How can I tell if my horse is in pain when ridden?
He's just grumpy. She's naughty. Or they're in pain. A checklist of 24 behaviours, a threshold of eight, and 171 horses whose scores fell when the pain was taken away.
He kicks out when the rug goes on. He kicks out when the saddle goes on. "Just tell him off." "He's just grumpy."
Tail swishing, head nodding and shaking, almost pulling the reins out of the rider's hands. "She's a bitch, she always gives her rider a hard time."
Nobody's being intentionally cruel. It's just what everyone says. It's what we've learned. I've always had an uncomfortable feeling that the horse is trying to tell us something, but I listened instead to the people I believed understood horses.
Here's the page I wish someone had handed me at 14. The TL;DR answer, the evidence, what our expert guests have said and, finally, the questions you should ask. And halfway down, a scorecard you can use on your own horse tonight.
TL;DR
Thankfully there is now a checklist, developed by Dr Sue Dyson, an orthopaedic vet with over 370 peer-reviewed papers, and it's been tested on hundreds of horses before and after their pain was taken away with nerve blocks. The checklist has 24 behaviours on it, each with a precise definition, and horses that show eight or more of them during five to 10 minutes of ordinary ridden work are likely to be uncomfortable. Take the pain away with a nerve block and the behaviours go too. They're not habits, and they're not personality.
This is the list, and all it requires is observation and a way to note down what you see.
Head: repeatedly up and down, tossed side to side, or tilted; held behind the vertical or well in front of it for 10 seconds or more; ears back for five seconds or more; eyes closing or the whites showing; an intense, glazed stare; mouth open with the teeth apart; tongue out; the bit pulled through.
Tail: clamped, or swishing hard and often.
Pace: rushing or crawling, an irregular rhythm, moving on three tracks, wrong canter leads, breaking pace unasked, stumbling. And the horse's answer to the rider: spooking or spinning off the line, refusing to go forward, rearing, bucking.
Flies make tails swish and beginners get the wrong canter lead. One of them on its own means nothing; it is the total that counts.
Film five to 10 minutes of your normal schooling on both reins, including canter, and tick what you see. Each item has to meet its definition; a fleeting flick does not count.
This is a rider's version of a clinician's tool. A high score is a reason to investigate, not a diagnosis. The 24 items and their thresholds are the published ethogram (Dyson et al 2018); the plain-English wording is ours, and the primary paper is paywalled so the definitions were checked against secondary summaries. Sue Dyson's book with Sue Palmer, Harmonious Horsemanship, illustrates each one.
What the evidence shows
The ethogram was developed from video of lame and sound horses. An ethogram is just a list of behaviours, each described so precisely that two people watching the same horse would tick the same boxes.
You may be wondering how they got to a threshold of eight. They started with 117 candidate behaviours and cut them down to the 24 that separated the lame horses from the sound ones; most of the 24 are at least 10 times more likely in a lame horse. Eight was then the number of those behaviours that best told the two groups apart.
The test of whether the behaviours are caused by pain, rather than just associated with it, is what happens when you take the pain away.
Ribbon length is the score out of 24. Orange is before diagnostic nerve blocks, blue is after. Dyson and Van Dijk, Equine Veterinary Education 2020, 32:104-111; Dyson and Pollard, Animals 2023, 13(12):1940.
"The absence of overt lameness does not preclude primary musculoskeletal pain." Dyson and Pollard, 2023. A horse can be uncomfortable without limping.
Show the numbers as a table
| Study | Horses | Before | After |
|---|---|---|---|
| Dyson and Van Dijk 2020 | 21 lame | median 10 (range 3 to 12) | median 3 (range 0 to 6) |
| Dyson and Pollard 2023 | 150 with pain | median 9 (IQR 8 to 11) | median 2 (IQR 1 to 3) |
The comparison group matters too. A healthy horse is not a zero.
1,358 sports horses scored at competitions, 805 judged non-lame and 553 lame. The median across all of them was 4, with half of horses between 2 and 5 (the shaded band). Eight is a real line, not an arbitrary one. Dyson and Pollard, Animals 2024, 14(12):1831.
Two things worth knowing before you go and score your horse.
Nearly all of this work comes from Sue Dyson's own team, and it's one trained person watching. In 2022 a separate group of behaviour scientists, including Paul McGreevy and Andrew McLean, reviewed the ethogram. They agreed the behaviours are signs that something is wrong. What they questioned is whether it's always pain: an ill-fitting saddle, a confusing rider or a frustrated horse can produce some of the same behaviours, and nobody has yet shown that all 24 deserve the same weight when you add them up. Notice what's not on their list. Nobody in this argument is saying "it's just his character".
