What do mild SI issues look like under saddle?

[grandprixer]

Hi everyone! Another fun post about my never-ending trouble maker. He’s about to turn 13 next week.

Context: This is a jumper turned eventer with some dressage dabbling. He’s a forward and independent horse, like if a stud was also mareish but also a chestnut gelding and always has been - I’ve had him since he was 4. Generally a good boy but quite opinionated - he’s not and will never be a great dressage horse for this reason, but he’s a beast while jumping! Due to my own finances and ignorance, I used a rather poor saddle for 4-5 years which caused some soreness. In July I bought a really high end saddle which I had fitted to him. I noticed a difference pretty much instantly and he didn’t seem back sore at all.

Sept last year, about 6 weeks with the new saddle, I had hip surgery and was off for a few weeks. He was just on pasture. Came back well from that and we didn’t do much beyond hacking until December, when I had another big knee surgery.

In early March this year, I was finally ready to get back on. Chestnuts being chestnuts, he got 3 abscesses at once the day I was cleared to ride. They did have to be popped by the vet and shoes pulled, but after they were popped he was 90% sound immediately. After the shoes went back on I noticed he was still a little off behind but not obviously or consistently. I attributed that to residual soreness from 2 hind abscesses.

3-4 weeks after the abscesses, he seemed totally healed from them. Sound on concrete, gravel, grass, and the arena, and no response to hoof testers. I still occasionally noticed some hind stride shortness and he started flinching while I curried his back, but he was 100% sound and still feeling pretty good under saddle. He’d just had 4 months off so I didn’t notice any unusual weakness for his fitness level.

My “mom” instincts were still jingling though, even though all I could see was exceedingly minor. Other horse people thought I was just so used to him being lame that I forgot what sound looked like. But I took him to the vet anyways.

The vet watched him move, felt where he was sore over his back, and mostly checked for other pain causes I think. He also mentioned his tongue was swollen and purple, which indicated chronic pain I guess? He thought it was SI soreness and injected it with PRP on last Tuesday.

Today, 7 days out from injection, I have noticed some good changes! He’s much less sore to the touch and seems a little more relaxed under saddle, but that might be the warmer weather. He’s still out of shape so it’s hard to tell.

So here’s my question - I know SI is characterized by weird under-saddle issues and unspecific hind end issues. The vet couldn’t tell me how long he’s been sore, but given he had back soreness before with a poor saddle that resolved with a good fit, I’m not sure I would’ve noticed a separate pain there if it is chronic.

What would I notice under saddle from this pain? As I’m bringing him back, I’m refinding all my training holes that I now wonder if the issues were pain related. At the same time, I don’t want to excuse previous bad manners if this truly was a new issue for him. What behavior problems are usually associated with very mild SI pain?

TIA! Sorry for the novel.

[Scribbler]

I don’t think we can limit the symptoms.

Anything to do with pain: not moving forward, pissy, short strided, bucking, trouble with leads etc. They can remember pain for a long time and anticipate it. Basically you don’t want to give him a pass on any bad behavior now that you have it fixed.

If a horse is in such pain that he protests under saddle, he should not be ridden until you are sure he is pain free.

[grandprixer]

What I’m struggling with is what behavior is a pain response and what’s him being silly. For example - he’s usually unhappy about collecting the canter, will flip his head and get crooked. I don’t know if this is him still potentially being sore, or if he’s an out of shape but hot horse who doesn’t want to work hard. My response to each would be very different! And, of course, it’s always possible there’s learned pain responses even though it doesn’t hurt anymore.

I’d love to go to my trainer and let her sit on him but that injection was $$

[blue_heron]

Is this the horse that had multiple abcesses and an EPM case in the last year?? What do his hind feet look like?

I think you’ve got it covered as far as big things to watch out for. A lot of those minor symptoms are going to come down to you knowing what is normal for him. If he was always unhappy collecting the canter and you’ve resolved what seems to be the pain issue, I’m assuming it’s behavioral-- from a completely outside POV. I’ve never heard of a purple tongue, but that doesn’t mean anything. I do think if this is an ongoing behavioral issue and you’re at a place where you’re not sure what is normal and what is not, your trainer needs to come into play. If you take a few lessons or have her do a couple pro rides and the behavior isn’t changing or it’s morphing into another evasion, then involve the vet again.

