
26/04/2025
Why I Don’t Recommend Water Treadmills in Early Rehab
This might ruffle a few feathers, but it’s something I see far too often in my work as an equine therapist.
Water treadmills are being used too early in the rehab process. And in many cases, they do more harm than good.
Let me explain why.
1. Movement without release isn’t healing.
If a horse’s body is locked up or compensating for pain, asking them to push through water doesn’t fix anything—it just reinforces that dysfunction.
2. Compensation patterns get stronger.
When a horse is protecting an area, it moves differently to avoid pain. If you strengthen that altered movement on a treadmill, you’re just building fitness on top of imbalance.
3. Every horse is different—most programs aren’t.
Water treadmill use often follows a one-size-fits-all approach. But every horse has unique needs, restrictions, and postural patterns that should guide their rehab.
4. The nervous system needs to feel safe.
A guarded, tense horse won’t move freely, no matter how therapeutic the setup seems. True healing comes when the body AND mind are ready to release and rebalance.
Let’s talk about the science.
A 2013 study by Mendez-Angulo et al. (Am. J. Vet. Res., 74, 557–566) showed that water depth on a treadmill affects joint range of motion in healthy horses—particularly increasing distal joint flexion, with the degree depending on the water level.
But here’s the thing: these were healthy horses.
Yet I frequently see horses with joint inflammation and underlying dysfunction being immediately sent into water treadmill programs. Asking inflamed joints to flex more under resistance before the body is even remotely ready?
Many people question the effectiveness of this approach, especially when the evidence supporting it is so unclear or lacking. It's really important to consider whether there's sufficient research.
And here’s another angle to consider.
Yes, I’ve seen studies suggesting water treadmill use may help develop hindquarter muscle mass. And I’ve had my hands on horses who did bulk up behind. But what else did I find?
A shut-down thoracic sling, tension through the shoulder girdle and viscera pulls.
A braced front end struggling to absorb that push from behind.
So even if the hind end looks “better,” the horse as a whole is still dysfunctional.
There may not be much research yet on how the water treadmill affects horses already moving in a compromised way, but here’s what I do know:
Building muscle at the expense of functional movement is not rehab. It’s just a different layer of dysfunction.
While there is research available on this modality, and we have some idea of its effects on healthy horses, we still need far more data on its impact in horses with soundness issues and deeper pathologies before it can be confidently used in true rehab settings. Particularly for me postural deficits.
And here’s the kicker…
Blanket 30-minute sessions on the water treadmill- While I suspect these are done in the shallowest water depths, I can’t help but ask:
At what point did we decide that 30 minutes of repetitive movement—against resistance—is appropriate for a horse, seeming many suffer with unresolved dysfunction?
Especially if they haven’t even been seen by a competent physio or osteopath who understands not just muscles and joints, but the viscera, parietal system, and deeper connections like thoracic sling development.
It’s not rehab. It’s just exercise with a hope attached.
So what’s the alternative?
1) Bodywork first – to release restrictions and reset the body, the WHOLE horse.
2) Turnout or liberty movement – to let the horse rediscover natural motion
3) In-hand work – to guide the body back to functional patterns
4) Gradual strengthening – once the foundation is right
While there is research available on this modality, and we have some idea of its effects on healthy horses, we still need far more data on its impact in horses with soundness issues and deeper pathologies before it can be confidently used in true rehab settings. In my experience, underlying body and postural dysfunction are often not thoroughly evaluated before horses are placed onto machines such as the water treadmill for rehabilitation, which risks compounding existing issues rather than resolving them.
Rehabilitation should create better movement, not just more of it. Let’s stop rushing the process, and start respecting the horse’s body and mind.
🐴 Let the horse tell us when it’s ready—not the rehab schedule.
https://pubmed.ncbi.nlm.nih.gov/23531063/
https://brill.com/view/journals/cep/18/5/article-p413_413.xml?
https://pure.hartpury.ac.uk/ws/portalfiles/portal/8585596/Current_knowledge_of_equine_water_treadmill_exercise_what_can_we_learn_from_human_and_canine_studies.pdf
https://www.sciencedirect.com/science/article/abs/pii/S0737080622001630