How to Tell If Your Horse Is in Pain When Ridden

How to Tell If Your Horse Is in Pain When Ridden

By Dr Duncan Houston

A horse that swishes its tail, repeatedly changes canter lead, resists going forward or becomes difficult to steer may be labelled stubborn, lazy or poorly trained.

Sometimes training, tack or rider balance is contributing. However, these behaviours can also be the earliest visible signs of pain, particularly when discomfort only becomes apparent once the horse carries a rider.

The challenge is that many painful horses do not show an obvious limp. They may simply shorten their stride, lose impulsion, become difficult in one direction or display a collection of subtle behavioural changes.

The Ridden Horse Pain Ethogram gives riders and veterinarians a structured way to recognise those patterns before they are dismissed as attitude.

Quick Answer

The Ridden Horse Pain Ethogram is a list of 24 precisely defined behaviours associated with musculoskeletal pain during ridden exercise.

A score of 8 or more out of 24 makes musculoskeletal pain likely, but it does not prove where the pain is or replace a veterinary examination. Horses with lower scores may still be painful, particularly when behaviours are new, consistently one-sided, worsening or associated with gait abnormalities. (Full Circle Horse)

What Is the Ridden Horse Pain Ethogram?

An ethogram is a structured catalogue of animal behaviours, with each behaviour defined clearly enough that different observers can look for the same thing.

The Ridden Horse Pain Ethogram, usually shortened to RHpE, was developed by equine veterinarian Dr Sue Dyson and colleagues to help identify musculoskeletal pain in horses during ridden exercise.

It includes 24 behaviours involving:

• Head and neck position

• Facial expression

• The ears, mouth and tongue

• Tail carriage

• Rhythm and speed

• Straightness

• Canter quality

• Willingness to move forward

• Bucking, rearing and other defensive behaviour

Each behaviour is scored as present or absent during the assessment, producing a total score from 0 to 24. The horse should be observed in walk, trot and canter, on both reins and through transitions. More advanced movements may also be included when the horse is trained to perform them. (MDPI)

What Does the Research Actually Show?

The ethogram was not created by simply collecting behaviours that riders found annoying. It was developed through comparisons between non-lame horses, lame horses and horses reassessed after pain causing lameness had been reduced through diagnostic anaesthesia.

Apparently comfortable horses may still be lame

In one study of 60 sport and riding-school horses believed by their owners to be working comfortably, 73 percent were considered lame in at least one limb and 47 percent showed abnormalities in canter.

RHpE scores ranged from 3 to 16, with a median score of 9. Lameness and rider skill were both associated with the final score, demonstrating that the horse should not be assessed without considering the rider’s influence. (PubMed)

This does not mean that 73 percent of every ridden-horse population is lame. It was a convenience sample and may not represent all horses. It does demonstrate how easily low-grade pain can become normalised when a horse continues working and does not display a dramatic limp.

Behaviour scores fall when pain is reduced

A larger study assessed 150 horses referred for poor performance or suspected musculoskeletal pain.

Before intervention, the median RHpE score was 9 out of 24. After diagnostic anaesthesia had improved the painful gait abnormalities, together with a saddle change where indicated, the median score fell to 2.

Only 30 percent of these horses were continuously lame when ridden. Approximately 35 percent had no overt lameness but showed bilaterally shortened steps, restricted hindlimb impulsion or reduced engagement. An ill-fitting saddle was considered likely to compromise performance in approximately 37 percent of the horses. (MDPI)

This is an important clinical point:

The absence of an obvious limp does not rule out musculoskeletal pain.

Bilateral foot pain, bilateral hock or suspensory pain, back discomfort and sacroiliac-region pain may produce reduced performance and behavioural change without creating a clear left-versus-right asymmetry.

