Rehabilitating a Horse with Kissing Spines

In my previous article, My Horse has Kissing Spines, What Should I Do? looked at the first steps to take following a diagnosis of kissing spines, including reviewing your horse's management, creating a rehabilitation plan and understanding why giving the body time to recover is so important.

Once those foundations are in place, it's time to focus on helping your horse develop strength and improve posture. In this second part, I will share with you the exercises and routines that I have found have worked the best.

It’s important to stress that there isn't one magic exercise that fixes kissing spines. Successful rehabilitation comes from combining a variety of exercises that encourage your horse to use their body more effectively. The aim isn't simply to make the back stronger, it's to improve the way the whole horse moves.

As always, every exercise programme should be carried out alongside the advice of your own veterinary surgeon and rehabilitation professionals.

Walk is One of Your Most Valuable Tools

One of the most valuable things you can do during rehabilitation is simply walk.

Walking encourages the natural movement of the spine, with gentle rotation, flexion and extension occurring with every stride. It helps mobilise the joints, activates the core muscles and develops strength without placing excessive strain on the back.

The important point, however, is that it needs to be an active walk. I'm not talking about ambling slowly around the arena. Aim for a purposeful walk where your horse is stepping forwards, engaging their core muscles and tracking up.

Make The Most of Walk Poles

If I had to choose one piece of equipment for rehabilitation, it would probably be poles. Walk poles encourage horses to think about where they're placing their feet, improve coordination, activate the abdominal muscles and encourage greater spinal mobility.

You don't need to do exactly the same exercise every day and poles are so versatile. Change the layout, alter the spacing, create different patterns and introduce variety to keep your horse mentally engaged as well as physically challenged.

If possible, leave your poles set up so they're easy to use regularly. The simpler you make your rehabilitation routine, the more likely you are to stick with it.

If you'd like ideas for progressive pole exercises, the Poles for Posture on-demand recorded webinar explores this in much greater detail and will give you lots of exercises.

The Value of Backing Up

Walking forwards is important, but backing up has a valuable role too.

Backing up is one of my all time favourite exercises. It encourages your horse to engage their core muscles, flex through the lumbosacral region and improve pelvic control.

Like every rehabilitation exercise, quality matters far more than quantity. A few calm, controlled steps are much more beneficial than rushing backwards with poor posture. Build up the number of steps you ask for and encourage your horse to lower their head and neck as they step backwards.

I’ve put together a useful tutorial video on backing up. It gives you lots of useful hints and tips to ensure your horse is getting the most out of doing this exercise.

Backing up is a hugely beneficial exercise for all horses and can be done in-hand as part of a rehabilitation programme

Keep Rehabilitation Interesting

One of the biggest challenges with rehabilitation is maintaining motivation for you and your horse. Repeating the same routine every day can become boring, so don't be afraid to mix things up. I encourage owners to think of rehabilitation as a form of circuit training.

For example, you might combine:

• A short period of active walking

• A set of walk poles

• A few steps of backing up

• A Pilates exercise

• Another short walk

• A simple in-hand movement

Not only does this keep your horse interested, but it also challenges their body in slightly different ways throughout the session.

Teach Your Horse Something New

Rehabilitation also provides a wonderful opportunity to improve your horse's training. Instead of thinking, "I can't ride for eight weeks," try this, "What can my horse learn during this time?"

You might introduce:

• Shoulder-in in-hand

• Leg yield in-hand

• Lowering the head from gentle pressure

• Better responses to voice aids

These exercises not only improve communication but also encourage better posture, balance and body awareness.

Introducing Trot

As your horse becomes stronger and your veterinary team are happy with their progress, you can begin to introduce short periods of trot. Initially, we're not looking for long periods of trotting around the arena.

Think more about the transition itself. Walk-trot-walk transitions encourage your horse to activate important postural muscles without spending prolonged periods in a pace that may still feel challenging.

Aiming for just four or five balanced trot strides before returning to walk can be extremely valuable.

Later on in your rehabilitation programme, transitions on gentle slopes can provide an additional strengthening exercise, but only if your horse remains comfortable.

Let Your Horse Guide You

Throughout rehabilitation, keep referring back to the problem list you created at the beginning (I talk about this in the first article - My Horse has Kissing Spines, What Should I Do?.) Has anything changed?

• Does your horse move more freely than they did last week?

• Are they happier to be groomed?

• Do they step underneath themselves more willingly?

