Help! My horse is girthy, crooked and has uneven front hooves… What can I do? 

This problematic trio is one of the most common reasons owners decide to seek some form of body therapy for their horse. 

After treating more than 10,000 horses and analysing related research over the past 20 years, Dr Ian Bidstrup, a Veterinarian, Veterinary Chiropractic and Acupuncture Practitioner from central Victoria, has realised that his original theory on the causes of girthiness and ‘one-sidedness’ has turned out to be only the tip of a very large iceberg. 

In this exclusive, four-part series, Dr Bidstrup will explore the cascading and longlasting effects of birth trauma in horses and the concept of a ‘neurological scar’. 

He will also discuss ways for reducing the severity of its effect to being hardly noticeable, and the need to routinely check and treat foals between one and three months of age, as well as ways to promote and maintain a more functional symmetry as horses develop. 

This is the first part of a 4-part series of articles written exclusively for Horses and People magazine. You can download the full series as an eBook here. 

A walk in the park?

Newborn foals act like birth was like a walk in the park and not major trauma. They are up walking and looking for milk from their mothers within an hour or two after birth.  

Except in a minority of very severe cases, it is difficult for us to imagine that the newborn foal could well be suffering from painful rib and spinal injuries, could be very tight and very tender through the ribcage area, and perhaps have one or more broken ribs. 

Imagining they may be suffering is even harder when we see the foal zooming around the day after birth despite showing signs of being very tender when the ribs and wither are tested. Clinical experience and thoracic birth trauma research, however, tell us otherwise.  

Rigorous and peer reviewed research into damage to the ribs and ribcage of foals after birth recorded in the esteemed Equine Veterinary Journal (1999, 2003 and 2007) has shown a very significant incidence of rib fractures and crumpling damage to the junction of the ribs and breastbone of the foal. 

One absolutely amazing finding of the research, is that the more severely damaged foals, the ones who commonly end up in veterinary neonatal intensive care facilities with multiple, life threatening rib fractures, are often up and playing within a day or two of admission despite the extensive damage.

Every foal I have examined in the days and weeks after birth has revealed considerable muscle spasm and tenderness to touch in the ribcage region and, very often, spasm of the triceps and serratus muscles at the rear of the upper foreleg of one or both forelegs.

Foal being treated to ease the neurologic effect birth trauma

After birth, the foal’s most tight and tender body parts are the front third of the ribcage and the muscles of the shoulder and girth. Photos by Louise Sedgman Photography.

In some foals, the tension extends right down the back of the foreleg, tightening the passive stay apparatus of the foreleg, and results in one or both forelegs becoming quite upright and, at times, bent forward at the knees.

This is the first part of a 4-part series of articles written exclusively for Horses and People magazine. You can download the full series as an eBook here. 

How does birth cause trauma?  

In human babies, the biggest part to leave the womb is the baby’s head. Baby skulls are quite flexible; the many plates of the skull are able to flex and contort as the head is delivered through the birth canal. Any woman who has had a child can tell you about the forces involved in the baby’s transit to the big wide world. They are huge! And mainly focused on the child’s head and, to a much lesser extent, the shoulders and upper chest combination and the hip area. 

A mare foaling

Any vet who has had to correct the alignment of a foal’s limbs within the birth canal can testify to the huge forces being exerted on the foal’s body with each of the mare’s uterine and abdominal contractions.

In foals, the largest part of their bodies to force open the birth canal and leave the womb is the combination of the shoulder blades and chest at the level of the wither.

The head cops its load of force because it acts as a wedge, dilating the birth canal but is substantially smaller than the front of the foal’s chest. 

When you look at any foal’s chest area and compare it to the space it exited the womb from, it becomes clear that they have to be quite compressed as they travel through the birth canal – much like a human baby’s head.

Any vet who has had to correct the alignment of a foal’s limbs within the birth canal and womb during parturition can testify to the huge forces being exerted with each of the mare’s combined uterine and abdominal contractions. At times, you literally feel like your arm is being squeezed to the point of breaking.

Fractured foal ribs and damaged rib-breastbone junctions occurring as the foal passes through the relatively small pelvic canal should not surprise any veterinary obstetrician. 

The other part of the foal which cops a great deal of pressure during birth is the pelvic region. The pelvis undergoes diagonal compression that is likely to stress the sacroiliac coupling and the attachment of the abdominal muscles to the pelvis, also appear to be badly strained in some foals.

What does the research say? 

Research published in the Equine Veterinary Journal since 1999 provides a great amount of detail on where the most detectable birth damage is found. 

One of the earliest studies revealed 20% of foals had major ribcage injuries including ribcage fractures in at least 5% of these cases. 

On average, the majority of the rib fractures and ribcage injuries were affecting the lower part of the ribcage on the left side of the chest. These are very revealing findings. 

The rib fractures were particularly of the third to seventh ribs, on the left side of the ribcage. The third to seventh ribs correspond with the highest part of the wither of an adult horse, and represent the most rigid and most substantial part of shoulder-chest combination. 

As mentioned earlier, after birth, the foal’s most tight and tender body parts are the front third of the ribcage and the muscles of the shoulder and girth. 

