Step by Step Veterinary Physiotherapy: For Sport, For Work, For Life.

14/01/2026

Thinking of Sally Butler Eventing, her family, friends and all those of us who were privileged to meet her through a love of horses and riding.

13/01/2026

⏬Estimating your horses weight. ⏬

12/01/2026

A weighty problem…
🤯How much load am I really subjecting my horse too..and how heavy is too heavy on a percentage basis ?🤯

Well today I had 2 University of Nottingham students with me and together we used a scientifically validated weight estimation method so that we can start our investigation with the weight of our horse. No need for a weighbridge - this method can be used by any horse owner and I will pop a short explanation on how to do this in the comments.

The students carried out a static and dynamic assessment on both hard ground and in the arena. We agreed that Bertie was a sound happy athlete today, assessed without his rider on board. Bertie has also been on a calibrated weighbridge 3 times this year which makes for a useful comparison to the estimation method.

👀Stop✋🏾

Before we consider my weight ( I know it’s the best bit !!) there are 2 scientific studies that we should be familiar with. At first sight they seem contradictory but in fact make perfect sense.

The Dyson pilot study (2018) showed that behavioural/pain indicators and gait changes, even lameness, started to be observed in heavy or very heavy riders, from 15% of the horse’s weight upwards. But in this study different riders (all competent) were used on the subject horses.

In another 2020 study, Christensen et al found no short term physiological, gait or behavioural changes when weight increased from 15 - 23%. Crucially the same familiar rider was used, with lead weights added to increase the load.
The measurements were made over the short term and during low intensity dressage work.
The following factors are therefore also very important to the horse :
Rider balance & coordination
Riding style & asymmetry
Familiarity to the horse
Potential saddle–rider interaction with optimal saddle fit being achieved for the horse and his usual ( NOT any ) rider.

So, if I weigh myself and calculate the percentage, take into account regular saddle fit and appropriate exercise and I am say 20% or less than my horses weight, I am good to go? Surely?

Well, yes possibly…

Firstly, your horse must have a normal ( not fat) body condition score.Over weight horses although heavier can carry LESS not more weight.

Your horse MUST be fit enough to be ridden. All ridden horses are athletes and should be sympathetically trained for their intended work, see saddlers, physios, farriers and dentists regularly.

Next use the estimation method to determine your horse’s weight, but check this regularly on a properly calibrated weigh bridge.

Then weigh yourself, your tack and you with your tack. Consider a) pouring a stiff drink b) taking up golf.

The results…

✅Bertie weighed 537 kilos in May 2025, 522 kilos 1st August and 539 kilos 24th October 2025. These were all different weigh bridges

✅His mathematically estimated weight 542 kilos. Good estimate! But do read about this method before using it.

✅My early morning weight 72.8 kilos, 5ft 8”

✅13.5% based on his actual October weight.

✅His saddle 9 kilos, bridle, neck strap 2 kilos

✅And me, swaddled in heavy riding gear, several layers under a waterproof coat and trousers, Xc hat, and boots.

✅88.3 kilos when carrying said tack.

✅👀16.4% of his body weight. 👀

✅This is 21% heavier than my “morning weight”, (no tack and little in the way of clothing).

Picture proof….

Food for thought…
Could I be lighter - yes pre Xmas 70 k 😜🤣
Could my kit be lighter - yes but I need to make sure safety and comfort don’t give way to just weight.
Could he be fitter - yes 2 weeks off will have had very little effect BUT we need to step up to Spring. His backing up a little hesitant his middle gluteal / hamstring/ quadriceps balance could be better.
Will I ride even heavier -yes if I don’t get back to my swimming, regular coaching and competing with him and don’t forget I am not wearing a body protector in the picture.

Final conclusion: Watch all of the above factors but holistically this particular horse has never felt better or happier, phew 😅

Ps : Neither have I. Morning weight Jan 2025 96.9 kilos, now add riding gear and tack, another 15.5 kilos. In total a massive 21% of Bertie’s weight. No wonder he is happier…now perhaps I understand.