The behaviours are not necessarily permanent habits

In earlier work involving horses assessed before and after diagnostic analgesia, behaviour scores decreased significantly once pain and lameness had improved. Both trained and initially untrained observers could detect a meaningful overall reduction, although experience improved the accuracy and consistency of scoring. (ResearchGate)

This challenges the assumption that a horse which has tossed its head, bucked or resisted for months will always behave that way simply because the pattern has become habitual.

Learned behaviour can remain after pain resolves, but pain should be investigated before the behaviour is treated purely as disobedience.

Larger competition data support the pattern

A later study combined RHpE observations from 1,358 horses competing in dressage and eventing. Behaviours from the ethogram occurred more frequently in horses assessed as lame or showing abnormal canter than in horses with no detectable lameness and normal canter.

The study also confirmed an important limitation: some lame horses scored below 8. A lower score therefore reduces suspicion but does not provide a clean bill of health. (MDPI)

Newer research supports assessing horses while ridden

A small 2026 study incorporated ridden exercise and the RHpE into pre-purchase examinations of 25 sport horses. The ridden assessment identified lameness or gait dysfunction that influenced purchase-risk decisions and appeared to add information beyond the standard stationary and in-hand examination.

The study was small, so it should not be used as a definitive prediction tool. It reinforces the principle that some performance-limiting problems only become apparent when the horse carries a rider and performs the job for which it is intended. (MDPI)

Is the Ethogram a Diagnostic Test?

No.

The RHpE is a screening and clinical-support tool. It can help answer:

• Does this ridden pattern make pain more likely?

• Has behaviour changed after treatment?

• Does the horse need a more detailed veterinary assessment?

• Are several apparently unrelated behaviours occurring together?

• Is the horse improving during rehabilitation?

It cannot tell you:

• Which limb is painful

• Which joint or tendon is affected

• Whether the pain comes from the feet, back or pelvis

• Whether gastric disease is present

• Whether the saddle is the only problem

• Whether a horse is safe to continue competing

• Whether a particular radiographic finding is clinically important

A score should therefore begin an investigation, not end one.

Much of the published development and validation research has also come from the research programme that developed the RHpE. The findings are persuasive, particularly the reduction in scores after pain was relieved, but the tool should still be applied as part of a complete clinical assessment rather than treated as a laboratory result. (MDPI)

The 24 Ridden Horse Pain Ethogram Behaviours

The behaviours have specific definitions. A momentary ear movement, a single tail swish at a fly or one stumble on uneven ground should not automatically be scored.

Head and neck behaviours

1. Repeated upward and downward head movement that does not match the normal rhythm of trot.

2. Repeated head tilting, rather than a brief response to an environmental distraction.

3. The front of the head held more than approximately 30 degrees in front of vertical for at least 10 seconds.

4. The front of the head held more than approximately 10 degrees behind vertical for at least 10 seconds.

5. Frequent head tossing, twisting or side-to-side movement, with the rider repeatedly attempting to correct the position. (MDPI)

Facial, ear and mouth behaviours

1. One or both ears held behind vertical or flattened for at least five seconds, or repeatedly laid flat.

2. The eyelids repeatedly half-closed or closed for several seconds, or unusually frequent blinking.

3. Repeated exposure of the white of the eye.

4. A fixed, intense or glazed stare lasting at least five seconds.

5. Repeated opening and closing of the mouth with clear separation of the teeth for at least 10 seconds.

6. The tongue repeatedly protruding, hanging out or moving in and out of the mouth.

7. The bit repeatedly being pulled through towards one side of the mouth. (MDPI)

Tail behaviours

1. The tail held tightly clamped or consistently carried to one side.

2. Repeated large tail movements, including forceful vertical, sideways or circular swishing, particularly when occurring repeatedly through transitions. (MDPI)

Rhythm, straightness and gait behaviours

1. A rushed or irregular gait, or repeated unrequested changes in speed during trot or canter.

2. An abnormally slow or passage-like trot that lacks normal forward rhythm.

3. The hindlimbs repeatedly travelling to one side of the forelimb tracks, so the horse moves on three tracks rather than straight.

