Holistic Care for the Dressage Horse

Understanding complementary therapies and how they work can help your horse perform at his best.
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Understanding complementary therapies and how they work can help your horse perform at his best.
Credit: Maren Leichhauer/Kosmos Dr. Ina Gösmeier, of Marl, Germany, has accompanied the German  National Equestrian Team to all international competitions and has been responsible for supporting the well-being, soundness and performance of the team’s horses by providing holistic veterinary care.

Credit: Maren Leichhauer/Kosmos Dr. Ina Gösmeier, of Marl, Germany, has accompanied the German National Equestrian Team to all international competitions and has been responsible for supporting the well-being, soundness and performance of the team’s horses by providing holistic veterinary care.

While developing our horses athletically, we strive to provide them the medical support they require to remain healthy in body, mind and spirit. It’s no secret that a horse who feels good performs better than one who doesn’t. While conventional Western veterinary medicine is essential to providing quality health care to horses, complementary medical and therapeutic practices, such as chiropractic care, acupuncture and sports massage, have become increasingly common elements of preventive, supplementary and rehabilitative health care for performance horses. 

Dr. Melissa Carlson, a veterinarian with additional qualifications in chiropractic care and acupuncture who practices in north-central Maryland, explains: “Conventional and complementary veterinary medicine can work really well together, especially if there’s understanding and communication between the horse’s owner, regular veterinarian and the provider of the complementary therapy.” According to Carlson, chiropractic care and acupuncture are rooted in a core belief of traditional Eastern medicinal practices: The purpose of treatment is to stimulate the body to heal itself. 

Dr. Ina Gösmeier of Marl, Germany, is the author of Acupressure for Horses and has been practicing equine acupuncture for more than 25 years. Since 2002, she has accompanied the German National Equestrian Team to all international competitions and has been responsible for supporting the well-being, soundness and performance of the team’s horses by providing holistic veterinary care. According to Gösmeier, “From the view of Traditional Chinese Medicine (TCM), when a horse has a medical problem, it’s always caused by a combination of physical and emotional or spiritual issues. Therefore, for the horse to recover well, you always have to treat both body and mind.” 

Complementary medical interventions support overall soundness and well-being in the healthy horse and are useful diagnostically for a horse presenting minor or unusual symptoms. According to Carlson, “Chiropractic, acupuncture and even sports massage can help us discover problems sooner and the primary vet can then also be notified. This way, you can get both early treatment and official diagnosis. And vice versa, when there is a major diagnosis or lameness that requires conventional medical intervention, there are often compensatory problems, whether from the original lameness or sickness or from side effects of medication or surgery. Acupuncture especially can support horses who are experiencing side effects.”

A basic understanding of each complementary therapy—the beliefs behind the practice, what to expect with a treatment, specific benefits for dressage horses and how to find a qualified practitioner—can help one make the most informed choices about the integration of complementary therapies into a horse’s care. In addition, it is always recommended to speak with the horse’s primary-care veterinarian before engaging in any of these therapies to ensure he or she is aware of the additional treatment and does not identify any contraindications for the horse.

Chiropractic medicine is a system based on movement and symmetry, which helps explain its immense relevance for dressage horses. Carlson explains that in chiropractic care, she is looking for joints that are not moving as well as they should be, primarily in the spinal column. Chiropractic treatments then involve a series of adjustments to the horse’s joints. An adjustment is a short, rapid thrust onto a vertebra in a very specific direction. Though a chiropractor focuses on the spine, she may also adjust joints of the horse’s jaw, legs or skull. 

“You’ll hear people describe these joints as ‘stuck’ or ‘out,’” says Carlson. “Chiropractors use the word ‘subluxation’ in a different way from how the term is used in Western medicine, so we started referring to vertebral subluxation complexes. This term encompasses the joints, the bones, the nerves, lymphatic system and the other tissues—muscles, tendons, ligaments. Everything is affected by a joint not moving normally, particularly in the spine, because the nerves run through there. So chiropractic seeks to have everything moving normally, and in this way, we are improving the sensory input to the horse’s central nervous system, allowing for better output and functioning.” 

Anytime an equine athlete is asked for major movement in performance, chiropractic issues can become prevalent, which makes this treatment especially relevant for dressage horses. According to Carlson, common chiropractic issues are found in the poll, withers, the thoracolumbar junction (mid-back) and the lumbosacral junction and sacroiliac (SI) joints (where the spinal column meets the pelvis). “Dressage horses in particular can have a lot of poll issues because we’re asking them to flex, and a lot of lumbosacral issues at the base of the spine, which is an essential joint for developing impulsion and having the power to generate through and forward,” Carlson explains. “If that joint is stuck, you won’t get the flexion or lift you need. I also almost always see SI problems with high performance horses.”