Good luck as we stride potter or jump towards Spring x

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02/01/2026

This writer, a veterinarian, makes some very important points here. When palpation reveals a stiff joint, some swelling or bony changes they decide on a treatment ( or no treatment) based on how important these problems seem to the horse at his current level of activity and in the environment he must navigate.
Crucially this means observing the horse “working” assessing his or her behavioural responses and then together making a plan.
At Step by Step we assess every horse dynamically, often on multiple surface types, taking video and assigning a Dynamic Asymmetry Score which also takes into account behavioural response.
This means we can be
✅ Objective
✅ Observe change over time
✅ Monitor progression through rehabilitation
✅ Assess more accurately for pain requiring immediate veterinary intervention vital for welfare.
Sarah is both a RAMP and NAVP physiotherapist and registered behaviour consultant with additional training in equine psychology and trauma response.
Contact her on WhatsApp 07885470670

Looking back to when I first graduated from veterinary school, prepurchase examinations were refreshingly simple. Horses fell into three clear categories: those with no apparent problems, those who were actively lame, and those who were what we called "serviceably sound." That third category has practically disappeared from modern veterinary practice, and I believe we're all worse off for it.

Serviceably sound horses weren't perfect specimens. They might have shown a little stiffness in one direction or carried themselves differently than a younger horse would. But these horses had been reliably doing their jobs for years, and there was every reason to believe they could continue for years more. Today, in our era of exhaustive radiographs, aggressive flexion tests, and what I affectionately call Scientific Wild Guesses about the future, I find myself wondering what happened to simply accepting a good, working horse for what he is.

The transformation hit me hardest about two years ago when I became the fourth veterinarian to examine a twenty-year-old warmblood mare. This horse had been subjected to every diagnostic tool modern veterinary medicine offers: MRIs, bone scans, ultrasounds, and radiographs of virtually every skeletal structure in her body. Multiple specialists from prestigious hospitals had weighed in with their professional opinions. The consensus was unanimous and dire: this mare should never be ridden again. The diagnostic reports left no room for interpretation.

When the owner called me, I honestly questioned what unique perspective I could possibly offer after such thorough evaluation by my colleagues. Still, I went through my examination process. I ran my hands along her legs and felt the subtle swelling in her stifle joints. When I flexed her legs, I noted the expected stiffness. Throughout the entire examination, this gentle, patient mare cooperated completely, never resisting or objecting to anything I asked of her. Then I requested to see her move. Her gait certainly wasn't expansive or effortless, but she moved forward willingly and, if I'm any judge of equine demeanor, happily.

I turned to the owner and asked a question that apparently none of my predecessors had considered important: "What do you want to do with her?"

The owner, who had clearly invested enough in diagnostics to fund a small developing nation, replied that she hoped the mare could give lessons to children.

My response was simple: "Why don't you give it a try?"

The owner's brow furrowed with concern. "But what about all of those reports?" she asked, gesturing to the stack of dire professional opinions.

I looked at the mare, then back at the owner. "Don't let her read them."

Three years have passed since that conversation, and that supposedly unrideable mare continues to give lessons to children regularly and happily. She doesn't move quickly or for extended periods, and she benefits from occasional pain-relieving medication. But she has a purpose, she's adored by countless young riders, and by all observable measures, she's content with her life.

Another case stays with me just as powerfully. An eighteen-year-old gelding had been through the complete diagnostic circus: MRI, nerve blocks, radiographs, medication trials, and therapeutic shoeing adjustments. All of this was in response to a hoof issue that caused a slight forelimb lameness, particularly noticeable when circling. I drove well beyond my normal practice area to evaluate this horse and review the mountain of accumulated data. After my examination, I asked the owner about the horse's current use.

"I take him out for walks on the trail two or three times a week," she explained.

My recommendation seemed almost too simple: "Why not give him a small dose of pain reliever before your trail walks and let him enjoy walking around this beautiful arena the rest of the time?"

The owner's immediate concern revealed how deeply the culture of worry had taken root. "But won't the pain reliever destroy his stomach?" she asked anxiously.

"No," I assured her.

That conversation happened four years ago. I encountered the owners at a lecture I presented about a year later, and everyone involved was thriving. As far as I know, the gelding's stomach remained intact, and the arrangement continues to work beautifully for both horse and owner.

I share these stories because the commercial side of the equine industry seems determined to convince horse owners that anything less than perfection is unacceptable. Words like "optimum," "ideal," and other carefully chosen marketing language imply that every horse harbors some hidden pathology just waiting to manifest as catastrophe. The message being sold is dangerously binary: your horse is either perfect or doomed.

