13/11/2025
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The “Stifle Lameness” That Wasn’t: A Story About Referred Pain
I once had a client who told me about a horse that developed an odd, on-again off-again hind-end lameness that no one could quite pin down. Some days the horse looked off behind, as if his stifle was sore; other days he moved completely normally. Nothing about it followed the usual patterns. Things that should have made a stifle issue worse didn’t seem to, and things that “should have” helped it, didn’t.
We were all very confused.
One day, the vet happened to be on the property with a brand-new scope and offered to scope several horses for gastric ulcers — partly to familiarize themselves with the equipment. When they scoped this particular horse, they found significant stomach ulcers.
The horse was placed on a veterinarian-directed ulcer-care plan, and within a few weeks, something unexpected happened:
the ulcers healed, and the mysterious “stifle lameness” vanished along with them.
It turned out the stifle itself had never been the problem. The horse had been expressing ulcer-related visceral pain as stifle discomfort — a classic example of referred pain.
Why Ulcers Can Look Like Hind-End or Stifle Issues
This situation is a great illustration of how the equine body handles pain. Signals from the internal organs and the limbs travel through overlapping pathways in the spinal cord.
Here’s what science tells us:
1. Visceral nerves and musculoskeletal nerves converge.
The stomach and the hindquarters share overlapping spinal segments, especially through the thoracolumbar region. When the stomach is irritated, the brain can misinterpret those signals as coming from the back, pelvis, or stifle.
2. Fascia connects everything.
The deep fascial membranes link the viscera to the musculoskeletal system. When the gut is irritated, the horse may brace through the abdomen and back, altering pelvic motion and limb loading.
3. Protective guarding changes movement patterns.
A horse in visceral discomfort often holds tension through the core, diaphragm, and back. This can create subtle gait irregularities that look orthopedic but aren’t.
When the gastric discomfort resolved under the veterinarian’s care, the nervous system stopped sending those distress signals — and the hind-end “lameness” disappeared.
✳️ Why This Matters
Not every hind-end irregularity originates in a limb. Sometimes the body is expressing visceral discomfort through movement changes.
This story is a reminder of how important it is to work closely with a wonderful veterinarian, and to consider the whole horse — inside and out.
https://koperequine.com/fascia-the-skeleton-of-the-nerves/
