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Last week we looked briefly at what fascia does and how it can restrict muscle function and movement. This week I’m going to outline the basic treatment and the improvements you’d expect to see after treatment.


The first thing about the treatment, is that its quick…but the assessment process to find the correct points to treat is time consuming and takes along time as a therapist to master.

As a physio that bases all of my treatments on clinical reasoning (there has to be a reason to treat), the assessment process of the treatment really appeals to be.

Step 1 – Watch

Watching the horse move, on the hard, on a surface, straight lines, circles, lunge and or ridden. What ever is appropriate for the horse and the facilities.

Step 2 – Segmental Movement Assessment

From watching the horse, I’ll get a read on which areas of the body look out of balance, maybe an area that looks a little stiff or the movement is restricted. I choose 3 or 4 segments from the segment chart below:


Fascia Segment chart

Fascial manipulation – Segment chart


To assess movement in each of the segments, I move and mobilise each area within the planes of movement and assess if there is any restriction. It is valuable to compare left and right side. By using a scoring system a pattern emerges about what lines of movement are restricted (the lines of movement are described in the previous blog – https://www.thecrescentvetphysio.co.uk/equine/part-1-fascinating-fascia/). Once I know which movement line is effected the most, its time for step 3.


Movement Assessment Chart

Fascia manipulation, movement assessment chart

Step 3 – Longitudinal Palpation

In each movement line there are fascia points along the length. I will only palpate the movement line that was identified as being the worst affected, i.e the extra rotational or intra-rotational lines.


Rotational Movement Lines

Fascia points along the rotational movement lines

I palpate each point along those lines and see if the fascia feels dense or restricted, I also pay attention to the horse’s reactions and see if there is pain present. Again using a scoring system, I grade each point, with 0 being normal and 3 being dysfunctional. At the end of the palpation I’ll have a chart with lots of grades on it.


Fascial Manipulation - palpation chart

Fascial Manipulation – Palpation Chart


Step 4 – Deciding on the Treatment

I choose 10 points to treat, I make a selection based on the areas that need treating the most, but also to include some points that your horse is happy for me to treat and alongside this, you have to balance the points with points from the other side of the body or in an opposite movement line.

Some points are too sore to treat straight away, so starting in a place that your horse is comfortable is a good way to build some trust and get a more effective treatment in the long run. Anyone who has me to treat their horses (or dogs), knows its really important for me to work with your horse and gain their trust and approval as I believe the treatment is much more effective if they trust me and are relaxed.

Step 5 –  Treatment

This is the quick and easiest part – its simply cross friction massage of the point. Fascia is made up of 3 layers that fibres run parrellel within the layer but not within the layers. It’s important to massage in different directions to release all the layers.


Fascial Layers

Fascial Layers

Step 6 – Re-assess

After treating the points, re-assess the movement and determine whether the treatment has been effective. A second treatment is sometimes required, especially if they’ve never had their fascia manipulated before. Once your horse has had this kind of treatment before, one treatment as part of a normal physio session should be adequate.

Following treatment, a quiet or rest day is necessary to allow the horse to recover and to allow the tissues to recover and for the body to find its balance.

What improvements to expect after treatment?

Following a treatment your horse should have:

  • Improved posture
  • Increased activation patterns and motor control
  • Improved function of the myofascial
  • Better proprioception and movement control
  • Reduced pain
  • A more motivated athlete and happier to perform


I’m going to put out an offer to anyone who reads this blog and would like a fascia manipulation treatment and assessment. I’m limiting this offer to 20 appointments:

First treatment £30

First Appointment plus a follow up appointment £55


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