Managing non-symptomatic kissing spines (ORSP) as a conditioning-focused trainer
Kissing spines—more correctly overriding/impinging dorsal spinous processes (ORSP)—is one of those diagnoses that can create instant panic… even when the horse is moving beautifully and acting totally normal. From a trainer’s point of view (especially if you specialise in core strength, topline development, and physical conditioning), the most useful mindset is this:
X-rays show bone spacing and bony change. They don’t automatically tell you whether the horse is in pain, or whether performance will be limited. A consistent theme in the veterinary literature is the imperfect correlation between imaging findings and clinical signs, which is exactly why some horses with “ugly” RADS compete happily, and some with mild changes struggle.
What follows is how I approach non-symptomatic ORSP: protecting the back, building a stronger “spinal support system,” and knowing when to escalate.
First: what “non-symptomatic” really means
Non-symptomatic doesn’t mean “nothing is happening.” It means your horse is not currently showing pain or performance-limiting signs that can be confidently attributed to the spine. ORSP is also common enough that radiographic abnormalities can be found in populations who are not presented for back pain, which is why context matters.
So the goal becomes:
Keep the horse comfortable and moving freely
Improve spinal stability and load tolerance
Avoid management choices that increase extension/brace patterns
Monitor for change
The spectrum: best case → worst case
Here’s a practical “trainer’s spectrum,” not a perfect medical grading system, but a way to think about what you’re dealing with.
Best case: “tight spacing” with no pain, no loss of function
Narrowing of interspinous spaces, minimal/no bony remodelling.
Horse tracks up, swings through the back, accepts contact, amicable attitude.
Management focus: conditioning + prevention + correct tack and hoof care.
Key concept: ORSP can exist without presenting clinical impact, and imaging alone shouldn’t dictate drastic decisions.
Middle ground: intermittent discomfort or performance “grey signs”
The horse is mostly fine, but you might notice:
occasional cold-backed behaviour
difficulty holding bend
inconsistent contact
weaker canter transitions
tension with saddle/girth
struggles to bascule over fences
Management focus: vet-guided pain localisation, plus a structured rehabilitation and conditioning program.
Worst case: persistent pain + clear performance limitation
Strong negative response to palpation, poor ridden tolerance, continuous/random or explosive bucking or rearing, inability to lift thoracic sling, loss of topline, secondary lameness patterns.
Often requires medical management and/or surgery with strict rehab.
Surgical options commonly discussed include procedures like interspinous ligament desmotomy (ISLD) and partial ostectomy/wedge ostectomy depending on case selection and vet preference.
Treatments you’ll hear about (and where they fit)
For a non-symptomatic horse, I’m usually thinking “support + monitor,” not “treat the x-ray.” But it’s important to know what’s available if things change.
Non-surgical medical management
Used when pain is suspected or confirmed:
Targeted injections (local corticosteroid/analgesic approaches) and controlled exercise are widely used in practice patterns.
Rehabilitation programmes focusing on progressive strengthening and correct movement, generally executed by a qualified rehabilitation facility being regularly monitored by the treating vet.
Adjuncts depending on vet plan.
Surgical management
Typically for horses that don’t respond to conservative care or have significant pathology:
ISLD and other surgical approaches are described as options for impinging DSPs.
Biomechanics studies have explored how common procedures may influence thoracolumbar motion (important, because surgery doesn’t replace rehabilitation—it changes the situation BUT you still need to rehabilitate and condition the horse to full recovery).
The “big picture” finding that matters to owners/trainers
Real-world outcomes are influenced by rehabilitation completion, saddle fitting, and (in some datasets) surgical vs non-surgical pathways—which reinforces what good trainers already know: management details matter.
Does kissing spines always affect performance?
No—and that’s the emotionally tricky part.
ORSP is well-recognised in sport horses and is often associated with back pain and poor performance when it is clinically active, but the true incidence of pain attributable to ORSP is uncertain, and imaging findings don’t reliably predict symptoms on their own.
Prevalence/severity studies show radiographic abnormalities in thoracolumbar interspinous spaces can be common, again supporting that, both context and clinical exam matter.
Trainer takeaway: if your horse is non-symptomatic, your job is not to panic—it’s to build a body that keeps the spine supported and reduce the chances of that back becoming sore as workloads increase.
The conditioning goal: build a “spinal stability system”
When I condition an ORSP horse (especially a non-symptomatic one), I think in layers:
Posture & thoracic sling (withers up, chest between the shoulders, not falling on the forehand)
Abdominal wall + breathing mechanics (ability to lift the ribcage and soften the back)
Hip/hindquarter strength (propulsion without hollowing)
Mobility where needed (ribcage, hips) + stability where needed (thoracolumbar control)
Consistency (frequent, appropriate loading beats occasional big sessions)
Practical exercises to stabilise the spine and protect topline
Below are a few of the exercises I use, that are generally low-risk, scalable, and aimed at reducing brace and building strength through better posture. (Always loop in your vet/physio if anything changes.)
