Balance Pads

What are Balance Pads?

The short answer is, foam pads of varying sizes, densities, angles and thicknesses that we train horses to stand on for short periods of time

The goal of Balance Pad work is to decrease postural compensations and compensatory gait patterns by targeting the proprioception and deep muscles in order to improve the horse’s proprioception, balance, coordination, and stability.

What is Proprioception? It is the awareness of one's body location in space. It utilizes a closed neurological feedback loop that does not require any conscious thought.

What is Balance? It is the ability to maintain one’s own center of gravity within its base of support during both static (standing) and dynamic (moving) activities.

Proprioception and balance are critical components of prehabilitation and rehabilitation. In fact:

Full recovery never occurs if proprioception is not treated
Reinjury will occur if proprioception is not treated
Balance requires proprioception and the visual and vestibular system
Balance is trained by creating instability

This simple activity will help you understand proprioception better. With your eyes closed, touch your pointer finger

first to your nose
then your 2 pointer fingers together
Then touch your 2 pinkie fingers together
Finally touch your 2 pinkie fingers together while standing on 1 foot

What your brain just went through attempting to perform those actions is Proprioception, utilizing a closed neurological feedback loop. Standing on 1 foot and doing that is Balance. Balance requires proprioception as well as the visual and vestibular system.

Proprioception is a learned neural motor pathway in the motor cortex of the brain that is learned, without conscious thought, in response to body position. The more a certain body position or movement is repeated, the stronger the pathway becomes, eventually becoming transferred to the brain's cerebellum, where it becomes an automatic pathway, not require any muscle involvement, rather a direct neural stimuli based on the speed (at which) and length (to which) muscle fibers are stretched.

How is Proprioception Retrained?

Always remember Pain alters Posture!!! The change in posture, to decrease pain, creates compensatory gait patterns. These patterns become a learned neural pathway which with repetition become automatic. These compensatory gait patterns, based on the automatic proprioception programming become the horses new normal way of moving. However, they are not efficient and often place more load on certain structures, to decrease the load on structures that were once painful. This increased workload causes fatigue. Fatigue is a main component to injury.

Prehabilitation and Rehabilitation interrupt these pathways and retrain the proprioceptive system by changing movement patterns. They ‘erase’ the muscle memory of pain inhibition, or pain generated compensatory gait pattern. By using the horse's stance (posture) the proprioceptive portion of the nervous system is retrained, which rewires the cortex and cerebellum pathways, ultimately retraining the muscles.

Remember: Balance requires proprioception and Balance is trained by creating instability. Instability and the need to constantly adjust to maintain proper balance rewires the proprioceptive system.

The most common tools used to safely create instability and retrain proprioception are:

Balance Pads (alone or with perturbations)
Therapeutic Exercise (perturbations when performed on balance pads)

Leg lifts, postural positioning
Lateral tail pulls
Poles

Theraplate: vibrational therapy

What are balance pads? The long answer is, foam pads of varying sizes, densities, angles and thicknesses that we train horses to stand on for short periods of time. When a horse stands on a pad and places weight on the hoof, the hoof sinks into the pad which creates an imbalance that the horse must constantly shift and adjust for in order to maintain balance and find the most secure way to stand.

A University of Georgia CVM study showed balance pad work improved postural stability and increased the cross sectional area of the multifidus muscle (a major proprioception muscle) in horses. The proprioception system is one of the first systems to recover strength and it recovers quite rapidly; however, use of balance pads to change muscle symmetry will require long term use. The Therplate has also been shown to have a positive effect on the proprioception muscles. In addition it also changes muscle symmetry more rapidly than balance pads alone.

When can Balance pads be used?

Proprioception can safely be retrained during the acute phase of injury, while the injury is still in the active inflammatory stage. Balance pad work is low impact without large pressure or tension; therefore it is safe for injured tissues. Balance pad work can begin during the acute phase, while the horse remains on stall rest, sooner than many other rehabilitation techniques.

Rewiring the proprioceptive system with Balance pad work can continue throughout the entire prehabilitation or rehabilitation program. Initially the challenges to the proprioception system are ‘easy’ and increased as the horse improves at each successive level. The workload can be increased by increasing the instability. As the postural sway becomes stable, the time may be increased, the firmness of the pads may be changed, and/or perturbations may be added with increasing difficulty. The angle of the pads may be changed as well, creating an extension or flexion in the distal limb joints (coffin and pastern) or placing tension on the collateral soft tissue structures depending on what is necessary. If a horse has a dominant limb, unequal firmnesses can be utilized to create more instability under one limb and more stability under the other. The pads return to their original form once the horse steps of tem. Over time some impressions may remain in the foam. These impressions are used to evaluate the differences in hoof shape, size, symmetry and weight bearing. Both the rehabilitation and prehabilitation programs can then be adjusted to improve symmetry in these characteristics.

At Henderson Equine Clinic, we use both the Sure Foot System and more generic balance pads that can be covered with Duct tape for longer durability. Our programs are tailored to the injury (for rehabilitation protocols) or compensatory gait patterns identified (for prehabilitation). Progress is monitored and adaptations made to increase the workload as necessary.

Thank you for your interest in learning more about Balance pads and how they can help your horse. If you have questions, think your horse would benefit from a Proprioception evaluation, or would like to set up a training session for your horse or barn, contact Henderson Equine Clinic by email or at (585) 226-5560. If we have not yet worked with your horse before, we do highly recommend an appointment before and/or after purchase so we can help you target the therapies most appropriate for your horse. In some cases, we do offer telemedicine consultations if you would like to implement balance pad within your horse’s training or are unsure what would be best for your horse.

Related Research:

Cathcart, J., Ellis, K.L., & Moorman, V.J. (2024). Short term use of balance pads on postural sway and
musculus multifidus cross sectional area in horses. Journal of Equine Rehabilitation Volume 2, 2024, 100006

Relationship between postural stability and paraspinal muscle adaptation in lame horses undergoing rehabilitation J. Equine Vet. Sci., 91 (2020), pp. 103-108, 10.1016/j.jevs.2020.103108

B.T. Halsberghe, P. Gordon-Ross, R. Peterson. Whole body vibration affects the cross-sectional area and symmetry of the m. multifidus of the thoracolumbar spine in the horse. Equine Vet. Educ., 29 (2017), pp. 493-499, 10.1111/eve.12630