Flipping the head and getting crooked sounds like he’s unfit. Spooking/bucking/running out/etc are obvious pain behaviors. Just like when we exercise, sometimes it’s hard work and it doesn’t feel “good” but it’s so much better a week out. I have a hot horse who gets opinionated when he’s asked to work hard, but once we get past the discussion, he’s excellent. Sometimes they aren’t hot in the way you want.

[beowulf]

In my own small circle of experience I’ve found that once you fully clinically address the pain and rehab the affected area injured, misbehaviors and “pain responses” disappear quite rapidly.

If this is the same nice chestnut gelding you have posted videos of before, I recall one of my comments to you in one of your threads was that this horse was quite unsound from the videos you posted, and that horse has had a whole litany of lamenesses since that conversation.

SI issues are typically secondary issues or injuries because of something else – so while you treat the SI remember that you are clinically treating a symptom and not the cause of lameness. Suspensory injuries, poorly fitting tack, lyme, EPM, ESPA/DSLD, kissing spine, bad farriery, navicular, racing (and other speed pursuits), stalling can all contribute to SI injuries, as can overworking the horse and/or sudden trauma events like flipping over a jump or a wreck … the horses hold their backs a specific way when they are in pain, which causes their SI to eventually become inflamed and sore. The SI does not have much “room” for inflammation before the reaction is a clinically lame horse.

In my own personal experience with SI injuries and rehabbing them, it was caused by one of three things: racing, bad farriery (NPA behind in particular), or bad saddle fit. Sometimes all three at once.

Under saddle, it can look like any of the following, but usually comes with two very distinct symptoms which I’ve starred because I have never seen an SI injury without either of these symptoms:

• abnormal tail posture *
• difficulty cantering *
• SI scarring on croup
• intractable disposition, particularly undersaddle
• poor behavior during tack up and farriery
• pain stance behind (hind hooves held forward of stifle)
• loss of performance
• crookedness most obvious at canter
• toe drag
• bunnyhop canter
• bucking or rearing or other misbehaviors
• bolting

At some point I think it needs to be asked: why have there been so many injuries and issues with this horse, and is it worth it or fair continuing to make him work if he has all of this physical baggage?

Looking critically at your own management may help, including his feet and management at home (stalling, how much he is ridden, for how long)…

[EventingMaff]

I have this same issue with my horse - it’s sometimes hard to tell what’s 5 year old mare “teenager-isms” vs pain related. We also suspect SI stuff going on behind, but are going with a slow and steady strengthening approach.

Like yours, my mare had back soreness even after several weeks without work (like 2-3 months) so clearly was not riding or saddle related and more likely secondary pain from hind end compensatory behaviors.

What makes us suspect my mare has SI issues (have not done diagnostics to confirm though): back soreness not related to saddle fit, hollowing / crookedness on canter depart, swapping of leads behind (especially to right), difficulty “sitting” in downward transitions, move her feet when asked to do pelvis tuck stretches while loose in her stall (tries to evade by moving away), some difficulty suppling to the left (hard for her to step up underneath herself with her left hind).

None of this is glaringly obvious and is more in the “NQR” bucket rather than the lameness bucket. She’s always been happy to move forward and if anything I’m now realizing that much of her perceived “hotness” was actually running from pain / discomfort. Now that I have really scaled back how quickly I ask for things and are staying within her physical comfort zone, she’s been a soft and responsive horse. What I’ve realized is that with pain / discomfort being an issue, I can’t muscle her into things but instead use her reactions to gauge what her limits are that day. Now, I don’t stop asking her something when she resists…I’ll push through that resistance to get progress on what I asked so that she understands she has to TRY, but once she tries I’ll make sure to adjust what I ask for next.

[grandprixer]

Same horse.

Almost all of these issues are a result of poor farrier work. I think I’ve posted pictures somewhere on here before - but the gist of it is I was a dumb teenager with my first horse and no trustworthy professionals to help me. I picked a bad farrier and he had awful angles for several years - starting with the collateral tears, ending with the suspensory fear and ultimately causing navicular. He’s with a much better farrier right now and we xray every 4 months to check internal angles and keep him on track. EPM was definitely a bad stroke of luck, there was at least one other case at my barn. It’s fairly common in my area. Same with abscesses - weeks of rain will ruin the best feet without a stall!

I’ve thought a lot about whether or not I should keep riding him. The biggest contributing factor for me is that aside from yearly osphos and now maybe si injections, he needs no maintenance to stay sound. And he’s 100% sound! Never even stiff in the cold mornings. Excluding navicular which is chronic, all of his events have healed totally and perfectly. No reoccurring injuries whatsoever.

