In this article I discuss some of the research that examines the perceived benefits of massage so you can make an informed decision about your horse’s welfare.

While first implemented as a training tool for human athletes, ‘…equine massage therapy is becoming a more common part of the management of equine athletes and pleasure horses alike’ [1]. The reduction in pain, stress and muscle recovery time as well as an increase in flexibility and range of motion all enhances a horse’s ability to perform [2]. However, while there is some evidence that suggests massage therapy may benefit human athletes, equine sports therapy is a relatively new area of study and as such, there is no consensus on whether massage has any benefit to the equine athlete. Here, I will discuss some of the conducted studies that suggest massage therapy has a positive effect on horses in terms of range of movement, the reduction of pain, stress and anxiety, and its effects on performance recovery. However, I will also indicate where studies have failed and where more need to be conducted before we can know for sure that massage has a positive effect on horses.

 

Flexibility and Range of Motion

In the equine massage industry, it is claimed that ‘massage increases a horses flexibility and range of motion’ [2]. When a horse performs a manoeuvre outside of its range of motion, it is likely to cause damage to the ligaments and the surrounding muscle tissue [3]. Therefore, a horse who has a larger range of motion and increased flexibility is less likely to injure itself and can perform better.

In 1962 a study was conducted by Nordschow and Beirman to assess the effects of neck and back massage on shoulder abduction and neck extension [4]. However, the range of neck extension motion was limited by anterior muscles and ligaments and the bony contact between the spinous processes, and therefore was not a good outcome measurement for the effectiveness of massage in this study [4].

In 1999 another study of the effects of massage on range of motion was conducted by Leivadi et al [5]. This study did not incorporate horses, instead using 20 university dance students [5]. In the study, they compared students who had a massage to students who had done other warm-up activities such as stretching, before testing their range of motion [5]. While the study did show an increase in flexibility for those students who were massaged beforehand, there are issues with the study as there was not an appropriate control group and the examiner was aware of who had been massaged, which created a bias in the results [4]. While this study may be considered irrelevant to the discussion on the importance of massage in equine athletes, the lack of study done in the equine field means that data from human experiments needs to be transferred across.

Both of these studies have made it difficult for there to be any sort of conclusion on whether massage has any effect on the flexibility and range of motion in horses. However, in 2002 there was a horse-based study done on the effects of sports massage. Wilson [6] analysed a horse’s range of motion before and after massage by assessing their stride length compared to stride frequency, as well as measuring the size of the main muscles used in horse motion. She found that there was an increase in range of motion by the horses, denoted by increased stride length and decreased stride frequency [6]. She also noted an increase in the ‘transverse diameter of all four muscle bellies and muscle tendon junctions’ [6]. While previous studies provide inconclusive results, this recent study suggests that massage does benefit horses through increasing the flexibility and range of motion in horses.

 

Pain Reduction

For many years, ‘A variety of techniques and modalities, including massage, are used clinically to enhance recovery [and therefore reduce pain] after exercise induced muscle damage’ [7]. However, the effectiveness of massage to reduce pain is still debated by many specialists.

Pain is difficult to evaluate in the equine industry, as horses are unable to communicate what they are experiencing [1]. Despite this, a study done by Sullivan, Hill and Haussler [8] in 2008 attempted to objectively assess three common treatments for back pain in horses in order to identify which is more effective for relieving pain. They measured the effectiveness by using pressure algometry to measure mechanical nociceptive thresholds (MNTs) along the axial skeleton, with low MNTs indicative of reduced pain [8].  The study found that massage therapy significantly reduced back pain in horses, with a daily single massage treatment increasing the number of MNTs over seven days [8]. However, the authors of the study cautioned that, in humans, the effects of massage are reported to be psychological rather than physiological and so suggest that the increase in MNTs could be a result of reduced anxiety, rather than a reduction of pain [8].

A clinical review conducted in the same year analysed 27 studies in an attempt to determine ‘the effectiveness of sports massage for improving recovery after strenuous exercise’ [7]. The 27 studies were made up of 17 case series and 10 randomised control trials (RCTs) and they represented a wide range of massage techniques [7].  All of the studies were conducted on humans, not horses, due to the lack of horse-based studies in this area. The data from the case series revealed inconsistent results, with some studies indicating that massage did have some benefit, while others indicated that there was none [7]. However, the analysis of the RCTs does provide moderate evidence that massage therapy was effective [7].  