This relentless pursuit of flawless equine health is, in my professional opinion, largely harmful. The constant anxiety, the hours spent researching potential problems on the internet, the fear of what might go wrong—all of this robs horse owners of the fundamental joy that should come with horse ownership. When a horse glances at his flank, it almost never means he's experiencing intestinal torsion. When a horse receives appropriate nutrition, he's not teetering on the edge of some nutritional catastrophe that only the latest miracle supplement can prevent. Excessive worry leads to unnecessary diagnostic testing, wasted money on veterinary and other services, and a futile quest for reassurance through endless interventions and products.

Understanding and monitoring your horse's health is certainly important. But there's a vast difference between reasonable concern when your horse shows signs of illness or injury and perpetual anxiety about potential future problems. Constant worrying about a healthy, normal horse creates problems primarily for the owner, not the horse.

Just recently, a seventy-year-old client brought me her nineteen-year-old gelding. She'd acquired him from a riding school and was concerned because someone had mentioned he was limping. I watched him trot and confirmed there was a slight irregularity in his gait.

"What do you do with him?" I inquired.

"I enjoy walking on the trails with him on weekends with my friends. Or maybe every other weekend," she replied.

I palpated his pastern and felt a minor enlargement. I was fairly certain he had some degree of osteoarthritis, commonly called ringbone.

Here's what I didn't recommend: radiographs, bone scans, MRIs, joint injections, joint supplements, specialty shoeing, liniments, platelet-rich plasma therapy, or stem cell treatments.

Instead, I gestured toward her seventy-five-year-old husband Fred and asked, "How's Fred doing? Is he moving around like he did when you two got married fifty years ago?"

She laughed. "No, definitely not."

"Thinking about trading him in?"

"Only sometimes," she said with a smile.

I suggested she continue enjoying those pleasant long walks and perhaps give the horse—not Fred, as I don't prescribe human medications—a pain reliever if he seemed uncomfortable. Several months have passed and everything continues to go wonderfully. I actually saw them both just the other day. The situation is ideal for everyone involved. Nobody moves with perfect soundness, Fred included. But everyone is functional, serviceable, and most importantly, happy.

So what does "serviceable" actually mean? To me, it means the horse can perform the work being asked of him without suffering. Horses typically go out and give their best effort—it's one of the qualities we treasure most about them. Our responsibility is to care for them, but that responsibility doesn't include achieving the impossible goal of perfection. A horse can be imperfect and still be wonderful.

Mark Twain captured a certain wisdom about horses when he wrote: "I preferred a safe horse to a fast one—I would like to have an excessively gentle horse—a horse with no spirit whatever—a lame one, if he had such a thing." (Roughing It, Chapter 64)

I rarely view situations in absolute terms. I believe firmly that the perfect is the enemy of the good. A horse isn't simply good or bad, serviceable or worthless. The equine world is full of wonderful horses who might have some minor flaw or imperfection but who will nevertheless be the best horse their owner could ever hope for. Don't pass by one of these treasures simply because he doesn't match someone else's arbitrary definition of perfection. He might not be flawless, but he can still be serviceable, useful, and even absolutely great.

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15/12/2025

This is a good read, expanding on the point that whilst anthropomorphising horses is not helpful to them denying them the deep rooted parallels with humans as fellow mammals is equally as bad….
As someone who has relocated - I think 8 times during my adult life including uprooting horses, children and having to re-start professional work in an entirely different area with no roots or initial sense of connection I can only say, I understand…

There is something we do routinely with horses that we would struggle to accept for ourselves: we relocate them. Frequently. Sometimes with careful thought, sometimes casually, sometimes because the timing suits us. New yard. New field. New companions. New routine. New handlers. New expectations. And we rarely pause to consider what this actually demands of them, not emotionally but biologically.

A horse experiences the world through their nervous system, not through concepts like practical or necessary. That system is continuously assessing: Am I safe. Is this predictable. Where is threat. Can I recover. When we move a horse, we are not just changing their address. We are erasing the entire sensory map their nervous system relies on to answer those questions.

