Enforced box rest following injury or surgery is one of the most welfare-challenging periods of a horse's life, requiring careful management to minimise psychological distress during confinement.
Box rest welfare is a genuine clinical dilemma because the confinement necessary for tissue healing creates significant psychological harm in an animal evolved for continuous movement. Horses on prolonged box rest commonly develop or intensify stereotypic behaviours, lose social contact, and experience frustration from movement restriction. Secondary problems including gastric ulcers are associated with box rest confinement. Evidence-based approaches now favour controlled exercise protocols over complete stall rest for most conditions, recognising that the welfare cost of absolute confinement may exceed the benefit for healing in many situations. Providing maximum forage, appropriate enrichment, and where possible companion proximity mitigates box rest welfare impacts.