Carlson says an initial chiropractic appointment typically lasts 60 to 90 minutes as she palpates the horse’s entire body, talks with the owner about the horse’s medical history and makes chiropractic adjustments and/or administers acupuncture. Following the initial chiropractic treatment, a horse may not need another treatment for some time or could require several follow-up appointments or ongoing maintenance, depending on his condition and response to treatment. According to Carlson, there are several reasons why horses may not require chiropractic care as often as humans in order to maintain the benefits of treatment: “Horses have more natural movement and better body awareness. People also tend to follow the follow-up care recommendations better for their horses than they do for themselves. And horses carry a lot less emotional baggage and have fewer bad habits than humans.”

After each treatment, Carlson advises the horse be hand-walked and turned out as much as possible so his body can naturally continue the healing initiated by the chiropractic adjustments. Typically, owners should give the horse the remainder of the day off from work and the following day as well. “I don’t want the horse to carry any tack or weight, mostly because I’m battling muscle memory,” says Carlson. “I want the horse to adjust to his new body and the way things are now. If we put weight or tack right back on them or throw them right back into a stall, their muscles will pull things out again, which negates the effectiveness of the treatment.”

Ester Noiles is the owner/operator of Wood’s Lane Farm in Mt. Airy, Maryland, where she breeds Hanoverians for competitive dressage and jumping. Carlson has performed chiropractic care and acupuncture on Noiles’s horses for more than 10 years. Noiles says, “Typically, we’ll hear from Lauren Kimmel, our trainer, when something doesn’t feel right with a horse—maybe there’s a training issue that seems to be stemming from a minor physical problem. In these cases, we always ask Dr. Carlson to examine and, if necessary, adjust the horse. Just last week, she adjusted a horse, and when Lauren rode the horse today, she commented that she could definitely feel he was more open through both shoulders. What we’ve learned from seeing these effects on our horses is that by combining Western medicine and Eastern medicine, we can make it work for the benefit of the horse. That’s the best way to support his athletic ability.”

In all cases, you should seek a certified chiropractor when choosing a practitioner for your horse. To be admitted to a certification course in veterinary chiropractic, the practitioner must first be either a licensed veterinarian or a chiropractor for people. The American Veterinary Chiropractic Association and the International Veterinary Chiropractic Association oversee the programs that offer veterinary chiropractic certificates. Keep in mind that laws vary from state to state as to who can offer chiropractic veterinary services, with only some states requiring that an animal chiropractor also be a licensed veterinarian.


Acupuncture is a system of complementary medicine that is based on the traditional Chinese belief that energy (called chi) flows through the body along known pathways (meridians), which connect and are connected to all of the body’s systems. When chi is blocked along a meridian, the body, mind and spirit do not function properly and the organism becomes symptomatic. Acupuncture involves the insertion of needles, sometimes with the addition of heat or traditional herbs, into known acupuncture points along the meridians of the body. This practice relieves the energy blockages and thus, initiates healing in the body. Acupressure, in turn, works without the insertion of needles. Instead, light pressure is applied externally to the relevant acupuncture point, typically using one’s hand or finger. While acupuncture should only be administered by a licensed practitioner, the average horseperson can learn to administer acupressure with some basic training and practice. 

Gösmeier advocates both methods for improving and supporting a horse’s physical, mental and spiritual wellness and recommends acupressure especially for enhancing the relationship between rider and horse. According to Gösmeier, “When we ride a horse, especially to pursue dressage, we take on a truly ambitious goal. With acupuncture and acupressure, we can support this effort by helping the horse muscularly, emotionally and by preventing lameness and illness. A rider often recognizes something is not quite right with the horse. For example, you arrive at the barn and are waiting to hear your horse whinny at you as he usually does. But today he doesn’t say hello and just doesn’t seem himself. If you call a primary-care vet at this point, he or she will likely say there’s nothing medically wrong with the horse. But from my point of view, incorporating the beliefs of Traditional Chinese Medicine, there is a disharmony in the horse’s body and mind. Often, if we can treat the horse with acupuncture at this point, we can prevent a bigger problem from developing.”

Gösmeier advocates the regular use of acupuncture by a veterinarian and supplementary acupressure by the horse’s owner or rider for many ailments common among dressage horses, including:

• Muscular pain, particularly in the back or legs

• Pain in the poll or jaw

• Lack of focus, anxiety or laziness, all of which often develop during times of intense training, competition or growth. 

In addition, Gösmeier utilizes both acupuncture and acupressure to support a horse’s well-being before, during and after competition. For example, when the German Equestrian Team’s horses were transported to Hong Kong and Rio for the Olympic Games, Gösmeier knew these long flights would demand a lot from the horses, physically and mentally, before the competition had even begun. She explains, “In these cases, I travel several days ahead of the German Equestrian Team horses. I want to be ready to administer acupuncture to the horses shortly after they arrive. Acupuncture supports their immune systems, keeping them functioning at a high level, and helps to prevent infections brought on by the stress of travel and a new environment. With acupuncture, I can also revive them after their travel so they’re fresh and ready for the competitive task that lies ahead.”

