Study tracks swimming rehab in showjumpers with back and neck pain

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A newly published Animals study suggests that a 2-month cross-training program including swimming did not increase axial skeletal scintigraphic activity in showjumping horses being managed for back and neck pain. The prospective study tracked 18 horses with documented vertebral lesions and used quantitative bone scintigraphy to compare skeletal radiopharmaceutical uptake after 4 weeks of ridden work and again after an additional 8 weeks that combined swimming with ridden exercise. (pubmed.ncbi.nlm.nih.gov)

That question matters because swimming occupies an uneasy place in equine rehabilitation. It’s widely used in training and rehab, but the evidence base is still thin, and some clinicians have worried that the spinal posture associated with swimming could be a poor fit for horses with axial musculoskeletal pain. The same French research group had already reported on this cohort earlier in 2026, finding no major, uniform change in thoracolumbar mobility during the 12-week program, which set up this follow-up imaging analysis. (mdpi.com)

In the new paper, investigators quantified uptake in 205 regions of interest and normalized results using Z-scores. Overall variation between week 4 and week 12 was minimal, with the mean change reported as less than 0.001 and a range from -0.28 to 0.24. Of the 21 regions with significant change, 13 were in the axial skeleton and showed decreased uptake, while eight were in the limbs and showed increased uptake, notably at the humeral tubercles on both lateral views. The authors interpreted that pattern as evidence that the swimming-inclusive program did not increase bone stress or inflammation in the axial skeleton under the conditions studied, while some limb changes may reflect musculoskeletal adaptation to swimming demands. (pubmed.ncbi.nlm.nih.gov)

The study population is worth noting. Horses were 5 to 14 years old, mostly Selle Français, regularly trained in showjumping, and competing at roughly 1.10 m to 1.30 m before enrollment. All had a history of poor performance or work-related problems attributed to back or neck pain, and all underwent a detailed locomotor, radiographic, and ultrasonographic evaluation before inclusion. According to the paper, all returned to their previous competition level after the program. (mdpi.com)

The broader imaging literature helps put the findings in perspective. Reviews and clinical commentary have emphasized that back pain in sport horses is common, difficult to localize, and often overinterpreted on imaging alone. Nuclear scintigraphy can be useful because it reflects active bone remodeling and may help assess the clinical relevance of lesions, but it also has limitations, especially for longitudinal follow-up in sport horses with chronic or degenerative changes that may persist on scans over time. (pmc.ncbi.nlm.nih.gov)

That caution is reinforced by survey and review data showing there is still limited consensus and a relative lack of randomized clinical evidence for diagnosing and managing primary equine back pain. One example from the same journal is a randomized sham-controlled trial of repeated monopolar capacitive radiofrequency energy treatment in 15 show-jumping horses with perceived chronic thoracolumbar pain. In that study, horses receiving five sessions at 72-hour intervals showed a progressive increase in mechanical nociceptive thresholds, with higher values than sham from the second treatment onward and persistence through a 45-day follow-up, while skin surface temperature increased after both active and sham procedures without a between-group difference. In other words, some adjunctive therapies may improve pain-related measures even when simple thermal effects do not distinguish them, underscoring how multimodal rehab for equine back pain is evolving but still evidence-limited. (mdpi.com)

In that context, this swimming paper doesn’t settle the rehabilitation question, but it does offer a more objective signal than anecdote alone. It suggests swimming may be tolerated in some carefully selected showjumpers with axial pain, provided case selection, monitoring, and concurrent ridden work are thoughtfully managed. That’s likely the most practical takeaway for ambulatory sports medicine veterinarians and referral rehab services. (pmc.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, the main value here is not that swimming is now “proven” for back-pain cases, but that one imaging-based dataset failed to show worsening axial skeletal activity during a structured program in a defined population. That may help clinicians discuss rehab options with trainers and pet parents who are balancing return-to-work goals against concerns about aggravating spinal lesions. Still, the study was exploratory, lacked a separate non-swimming control arm in this report, and showed marked horse-to-horse variability, so individualized assessment remains central. The emerging literature on other modalities, including sham-controlled radiofrequency-based treatment for thoracolumbar pain, also points to a field that is moving toward more measured, objective outcome tracking rather than relying on tradition alone. (mdpi.com)

What to watch: The authors call for larger controlled studies, especially in horses with predominantly cervical lesions. Watch for follow-up work that compares swimming directly with land-based rehab, links imaging changes to pain and performance outcomes, and clarifies which lesion patterns predict benefit, neutrality, or risk. It will also be useful to see whether future studies combine exercise-based programs with adjunctive pain-modulating therapies and standardized outcome measures such as nociceptive thresholds. (mdpi.com)