Pelvic Anatomy and Horse Size: Is the size of my horse causing my hip/back pain?

I am a big believer that there is rarely one absolute, black and white reasoning behind why something is how it is. That being said when it comes to anatomy there are certain “structural” elements that are not always within our control.

In posture science we tend to label things as “structural” and “functional”. The latter being something we typically are born with that is unlikely to be changed, whereas functional manifestations come on over time and can usually be adapted with some effort and time.

Whether it’s scoliosis to leg length to hip mobility; When it comes to equestrians I have seen many examples of both these things, and many things once deemed structural that turned out to be more functional given a new awareness.

A common injury or complaint among riders is various forms of “hip impingement“ conditions. The symptoms include: pinching pain, locking in the front of the hip when riding, getting out of a car or seat, walking. Often this can trigger other things like back pain, knee pain and sciatic-like pain too.

Hip impingement often comes around due to functional issues with how the hip joint (where the head of our femur connects into the deep socket found in our pelvis) moves (or doesn’t) within the capsule. The hip is a ball and socket joint, stable in its own right, made more complete by surrounding ligaments, large muscle groups and dense bone structures of our pelvis and femur themselves.

In some cases hip impingement can be more likely or made worse by structural factors like a narrower pelvis and shallower hip capsule, injuries to the surrounding tissues and degenerative conditions to the joint itself.

Women have a wider pelvis compared to men, however this doesn’t necessarily mean less vulnerability to hip impingement. Women also have a wider “Q” angle, which is the angle of the femur hip to knee. There are various evolutionary reasons for this, the summary being this angle also means more movement to stabilize through the pelvis. This means a higher rate of hip joint mobility potential, when not managed well = chance of impingement.

The evolution of our pelvis Is truly quite fascinating. Here are some cool articles to check out:

When we factor in the requirements of riding on our anatomy the biomechanics of the hip and pelvis begin to shift from what’s required for our typical human tasks (walking and squatting- if you take the evolutionary approach!).

There is no “perfect“ pelvis or hip structure for riding. Functionally, though, we ideally have unencumbered hip mobility (we can rotate our legs/hips in and out, we can extend them behind us and flex them forwards with no issue) and pelvis mobility (this really means sacral joint mobility - where the pelvis meets the spine- if you want to get particular).

Whether our pelvis is narrower or wider, our hips deeper or shallower doesn‘t *necessarily* mean our ability to have all the above functions intact is effected.

Now- if you put a particularly small or narrower pelvis/hip complex on top of a wide, draft-type horse and expect to maneuver progressive lateral work, over fence work, or long extended trail rides you may be setting the stage for some unhappy hips. There is something to be said for matching horse type and structure to the rider’s structure.

Saying that I can safely say of all the riders I’ve met so far in my career, typically size matching happens pretty organically and the hip impingement or other complaints I’ve seen that may link back to perceived structural things have more often than not turned out to be pretty functional in nature, and therefore resolved with some re-education of how we move and stabilize ourselves on and off of the horse.

All rider’s will benefit from crosstraining their hip mobility and stability, pelvis awareness and mobility/stability and spine/core function.

Typically in the case of hip impingement symptoms the head of the femur has shifted forwards towards the front of the joint, to correct this we need to re-engage the muscles on the side and back of the hip (glutes glutes glutes!) and make sure the front of the hip and pelvis itself is in relative alignment to the function we need (This will be person dependant so apologies for the vague-ness).

Bridges are a go-to for me to check my glute action:

So are lateral moves like clamshells, hip abductions with an internally rotated leg, and active hip rotations for mobility and stability!