At an initial appointment, Gösmeier will work with a horse’s owner to identify any physical and mental issues troubling the horse as well as his “Body Constitution Type.” Traditional Chinese Medicine refers to an individual’s Body Constitution Type to identify how various elements and circumstances will likely affect health. Gösmeier has adapted this traditional belief in order to identify five Body Constitution Types in horses—Liver, Kidney, Spleen, Heart and Lung. The horse’s type is usually determined by observing his character, behavior and physical build. For example, a Gan, or Liver type, is a strong, dominant horse who is often a top performer. But this type of horse can also tend toward tight muscles and resistant behavior. In contrast, a Pi, or Spleen type, is a calm, trustworthy horse who tends toward soft muscles, stocking up and laziness. Gösmeier believes that knowing a horse’s type can aid with both diagnosis and treatment of issues that tend to come up for the horse on a regular basis, such as a seasonal cough, recurring skin issues or nervousness in new situations. By understanding your horse’s Body Constitution Type, Gösmeier believes a rider can better enhance his performance strengths and likewise have more tolerance for his weaknesses and problem-solve more effectively in the case of illness or performance issues.

Occasionally, a horse will not tolerate the needles well, but most quickly learn to anticipate the good feelings that come from acupuncture treatments. Should a horse object too much to the needles, acupressure is a good alternative. According to Gösmeier, though acupuncture has a stronger effect on the body than acupressure, horse owners can learn to effectively utilize acupressure to support their horses’ general well-being, performance and comfort in new or stressful situations. “Dressage horses train hard for competitions in a sport that is physically and mentally challenging,” says Gösmeier. “With acupuncture supported by acupressure, I can collaborate with the horse’s owner or rider to expedite the horse’s physical, mental and spiritual recovery.” 

As with chiropractic care, laws vary from state to state as to who can legally apply acupuncture to a horse. To find a practitioner certified in the administration of acupuncture, visit the website of the International Veterinary Acupuncture Society (IVAS), the American Academy of Veterinary Acupuncture (AAVA) or the Chi Institute—all offer search features for finding licensed practitioners by location. 


Sports-Massage Therapy 
Massage therapy involves the application of hands-on techniques to improve a horse’s physical and mental well-being. Lisa Carter, who operates Heavenly Gaits Equine Massage in Texas, is a certified equine sports massage therapist with additional training in the use of essential oils to support animal health. Carter explains: “First and foremost, muscle fatigue and soreness is the primary issue I see in dressage horses. We all want our horses to feel as good as they can, and massage is one of the simplest techniques to support that.” 

According to Carter, performance horses can be especially prone to muscular adhesions—fibrous bands that form between tissues like a scar on the inside of the body—which we may commonly refer to as muscle knots. “Muscular adhesions and tension can really limit the normal range of motion and the flight of a limb,” says Carter. “Massage can combat this, helping to effectively promote flexibility in the whole body.” Carter emphasizes that all horses have unique postural habits and naturally occurring asymmetries that, in turn, affect performance, particularly when it comes to work that tests a horse’s straightness and flexibility, such as lateral movements or lead changes.

Typically, an initial appointment with an equine massage therapist will last up to two hours as the therapist records the horse’s history, palpates his body and then performs massage. Carter explains that even a single session can help a horse feel significantly better. From there, the frequency of treatment varies. “It will depend on the horse’s fitness and activity level and any pre-existing conditions,” she says. “As a general rule, for a basic maintenance massage, we recommend about once a month. If you go beyond that, you’ll lose some of the benefit, as each session adds to the benefits of the previous session.” Competitive performance horses may get a sports massage twice a month, weekly or even more frequently if they respond well to treatments. According to Carter, horses do not require time off following a regular maintenance massage, and pre- and post-competition massages can be very beneficial to equine athletes. With any bodywork, it is always advisable to know how the horse responds to the treatment within his normal training schedule before making an appointment at or very close to a competition. 

 Jaclyn Sicoli, USDF silver medalist and head trainer at Peace of Mind Dressage in Frederick, Maryland, believes holistic health care is vital when horses are being asked to perform in dressage because of the high degree of symmetry and suppleness the sport requires. According to Sicoli, “Within our training program we keep all our horses on a regular four- to six-week cycle with a licensed massage therapist and a veterinarian who performs chiropractic and acupuncture treatments. Both professionals identify problem areas within the horses’ mechanical function or muscular system and recommend daily exercises and stretches for owners to perform prior to tacking up. Horses who show a benefit from chiropractic adjustments, acupuncture and massage can demonstrate movement symmetry, increased range of motion and appropriate muscle tone/tension in the topline.” 

When seeking an equine massage therapist, it is important to recognize that there is a wide range of certification programs for practitioners in this field of work. Your equine massage therapist should be willing to share information with you about his/her qualifications, experience and references. Online research can reveal how many hours of training and practical experience are required by his/her certification program. In addition, the National Certification Board for Therapeutic Massage & Bodywork (NCBTMA) offers a search engine for practitioners who are Board Certified in Animal Massage. Your veterinarian or trainer can also often make a good recommendation.

essential oils

Take-Home Message
Chiropractic, acupuncture and sports massage are complementary therapies that supplement and enhance your horse’s primary veterinary care but do not serve as an alternative or replacement. Implementing complementary therapies, including diagnostic techniques and preventive care, provides benefits to the dressage horse that enhance both his quality of performance and quality of life.