4. Repeated incorrect canter strike-offs, disunited canter or unrequested leg changes in front or behind.

5. Spontaneous gait changes, such as repeatedly breaking from canter to trot or moving into canter without being asked.

6. More than one stumble or trip, or repeated dragging of both hind toes.

7. Sudden changes of direction against the rider’s cue, including repeated spooking away from the intended line.

8. Reluctance to move forward, requiring repeated strong leg or voice cues, or stopping without being asked.

9. Rearing.

10. Bucking or kicking backwards with one or both hindlimbs. (MDPI)

How Is the RHpE Score Calculated?

Each of the 24 behaviours receives:

• One point if present

• No point if absent

A behaviour occurring repeatedly does not receive several points. The score measures the number of different pain-associated behaviours displayed, not the total number of times the horse swishes its tail or opens its mouth.

The score should be collected over a meaningful ridden assessment rather than from one photograph or a five-second social media clip.

A useful assessment should include, when safe and appropriate:

• Walk, trot and canter

• Both reins

• Straight lines and circles

• Upward and downward transitions

• The horse’s normal working outline

• Movements relevant to the horse’s discipline

• The normal rider and usual tack

• Enough time for consistent patterns to become apparent

Do not deliberately continue riding a horse that is severely lame, dangerous, neurologically abnormal or clearly distressed merely to complete the score.

What Does a Score of 8 Mean?

A score of 8 or more out of 24 means musculoskeletal pain is likely.

It does not mean:

• The horse is exactly eight points painful

• The horse has eight separate injuries

• The horse requires emergency treatment solely because of the number

• A score of seven proves the horse is pain-free

• The score identifies the painful structure

The threshold is accumulated over the assessment. The horse does not need to display all eight behaviours simultaneously.

Some lame horses score below 8, and individual behaviours can occur in non-lame horses. What strengthens the suspicion is the combination of several behaviours, particularly when they are consistent, new, asymmetrical or improve after pain is correctly treated. (MDPI)

A Practical Way to Interpret the Score

Only the threshold of 8 or more has been specifically supported by the RHpE research. The lower categories below are practical clinical triage guidance, not separately validated diagnostic cut-offs.

RHpE pattern	What it may mean	What to do
0 to 3 behaviours	Few pain-associated behaviours observed	Continue monitoring if the horse is moving normally and the behaviours are not new
4 to 7 behaviours	Pain is not confirmed, but the pattern deserves attention	Review video, tack, rider and recent changes. Arrange veterinary assessment if signs persist or performance has changed
8 or more behaviours	Musculoskeletal pain is likely	Stop demanding work and arrange a lameness or poor-performance examination
Any score with severe signs	One dangerous or dramatic sign may outweigh the total score	Stop riding and seek prompt or emergency veterinary advice

A horse that repeatedly rears, nearly falls or becomes severely lame does not need to collect another seven points before you take the problem seriously.

What Does a Comfortable Ridden Horse Usually Look Like?

A comfortable horse should not look completely expressionless or move like a machine. Horses may look around, respond to the rider, briefly move their ears or swish at an insect.

However, a comfortable ridden horse will generally:

• Maintain a regular rhythm

• Move willingly forward

• Travel reasonably straight

• Strike off onto the requested canter lead

• Maintain canter without repeated disuniting

• Make transitions when asked

• Carry the tail freely

• Keep the tongue inside the mouth

• Maintain a relatively stable head and neck position

• Avoid repeated stumbling or bilateral toe dragging

• Respond proportionately to the rider’s aids

• Show no persistent cluster of defensive behaviours

In the large competition study, horses assessed as non-lame with normal canter were generally characterised by regular rhythm, straight movement, correct strike-offs, willing forward movement and an absence of spontaneous gait changes, repeated stumbling, bucking and rearing. (MDPI)

Can a Horse Be Painful Without Looking Lame?

