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Tying Up in Horses: Causes, Symptoms, & Care for Your Horse

Published on: June 28, 2023

By: Miles HenryFact Checked

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In the world of equine care, tying-up is a term that often sparks concern. It refers to a group of muscle disorders resulting in stiffness, pain, and in severe cases, immobility in horses. The formal term for ‘tying up’ is Exertional Rhabdomyolysis, but it’s also known colloquially as Monday Morning Disease.

Understanding tying-up is crucial if you’re a horse owner. The condition can vary from mild discomfort to severe and life-threatening issues. Recognizing the signs and symptoms can be the difference between a quick recovery and a lengthy, costly treatment period.

Being informed about tying up in horses empowers you to provide the best care for your horse. With the proper knowledge, you can recognize this condition and implement strategies to manage it effectively. Let’s dive deeper into understanding tying-up, its causes, symptoms, and how you can address it.

Understanding Tying Up in Horses

So, let’s dig a bit deeper into ‘tying up.’ This phrase might sound strange, but it actually depicts a situation that can be pretty distressing for a horse. When a horse ‘ties up,’ it experiences severe muscle cramping or damage, generally accompanied by distress and an inability to move freely.

The condition tends to occur most often after intense exercise, especially when the horse isn’t adequately conditioned for such a strenuous activity. Now, if we peel back the layers of terminology, we’ll find that ‘tying up’ goes by many names in the equestrian world.

Picture of a horse not wanting to move, one symptom of tying up in horses.
The horse is reluctant to move.

It’s technically known as Exertional Rhabdomyolysis, but that’s a bit of a mouthful and can be challenging to remember, let alone pronounce. This term refers to the process where the muscle tissue breaks down due to excessive exertion, releasing muscle enzymes and proteins into the bloodstream.

In addition to Exertional Rhabdomyolysis, you might also hear tying-up referred to as Azoturia, Setfast, Monday Morning Disease, or even Equine Rhabdomyolysis Syndrome (ERS). Each of these terms points to the same concerning condition that any horse, regardless of breed or discipline, can potentially face.

There’s a wealth of information and, as you can see, terminology associated with this condition. But don’t worry; we’ll untangle it together, enabling you to understand the various aspects of ‘tying up.’ By the end of this journey, you’ll be well-equipped to recognize the signs of tying up, know how to handle it, and, most importantly, how to prevent it. So let’s continue exploring this important aspect of equine health.

Causes of ‘Tying Up’

Alright, now that we’ve got a good understanding of what ‘tying up’ is, let’s delve into what causes it. Understanding the causes can not only help you identify the condition, but it can also be a key to preventing it.

Underlying Health Issues and Their Impact on ‘Tying Up’

A host of underlying health issues can predispose horses to episodes of tying-up. To begin with, electrolyte imbalances can lead to muscle abnormalities and dysfunction. Sodium, potassium, and calcium are essential for proper muscle function, and any imbalance can lead to muscle stiffness or even rhabdomyolysis.

Furthermore, hormonal disorders, particularly Equine Metabolic Syndrome (EMS), are potential culprits. EMS is characterized by insulin resistance, obesity, and a predisposition to laminitis. Horses with EMS often store excessive glycogen in their muscles, which can, in turn, increase the likelihood of ‘tying up’.

Infections are another significant concern. Systemic bacterial infections or localized muscle infections can result in muscle inflammation and damage, thus causing ‘tying up.’ Viral illnesses such as equine influenza or equine herpes virus can also lead to muscle damage and rhabdomyolysis.

Ensuring your horse is in good health is paramount in preventing tying- up. Regular veterinary check-ups can help identify and address these health issues promptly. Moreover, keeping a keen eye on your horse’s behavior and physical condition can help detect any abnormalities at an early stage, thus averting any potential crisis.

Diet and its Role in ‘Tying Up’

Dietary habits can significantly impact a horse’s susceptibility to ‘tying up.’ For instance, a diet high in carbohydrates can predispose a horse to this condition, particularly if they don’t have adequate exercise to metabolize the energy supplied by these carbohydrates.

Therefore, maintaining a balanced diet that aligns with your horse’s exercise regimen is key. Major alterations to your horse’s diet should always be carried out under the guidance of a vet or equine nutritionist.

Additionally, it’s worth understanding the role of certain nutrients, like calcium, in muscle functionality. Calcium is integral to muscle contraction and relaxation in horses, much like in all animals. During muscle contraction, calcium is released and then pumped back into storage for muscle relaxation.