For a prey animal, every detail of their environment provides information. The terrain underfoot. The pattern of sounds. The quality of shelter. The rhythm of the day. How light moves through the space. Where other horses are. Whether they can move away when they need to. When a horse arrives somewhere new, the body immediately starts reassessment. Muscle tone shifts. Sleep patterns change. Digestion can alter. Startle responses may rise. Some horses become hypervigilant. Others go quiet and still, a state that often looks like settling in but may actually be conservation mode. This is not dysfunction. This is biology doing its job. But disruption without adequate recovery time carries a cumulative cost.

Horses do not simply live beside other horses. They regulate with them. Established herd relationships offer shared vigilance that allows rest, predictable social structure, buffering through proximity, and safety through numbers. Every time a horse is moved, these regulatory relationships are severed. Even when a horse appears to make friends quickly, the nervous system still has to renegotiate hierarchy, boundaries, proximity, and trust. Some horses do this obviously. Others do it quietly. Both require energy. A horse who has been moved many times may eventually stop investing deeply in connection, not because they do not want it, but because repeatedly rebuilding it is metabolically expensive.

After relocation, people often notice changes that get labelled as behavioural problems. Sudden spookiness. Separation anxiety. Irritability or shutdown. Resistance under saddle. Digestive changes. Altered movement quality. Loss of curiosity. Reactivity to touch. These are not random. They are often the nervous system saying: I am still orienting. I am still assessing threat. I am not yet resourced. When we ignore these signals, push through them, or try to suppress them, we do not build resilience. We build defensiveness.

To understand this without anthropomorphising, consider a human parallel. Imagine being repeatedly moved into unfamiliar homes in unfamiliar neighbourhoods with unfamiliar people, no choice, no preparation, and no stable base to return to. You would not need to feel emotional about it for your nervous system to register instability. Your sleep would shift. Your baseline tension would rise. Your tolerance for novelty would narrow. Your capacity to relax deeply would shrink. That is not a flaw in character. That is physiology. Horses operate under the same biological principles.

Some horses cope better than others depending on temperament, early experience, genetics, and support. But coping is not the same as thriving. And the absence of visible distress does not mean regulation. A horse can appear functional while carrying elevated baseline stress, and research in stress physiology shows that the body keeps score even when behaviour looks fine.

Before relocating a horse, it is worth slowing down to ask different questions. Is this move necessary or simply convenient. What does this horse stand to lose in terms of predictability, relationships, and environmental familiarity. What support will they need neurologically, not just behaviourally. Am I allowing enough recovery time, or expecting performance before safety is re-established. Am I watching for subtle strain in sleep, digestion, curiosity, recovery after work, or social engagement. How many times has this horse already faced this disruption. History matters.

When moves are necessary, we can support the transition responsibly. Give the horse several weeks for genuine settling rather than surface adjustment. Maintain as much routine consistency as possible. Reduce performance expectations at first. Provide choice where possible. Integrate into the herd gradually and thoughtfully. Watch for signs that the nervous system is still working hard. Recognise that turnout with compatible companions supports co-regulation. Understand that some horses need weeks or months, not days.

Stability is not a luxury. Horses do not reset simply because they arrive somewhere new. They carry their nervous system history forward. Every relocation adds to that history. Every disruption registers. Every period of stability is protective. This does not mean never moving horses. Life happens and circumstances change. Sometimes relocation genuinely improves welfare. It simply means acknowledging that movement is not neutral. Environment matters. Herd continuity matters. Predictability matters. Recovery time matters. And a regulated nervous system is not optional. It is the foundation for everything else we ask.

At WHJ, we are not asking for guilt. We are asking for awareness. When we truly understand the biological cost of repeated instability, we begin making different choices. We move horses less casually. We plan transitions more carefully. We watch more closely. We allow more time. We question whether convenience for us is worth destabilisation for them. These choices shape behaviour, health, and wellbeing across a lifetime. That is what it means to think well of our horses, not just in moments but in the long term.