Yes.

This is one of the main reasons the RHpE is useful.

Bilateral pain can look symmetrical

When both front feet, both hocks or both hind suspensory regions are painful, the horse may not show an obvious left-versus-right head nod or pelvic asymmetry.

Instead, the horse may:

• Take short steps

• Lose suspension

• Move with reduced impulsion

• Feel heavy in the hand

• Struggle to lengthen

• Become unwilling to collect

• Break repeatedly in canter

• Feel different on one rein despite appearing even from the ground

Pain may only appear with the rider

The additional weight and forces created by the rider, saddle, circles, transitions and collection may expose discomfort that is not obvious when the horse walks or trots in hand.

Canter may reveal the problem

Some horses trot relatively normally but show:

• Difficulty striking off

• Disunited canter

• Repeated lead changes

• Loss of three-beat rhythm

• Shortened suspension

• Reluctance to canter on one rein

• Bucking during transitions

This is why a comprehensive poor-performance examination may need to include ridden exercise, provided it is safe for the horse and rider.

What Musculoskeletal Problems Can Cause These Behaviours?

The RHpE does not identify the painful structure, but potential causes include:

Hoof and foot pain

• Sole bruising

• Thin soles

• Hoof imbalance

• Heel pain

• Navicular-region pain

• Coffin-joint disease

• Laminitis

• Hoof abscesses

• Poor shoe fit or nail pressure

Joint pain

• Fetlock arthritis

• Hock arthritis

• Stifle pain

• Coffin-joint disease

• Sacroiliac-region pain

• Cervical or thoracolumbar joint disease

Tendon and ligament injury

• Proximal suspensory desmopathy

• Flexor-tendon injury

• Collateral-ligament injury

• Sacroiliac-supporting soft-tissue pain

• Previous injury that becomes painful under increased load

Back and pelvic pain

• Thoracolumbar muscle pain

• Impinging dorsal spinous processes

• Articular-process joint disease

• Lumbosacral pain

• Pelvic injury

• Compensatory back pain secondary to limb lameness

Multiple simultaneous problems

Performance horses frequently have more than one source of discomfort.

A horse may have bilateral foot pain, secondary back tightness and a saddle that becomes unstable because the horse has lost topline muscle. Correcting only one component may improve the score without completely resolving it.

What Else Can Cause Similar Behaviours?

Not every high head, open mouth or incorrect canter lead is caused by musculoskeletal pain.

The real clinical task is separating pain-related behaviour from tack, rider, training, environmental and medical factors.

Saddle fit

An unsuitable saddle may:

• Restrict the shoulders

• Create focal pressure

• Tip the rider forward or backwards

• Slide to one side

• Concentrate weight beneath the front or rear panels

• Become painful as the horse’s musculature changes

In the 150-horse study, saddle fit was considered likely to compromise performance in more than one-third of the horses, reinforcing that tack assessment should be part of the investigation. (MDPI)

Bit, bridle and dental discomfort

Mouth opening, tongue movement and head tossing may be influenced by:

• Dental disease

• Oral wounds

• Wolf teeth

• Bit size or shape

• Uneven rein pressure

• Noseband pressure

• Temporomandibular discomfort

• Previous painful experiences

Rider influence

Rider skill was associated with RHpE scores in the 60-horse study.

A rider who is unbalanced, consistently sits to one side, holds uneven rein tension or gives conflicting cues can influence the horse’s head position, straightness, rhythm and mouth behaviour. (PubMed)

This does not mean the horse should be blamed on the rider or the rider should be blamed for the horse.

The horse-rider combination should be evaluated together.

