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Saddle Up for Success: Sagittal Imbalance Versus Equestrian Performance

In the world of equestrian sports, the rider must coordinate with their horse to perform in sync. It’s a full body exercise, not just for the horse, but for the rider too, as their fitness, balance and stamina are all put to the test. Spinal alignment is more critical in equestrian than in any other sport because the rider’s connection with their horse starts with the seat in the saddle is the primary means of communication, and spinal alignment and stability are the building blocks of that connection.

Imagine a plumb line running from the base of the rider’s skull to the connection between their lower back (lumbar) and their pelvis (sacrum) – this is the rider’s sagittal balance of their spine, and it's a vital component of their riding performance.

Sagittal balance is the front-to-back balance of the spine. In a healthy spine there are two front-to-back curves in the lumbar (lower) spine and the thoracic (middle) spine. If one of these curves becomes too pronounced or too flat, sagittal imbalance occurs.

Types of Sagittal Imbalance:

  1. Flatback syndrome: When the outward curve of the thoracic spine is the only curve, the center of gravity juts out too far forward.
  2. Kyphosis: When weak upper backs lead to an undesirable rounding forward, it’s known as a condition called kyphosis.
A healthy thoracic spine normally maintains an angle of 20 to 40 degrees forward, but when this angle deteriorates to 60 to 80 degrees, your body can no longer compensate by arching your lower back or pulling your head back. This results in pain in the lower back or neck, and an unstable seat for equestrian riders – meaning neither horse nor rider will be happy.

Other symptoms of sagittal imbalance include:

  • Pain in the lower back
  • Rounding of the mid-back
  • Difficulty walking, or facing forward while in an upright position
  • Fatigue and difficulty performing daily tasks
  • And in severe cases, difficulty breathing

Sagittal Imbalance Diagnosis and Treatment:

Luckily, DISC can evaluate patients’ spinal balance with 3D imaging of the entire spine using an EOS system rather than a magnetic resonance imaging (MRI) or computed tomography (CT) scan. This cutting-edge EOS system delivers low dose stereoradiographic images of patients in functional position, which reduces patient radiation doses and provides exceptional image contrast. The unique design gives precise 2D and 3D measurements, which helps DISC clinicians better visualize mechanisms between the spine, hip and knee.

These images allow our experts to identify and address any potential issues in the making, so equestrian riders can correct the issues identified and improve their connection with their horse. 

Paying attention to flexibility and building core strength in both the upper and lower body can correct a problem in the making and help riders correct emerging problems and unlock their full riding potential. 

Treatment for sagittal imbalance is usually non-surgical. Various treatments for spinal alignment include:

  • For Kyphosis: Treatment typically includes upper back exercises to decrease kyphosis.
  • For the Cervical Spine: Cervical disc replacement for the cervical spine (located in the neck region), where a surgeon removes a damaged or deteriorated spinal disc and replaces it with an artificial disc.
  • For the Lumbar Spine: Disc replacement is typically preferred for the lumbar spine (located in the lower back). It involves replacing the worn or degenerated discs with an artificial version.
  • For the Thoracic Spine: Imbalances in the thoracic spine (located in the upper and middle back) are rarely addressed with surgery and more commonly treated with postural exercises. However, surgery may be required to correct scoliosis.
Don't wait until discomfort holds you back—invest in your spine health and take your equestrian skills to the next level. Your horse and your riding career will thank you.

Video: Sagittal Imbalance

Dr. Robert Bray explains why sagittal balance is so crucial to equestrian performance.


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About the author

discmdgroup DISC Sports and Spine Center (DISC) is one of America’s foremost providers of minimally invasive spine procedures and advanced arthroscopic techniques. Our individually picked, highly specialized physicians apply both established and innovative solutions to diagnose, treat, and rehabilitate their patients in a one-stop, multi-disciplinary setting. With a wide range of specialists under one roof, the result is an unmatched continuity of care with more efficiency, less stress for the patient, and a zero MRSA infection rate. Read more articles by discmdgroup.

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