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Horse palpating sore near the SI

Looking for people to share their experience with SI problems in their horses.

I have a horse that I am treating for ulcers. He’s still resistant under saddle despite a rescope showing that the ulcers are largely healed.

He’s not been sore at all down his back, but yesterday I noticed as I got close to the SI (particularly standing on his right side) that he pinned his ears as I got close to the SI while palpating.

Horse is just coming back into work after having the winter off, and hasn’t really been body sore until now and any crankiness during tacking or resistance to my leg, I’ve attributed to his ulcers.

I’m still waiting to hear back from my vet, but in the meantime, I’d like to know what experience people have had when their horses have had SI joints and if they were reactive to palpation.

We first noticed some SI soreness at the end of the summer 2021, for a few weeks he just seemed stiff at the trot in that area and then eventually started to palpate slightly. We injected the SI and it made a world of difference. Recently we also started treating for ulcers but I noticed some of the same signs we saw a year and a half ago with the SI. Had the vet out to palpate and watch him go and she agreed it was probably time to inject again. Now that we’ve been treating for ulcers and re-injected the SI, I notice a huge change in his comfort and he feels like a brand new horse. He was never very reactive to palpation but this is also a horse that will let you know if something is just slightly wrong so even a mild reaction for him to palpation told us that he was feeling something and we didn’t let it go on past that point.


SI soreness is a symptom. It could be due to the SI itself, it could be due to sore hocks or stifles, or unbalanced hind feet, or even something sore up front to the point the horse is carrying more inappropriate weight in his hind end.

I always look to the feet first, because with unbalanced feet, it’s a matter of when, not if, it will cause problems higher up.


I should have mentioned I do have fairly recent normal xrays of the feet up through the hock. It doesn’t rule out the stifle, but I do have another horse that has stifle issues although there are some similarities between them, I don’t see a lot of the characteristic stifley problems (like tripping behind with a locking stifle).

That said, my understanding was that when the SI joint becomes sore, horses rarely palpate there. I was wondering how true this might be.

My horse had a bad trip behind during a trot set, and was sore in his SI afterwards - the main symptom was in the canter for him, with one lead worse than the other. My Training/Prelim horse suddenly couldn’t do canter poles on one lead - he was shortening his stride so much he couldn’t make the distance - and of course he’d been doing canter poles for years prior to this.

When the vet palpated his SI he dropped halfway to the ground. We did SI injections, and have had great luck with regular PEMF treatments as a follow up to that. The vet gives him a full physical and lameness exam at minimum every spring before we start are competition season and commented regularly on how great he felt in his back/SI. He did just in the last year present with some soreness there again, but that was over 5 years since the last injection.


I should also mention part of the reason I am leaning towards a joint like the stifle or the SI is that he seems to really improve as he builds fitness/muscling.

I noticed some of these issues after the winter off last year, but with NSAIDs and an exercise plan under the guidance of my vet, I was able to work through it. I gave him a bit of a longer period off this year and he’s just come back into it a bit more ornery this year.

Thinking I’ll just ask my vet about doing a short bute trial to see if we see an improvement just to make sure this isn’t related to the ulcers before I move onto diagnostics.

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I had a horse with SI issues, did 1 injection which helped for about a year. After that I did shockwave. It took about 30 days to see an improvement.

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This requires a permanent fix- not an injection in my experience.

I have dealt with many of these, due to the fact that my breed has people stress that area trying to do things with the horses that they are not made to do.

Ask your horse for a back lift. If he tries to kill you, this is all about weakness. He needs to do a bunch of long and low ground work (I prefer long lines) and also a bunch of caveletti. For a couple of months, not days or weeks. The back is the hardest area to put correct musculature on, but once you get it, you can maintain, and you are good to go. You can actually change their movement for the better doing correct ground work.

IMHO, and pardon to everyone who has gone the injection route, you cannot fix this from the saddle, and your Vet will inject just to make you happy being able to get back on. Do it right, and you’ve got a whole new horse.

I have done accupuncture and chiiro in conjunction with correct ground work. Jury is out, but it certainly can’t hurt, if you have the right people.


have you checked his heels? 99.99% of the time a horse who palpates sore in the SI is down on the heels or contracted and is sore back there. Get some hoof testers and check the sole/ wall in that area, then palpate the soft tissue with your thumbs and get xrays of the palmar angles before you do anything else.

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Yes…but… if you don’t fix what caused the soreness in the first place, all the back lifts and caveletti poles in the world won’t help in the long run.

Start with the feet, and work your way up. Speaking from personal experience here. If you have no issues with NPA (negative plantar angles) in your hind feet, great. Move to the hocks, move to the stifles.
With my own horse, yes she was reactive to palpation in the SI area and by this time we’d pretty much exhausted and were on top of absolutely every last little other thing it could be. At that point we did inject. For my mare, it helped a great deal but was not quite enough and we ended up doing mesotherapy along her back also.

So, ASB Stars is not wrong, but there’s a lot more to consider.


Pathology in the SI joints is a thing as well. OA type changes, bone spurs, etc. Sometimes it is the root cause and can cause soreness down the leg from compensation (like sore hocks or stifles) and not the other way around. Some things can be seen on rectal ultrasound.


What JB said. SI can mean sore hocks and stifles.

My horse had SI ligament damage and nearly fell down when the vet ran a finger down his back and over the SI area.

Same horse, when his symptoms were getting really bad (and before he got sent for a bone scan), we did a bute trial with zero response. I don’t remember exactly how much we gave him but it was per the vet’s directions, and I remember thinking it was a BIG dose so you’d think there would have been some response if it was pain-related, but there wasn’t any improvement. Adding this to say that if you don’t see a response to a bute trial, you can’t necessarily exclude the SI.

A “real” chiro adjustment and doing hill work helps one of mine who has sore SI, and regular maintenance including bi-yearly hock injections and a 10cc Estrone/week- The estrone is amazing- keep him in work at all costs -

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If you can, maybe see if your vet can do an intrarectal ultrasound of his SI. This can help them see if there’s some sort of SI disease going on and if there’s chronic inflammation. That way, you know if the pain is stemming from the SI or a result of compensation from pain in another area. SI injections can be literal magic in horses that need them. My vet likes to start with a powerful steroid for the first injection, followed up by a regenerative medication like PRP, IRAP, or Alpha 2 after 6-12 months :slight_smile:

If you do not do the work to support the area, and build up the horses topline correctly, the cycle continues, as does the need for continual injections. Hill work is great, but it can be hard on areas that have collateral issues due to the causes of the SI problems. Correctly done cavaletti, on a controlled surface, offers a much more gymnastic and consistent solution.

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I don’t have that problem with the horse I am speaking of- he is show fit and athletic and my vet who knows him best was the one to tell me to keep him in work - otherwise he is not okay - So I am just telling about my personal experience. Every situation is different I guess

There is a great old book- “Beating Muscle Injuries for Horses” that I highly recommend for horse owners.