation to walk forward or canter.
  • Loss of performance. The rider may feel the horse’s canter is choppy or lacks impulsion from the hindquarters.
  • The back is stiff and rigid. The croup region might be sensitive to the touch, and the horse might have muscle spasms there.
  • Muscle loss on the hindquarters.
  • The horse will refuse to raise its hind leg to the farrier.

A way to assess whether your horse has a sacroiliac problem is to see whether the horse moves like it’s on a tightrope. This tracking of the hind is significant because the horse will look for stability of the sacroiliac joint. This is especially visible during the trot. Longing the horse, you might see a drop to one hip, often a sign the horse is in pain. Leading the horse in a serpentine pattern, you might see the tail “dock” to one side, also indicating stiffness in the sacroiliac region. Bunny hopping as well: during canter, a horse might “hop” with its hind legs, like a bunny, rather than move them.

Not all horses will show all symptoms, but usually, at least three of them will be present.

Diagnosing of sacroiliac disease

To confirm whether a horse really does have a sacroiliac joint problem, you need imaging exams.

Nuclear scintigraphy is the one that works the best. In this exam, they will inject a radioactive material in the horse, which will gather in the affected regions and be apparent. Ultrasound exams are also effective, and radiographs will show issues in the higher areas of the ilia. The latter is ineffective if the damage is to the soft areas, which is why an ultrasound scan is necessary.


Treatment is variable and depends on your horse’s actual condition and needs. Corticosteroids and anti-inflammatories may be necessary. Gentle exercise and stretching of the high limbs will help the horse recondition and recover from its injuries and the joint condition as well. Some might look into massage therapy on the horse’s back to help with muscle tightness and further pain. Turnout might also help the horse, as the free, natural range of motion of the horse will help its hindquarters to recover stress-free. Exercises that allow for the suppleness of the hindquarters, but without repetitive motion and stress to the joint, is also helpful. Before applying any sort of treatment, always consult your veterinarian.

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