Postural Sway and Stability

  Balance starts from the ground up - stability at a standstill is a prerequisite for stability in motion.

“Lameness has been shown to significantly improve in horses with experimentally induced carpal osteoarthritis that underwent exercise aimed at improving postural stability compared with controls” (King et al., Am J Vet Res, 2013).

🤔💭Have you ever thought about how stable your horse is -or even how stable you are?

If you read the post I shared from Hoofflix (21.07.25 on Facebook) you will already be aware of how challenging it is for horses to deal with different surfaces and the increased risks of injury and why some horses with certain pathologies should be aware of the risks associated with each type. 

⚖️Correct postural stability is crucial to protect and stabilise the vertebral column and to maintain balance. It is because of this I always build into my assessment and plans, in particular to begin with, stability testing, this is because a horse lacking in balance at rest will exhibit compromised stability during locomotion. This is then supported and followed by targeted exercises designed to build a horse with strong foundations-developing stability, postural control, core strength, proprioception and range of motion to support optimal gait function and biomechanics. 

💪🏻 This enables your horse to be better equipped to not only deal with unstable and unpredictable surfaces but also supporting the ability to carry both the weight of the tack and rider with the least compensation as possible and therefore reducing injury risk. 

🐎The programme will take into consideration you and your horses’ circumstances and your access to facilities, and we will work together to achieve the best possible outcome for you both.

🥴Unfortunately, we cannot avoid surfaces that are challenging that put stress and strain on the musculoskeletal system, because like I said in my previous post we can’t control what surfaces we will be faced with at the next competition, or indeed the weather! But what we can do is try to help your horse become as risk free as possible, by building stability at your own horse’s rate and gradually through a range of modalities, we can then build on top strength, because just as structural loads must be supported by a solid base, muscular strength must be developed on stable postural control.  

💡One of the ways we can achieve this is through the use of balance pads. 

🐎This particular pony has been thoroughly assessed, been manually treated for muscular tension, had spasms released, and has completed other stability exercises first, so is now progressing through his plan and is now incorporating the use of balance pads to build on his postural control. 

What you hopefully can see here is what we call postural sway. This is a completely normal phenomenon, but to what degree is individual to each horse depending on their postural control ability. Postural sway is the small, natural movement a horse (or human!) makes whilst trying to stay balanced when standing still, counteracting the effects of gravity and therefore maintaining stability. It is a way to measure how steady the body is - more sway means less stability, which can be a sign of pain, weakness or injury. 

🤕🩼Postural stability plays a major role in how both humans and horses recover from injury.

📖In their 2020 study, Ellis & King found that horses undergoing rehabilitation showed better postural stability when they had improved core muscle function. The study showed that horses undergoing individualised rehab programs with targeted core strengthening and controlled exercises experienced significant growth in the multifidus muscle and improved postural stability. Multifidus is located adjacent to the vertebrae running along the spinal column, it is a key spinal stabilising muscle that helps control and stabilise individual segments.

🤔💭💡Some other interesting information they presented in this paper relating to humans were: 

“Improved postural stability has been shown to have multiple benefits in humans including protection of the spinal column (1,2) and enhancing the ability to respond to destabilising forces (3,4).

Increased postural stability has been shown to reduce the number of falls in the elderly (5).

In healthy humans, postural stability is maintained using segmental control that is based on flexible centrally organised responses (6,7).

Humans with chronic back pain and poor core stability lack the ability to use this multisegmental control (8,9). Instead, these people control their postural balance with a more rigid approach that involves the ankle. Use of this ankle strategy leads to fatigue, disturbed segmental stability, and increased mechanical strain and disability. Consequently, poor postural stability, delayed postural reflexes, and diminished position sense may contribute to risk of reinjury (10).

Human athletes who incorporate core, balance exercises into their rehabilitation programs are significantly less likely to suffer reinjury during a 12-month period after injury, compared with those individuals who did not emphasize core strength (7 % reinjury rate in the balance training group vs. 29% reinjury rate in the control group) (11)”

💪🏻⚖️Experiment! How stable are you? You can test your own postural stability by standing still, bring your awareness to your feet (I find it helps if you close your eyes- but please be careful!) and notice how much you are moving/swaying.

🐎Similar to humans, horses with poor postural control are more prone to re-injury, especially if, due to multifidi weakness and dysfunction, their movement strategies rely on other global muscles such as Longissimus Dorsi for spinal stability. Although Longissimus does play a part in spinal stabilisation during propulsion, this muscles main function is locomotory, transferring forces from the hind limbs, and not a deep spinal stabiliser such as multifidi. So being reliant on this muscle is when compensation strategies are deployed, tension, atrophy, stress, and uneven wear and tear on all other musculoskeletal structures will be affected, increasing the risk of injury and disease.  

💪🏻😃Through a different range of targeted exercises, we can challenge the horses balance to engage core strength, enhance joint stability through restimulation of the stabilising muscles and re-establishing neuromotor control within the limbs through proprioceptive feedback and therefore helping them to become more capable of working on unstable surfaces and reducing the risk of injury. 

References

1.Riemann B, Lephart S. The sensorimotor system, part 1: the physiologic basis

of functional joint stability. J Athl Train 2002;37:71-9.

2. Lyytinen T, Lilkavainio T, Bragge T, et al. Postural control and thigh muscle

activity in men with knee osteoarthritis. J Electromyogr Kinesiol 2010;20:

1066-74.

3. Sayenko DG, Masani K, Vette AH, et al. Effects of balance training with visual

feedback during mechanically unperturbed standing on postural corrective

responses. Gait Posture 2012;35:339-44.

4. Xie L, Wang J. Anticipatory and compensatory postural adjustments in

response to loading perturbation of unknown magnitude. Exp Brain Res 2018:1-8.

5. Simmons V, Hansen P. Effectiveness of water exercise on postural mobility in

the well elderly: an experimental study on balance enhancement. J Gerontol A

Biol Sci Med Sci 1996;51:M233-8.

6.Allum JH, Bloem RR, Carpenter MG, et al. Proprioceptive control of posture: a

review of new concepts. Gait Posture 1998;8:214-42.

7.Schieppati M, Giordano A, Nardone A. Variability in a dynamic postural task

attests ample flexibility in balance control mechanisms. Exp Brain Res

2002;144:200-10.

8.Mok NW, Brauer SG, Hodges PW. Hip strategy for balance control in quiet

standing is reduced in people with low back pain. Spine 2004;29:E107-12.

9.Brumagne S, Cordo P, Verschueren S. Proprioceptive weighting changes in

persons with low back pain and elderly persons during upright standing.

Neurosci Lett 2004;366:63-6.

10.Brumagne S, Janssens L, Knapen S, et al. Persons with recurrent low back pain

exhibit a rigid postural control strategy. Eur Spine J 2008;17:1177-84.

11. Holme E, Magnusson SP, Becher K, et al. The effect of supervised rehabilitation

on strength, postural sway, position sense and re-injury risk after acute ankle

ligament sprain. Scand J Med Sci Sports 1999;9:104-9.