What you see. The starting point for addressing any equine health related issue is your observation.


Pain Response to Pressure on Flexor Tendons or Suspensory Ligament


The flexor tendons on the rear of the front and hind lower limbs are vital anatomic structures for the support of the lower limb. Horses are sensitive to grasping pressure on these structures. Horse people commonly squeeze these tendons between thumb and fingers to encourage horses to raise their limbs. Injuries and certain other conditions can cause a horse to react excessively when pressure is applied to these tendons.

  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If you notice swelling of the painful area, or notice any lameness.
  • Code Green

    Contact Your Vet to Obtain Useful Advice & Resources
    • Even if the horse does not appear to be lame to you.

your role


What To Do

Evaluate the apparently sensitive area for swelling and heat. Carefully compare the size and skin temperature of that area to the same location on the opposite limb. Assess the horse for lameness at the walk and trot. Share your findings and concerns with your vet.

It can be difficult to distinguish between a normal (and desired) response, and a pain response. If you believe that the pressure you are placing on your horse's tendons is causing undue pain or is simply not normal, compare the horse's response to that of the other limbs. Is the response consistent left to right, or is it consistently greater in the suspected limb?

Keep in mind that a nerve passes horizontally across the middle region of the rear part of the flexor tendons. It feels like a thin cord under the skin at this level. This location is particularly sensitive to pinching pressure.

What Not To Do

Do not assume that because a horse reacts to pressure here, that the tendons are injured.

your vet's role

Your vet may advise you to monitor the horse for awhile, if this is the only sign you see, and particularly if you don't notice lameness. If there is any concern, your vet evaluates the area and performs a lameness exam. Our most sensitive diagnostic method for assessing the flexor tendons and ligaments of the lower limb is ultrasound.
Questions Your Vet Might Ask:
  • Do you notice any swelling or abnormality in the limb?
  • Do you notice any lameness?
  • Do you notice heat in the area?
  • How do the responses compare, left versus right?
  • What are the results of the Whole Horse Exam (WHE)?

Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

Very Common
Less Common
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Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

Very Common
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Author: Doug Thal DVM Dipl. ABVP