Training and misunderstanding

A horse may:

• Not understand the aid

• Lack the strength required for the movement

• Be asked for work above its training level

• Lose balance on small circles

• Become anxious after repeated correction

• Have learned to anticipate pressure

Fear and environmental distraction

Spooking or sudden direction changes may result from:

• Wind

• Noise

• New objects

• Other horses

• Previous frightening experiences

• Poor vision

• Rider tension

Fatigue or insufficient conditioning

A horse may initially work normally but become crooked, slow or resistant as the session continues because the required muscles fatigue.

That fatigue may reflect inadequate fitness, but it may also expose pain or weakness that requires investigation.

Non-musculoskeletal disease

Behaviour under saddle may also be influenced by:

• Gastric disease

• Respiratory disease

• Cardiac abnormalities

• Eye pain or reduced vision

• Neurological disease

• Skin wounds beneath tack

• Reproductive discomfort

• Heat stress

• Systemic illness

The RHpE was developed primarily for musculoskeletal pain. A low score cannot rule out these other conditions.

Pain Versus Behaviour: Useful Decision Clues

Pain becomes more likely when:

• The behaviour developed suddenly

• The horse was previously willing

• One rein or canter lead is consistently worse

• The horse has lost performance

• The problem worsens with increased collection or speed

• A particular movement repeatedly triggers the behaviour

• The horse has become difficult for the farrier

• There is stiffness after rest

• The saddle has begun slipping

• Stride length or impulsion has changed

• The horse reacts during back or limb palpation

• The behaviour improves after veterinary treatment

Training or environmental factors become more likely when:

• The horse is young and has never learned the movement

• The behaviour changes dramatically with clearer cues

• The problem occurs only in one frightening location

• The horse remains physically relaxed and moves symmetrically

• The behaviour improves gradually with calm repetition

• There is no consistent relationship with gait, direction or workload

These categories overlap.

Pain can create fear. Fear can create defensive behaviour. Repeated painful work can turn a physical problem into a learned response that remains after the original injury has improved.

How Worried Should You Be?

Low Risk

The horse:

• Displays one or two brief, context-appropriate behaviours

• Maintains normal rhythm and straightness

• Performs equally on both reins

• Has no lameness, stiffness or loss of performance

• Returns immediately to normal after a distraction

What to do: Monitor. Record occasional video and watch for any trend over the next several rides.

Moderate Risk

The horse:

• Repeatedly displays several behaviours

• Has a score below 8 but the pattern is new

• Struggles more on one rein

• Repeatedly breaks canter

• Has become girthy or resistant to saddling

• Shows mild back sensitivity

• Is taking longer to warm up

• Has recently changed weight, workload, rider or tack

What to do: Reduce demanding work. Review saddle, bridle, feet and recent management changes. Arrange a veterinary examination if signs continue over the next few rides or worsen within days.

High Risk

The horse:

• Scores 8 or more

• Has definite lameness

• Repeatedly bucks, rears or refuses to move

• Shows repeated stumbling or bilateral toe dragging

• Has a sudden major performance decline

• Cannot maintain the requested canter

• Becomes dangerous during transitions

• Has focal heat, swelling or back pain

• Needs pain relief to continue working

What to do: Stop strenuous ridden work and arrange a prompt veterinary lameness or poor-performance examination. Do not continue jumping, galloping or competing while waiting.

Critical

The horse:

• Becomes non-weight-bearing

• Falls or repeatedly nearly falls

• Develops severe incoordination

• Cannot stand normally

• Collapses

• Shows severe breathing difficulty

• Has a suspected fracture

• Develops severe pain after a fall

• Has neurological signs

• Becomes uncontrollably dangerous because of apparent pain

What to do: Stop riding immediately, keep people safe and contact an equine veterinarian as an emergency.

When Is This an Emergency?

A high RHpE score alone is not necessarily an emergency. Urgency depends on the behaviours, gait abnormalities and the horse’s physical condition.

