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Lameness Signs, Assessment and Diagnosis

Lameness can come from any part of the horse’s body and alter the way they move, behavioural traits and their ability to perform.

  • Last reviewed: 22nd January 2024

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Lameness Signs, Assessment and Diagnosis

Lameness can come from any part of the horse’s body and alter the way they move, behavioural traits and their ability to perform. As horse owners it’s our job, alongside our vet to interpret what we see to find the source of discomfort and safeguard our horse’s welfare. Some lameness can be obvious with others being harder to detect.

Behavioural indicators of lameness

Being aware of our horse’s behaviour and learning to recognise any changes in behaviour when ridden or handled can be crucial in indicating discomfort and potential lameness. If your horse is unable to perform, consider whether you’ve seen any of the following behaviours displayed on repeated occasions for sustained periods.

Behavioural Indicators Ridden Behavioural Indicators
Uncharacteristic change in attitude e.g. becomes aggressive1 Mouth opening and shutting repeatedly with separation of teeth, for ten seconds or more3
Continuously resting the same limb or weight shifting1 More reluctant to exercise e.g. reluctant to move forward and stops spontaneously3
Noticeably moves around the stable or field less1 Ears repeatedly back or lay flat (both or one only) for five seconds or more3
Dislike having their legs lifted and feet picked out. May be seen as kicking out, reluctance to pick their leg up, leg stamping down when picked up1 Regularly head tossing or twisting from side to side3
Dull expression/depressed demeaner – low hanging head, eyes closed/half closed1 Tail swishing: repeatedly up and down/side to side/ circular; during transitions3
Lying down more, regularly readjusting position including limbs, head and neck to get comfortable and struggle to stand easily1 Tail clamped tightly to the middle or held to one side3
Supporting weight and/or stabilising balance by backing up against a wall, fence or hedge line, usually during standing rest1 Bucking and rearing3
Shows resentment when you try to tack them up – dislike of bridle and saddle going on. May see ears back, trying to bite, kick, teeth grinding, head tossing2 Intense stare (glazed ‘zoned out’ expression) for five seconds or more3
Resentment to the rider mounting. May see fidgeting, tail swishing, head tossing, walking forward immediately after mounting with no cue from rider2 Reduced performance – e.g., lower dressage scores/knocking down jumping poles etc.

If you have any concerns about your horse and are noticing any indicators of discomfort, contact your vet so the appropriate support can be provided. When your horse is working with no signs of lameness, it can be useful to film them trotting up and down on a firm flat surface, and trotting on each lunge rein, to have as a record for future comparison if you do notice any signs of discomfort.

What to expect from your horse’s lameness assessment

Lameness can be seen in hand or ridden, on a straight line or on a circle and on a hard or soft surface. Lameness will present differently depending on several factors and by working with your vet, a thorough assessment can be performed to pinpoint the area of discomfort.

Watch below as equine vet and lameness expert David Rutherford from the University of Nottingham, talks through the different stages of the lameness assessment and some key physical signs to look out for.

Lungeing and flexion tests may also be carried out during the lameness assessment.

Lungeing: Lameness is often more pronounced when the horse is worked in a circle so lungeing can help vets to identify more subtle problems.  

Flexion tests: Following the initial trot-up assessment, flexion tests may be performed one at a time and the horse's response will be assessed by comparing the movement to the original trot-up. Flexion tests involve holding the leg fixed in a flexed position for a period of time and then trotting the horse away. By placing more pressure on the joints any issues that may be causing lameness should become more obvious. 

Biometric gait analysis & Ridden assessment

Following a static and dynamic lameness assessment, biometric gait analysis and ridden assessments may also be used to draw a more accurate diagnosis. Watch below as David explains more.

Imaging techniques for lameness diagnosis

If required, the use of imaging techniques can be a useful tool to provide a definitive lameness diagnosis. Early and accurate detection of a problem can often prevent more serious injury and means a targeted treatment plan can be followed as soon as possible.

Be aware that sedation may be given by your vet to perform the following diagnostic imaging techniques.

Radiography (X-Ray)

Radiography is the most common imaging technique in horses and portable machines can often be used to assess the musculoskeletal system, the head and parts of the spine. The imaging technique is often used to assess potential fractures or dislocations and will show changes in the tissues, joints, and spinal processes in the back. Radiography can also be a useful tool to assess the extent and nature of wounds.


Ultrasound scans are the second most common imaging technique in horses. Often performed using portable machines for diagnosing and evaluating different musculoskeletal conditions including joint, tendon, muscle and ligament injuries and for monitoring the healing process in these cases.

Ultrasounds are also a useful tool for the assessment of colic cases and pregnancy checks.

Magnetic Resonance Imaging (MRI)

MRI gives a very detailed 3D view and can be used to show injuries to tendons and ligaments as well as bones and joints. The area to be examined is placed inside a powerful magnet and radio waves are applied. MRI is especially helpful when assessing the horse’s hoof, the most common site of lameness.

Nuclear Scintigraphy (Bone Scan)

Nuclear scintigraphy captures images of the horse’s skeleton that helps pinpoint sites of damaged or injured bone, or areas of inflammation.

The horse is injected with a special radioactive dye which is taken up by the bone. Where there is a problem, an increased amount of radioactive dye will be taken up in the area. After a few hours have passed, the horse is scanned to pick up any of these ‘hot spot’ areas that indicate damage or injury.

Once the problem area is identified, further imaging such as radiographs will likely be required to characterise the exact nature of the injury.

Computerised Tomography (CT)

A CT scan will produce 3D x-ray images to show abscesses, tumours, fractures, cysts and a range of other disorders affecting the horse’s head, neck and legs. It’s a very helpful technique for assessing trauma along with surgery planning and evaluation of treatment. A CT scan is also ideal for diagnosing dental or sinus problems.

  1. Torcivia C et al. (2021), Equine Discomfort Ethogram. Animals, 23;11(2):580.
  2. Dyson, S et al. (2022), An investigation of behaviour during tacking-up and mounting in ridden sports and leisure horses. Equine Vet Education, 34: 245-257.
  3. Dyson, S. (2022), The Ridden Horse Pain Ethogram. Equine Vet Education, 34: 372-380.

Get in touch – we’re here to help 

The BHS Horse Care and Welfare Team are available to offer you advice and support with any questions or concerns you may have. 

Don’t hesitate to call us on 02476 840517* or email – You can also get in touch with us via our social media channels. 

Opening times are 8:35am-5pm from Monday – Thursday and 8:35am-3pm on Friday. 

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