Further reading:
The term “New Home Syndrome” has been used by Dr. Shelley Appleton to describe behavioural changes observed in horses following relocation. Readers interested in a behavioural transition perspective may wish to explore her work alongside nervous-system-based approaches. https://www.calmwillingconfidenthorses.com.au/blogs/new-home-syndrome

30/11/2025

A beautiful bright Sunday. It’s December and so we extend a warm festive welcome to our new followers.
Time perhaps to re introduce myself, my human and equine team before the festive season is truly upon us!
My name is Sarah and I am a specialist equine physio with a Masters degree from Nottingham University. I am a member of the National Association of Veterinary Physiotherapists and Society of Equine Behaviour Consultants. I am an accredited RAMP practitioner. I also work with the University of Nottingham as a placement provider with their final year students which is
We offer:
🌟 Manual therapy, massage and mobilisation
🌟 Exercise therapy and demonstrations, working with you and your horse
🌟 Rehabilitation plans and support following surgery or injections, alongside your vet practice.
🌟 Electrotherapy, INDIBA laser and PEMF.
🌟 Behavioural therapy for the more challenging moments, to decide whether discomfort is emotional or physical and how we can improve the situation.

Annemarie Mullen runs the yard of 2 donkeys, (Lola and Harry) 2 horses (Herbie and Bertie) and our latest recruit Mitsy the pony. We are amateur riders enjoying hacking jumping and the odd bit of dancing in the sand! We experience all the highs and lows of our human clients whose horses range from happy hackers to team GB hopefuls, ex race horses to Irish Draft stallions, the very small and the extremely tall! They are our teachers and our inspiration.

We can be contacted here, on the web site https://www.stepbystepvetphysiotherapy.co.uk/ and on 07885470670.

Winter tune up, not quite right? New horse?
Give us a ring we would love to hear your story.

24/11/2025

I was lucky to train with Karen a few years ago . This post describes our role very well!

✔️Veterinary physiotherapists provide a referral service, complimenting treatments by veterinary surgeons, and aimed at providing quality, tailored physical therapy programs for animals to aid recovery.

❌ Veterinary physiotherapists are not veterinary surgeons and vice versa (unless they have completed both training routes separately)

The ability to provide a physiotherapy service does not come easily -there is no short course to fast track skill learning at this level. It takes:
Hundreds of hours of training to obtain skills worthy of a respected and professional qualification
- Commitment to provide the best research based treatments available.
-Dedication to ongoing CPD to ensure standards are maintained
-Compassion to treat each and every patient as if they were our own - every day with no exceptions.

🐶 Veterinary surgeons and Registered veterinary nurses also have their own rigorous training courses, and we each have very different roles in animal care. Each one invaluable, each one with a unique skill set, and each one complimenting the others.

✨Together we are a team. Together we optimise possibilities in multidisciplinary care
Together we strive for the best outcomes.

For us as individual ‘Veterinary Physiotherapists’ our job titles are not protected in the same way as vets or nurses. This means we have to work hard to earn trust from vets. We find ourselves continually justifying our qualifications, proving our right to be a part of the team and trying to educate owners on how to find an appropriately qualified practitioner.

❤️ Despite this, we continue to wear our hard earned titles with pride, driving not only as an individual clinic but also as a profession, to achieve more for our loyal companions.

20/11/2025

🌟🌟Exciting news - is coming to the UK very soon🌟🌟
With an emphasis in 2026 on manual therapy after an exciting year incorporating radio frequency treatments in the practice, I am super excited to
✅ Refresh my manual therapy toolbox
✅ Supercharge my use and knowledge of kinesiology taping.
✅ Teach my clients so that they can help their horses at home.
✅Learn and work with the worlds best Christa Veinotte
✅Use and and supply her amazing products across the UK.

08/11/2025

 Screen day today, the Vet Rehab Summit is a rich menu of learning and discussion and in the breaks I am writing a blog for the website!
The link is here

https://www.stepbystepvetphysiotherapy.co.uk/post/understanding-equine-normal-behaviour-during-initial-interactions-and-strategies-for-successful-intr

08/11/2025

Are you welcoming a new horse to your yard? It's a moment filled with anticipation! Understanding normal equine behavior during these initial interactions is crucial for fostering lasting relationships. Discover valuable strategies to ensure successful introductions. Read more here: https://wix.to/CQkLGdU

Introducing a new horse to your yard or home can be an exciting yet anxious moment for horse owners and yard managers. Horses are social animals with complex herd behaviour, and their first interactions often set the tone for future relationships. Understanding what normal horse behaviour looks like...