Seek urgent veterinary care if your horse develops:

• Sudden non-weight-bearing lameness

• Repeated falling or severe stumbling

• Marked weakness or incoordination

• Inability to turn or back normally

• Collapse or recumbency

• A deformed or unstable limb

• Severe back, neck or pelvic pain

• Profuse sweating with muscle pain

• Dark red or brown urine after exercise

• Severe respiratory effort

• Severe colic signs

• Sudden blindness or a painful closed eye

• Dangerous behaviour immediately following a fall or collision

Do not remount to see whether the problem happens again.

A horse that has nearly fallen once has already supplied enough information for the day.

What Should You Do Right Now?

1. Stop escalating the pressure

Do not respond to repeated resistance by:

• Applying stronger leg aids

• Using a harsher bit

• Tightening the noseband

• Adding larger spurs

• Chasing the horse forward

• Continuing to jump

• Punishing bucking or rearing

You may suppress a warning without addressing the cause.

2. Decide whether it is safe to continue

Dismount if the horse is:

• Repeatedly stumbling

• Bucking or rearing

• Clearly lame

• Losing coordination

• Becoming increasingly distressed

• Unable to maintain balance

• Dangerous to the rider or people nearby

There is no useful information gained by turning a concerning ride into an ambulance hobby.

3. Record the exact pattern

Write down:

• When the behaviour started

• Which gait triggers it

• Which rein is worse

• Which canter lead is difficult

• Whether it begins immediately or after fatigue

• Whether it occurs during saddling, mounting or riding

• Any recent fall, shoeing change or increase in workload

• Whether a new saddle, pad, bit or rider was introduced

• Current medications

Specific information is much more useful than saying the horse was “awful” or “not itself”.

4. Obtain useful video safely

When the horse is safe to ride, record:

• Walk, trot and canter

• Both reins

• Straight lines and circles

• Transitions

• Views from the side, front and behind

• The horse’s normal rider and tack

Do not create an intense or painful session solely to produce footage.

If the horse is dangerous or clearly lame, do not ride for the camera.

5. Examine the horse at rest

From a safe position, look for:

• Limb heat or swelling

• Increased digital pulses

• Hoof heat

• A loose, twisted or missing shoe

• Cuts or rubs

• Back sensitivity

• Muscle asymmetry

• Swelling beneath the saddle or girth

• Reduced appetite

• Fever or general lethargy

These observations can guide urgency, but they do not replace a lameness examination.

6. Reduce the workload

Until the horse has been assessed:

• Avoid jumping

• Avoid fast work

• Avoid small circles

• Avoid intensive collection

• Do not compete

• Do not use pain medication to continue training

Quiet turnout or controlled walking may be suitable for some comfortable horses, but the correct plan depends on the suspected injury.

7. Arrange the appropriate professionals

The horse may need input from:

• An equine veterinarian

• A qualified saddle fitter

• The farrier

• An equine dental veterinarian or appropriately qualified dental provider

• A rehabilitation professional

• A riding coach

The veterinarian should lead when pain, lameness, weakness or a sudden behavioural change is present.

A saddle fitter cannot diagnose suspensory pain, and a lameness examination cannot permanently correct a saddle that is creating pressure. Many cases need collaboration.

How Do Veterinarians Investigate Ridden Pain?

A complete investigation may include several stages.

History

The veterinarian will ask about:

• The horse’s normal performance

• Exact behavioural changes

• Workload and discipline

• Previous injuries

• Medication and joint treatments

• Farrier and dental history

• Saddle history

• Competition schedule

• Whether the problem is rider-specific

• When the horse was last considered completely normal

Examination at rest

This may include:

• Limb and joint palpation

• Tendon and ligament assessment

• Hoof evaluation

• Back, neck and pelvic palpation

• Muscle symmetry

• Joint mobility

• Neurological screening

• Examination of tack and saddle fit

Movement in hand

The horse may be assessed:

• Walking and trotting in a straight line

• Turning

• Backing

• On firm and soft surfaces

• Before and after flexion tests

Lunging

Lunging can reveal:

• Subtle asymmetry

• Circle-specific lameness

• Loss of rhythm

• Reduced suspension

• Difficulty maintaining canter

• Abnormal limb placement

Ridden assessment

When safe, the veterinarian may observe:

• The horse with its usual rider

• The horse with another suitably skilled rider

• Both reins

• Different surfaces

• Transitions

• Discipline-specific movements

• The RHpE behaviours

• Saddle movement

• Rider balance and rein tension

Diagnostic anaesthesia

Nerve and joint blocks temporarily reduce sensation from selected structures.

