Sacroiliac (SI) pain is a common cause of poor performance and low-grade lameness in performance horses. [1] The sacroiliac joint is the point on the horse’s body where the pelvis and the spine connect, playing an important role in their stride.

Damage to the ligaments supporting the region or the sacroiliac joint itself can produce pain and discomfort, resulting in symptoms such as poor-quality gaits, refusing jumps, and “bunny hopping” in the canter.

Sacroiliac pain may result from trauma, repetitive stress, overuse injuries, poor conformation or arthritis. Competition horses involved in dressage and show jumping have the highest risk of this condition.

Treatment typically involves a prolonged rehabilitation period of up to 4 – 6 months. Many horses with SI pain recover and return to performance careers, often at a lower level than their previous level of performance.

Sacroiliac Joint in Horses

The sacroiliac region in horses is the junction between the hind limb and the spinal column. The major components of this region are: [1]

  • The sacrum, the fused spinal vertebrae of the sacral region
  • The ilium, the sides of the pelvis
  • Several ligaments that support these structures

The sacroiliac joint is the connection point between the sacrum and the ilium. The joint has very limited movement capacity due to the supporting ligaments and helps transfer concussive forces from the limbs to the spinal column. [1]

Sacroiliac disease in horses refers to a range of conditions that affect the sacroiliac joint, commonly leading to pain and poor performance. In SI disease, either the joint itself, the ligaments surrounding the joint, or both, are affected. [1][2]

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Cause of Sacroiliac Pain

During normal movement, the muscles surrounding the horse’s sacroiliac joint prevent it from overextending or exceeding its physical limits. However, if the muscles of the hind limbs and back fail to prevent overextension, the SI joint may become strained or damaged. [1]

Common causes of SI disease include: [1][2]

  • Falling or slipping
  • Becoming cast in a stall
  • Muscle fatigue from overuse
  • Repetitive stress injuries to the muscles due to intensive training

The most common types of SI disease are: [1]

  • Damage to the ligaments between the top of the sacrum and the top of the pelvis (dorsal sacral ligaments)
  • Damage to the ligaments between the sides of the sacrum and sides of the pelvis (intraosseus sacral and ventral sacral ligaments)
  • Arthritis of the sacroiliac joint

Damage to the intraosseus sacral and ventral sacral ligaments can result in luxation or subluxation of the joint, where the bony components of the joint become misaligned. [1]

Risk Factors

The prevalence of sacroiliac disease in racing and competition horses is high. However, many horses show degenerative changes in the SI region without signs of lameness. [3]

Risk factors associated with SI disease include: [3][4]

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Sacroiliac pain typically causes low-grade lameness or poor performance in competing animals. [1]

Symptoms of SI disease are highly variable, but can include: [1]

  • Reduced stride length in the hind limbs
  • Changes in the quality and rhythm of the gaits, particularly the walk and canter
  • Refusing jumps
  • “Bunny hopping” in the canter
  • Swapping leads or cross-firing frequently
  • Behavioural changes such as rearing, kicking, bucking, or resisting forward movement

Symptoms are usually worse when the horse is ridden as opposed to worked in hand. [5]

Physical changes associated with SI disease include: [1][6]

  • Lowering of one hip when viewing the h