1) In-hand “posture first” walking programme
Goal: rhythm + relaxation + long frame without dumping onto the forehand.
Marching walk on straight lines, large loops, gentle gradients
Encourage nose slightly in front of vertical, with the base of their neck soft
Build duration before intensity (this is important)
Progression: add short walk–halt–walk transitions focussing on stepping under, not bracing.
2) Correct pole work (the topline builder—when done right)
Goal: improve trunk control, coordination, and hip flexion while maintaining a lifted posture.
Start:
4–6 ground poles, 60 to 80cm for walk. 1.30m to 1.45m for trot on average (adjust for your horse’s stride)
Prioritise quality of posture over “getting through the poles”. Once you have established the horses action, rhythm and straightness they will begin to execute the poles exercises accurately.
Progression ideas:
Slightly raised ends (small lift at first, increasing height as the ability to increase the intensity of the exercise is enabled)
Fan poles on a large circle to encourage ribcage control and inside hind engagement, raising the inside of the pole as the horse improves.
Poles on a gentle incline (light hill + poles is potent but build this exercise slowly)
Rule: if poles create rushing, hollowing, tail swishing, or tension, scale it back.
3) Hill work (quiet power without speed)
Goal: strengthen hindquarters and encourage natural back use.
Walk up hills in a calm tempo, straight lines. This is a great low intensity core strengthening exercise.
Walk down hills slowly to build control, strengthen chest and shoulder muscles while improving balance and proprioception.
Progression: incorporate halt–walk transitions on the incline (tiny steps, strong posture).
4) Backing (reversing) for controlled core + pelvic mechanics
Goal: Teach the horse to shift weight back and recruit abdominals without running forward.
3–6 straight steps, reward
Repeat 2–4 times, a few days per week
Progression: back up a slight incline only if posture stays soft.
5) Carrot stretches and dynamic mobilisation (physio-supported)
Used correctly, these can support mobility and neuromuscular control. Work with a qualified equine physio to ensure you’re not encouraging compensation.
6) Long reining / in-hand transitions for “lifting work”
If you can safely long rein:
frequent transitions
large circles
focus on rhythm, soft poll, and stepping under
The non-negotiables: saddle fit, shoeing, and bodywork
Correct saddle fit
A poorly fitting saddle can:
increase bracing and extension
restrict scapular movement
create pain that changes movement patterns or create explosive and dangerous reactional behaviour
Saddle fitting is not a “nice extra”—it’s foundational. In outcome data, saddle fitting has shown up as a factor associated with better return to ridden work in horses managed for ORSP.
Correct hoof balance and shoeing
Feet influence:
thoracic sling loading
posture
stride symmetry
and back muscle tone
Work with a farrier who can keep the horse balanced and comfortable, especially if you’re increasing conditioning load. I cannot stress enough how important it is for your horse to have the very best farrier possible. Slight imbalances and incorrect angles can throw your horses entire physical soundness out the window!
Qualified equine physio/bodywork
A good physio helps you:
identify restriction patterns early
keep the horse moving well through the ribcage/hips
support appropriate muscle development
This is especially valuable for non-symptomatic horses, because you’re playing prevention and optimisation.
Rider impact: be the light, balanced load your horse can carry
Even a strong back will struggle under a rider who:
collapses at the waist
continuously drives with the seat pushing the horses spine down
holds tension in the hand and causes a head carriage that sits behind the vertical, which in turn creates a hollow back in the horse
or tips the horse onto the forehand by falling or leaning forward in a way that causes the horse to carry more weight over their front end, creating a weak and stiff core
If you want a non-symptomatic ORSP horse to stay that way, the rider must be:
balanced (stacked ear–shoulder–hip–heel) with their own strong and supple core to move with the horse
quiet (independent hands, seat and leg)
effective and light (intuitive feel)
committed to straightness, balance and rhythm before collection
A lot of “kissing spine horses” look dramatically better when the rider stops accidentally asking them to hollow.
Monitoring: when I’d change the plan
Even with a horse that looks great today, I watch for:
change in attitude during grooming/tacking
soreness after harder sessions
reduced stride length, cadence or softness
sudden crookedness, uneven gait or stepping short
new resistance to training exercises they were previously amicable about
If any of those appear, I want a veterinary work-up rather than guessing, because imaging + clinical exam (and sometimes diagnostic analgesia) is what clarifies whether ORSP is actually the limiting factor.
Closing thoughts
Managing non-symptomatic kissing spines is often about earning durability:
build a stronger core and topline,
keep the horse moving in correct posture,
protect comfort through saddle fit, hoof balance, and physio support,
and ride like you’re a partner—not a burden.
If you would like a road map to building your horses topline and core strength - download my How To Build Your Horses Topline course.
If you need more help gaining or retrieving a balanced position you can find the tried/tested and proven methods in my AML Six Week Rider Balance Challenge. True foundational training that will get your horse riding position on track.
This article is a great explanation of of the progresses in treating severe kissing spine with clear RADS for a visual of the condition and how it effects horses - https://www.endellequinehospital.co.uk/services/ks/