Racehorse owners warned to take a look under the saddle for ‘kissing spines’

Female horse trainer walks with horse in stable with the light shining through the stable entrance.

Racehorse owners warned to take a look under the saddle for ‘kissing spines’

Female horse trainer walks with horse in stable with the light shining through the stable entrance.

Animal physiotherapists are shining a light on a common condition affecting more than two thirds of racehorses to prevent injury to both the animal and rider if left untreated.   

The underdiagnosed and increasingly prevalent injury ‘kissing spines’ sidelined multiple Group 1 winner Alligator Blood in 2020, steering him close to retirement¹, proving his comeback at the Might and Power Stakes 2024 last month and most recent third place at the Cox Plate last weekend all the more memorable.  

‘Kissing spines’ most frequently impacts performance horses such as sport horses and Thoroughbred racehorses2, with one study showing 68 per cent of horses with back pain had the injury3.  

The injury occurs when spinous processes end up touching or ‘kissing’ each other, causing pain in the affected area and a decrease in performance4, said Elycia Metaxas-Belt, Australian Physiotherapy Association Animal group Victorian Chair and equine physiotherapist.   

“Despite its name, the condition is painfully unromantic, and widely seen in racehorses. Unfortunately, the resultant back pain can sometimes be misdiagnosed, because the horse’s gait is not severely compromised, or because the horse doesn’t exhibit more pronounced symptoms,” Ms Metaxas-Belt said.  

“Symptoms are often only seen during a full assessment by an equine physiotherapist as the primary issue often lies in the horse’s limbs, and not their back,” she said. 

One of the main causes of this condition is training under saddle before the horse’s musculoskeletal system has had enough time to develop to handle the weight of the rider. 

Surgical and non-surgical treatment options are available for this condition, depending on the severity of the condition and perceived pain levels⁵.  

“Equine physiotherapy techniques can strengthen the horse’s core muscles and those along the back to support its spine, and are required even if surgery is undergone to reduce the chance of the condition reappearing,” she said.  

“Most horses can return to racing and other activities once they have completed rehabilitation, but it is not uncommon to see this condition permanently disable a horse. It is crucial owners seek equine physiotherapy and other veterinary services prior to the horse competing to ensure any pain, impingement or discomfort is addressed,” she said.  


Elycia Metaxas-Belt is available for comment. 


1 Alligator Blood back with a vengeance. (2023). Victoria Racing Club. Available from https://www.vrc.com.au/latest-news/alligator-blood-back-with-a-vengeance/ 

2,3 Turner T. Overriding spinous processes (“kissing spines”) in horses: diagnosis, treatment and outcome in 212 cases. Proceedings of the American Association of Equine Practitioners. (2011). 57;424-430. Available from https://aaep.org/sites/default/files/issues/proceedings-11proceedings-424.PDF 

4 Haussler, K (2015). Managing Back Pain, Chapter 22 in Robinson’s Current Therapy in Equine Medicine, 92-96.  

5 Kissing spines in horses: what all owners need to know. (2023). Horse & Hound. Available from https://www.horseandhound.co.uk/horse-care/vet-advice/kissing-spines-horses-58084


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