Since his feet were fixed, the only issues he’s had were EPM which is random, and abscesses, and he doesn’t have a lot they’re just ugly and like to mimic much scarier things.

[PossumHorse]

Be aware high suspensory sprain seems to cause SI pain. I assume from compensating. Have that checked as you do vet checks.

[sportyspicepony]

@beowulf

Under saddle, it can look like any of the following, but usually comes with two very distinct symptoms which I’ve starred because I have never seen an SI injury without either of these symptoms:

• abnormal tail posture *
• difficulty cantering *

Sorry, just a quick question - what constitutes an abnormal tail posture? Would that mean like holding it out too straight, or excessive flipping or crookedness or all of the above?

[Scribbler]

In my observation, unless you are dealing with an Arabian or Saddlebred that naturally flags their tail, anything besides a nice normal slightly raised but essentially quiet tail raises a question mark. It should swing with the walk and undulate at the trot just from gravity.

[leheath]

@EventingMaff

What makes us suspect my mare has SI issues (have not done diagnostics to confirm though): back soreness not related to saddle fit, hollowing / crookedness on canter depart, swapping of leads behind (especially to right), difficulty “sitting” in downward transitions, move her feet when asked to do pelvis tuck stretches while loose in her stall (tries to evade by moving away), some difficulty suppling to the left (hard for her to step up underneath herself with her left hind).

My mare is essentially retired (at 11yo) due to SI pain/issues and very extensive diagnostics have localized it to just that. No saddle fit issues, farrier issues, etc. She is technically “sound” but has “limited mobility” in the pelvis/SI area. Other than the bone scan (which we’ve done), it is not possible to fully visualize the SI so we don’t know exactly what the issue is (best guess is injury from when she was younger/before I got her). Her symptoms are almost exactly those EventingMaff list above with the addition of unexplained jump refusal in canter (not trot) and I never actually tried the pelvis tuck with her loose in the stall. SI injections did nothing and pasture turnout on hills (rather than small paddock boarding, which is most common here in SoCal) has helped, but not enough for her to really be comfortable when ridden.

[Oberon]

My gelding (retired) had SI issues diagnosed by nuclear scintigraphy and internal ultrasound (so I’m sure of the diagnosis). Both sides of the SI joint but worse on the right. Signs were:

• holding tail to the left
• grunting and tail swishing when asked to canter on right rein
• difficulty bending to the right
• toe dragging and squaring off toe (both hinds)
• holding right hip higher (eg when trotting right hip didn’t drop as right hind leg moved)
• putting left hind on ground quicker to relieve weight from right hind, so taking a shorter step with this left hind leg
• became reluctant to walk up any kind of slope
• visibly in pain if pivoting on right hind leg (eg if turning while led out of a gate).

He had steroids injected into both sides of the joint and this improved him for a few months. Ultimately he still showed pain signs under saddle despite a big on-ground rehab effort so I retired him. Few years down the track now and he has much improved and you’d hardly know he has a problem. Just looks a bit stiff at times and needs to put his hinds down regularly for a rest when getting a trim. He is never ridden. This kind of problem can look ok on the ground and only fully manifest itself under saddle.

[joiedevie99]

From a few different horses, all mild enough that the horses were treated and continued under saddle in the same level of work:

1. Less separation between hind legs than previously in canter
2. Two-footed push off into canter (both hind legs push together for first stride, then separate)
3. Lost right pirouette
4. Dropping back and contact in collected canter with some tail swishing
5. Head up, bracing, tiny strides walking down hill
6. Bunny hop/buck in the change

[Amy3996]

@Scribbler

In my observation, unless you are dealing with an Arabian or Saddlebred that naturally flags their tail, anything besides a nice normal slightly raised but essentially quiet tail raises a question mark. It should swing with the walk and undulate at the trot just from gravity.

Can flagging the tail be a coincidental behavior while playing in turnout or free lunging? I ask because my gelding appears to carry his tail in a normal, relaxed position on the lunge line and under saddle, but will flag his tail when he’s bombing around out in turnout or if I turn him loose in the arena to get his bucks out.

[TheDBYC]

I think so, yes.

[Scribbler]

They will all flag the tail in turnout if they are excited enough. Especially if there’s any horsey romance in the air. I meant under saddle, when they aren’t particularly excited.