• Do they find backing up easier?

• Are they dragging their hind toes less?

Small improvements often tell you that you're heading in the right direction. Equally, if an exercise consistently makes your horse less comfortable, that's valuable information too. Rehabilitation should always be flexible and adapted to suit the individual horse. There’s no one size fits all when it comes to rehabilitation and you should always be guided by your horse.

My Favourite Pilates Exercises

I’m asked a lot, "Which Pilates exercises should I do?"

I recommend The Complete Pilates for Horses Programme. It contains more than 70 exercises, but don't let that overwhelm you. You don't need to do them all. I'd much rather see you perform two or three exercises consistently and correctly than try to fit in twenty different exercises.

Here are four that I would recommend for a horse that is on a rehabilitation programmed for kissing spines.

1. Low carrot stretches

These encourage activation of the abdominal muscles, improve spinal flexion and help your horse develop better postural control.

The most beneficial positions are:

• Low between the forelimbs

• Low to each side

Higher stretches are useful for other purposes, but for horses with kissing spines, it's these lower positions that are particularly valuable.

2. Weight-Shifting Exercises

Gentle weight-shifting exercises encourage your horse to transfer weight appropriately and activate the muscles that support the back and pelvis.

As your horse progresses, these exercises can become slightly more challenging while remaining calm and controlled.

3. Tail Exercises

Tail pulls and tail presses can also encourage activation of the postural muscles and promote better engagement through the back. Performed correctly, they're a simple but effective addition to your routine.

4. Reflex Exercises

Reflex exercises can be incredibly useful but remember that they should always be comfortable for your horse.

The abdominal lift reflex encourages the horse to activate the muscles that help support the spine. Rather than creating an unpleasant sensation, perform them using a flat hand or gentle scratching, almost as though you're grooming your horse.

Massage Can Make a Real Difference

Massage is another valuable tool during rehabilitation. Learning some basic massage techniques yourself allows you to help your horse regularly between professional treatments and isn't meant to be used as a replacement for working with a qualified therapist.

A good therapist provides another experienced pair of eyes, helping you monitor your horse's progress and identify areas that may need additional attention.

If you'd like to develop your own skills, the Horses Inside Out Online Massage Course is a great place to start.

What About Therapy Machines?

This is another question I hear regularly. Therapy machines certainly have their place, and if you already own one, they can be a useful addition to your rehabilitation programme.

However, they should never replace correct work. No therapy machine can substitute for correct movement, appropriate strengthening exercises and good management.

Sometimes we all hope for a quick fix, but rehabilitation doesn't work like that. It's the consistent work you do with your horse that produces long-term change.

Returning to Ridden Work

Returning to ridden exercise should always be gradual and carefully planned. Discussing when the is the right time with your vet is crucial.

Before getting back in the saddle, it’s worth asking yourself:

• Is my horse moving comfortably?

• Are they stronger than they were?

• Have the behavioural signs improved?

• Are they coping well with the groundwork programme?

If your groundwork rehabilitation programme is working well, it’s very likely that your horse will have changed shape. If they have, their saddle will need checking to ensure it is fitting correctly and comfortably.

Working closely with your saddle fitter, dentist, farrier and veterinary team helps ensure every aspect of your horse's comfort is optimised before ridden work resumes.

Rehabilitation Doesn't End After Eight Weeks

One of the biggest mistakes owners can make is thinking rehabilitation finishes once they're back in the saddle. Rehabilitation should become part of your horse's long-term management. During this time, you may have discovered that your horse is happier with more turnout, feeding from the floor has made a noticeable difference, and regular pole work has transformed the way they use their back. It’s important to keep those positive changes.

A diagnosis of kissing spines is often an opportunity to reassess everything we do for our horses and make improvements that benefit them for years to come. I’ve already said this, but remember, rehabilitation isn't about chasing perfection. It's about helping your horse become as comfortable and strong as they possibly can.

Further Horses Inside Out resources

As well as resources I've already mentioned in this article, if you'd like to explore these topics further, I also recommend:

• Understanding the Horse's Back on-demand webinar

• Kissing Spines on-demand webinar

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

• Posture and Performance book

• The Horses Inside Out Anatomy Exhibition - 14-23 August 2026 at Wavendon Grange, Near Melton Mowbray, Leicestershire

Together, these resources explain in much more detail the science behind posture, movement and rehabilitation. This will help you better understand not just what exercises to do, but why they work.

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