They help determine whether pain from a particular region is responsible for the gait or behaviour change. They are not simply a general painkiller trial and must be performed by a veterinarian.

Imaging

Depending on the findings, imaging may include:

• Radiographs

• Ultrasound

• MRI

• CT

• Scintigraphy

• Endoscopy or other tests when non-musculoskeletal disease is suspected

The investigation should be directed by the examination rather than beginning with random radiographs of every available joint.

Should You Give Bute to See Whether the Horse Improves?

Not without veterinary direction.

A home pain-relief trial has several problems:

• Some painful conditions respond poorly to NSAIDs

• Improvement does not localise the source

• Lack of improvement does not rule out pain

• Medication can mask signs during the veterinary examination

• NSAIDs carry gastrointestinal and renal risks

• Competition medication rules may apply

• Continuing work after signs are masked may worsen an injury

Diagnostic anaesthesia used in lameness investigations is much more targeted than giving systemic phenylbutazone and seeing whether the horse seems happier.

Tell your veterinarian about every dose already given and when it was administered.

Can the Behaviours Remain After Pain Is Treated?

Yes, but not always.

Once pain has been present for long enough, the horse may learn to anticipate discomfort during:

• Saddling

• Mounting

• Canter transitions

• Jumping

• Collection

• A particular arena movement

• Contact with the bit

After the physical cause has been treated, the horse may still need:

• Gradual rehabilitation

• Strength rebuilding

• Saddle reassessment

• Clearer training

• Short, positive ridden sessions

• A temporary reduction in task difficulty

• Rider coaching

• Time to rebuild confidence

However, do not assume persistent behaviour is merely a habit until the horse has been properly reassessed.

The original pain may not have been fully resolved, or several painful conditions may have been present.

Common Mistakes Riders Make

Waiting for an obvious limp

Some painful horses remain bilaterally symmetrical or show abnormalities only in canter, transitions or collection.

Counting every normal movement as pain

An ear flick, one tail swish or one stumble does not automatically meet the ethogram criteria.

Scoring a short social media clip

The RHpE should be applied over a meaningful ridden assessment in several gaits and directions.

Treating eight as a magical dividing line

A horse scoring seven may still be painful. A horse scoring eight still requires diagnosis.

Punishing the warning signs

More force may suppress behaviour while increasing fear and discomfort.

Assuming the saddle is the entire answer

Saddle fit matters, but underlying lameness may change back shape and cause a previously suitable saddle to become unstable.

Assuming every problem is ulcers

Gastric disease may affect behaviour, but lameness, back pain, dental pain and tack problems should not be skipped.

Giving pain medication before the examination

This may alter the findings and reduce the veterinarian’s ability to identify the problem.

Asking the horse to repeat the behaviour

You do not need six more bucking transitions to confirm that the first five were not a clerical error.

How Can You Prevent Ridden Pain From Being Missed?

Establish a normal baseline

Record short videos of the horse when performing well.

Include:

• Walk

• Trot

• Canter

• Both reins

• Transitions

• Straight lines

• Views from behind

Future changes are easier to detect when you have a genuine normal comparison.

Track patterns over time

Record:

• RHpE behaviours

• Lameness or stiffness

• Saddle changes

• Farrier visits

• Dental treatment

• Competition dates

• Recovery

• Rider feedback

• Medication

• Surface conditions

One unusual ride may be insignificant. The same change appearing for three consecutive sessions is much more informative.

