Muscle disorders including tying-up (exertional rhabdomyolysis) cause significant acute pain in horses and require management combining exercise protocols, nutrition and in some cases genetic testing.
Muscle disorder welfare management requires recognition that tying-up episodes cause severe acute pain that can be reduced or prevented through appropriate management. For horses with recurrent tying-up, identifying the specific underlying cause — whether RER, PSSM or another condition — enables targeted management. Nutritional adjustment reducing dietary starch and sugar intake benefits horses with PSSM. Exercise management providing daily consistent exercise rather than erratic work patterns reduces RER episodes. The welfare cost of recurrent tying-up over a working career is substantial — each episode involves significant suffering that appropriate management can prevent. Genetic testing now enables identification of specific myopathy subtypes guiding targeted management.