Beyond head tilt - head turn?

My OTSTB has a history of being fussy with his mouth. He tilts his head dramatically - the right cheek is facing the sky. He snakes his neck and the head is literally lying on its side, and he fusses with his tongue, mouth gaping open. I’d liken it to a person with taffy stuck in a back tooth or something.

His teeth have been checked many times without any notable issues. I had his eyes/sinuses examined as he gets weepy eyes in the summer. I’ve done saddle fitting, ridden bitless, did a bitting clinic, etc. He became my primary riding horse this year and the issues were not a problem until recently, so it appears to perhaps be seasonal? It is genuinely not triggered by riding - he fusses sometimes in the same way even loose in his stall. It does seem related to “anxiety.” He has a pretty stress-free life, but watching me prep dinner, or being ridden - doing something - that’s when he’s doing this. He is not obviously doing a head turn/tilt in pasture, but he does fuss with the other horses at times with his neck/head.

I’m wondering if anyone has horses with sinus-related issues that do this? I ask because I get sinus pain with weather changes, and wonder if that’s part of it. This horse is ridiculous about flies, so I could see a bit of post-nasal drip tickling him into doing this. He does have some clear discharge, not copious amounts, from both nostrils, but nothing remarkable/abnormal.

It could also just be learned behavior from tongue tying in his track days emerging in winter since he’s worked less, but wanted to get inputs on anyone who had a horse do something similar and what the cause/cure was for your horse?

Edited to add: I plan to get my massage person out (myofascial release) to try to ID any source of physical discomfort, then talk to my vet… But still think polling other horse owners is helpful!

If you want to go zebra hunting, google “hyoid fusion in horses”.


Ulcers. This behavior sounds like ulcers, rather than sinus. I’ve known several ‘internalizers’ who act like this.

One of my horses will head tilt and snake his head when the saddle isn’t fitting well through the tree points.

Could you give more of a timeline. It sounds like you’ve been riding him this year but the issues have only started recently but you’ve chased down a number of paths already. Did you ride him in previous years but with less intensity? How much time did you give for each thing you explored? There are people way smarter than I am on COTH who are great at brainstorming but a consistent piece is that the more data you provide up front, the more tailored the responses will be to your needs. The less information, the more things you’ll get that you may have already tried or would seem less relevant with more detail.

You might want to scope his throat if you think it’s allergy related and the sinuses are fine. But it sounds also like a learned anxiety behavior unless there are seasons where he totally stops but no other changes in management happen at that time.

My OTTB mare does this also, sounds very similar to what you are describing.
I recently came across something I believe in ‘The Horse’ magazine, about head tilting being related to pain elsewhere such as the hind end.

I don’t know your horse at all, but it’s something to think about just in case.

What I do know is my mare hates having anything bothering her nose. She is getting over a snotty nose and when it was ‘snotting’ oh she was mad, rubbing and flinging, anything to get that feeling off her nose.

I also think in some ways this becomes a habit. I see my mare doing it for no apparent reason at all. She also does it when I’m next to her - begging for a scratch.

I would rule out physical discomfort, and keep an eye on management practices.

So for a bit more of a timeline - I got this horse in 2014 from NV as a third horse when I moved my two home. He preferred to pace undersaddle, so plan was gaited trail horse for DH. So the first few years, I just hacked around, and even then, he’d fuss with his mouth. I went bitless, tried Myler, etc., but mainly thought it was related to the track, but having ridden a lot of OTTBs, it was worse than any of them. And he doesn’t hang his tongue out of the mouth, but just fusses with it and the snaking neck/head turn stuff. It wasn’t until another horse retired that I got more focused on the STB as a “sport horse.” But he was second horse to my other one. So we did a few low shows, lessons, clinics, and I honestly would be lying if I tried to pinpoint when the head thing would happen.

I have my horses at home in OH with an outdoor with lights. But with winter, I ride less. This year, I was fully focused on this horse as my other horse was slowing down a bit, so I just rode him more consistently. And we did show on the local circuit. He does not actually do the head thing at the shows - he paced with his head high because of nerves at the show in his first tests (Intro A) and then would actually trot and be relaxed for his second test. Scores went from 45 (55 in a CT) to 70% by the last show. So I don’t really think this is just about anxiety - he didn’t do this at the shows. He does this at home, now that it’s colder out. At least, this year, it’s a notable change from how he was going to now. Either it’s that he’s being ridden less, so he’s full of it and this is how he displays it, or there’s a physical issue linked to the colder weather. The saddle - I had it fit and have my chiro check his back, and no signs of pain there. The only area of possible pain, from my observation - he’s always been a little funny when I groom his chest - like, sort of wants to nip, which I correct, but I plan to ask the masseuse about it (myofascial release). He also has a bit of thrush in a hind hoof, which I’m treating, but maybe that’s the trigger? Hadn’t thought of that.

It’s not so severe I’m not riding him, and since it’s not new - I just can’t pinpoint the pattern because I wasn’t consistently riding him and he was so green/weird, I can’t delineate when he stopped being weird until this season, lol. I am not trying to correct it - I just let the reins be loose and keep riding. But I do plan to have it checked - things can change, certainly! I’ll keep everyone posted - thanks for the inputs so far!

Some horses just like to go show because it gives them something more to focus on. I had a hot TB mare who was sometimes kind of a nightmare to ride at home. Hot hot hot, spooky, anxious. But at a horse show, she was all business and a fairly good hunter/eq horse. So, while you’d think most of the time anxiety would increase away from home, occasionally it does not. And, do you show when it’s cold? Sometimes horses are literally cold backed. My current guy was really spooky and anxious last winter until I figured out that he liked to wear borderline too much blanket. The warmer he was overnight, the better my ride in the morning. Yours might not have a major issue linked to cold (like arthritis stiffening up or something like that), but he just might not like being cold!

One physical thing that could be related to both the head tilt and cold is a neck issue like neck arthritis. They may twist or tilt the head because it lets them cheat out of compressing the joints on one side. Could be cranial but could also be base of the neck. Probably less likely to be somewhere right in the middle.

UPDATE - had our myofascial massage today, and he was clearly reacting and releasing, with big yawns. Therapist thought hyoid from description, but his head/poll all felt pretty good. But he really reacted under his left leg - in front of girth area. The pressure point is posterior pectoral. He was also loving having his bracheals massaged on both sides of his neck. His back was fine, but abs tighter. And the most surprising was his left gaskin. He’s a STB, so he has a massive butt and is slightly downhill. We’ve been working on him using his hind end betterment, lifting his back. Therapist wasn’t sure if it was cumulative stress, as she noted he could have tweaked it in turnout, too. Good news is he was clearly responsive to the treatment, but I’ll wait a day or two to ride him, and see how he is. And I’ll keep up with the massage myself, and see if we can manage things.


Thanks for the update, hope he continues to improve!

I think like Obsidian- possible hind end pain.

With winter and no indoor, was able to get in one ride after his massage, and no improvement. Vet came today and no dental issues. Wondered about ulcers, but upon exam, she found back soreness. Not sure why massage didn’t feel it - maybe too focused on the neck/jaw? But I’ll be contacting a saddle fitter! Fingers crossed that’s the issue!