Maintain regular saddle assessment

Saddle fit changes with:

• Weight gain or loss

• Muscle development

• Rehabilitation

• Changes in workload

• Age

• A different rider

• Changes in gait caused by lameness

Maintain appropriate foot balance

Hoof pain is a common reason for reduced stride, reluctance to go forward and poor performance.

Regular farrier care should be coordinated with veterinary imaging or lameness findings when needed.

Build workload progressively

Sudden increases in:

• Jump height

• Collection

• speed

• Hill work

• Schooling frequency

• Competition frequency

can expose weakness or overload previously comfortable tissues.

Include recovery

Monitor how the horse feels:

• The day after competition

• Following travel

• After hard ground

• After several consecutive workdays

• During rehabilitation

• When returning from time off

Improve rider balance

Independent rider assessment can help identify:

• Uneven stirrup use

• Collapsing through one hip

• Unequal rein tension

• Excessive movement

• Poor saddle fit for the rider

• Conflicting aids

Better rider balance cannot cure an injury, but it can reduce unnecessary strain and make the horse’s true movement easier to assess.

Will My Horse Be Okay?

Many horses displaying pain-associated behaviours can return to comfortable work once the source is correctly identified and treated.

The outlook depends on:

• The underlying diagnosis

• How long the pain has been present

• Whether one or several structures are involved

• The horse’s age and workload

• Whether tack and rider factors contribute

• Whether rehabilitation is followed

• Whether treatment begins before a significant injury worsens

A high RHpE score does not automatically mean a career-ending diagnosis.

It means the horse is giving enough warning signs that continuing to ride without investigation is no longer a reasonable gamble.

Early recognition often provides more options, shorter rehabilitation and a better chance of preventing defensive behaviour from becoming deeply learned.

Frequently Asked Questions

Does a score of 8 prove that my horse is in pain?

No. A score of 8 or more makes musculoskeletal pain likely, but the score is not a diagnosis. The horse still needs a veterinary assessment to identify the cause.

Can my horse be lame with a score below 8?

Yes. Some lame horses score below 8, particularly when the lameness is mild or the horse displays relatively few behavioural markers. New or consistent gait changes should still be investigated.

Can gastric ulcers increase the RHpE score?

Gastric discomfort may contribute to behavioural changes, but the RHpE was developed specifically to help recognise musculoskeletal pain. Gastroscopy and a complete clinical assessment may be required when gastric disease is suspected.

Can a poor rider make a horse appear painful?

Rider skill, balance and weight distribution can influence the horse’s behaviour and RHpE score. This is why the horse, rider, tack and gait should be assessed together. Rider influence does not rule out simultaneous pain.

Can I use the ethogram on a video?

Yes, video can be useful for screening and monitoring changes. The recording should include enough work in several gaits and directions. A score from video cannot replace an in-person lameness or poor-performance examination.

The Real Takeaway

Horses do not need to show an obvious limp before pain affects their performance.

Repeated tail swishing, mouth opening, incorrect canter, spontaneous gait changes, reluctance to move forward, stumbling, bucking and rearing may be behavioural expressions of discomfort rather than deliberate disobedience.

The Ridden Horse Pain Ethogram helps riders recognise when several of these signs occur together. A score of 8 or more makes musculoskeletal pain likely, but lower scores do not completely rule it out, and the total score never replaces diagnosis.

What matters most is change.

When a previously willing horse becomes difficult, one rein deteriorates, the canter loses quality or several pain-associated behaviours begin appearing together, listen before applying more pressure.

The horse may be communicating the only way it can.

---

Concerned that your horse’s ridden behaviour may indicate pain? ASK A VET™ can help you organise safely recorded videos, behaviour scores, tack history and performance changes so you can understand the urgency and prepare for an in-person equine veterinary assessment.