While there is some evidence to suggest that massage is an effective treatment for pain relief, it is also evident that more studies need to be done to fully understand how massage affects the equine body, and whether any effect in pain reduction is due to physiological effects or rather just a by-product of lowered anxiety levels.

 

Reduction of Stress and Anxiety

As mentioned, some theories suggest that massaging may result in a reduction in stress and anxiety. In the Oxford Dictionary of Psychology, stress is defined as ‘psychological and physical strain or tension generated by physical, emotional, social, economic, or occupational circumstances, events, or experiences that are difficult to manage or endure’ [9]. While horses may not be under the same circumstances as humans are, and are unlikely to experience stress due to economic issues, as flight animals it is likely that horses have experienced stress, and to a larger extent anxiety, at one point or another.

In 2004, McBride and associates [10] experimented to determine if massage affected stress reduction in horses. They measured horses heart rate to determine the effect of massage at 6 different places on the horse, 3 of which are considered allogrooming sites which horses use as a form of social interaction and connection [10]. They found that most sites indicated a reduction in heart rate, with the allogrooming sites having the greatest effect [10]. They also found that allogrooming seems to have a reward or pleasure aspect, which allows the massage to have stress-reducing qualities [10]. This suggests that massage does have some effect on the reduction of stress and anxiety levels in horses, but how long that effect lasts is an important element to consider that was not observed in the study.

In 2008, Moraska and associates [11] reviewed 25 studies to analyse the effects massage had on stress and anxiety in humans. They found that studies that used salivary cortisol and heart rate to measure effectiveness were consistently successful in reducing stress during a single treatment [11]. However, the review also found that this reduction could not be sustained over time, though the beneficial effects of a single treatment could be repeated [11]. This means that it is possible that massage does result in the reduction of stress and works to minimise anxiety, but these effects only last for a short length of time before the client returns to their original state. Lastly, the study also suggests that more research in this area needs to be conducted before reaching a definitive understanding of the effects of massage on stress and anxiety [11].

So, it seems likely that sports massage does positively influence stress and anxiety within horses, however it is unlikely that this influence has any lasting effects and more research needs to be conducted before reaching any conclusions.

 

Post Exercise Recovery

Another considered benefit of sports massage is its positive effects on post exercise recovery. It is suggested that ‘massage therapy immediately after exercise may lead to improved recovery and may reduce damaging effects to the muscle’ [1]. In 2008 a study was conducted by Arroyo-Morales and associates [12] to investigate the effects of massage on heart rate variability and blood pressure after a repeated high-intensity cycling exercise. They found that a whole-body massage straight after exercise has a significant effect on heart rate and blood pressure, assisting the return of these parameters to pre-exercise levels [12]. This suggests that sports massage does have a positive effect on post exercise recovery that is not directly related to muscle recovery.

Another study was released in 2008 by Butterfield and associates [13] that analysed the effects of compressive loading after eccentric exercise. This was done using rabbit legs, which they subjected to a round of eccentric contractions followed by compressive loading [13]. Now, while this may seem unrelatable to what we are discussing, the compressive loading was used to mimic the compression techniques massage therapists use. The results indicate that compression directly after exercise will lead to enhanced recovery of muscle function [13]. Therefore, massage post-exercise is likely to result in increased recovery both in muscle function and in heart rate and blood pressure. However, both of these studies suggest there is a need for more study in this area before a more definitive understanding can be reached.

In conclusion, there is no consensus on the effects of massage on horses. Many studies indicate that massage has a positive effect on range of motion, pain reduction, minimisation of stress and anxiety and post exercise recovery. However, it is clear that in all areas, more study needs to be conducted before any conclusive understandings can be drawn on how effective massage is. I believe massage to be important and worthwhile, but I also believe it is important to know what the research has to say before drawing conclusions. Unfortunately, research into this field is relatively new, so it is difficult for any true consensus to be made at this point.