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Writer's pictureJay Mackay

Recognising Pain-Related Poor Performance with Dr Sue Dyson

Updated: Apr 2, 2023

In this blog article, Jay Mackay, equine osteopathy student and Horses Inside Out social media assistant, reviews the online seminar, Pain Related Poor Performance with Dr Sue Dyson. The seminar recording is available (with handouts and CPD certificate on completion) to purchase and view in the Horses Inside Out Academy.

Knowing Sue Dyson’s seminar was going to be 6 hours long, I cleared my Saturday schedule and made a flask of coffee just in case I needed perking up a few hours in. But there was no need for my caffeine at all - her presentation was so informative and interesting that I couldn’t believe how quickly time passed.


In the first third of the seminar, Sue uses plenty of photographs and videos to talk about how we can identify normal gait, posture and behaviour in a horse. We get to observe lots of horses move from the front, the side and from behind, and Sue points out the areas on a horse that we should focus on and explains what a good example should look like.



We need to know what is normal so that later on in the seminar we can then identify what is an abnormal movement or behaviour - all the little changes from ‘good’ to ‘bad’ can be signs that the horse is in some level of discomfort or pain.


Before we get to part two, however, Sue does some myth-busting: ‘’My horse has always been grumpy’’ or ’’He must have been badly treated because he never stands still to mount’’ or ‘’He has always found right rein lead difficult’’..... In fact, a horse shouldn’t be consistently grumpy, nor should a pain-free horse have difficulty with being ridden on a right canter lead but not on the left, and he definitely shouldn’t always be pinning his ears back whenever you go to tack him up. All these behaviours indicate that the horse is most likely experiencing discomfort. Various reasons as to why the horse is uncomfortable are discussed such as badly fitting tack or inappropriate training.



In the second section of the seminar, Sue talks about how her many years of observation and research helped her develop a 24 point check list of body signals or behaviour changes that a ridden horse might show if he were in pain, but before he shows any obvious signs of lameness. For example, a horse might swish his tail, hold his ears back, show the whites of his eyes, open his mouth, close his eyes for longer than 2 seconds, and so on. A horse will also modify his gait and Sue discusses what differences we might find in the way a ridden horse moves if experiencing discomfort. She calls this list of signals the Ridden Horse Pain Ethogram, or RHpH. We get to see some before and after videos of horses being ridden in trot, walk and canter while Sue clearly talks us through which signals are being shown. If a horse shows 8 or more signals in a riding session, he is almost without doubt in some discomfort. Next, Sue shows us the same horses being ridden but after they have had a nerve blocks. The difference is amazing! I think what is most interesting, though, is that most people would not have thought the horses were showing any pain in the first lot of ‘before’ videos. We would probably say he was being a bit stubborn or naughty, lazy or quirky….., but as Sue mentions several times in the presentation, the earlier we can detect these subtle signs that the horse is in some discomfort, then the sooner we can treat the horse. Treatment might be as simple as having a couple of months of field rest, but it could be enough for the horse to self-heal.



In the final part of the seminar, Sue discusses the concept of Social Licence and equine sports. This is the approval that society as a whole, horsey and non-horsey, has towards how we competitively use horses. Equine sport has come under a lot of negative press recently and there have been several high profile cases of horses being mistreated in sport and competition situations. Horse associations such as the FEI have conducted surveys and they all show that there is a growing sense of concern amongst the public for the horse’s welfare. Sue discusses how she used her 24 checklist to observe 100s of horses competing in low and high level eventing competitions. Her results are fascinating and quite surprising. Most importantly, though, these results can be used to better the welfare of the horse plus improve awareness of pain-related issues for everybody involved in horse sports from competitor to judge.

All in all, the main message I got from watching Sue's presentation is that it doesn’t matter if we are riders, coaches, owners, competitors, dressage judges, vets or paraprofessionals - we all need to educate ourselves and others in being able to identify pain signals in ridden horses. The 24 point check list gives owners something structured that they can use to help them improve their observations, and it gives therapists a valuable tool to help them support their clinical observations.


This seminar is definitely one to add to the very top of your must-see wish list. Sue’s experience, insights and beautifully clear explanations make this absorbing and compelling viewing. I know I will always be watching horses with extra interest from now on.


Lifetime access to this seminar recording is available to purchase and view in the Horses Inside Out Academy.


The package includes:-

  • Video Presentation 1: 1hr 50minutes How to recognise low-grade lameness and question and answer session

  • Video Presentation 2: How do horses adapt their behaviour in the face of musculoskeletal pain? and question and answer session

  • Video Presentation 3: Social licence: Do we have evidence to support the use of horses in competition? and question and answer session

  • Handouts:

    • Adaptation of behaviour with musculoskeletal pain

    • How to recognise low-grade lameness in sports horses

    • Social licence: Do we have evidence to support the use of horses in competitions?

  • Certificate of Completion



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