And the score doesn't tell you where the pain is or how bad it is. A horse scoring five isn't necessarily fine; Sue told Anna the pain may be low grade, or the work too easy to show it.
So here's what the score is for. Eight or more means your horse is telling you something, and the something is one of pain, tack, rider or confusion, all of which can be fixed. It's not a diagnosis. It's the reason to go and get one.
What our podcast guests have said
Sue Dyson told Anna she built the checklist because riders, trainers, saddle fitters and vets alike were "rather poor at recognising lameness". Horses that weren't performing got blamed for being "lazy or unwilling or uncooperative or naughty". She didn't see it that way. She saw a horse trying to tell us something wasn't right.
She grew up with the same labels we did. "Mum bites, and she's always done that, so that's normal for Mum. Nymph is her daughter, so she bites as well. Bert always has his ears back." And the reason so many riding school horses are safe for a beginner, she says, is that they're slow, "and they're slow often because they have got some degree of discomfort".
Her method: stand in the corner of the arena on the short side, watch the horse away from you, past you and towards you, cross to the opposite corner when the rider changes the rein, and tick the list. Ten-metre circles in rising trot are revealing, because they're harder for the horse.
She isn't alone. Gillian Higgins hears the same thing over and over: "my horse is not behaving well, or he's naughty". Her answer is that horses "don't misbehave on purpose"; look for pain, training or tack first. Marcel Olivé put it as a list of everything a horse isn't: "They are not stubborn. They are not silly, temperamental, mischievous, lazy or grumpy or sneaky or jealous or moody or trying to annoy you. They are just communicating in plain English to you." And Shelby Dennis turns the label into a question: is he afraid, in pain, confused or frustrated? "There's always a reason."
Three guests from three different disciplines, none of whom have met, and the same answer.
What to ask at your yard
Score your own horse first. Get a friend to film five to 10 minutes of your normal schooling on both reins, including canter, and go through the list above. It may help to watch the documentary first, Sue Dyson's documentary walks through every behaviour on a real horse.
Take it to your instructor, your yard manager or your vet.
What a good answer sounds like
A number, and what happens next. "He scored nine on the lunge and ridden, so we're going to nerve block the left fore first and see what changes." Or, just as good: "He scored two. Whatever this is, it isn't likely to be pain."
What a weak answer sounds like
"That's just how he goes." Sue Dyson's reply to that is one you are allowed to borrow: he is showing eight of the 24, so he must be uncomfortable, and I would like to find out why. check audio
If the vet's answer is a trot-up and a shrug
You are entitled to ask for a referral to a vet with lameness and poor-performance training. Most vets never received it, and Sue Dyson's point is that a referral is a win for everyone, including the vet who admits it isn't their field. check audio
What would change this answer
The 2022 reviewers asked for three things: evidence on whether all 24 behaviours deserve the same weight, tighter definitions for some of them, and tests of how often tack, rider or confusion produce the same score as pain. A study of how reliably owners, rather than vets, apply the checklist would tell us how much to trust a home score. Any of those would move the numbers above, and this page will be updated when they arrive.
Sources, read at source. Dyson S et al, Development of an ethogram for a pain scoring system in ridden horses, Journal of Veterinary Behavior 2018; 23:47-57 (abstract). Dyson S, Van Dijk J, Application of a ridden horse ethogram to video recordings of 21 horses before and after diagnostic analgesia, Equine Veterinary Education 2020; 32:104-111. Dyson S, Pollard D, Application of the Ridden Horse Pain Ethogram to 150 horses with musculoskeletal pain before and after diagnostic anaesthesia, Animals 2023; 13(12):1940. Dyson S, Pollard D, Determination of equine behaviour in subjectively non-lame ridden sports horses, Animals 2024; 14(12):1831. Ladewig J, McLean AN, Wilkins CL, Fenner K, Christensen JW, McGreevy PD, A review of the ridden horse pain ethogram and its potential to improve ridden horse welfare, Journal of Veterinary Behavior 2022; 54:54-61. RCVS Knowledge, Quality of life assessment tools.
Listen: Anna's conversation with Sue Dyson, 27 November 2024. Sue's documentary "The 24 behaviours of the ridden horse in pain" is free on YouTube. Her book with Sue Palmer, Harmonious Horsemanship, illustrates every behaviour. If you buy through that link, Bookshop pays us a small commission and a share goes to independent bookshops. It costs you nothing extra and it doesn't affect what gets recommended here.
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