My Horse Has Kissing Spines, What Should I Do?

A diagnosis of kissing spines can feel overwhelming. It's natural to wonder what it means for your horse's future and whether they'll ever be comfortable again. The good news is that a diagnosis of kissing spines doesn't automatically mean the end of your horse's ridden career. With the right veterinary guidance, appropriate management and a carefully planned rehabilitation programme, many horses go on to become happier, stronger and more comfortable.

It's important to remember that every horse is different. Some horses have significant changes visible on x-rays yet show very few signs of discomfort, while others with less obvious changes can be considerably affected. That's why it's so important to look at the whole horse rather than focusing solely on the x-rays.

The advice I give in this article is designed to complement the guidance of your own vet and rehabilitation team. Every rehabilitation programme should be tailored to the individual horse.

Understanding Your Horse

One of the first things I encourage owners to do after a diagnosis is to sit down with a notebook and write a problem list. This isn't simply a list of veterinary findings. Instead, it's a record of everything your horse does that could indicate discomfort.

Ask yourself:

• Does your horse resent being groomed over the back?

• Do they swish their tail more than they used to?

• Are they reluctant to move forwards?

• Have they become resistant during schooling?

• Do they react when being tacked up?

• Has their performance changed?

• Are there any subtle behavioural changes that you've noticed over time?

The truth is that you know your horse better than anyone else. Your vet, physiotherapist, saddle fitter and other professionals each bring invaluable expertise, but you're the person who sees your horse every day. That means you're in the best position to notice the small changes that tell you whether there comfort is improving, or something is making them worse.

It's important to keep adding to your notes as your horse's rehabilitation progresses. You'll often find patterns begin to emerge, helping you identify what benefits your horse and what doesn't.

Don't underestimate the value of observation. The more closely you watch your horse, the more they'll teach you about how they're feeling.

Review Your Horse's Management

Once you have a diagnosis, it's worth taking a step back and evaluating every aspect of your horse's daily life.

• How much turnout do they get?

• How much time do they spend moving?

• How are they fed?

• How are they stabled?

• How are they exercised?

• How much variety in surface and terrain are they exposed to?

• Are there any unnecessary sources of stress?

Consider every aspect of the way you care and manage your horse

Small changes made consistently can make a remarkable difference.

Feed from the floor

One of the simplest changes you can make is to encourage your horse to spend as much time as possible eating with their head lowered.

Whenever appropriate, feed forage from ground level rather than from high hay nets.

A lowered head encourages a more favourable posture through the neck and back. In contrast, if your horse is repeatedly holding its head high for prolonged periods, it can encourage a posture that places greater strain through the back.

Take a look at your stable

Is your horse constantly stretching up over a high stable door? Are they spending long periods looking over tall partitions? If they are, it may be worth considering whether these can be modified to encourage a more comfortable posture throughout the day.

Keep your horse moving

Movement is one of the most valuable forms of medicine. Wherever possible, encourage regular, gentle movement throughout the day rather than prolonged periods standing in a stable.

Turnout is invaluable because it allows horses to keep walking naturally. Even better is creating an environment that encourages movement. For example, placing water and forage in different locations so your horse has to walk between them. The aim isn't about asking for strenuous exercise, it's to encourage comfortable, relaxed movement little and often.

Don't overlook stress

Stress changes posture. A horse that's worried or anxious often adopts a different way of carrying themselves. This increases muscular tension and potentially makes discomfort worse.

While every horse will experience occasional stress, it's worth considering if there are aspects of your horse's daily routine that could be improved. Calm horses generally move more freely, carry themselves in a more relaxed way and in turn are often better able to benefit from rehabilitation.

Check Your Horse's Weight

As kissing spines commonly affects the middle of the back, anything that increases the load placed on that area has the potential to make your horse less comfortable. That includes excess bodyweight.

Aim to keep your horse in a safe body condition score throughout rehabilitation. If you're unsure, seek advice from an independent equine nutritionist who can help develop a feeding plan that supports recovery while maintaining healthy condition.

Give Rehabilitation the Time it Deserves

One of the most commonly asked questions I get asked is: "How long should I rehabilitate my horse before riding again?"

Although every horse is different, I generally recommend allowing six to eight weeks of non-ridden intensive rehabilitation work. This may be after a period of lighter work and rest advised by your veterinary surgeon depending on their treatment.

This rehabilitation work is important because meaningful change takes time. Muscles need time to become stronger and movement patterns need time to improve. Crucially, the body needs time to adapt.

If your horse requires veterinary treatment, whether that's medication, injections or surgery, that rehabilitation period remains just as important and may be longer. Veterinary treatment addresses one part of the problem but rebuilding strength and improving posture are equally essential for long-term success and hopefully ridden work.

Make Yourself a Rehabilitation Plan

It can be rather daunting thinking about a suitable rehabilitation programme. I find that instead of deciding what to do each day, take some time to do some planning. Sit down and create a simple weekly timetable, writing down the exercises you intend to do each day. I appreciate that some days you'll have plenty of time and other days work, family and life in general may get in the way - that's perfectly normal. The important thing when it comes to rehabilitation isn't perfection, it's consistency.

If you miss an exercise one day, don't worry. Simply pick it up again the following day.

Having a written plan also allows you to look back and see which exercises you've been doing regularly and which you've perhaps been neglecting.

If you're like me and find it easier to work from a structured programme, I'd highly recommend the Horses Inside Out Pilates Planner.  This provides you with a practical way of organising your rehabilitation sessions and keeping a useful record too.

Rehabilitation is About More Than Exercises

One of the biggest misconceptions is that rehabilitation is about finding one perfect exercise. Successful rehabilitation comes from making lots of good decisions, every single day. It's about:

1. Management

2. Observation

3. Improving comfort

4. Building strength gradually

Most importantly, it's about listening to your horse.

In the next article in this series, we'll look at the groundwork, Pilates exercises and practical rehabilitation techniques that I find most valuable for horses with kissing spines. This will help you build a programme that develops strength, improves posture and supports long-term comfort.

Further Horses Inside Out resources

If you'd like to learn more about kissing spines and rehabilitation, you may find the following Horses Inside Out resources helpful:

• Understanding the Horse's Back (on-demand webinar)

• Kissing Spines (on-demand webinar)

• Understanding and Assessing Your Horse's Posture (on-demand webinar)

• Poles for Posture (on-demand webinar)

• The Complete Pilates for Horses Programme (book and online programme)

• Posture and Performance (book)

• The Horses Inside Out Massage Course (book and online course)

• Inside the Horse Anatomy Exhibition 14th - 23rd August 2026

These resources explore the science behind posture, movement and rehabilitation in much greater detail and can help you build confidence as you support your horse through recovery.

This article is intended for educational purposes and should always be used alongside advice from your own veterinary surgeon and rehabilitation professionals.