Girth Pain - it's very real, and can be treated very effectively!

by Ian Bidstrup, BVSc (Hons), MACVSc (Equine Medicine), CertVetChiro. (AVCA), CertVetAcup (IVAS)

All horse owners have had at least one - a "girthy horse", a horse that turns it's head and tries to bite when being girthed up. They've been called "pigs', bad mannered, and every other name under the sun. Most people put this behaviour down to attitude - bad attitude - but they've actually got an excuse, and a very good one. Pain around the lower girth area is very real and affects at least 80% of the horse population to some degree. We usually only notice the "pigs".

"Girthiness" can be caused by painful withers, which most commonly result from ill-fitting saddles, from girth galls and, most commonly, from abnormal sensitivity of the chest behind the elbow. The latter cause outnumbers the others at around 20 to 1.

The origin of this girth pain appears to be an upset of the joint or joints between the vertebrae of the highest part of the wither and of the ribs that attach to them. This in turn upsets the nerve that passes between the affected vertebrae and over the joint between the vertebra and rib. The resulting pain follows the course of the nerve down between the associated ribs, all the way under the shoulder blade down to the pectoral muscles near where the girth is placed at the bottom of the chest. The pectoral muscles become tender so the girth squashing them is uncomfortable. The trapezius muscles under the point of the saddle tree are tight and tender - they are fed with nerves from the same vertebrae - and pressure from the saddle is uncomfortable as a result. The real pain, though, usually comes from the ribs being pushed back up. The joints are further upset by this, causing the pain to be magnified. The horse effectively feels like it has a broken rib and reacts accordingly - and tries to let you know it doesn't want that girth tightened! Luckily after a while the pain becomes duller and the horse can breathe again.

Symptoms of rib pain on fastening of the girth include -

q      Slight change in facial expression, often a partial closing or tightening of the eyes or a frown.

q      Grunting.

q      Lifting the head.

q      Inflating the chest to fix and splint the ribs. Also prevents the girth being applied very tightly.

q      Attempting to bite the handler. Often repeated at each stage of tightening the girth. This is the most common and most obvious symptom.

Once girthed up the symptoms include -

q      Grunting while being ridden, especially when going down hill.

q      Refusing to move forward freely for 10-20 minutes after being saddled.

q      Swishing the tail, laying ears back and shortened foreleg stride until warmed up.

q      In extreme cases bucking and/or pigrooting and /or lying down for a short spell after being girthed up.

q      Generally being unhappy and piggy through the ride.

q      Rushing jumps.

q      Hurrying after being turned for home.

q      Resisting leg aids.

q      Resistance to turning sharply.

Signs of rib pain -

q      The skin of the girth area of most horses is ticklish behind the elbow; however, gentle stroking should remove any reaction. If the skin remains jumpy when touched after gentle stroking then there is probably an active problem.

q      When tapping or prodding the skin behind the elbow, the muscles all jump, including the muscles of the leg above the elbow.

q      Tightness and tenderness of the muscles under the girth.

q      Tightness and tenderness of the muscles above the shoulder blade.

Causes - this area is still under debate. It is highly likely that this rib problem starts at birth. Recent research into birth trauma in foals revealed a 5% incidence of broken ribs and a 20% incidence of rib cage trauma in newborn foals. The problem area corresponded with the highest part of the wither and overlaps with that of the rib pain described here.

How does this problem develop? -

Most of the time the rib pain is there but is low grade. Horses, I believe learn to live with it. When you're broken in you get a saddle and girth on and it's a bit uncomfortable, but it is made clear that you're not allowed to complain, so you don't - well not unless you've got "attitude" and you have to let every one know about it. Humans must sometimes look dumb to a horse and so the horses with considerable discomfort or pain have to either put up with the problem or get more aggressive to get their message across. We also have those individuals that will complain about any minor discomfort. When a horse falls on its shoulder or trips badly with a saddle on or is girthed up roughly, the problem that started at birth can be made much worse, and as a result a good horse can quickly or gradually turn sour. Alternatively the problem may be associated with the horse favouring one foreleg, or leaning. This may produce a chronic postural twist of the ribcage that results in a low-grade discomfort becoming a major source of pain.

Treatment Options -

The most effective and long lasting treatment that I have seen is chiropractic adjustment of the joints between the affected vertebra and the vertebrae and rib. (Using true bony chiropractic and not massage "chiropractic"). Results are usually immediate, and at times nothing short of spectacular. Acupuncture is very useful in settling down the affected joints and muscle knots and so the combination of these therapies give the ultimate result.

Massage of the girth area and wither area is helpful and will, where tolerated, at least give temporary relief. Some skilled massage therapists are able to produce long-term alleviation of the signs of girth pain.

Postural adjustment via rider balance and training under lunge can also reduce the twist of the ribcage and thus alleviate the problem.

TENS or Faradic machines may be used to break the pain cycle associated with the affected nerves. These often give considerable relief if used properly. The results, however, are removal of the obvious symptoms rather than the cause. Thus the overall benefit is less and the symptoms are more likely to return.

Using a broad cushioned girth that has 10-15cm of elastic at each end can increase you horse's comfort and reduce the chance that an underlying problem will be aggravated if the horse has a fall when being ridden.

Who can help your horse? To contact a veterinary chiropractor -

In the USA phone the American Veterinarians and Chiropractors Association (AVCA)

623 Main Street

Hillsdale, IL 61257


fax - 309-658-2622

e-mail -

In Australia contact Dr Fiona Kates, DC on 03 99257314 or fax 03 94672794 at the RMIT University Animal Chiropractic Department or the Australian Veterinary Chiropractic Association on (02)6722 4305.

Copyright © Ian Bidstrup 2000

About the author:

Dr. Ian Bidstrup is a veterinarian pursuing a full time practice of veterinary chiropractic and acupuncture. He has spent most of his life either riding or treating horses. He has a Graduate Diploma in Animal Chiropractic from the RMIT University, Melbourne, Australia, a certificate in animal chiropractic from the American Veterinarians and Chiropractors Association, and a certificate in animal acupuncture from the International Veterinary Acupuncture Society.  He is currently undertaking a Master of Animal Chiropractic thesis on girth pain syndrome of equines.