Safe Practices for Handling and Restraining Your Sick or Injured Horse

A sorrel horse needing first aid is cross-tied with chains in a stable.
A sorrel horse needing first aid is cross-tied with chains in a stable. Margo Harrison

Newsdate: Tuesday, September 13, 2022, 11:00 am
Location: GILROY, California

Like any animal that is sick or injured, your horse may respond differently to your attempts to help it. In fact, the horse may be a potential danger to itself, as well as to its handlers. In many cases, the horse will need to be tranquilized or given an intravenous sedative before treatment can begin. Knowing the ways a horse may be safely restrained is important for every caretaker of horses.

Owner holding horse's head while veterinarian stitches up a laceration in horse's cheek.

Owner holding horse's head while veterinarian stitches up a laceration in horse's cheek

When a horse needing treatment or first aid is too agitated and uncooperative, some type of restraint will be necessary to protect both the horse and the handler from injury.
© 2012 by Mark Sellers New window.

The horse's disposition, prior training, amount of pain or fear, the place and extent of an injury, and the duration of the treatment for the illness or injury determines how extensive any restraint will need to be.

Often a horse can be calmed by soft talk and a comforting atmosphere if the injury or illness are not causing much pain or agitation. If the horse is too agitated and uncooperative, some type of restraint will be necessary to protect both the horse and the handler.

Typically, you or your veterinarian will choose one of the following types of restraints:

  • Intravenous sedation is used with a horse that resists physical restraint or when a painful procedure is necessary. Depending on the circumstances, your veterinarian may use one drug or a combination of drugs. Phenothiazines such as acepromazine act on the central nervous system to produce a calming effect or deep drowsiness; Narcotics such as morphine or Demoral are pain killers; Xylazine combines tranquilization and pain control. Effects of any of these drugs will be variable, and it's important to remember that horses can still kick or strike when thought to be tranquilized.
  • Halter and lead restraints are used to gain control of a frightened or stubborn horse. Once the horse is calmed and under control, a chain across the gums can be added to keep the horse from backing or rearing. Also a chain can be placed through the mouth or over the nose as an added method of keeping the horse under control. A horse that refuses to be led will often cooperate more fully if blind folded.
  • Twitches are among the most widely used methods of restraint. Twitches are considered by some to be similar to acupuncture since they are thought to release endorphins and produce a calming, sedative-like action. The nose twitch and the lip twitch are used most often. To apply a nose twitch, grasp the upper lip between thumb and fingers to steady the head, then slip a looped chain attached to a stick over the horse's nose with the lip folded under so that the lining of the mouth is not exposed. Tighten the loop by twisting the handle. The best twitch is a lip twitch attached to the halter so that it can't come off during the procedure.

Some horses may fight being twitched because of past experience or fear and if this is the case, another method of restrain should be used. A skin twitch is accomplished by grasping a fold of skin in front of the horse's shoulder. This may provide enough distraction for a short procedure. The ear twitch involves grasping and squeezing the ear with the heel of the hand pressed against the horse's scalp. It should be used cautiously and only by an experienced handler.

  • The head restraint is used for procedures that are relatively minor and painless. An assistant holds the lead and diverts the horse's attention while standing on the same side as the person doing the procedure. The assistant can hold the muzzle with the left hand and the nape of the neck with the right hand. Inserting the left thumb beneath the nose band of the halter will keep the horse from ducking.
  • Hobbling the hocks is used when danger of kicking needs to be averted. It allows the horse to bear weight on all four legs and is important for long procedures.
  • Stocks or a palpation chute are usually used as restraints for rectal and vaginal examinations. Stocks also work well for dental extractions or surgery on a standing horse. Once the horse is in stocks, it should be backed against the partition to prevent it from kicking over the top.
  • Tail restraints are used when using a halter and lead would be difficult. The tail is grasped and pulled over the back in a circular wheel while encircling the base of the neck with the other arm. This technique should be used with caution in older horses to prevent coccygeal fractures or nerve damage. This works well for short procedures such as passing a stomach tube or giving an injection. Another tail restraint includes tying a rope to the tail and pulling it straight back. The rope is held by an assistant and is not tied to a stationary object. This restraint works well for rectal and vaginal examinations.


Restraining a horse can be extremely dangerous. Be very realistic about your skills and experience prior to attempting any restraint. Always follow the instructions of the veterinarian or other healthcare professionals when using restraints as part of a medical treatment or examination.

About the Author

Flossie Sellers

Author picture

As an animal lover since childhood, Flossie was delighted when Mark, the CEO and developer of EquiMed asked her to join his team of contributors.

She enrolled in My Horse University at Michigan State and completed a number of courses in everything related to horse health, nutrition, diseases and conditions, medications, hoof and dental care, barn safety, and first aid.

Staying up-to-date on the latest developments in horse care and equine health is now a habit, and she enjoys sharing a wealth of information with horse owners everywhere.