In clinical practice and on average, in foals that are one month old, yearlings and adult horses, the tightest and most tender parts of the front end are the right side of the wither, girth and shoulder rather than the lower left of the ribcage as would be expected from the rib fracture research findings. 

This may sound counter-intuitive, but it is reasonably easy to work out why.

The ribs and rib-breastbone junction heal quite quickly in a newborn foal growing at a tremendous rate. However, diagonally opposite to the lower left rib fractures there will be damage to the spine (under the top right shoulder blade), which is not as apparent at birth but can deteriorate over time. 

Like so many traumas occurring during the life of a horse, spinal damage can leave a neurological ‘scar’, causing altered neurological function that never resolves without specific rehabilitation. 

Muscle and skeletal anatomy of the horse

Rib fractures reported in the literature particularly affect the third to seventh ribs, on the left side of the ribcage. This corresponds with the highest part of the wither of an adult horse, and represent the most rigid and most substantial part of shoulder-chest combination. Muscle anatomy illustration by SciePro. Skeleton illustration by Motionblur Studios. Adapted by Horses and People.

Altered neurological function… It’s really a brain issue!

In order to understand birth trauma and its lasting impact, we need some background knowledge.  

When subjected to injury by tripping, falls, etc., most parts of the spine become neurologically dysfunctional during the time they are held braced by swelling and inflammation – the natural processes that help the body to heal. 

The neurological dysfunction includes the brain getting a distorted perception/reading of the tissues serviced by the injured part of the spine.

If the injured part of the spine contains nerves that feed the limbs, the neurologic dysfunction can lead to diminished coordination of the movement of that limb and result in tightness and tenderness of that limb’s muscles. 

This tightness and tenderness is largely a result of changed brain perception of the limb and its muscles leading to a mismanagement of the control exerted on the limb. 

A common human example is a lower back/lumbar injury leading to tight and touchy hamstring muscles. 

Until the lower back spinal function returns to normal, the hamstrings will continue to become tight and tender, even after an effective leg massage which relieves any tension and tenderness of the hamstrings. 

Return to normal spinal function

In many parts of the spine, the natural resolution of trauma-induced inflammation will allow the return of normal spinal movement and function and with it, the neurological function also returns to normal. 

Coordination and leg muscle tenderness and comfort returns to normal when unimpeded spinal flexibility resumes.  

Common activities including playful weaving, bending and jumping are enough to free up recovered sections of the spine. 

Not all of the spine is the same when it comes to self-correcting after injury

For much of the spine, acute spinal injury can resolve through common horse activities. Activity that just bends and stretches the spine beyond its post-injury stiffness, will often be enough to prompt the brain into correcting spinal movement back to a normal balance. 

However, the spine of the upper chest of the horse, the part heavily impacted on during birth, is quite different. 

The upper chest spine is heavily splinted and restricted in movement in horses by the bracing effect of the rigid shoulder blades and shoulder girdle muscles. 

Add the breastbone-attached ribs (ribs 1-8) and the interspinal ligaments, and you have one hell of a movement-resistant unit. 

Without movement, which takes the flexion and extension of the spine from stiff to normal movement, self-correction has little chance to occur. 

Without the prompt that activates a self-correction, the section of spine which lies under the shoulder blades usually fails to return to normal movement through normal activity. 

The ‘neurological scar’ occurring as a result of spinal damage during birth, very often does not resolve naturally, leaving the progressive development of a one-sided horse that is so common that most consider this to be normal and even unavoidable. 

A rear view of high-heel, low-heel syndrome

High-heel, low-heel syndrome My horse is girthy, crooked and has uneven front hooves… A desire to solve this problematic trio is one of the most common reasons owners decide to seek some form of body therapy for their horse. Photos by Louise Sedgman Photography.

Thus, trauma, which occurs in particular to the thoracic spine of foals as the foal passes through the very cramped birth canal, can leave changes in foreleg comfort, flexibility and coordination which can change a horse for its lifetime. 

These changes include the tendency to place more weight or lean more on one foreleg with a reciprocal effect on the hind end of the horse, as well as the tendency to be sensitive in the wither and girth areas. All of which cascade and change movement and posture, the latter causing disengagement of the horse’s sacroiliac coupling. 

The second part of this series on birth trauma, goes deeper into the closely related problems of girthy horses, anxiety, stomach ulcers and posture, and how wither and girth pain associated with birth trauma effects saddle fit in a common and very serious way.

This is the first part of a 4-part series of articles written exclusively for Horses and People magazine. You can download the full series as an eBook, it includes: 

  • Part 1 – Introduction to thoracic birth trauma: An detailed account of what it is, what the research shows, which systems are affected and an overview of the consequences.
  • Part 2 – The ‘girthy’ horse: A deeper look into the closely related problems of girth sensitivity, anxiety, stomach ulcers and posture/conformation issues, as well as how wither and girth pain associated with birth trauma affect saddle fit in a very serious way.
  • Part 3 – The ‘crooked’ horse: The effect that birth canal trauma has on the development of asymmetries commonly referred to as ‘crookedness’, ‘laterality’, ‘one-sidedness’, and high-heel low-heel syndrome.
  • Part 4 – Treatment and Rehabilitation: Treatments to reduce the impact of birth trauma following birth and rehabilitation strategies for adult horses affected.

The eBook downloads instantly for just $25.00. Order here.