However, horses prone to certain types of ‘tying up,’ such as those with Recurrent Exertional Rhabdomyolysis (RER), have muscle cells that struggle to regulate calcium properly. This can lead to prolonged muscle contraction, thereby causing the pain and muscle damage often associated with ‘tying up.’

But it’s crucial to note that this calcium regulation occurs at a cellular level and isn’t linked to the horse’s overall calcium intake. Consequently, simply adjusting dietary calcium levels is unlikely to prevent or treat ‘tying-up.’ Understanding the unique nutritional needs and health considerations of your horse is vital for their well-being.

Overexertion and its Impact on ‘Tying Up’

Let’s shift focus to the part played by overexertion and high-stress situations in triggering ‘tying up’. It’s worth noting that horses can commonly experience ‘tying up’ after an intense workout that surpasses their current level of conditioning.

Similarly, high-stress situations, such as a competitive event or a prolonged haul in a trailer, can precipitate the condition. It’s, therefore, essential to ensure your horse’s exercise regimen aligns with its fitness level and to control stressors wherever feasible.

Furthermore, taking into account any breed-specific predispositions and understanding the genetic factors related to ‘tying up’ can contribute significantly to preventing this condition. Awareness and prevention are your best allies in maintaining your horse’s health and performance.


Genetic predispositions can play a significant role in a horse’s susceptibility to ‘tying up,’ with certain breeds like Thoroughbreds, Quarter Horses, and Arabians showing a higher propensity due to their genetic makeup.

For example, PSSM horses, known for their genetic muscle disorder called Polysaccharide Storage Myopathy, often face increased susceptibility to episodes of ‘tying up,’ making diligent management of diet and exercise crucial for their well-being.

Equally, horses diagnosed with Malignant Hyperthermia (MH), a disorder characterized by a rapid increase in body temperature, often exhibit an increased likelihood of ‘tying up.’ This necessitates proactive preventive measures, along with vigilant health monitoring.

For horse owners whose equine companions belong to breeds with these genetic susceptibilities, frequent vet check-ups and genetic testing aren’t just recommended – they’re vital. Knowing what triggers ‘tying up’ is half the battle. With this understanding, you’re well on your way to providing the best care for your horse and ensuring they stay happy, healthy, and active.

Picture of a vet checking out a horse for tying up.

Symptoms of ‘Tying Up’

Now that we’ve covered the causes of tying-up, it’s crucial to understand how to recognize it. Just as knowing the causes helps you prevent the condition, understanding the symptoms allows for prompt recognition and action.

Physical signs of a horse ‘tying up’ can be varied and often depend on the severity of the episode. One of the most common signs is stiffness, especially in the hindquarters. Your horse might seem locked up, have difficulty moving, or even refuse to move at all.

Some horses may also sweat excessively, exhibit signs of discomfort like pawing or rolling, and in severe cases, they may fall and be unable to rise. Changes in your horse’s performance or energy levels can also signal a ‘tying up’ episode.

A horse that is typically energetic and eager to work may seem unusually lethargic or unwilling to perform. They may be slower to respond, seem less interested in activities they usually enjoy or show a general lack of enthusiasm.

Keep in mind that any sudden change in behavior or performance is worth investigating, as it could indicate an underlying issue. During or after exercise, a horse tying up might show symptoms like muscle tremors or cramping, reluctance to move, or a shortened stride.

They might also have a firm, swollen, or painful back or hindquarters. Observing your horse carefully during and after exercise and recognizing these signs can help identify a ‘tying up’ episode early.

While any sign of ‘tying up’ should prompt a call to the vet, some symptoms necessitate immediate veterinary attention. These include severe distress, dark red or brown urine (indicating a potentially life-threatening breakdown of muscle tissue), prolonged inability to move, rapid heart rate, and heavy breathing even at rest.

If you observe any of these signs, don’t hesitate to call your vet immediately. Becoming familiar with these symptoms will equip you with the knowledge to respond appropriately if your horse ‘ties up.’ Remember, every minute counts when it comes to the health of your horse, and timely action can significantly affect the outcome.

Diagnosing ‘Tying Up’

If you suspect your horse might be tying-up, what’s the next step? Diagnosis. And this is where the expertise of a veterinarian becomes invaluable. No matter how knowledgeable you are about horses, a professional diagnosis is essential when dealing with ‘tying up.’

Diagnosing ‘tying up’ usually begins with a thorough physical examination by your vet, who may also ask you about the horse’s recent activities, diet, and overall behavior. Blood tests are commonly used to measure muscle enzymes, which can become elevated during an episode of tying-up.

Depending on the situation, the vet may also use ultrasound to evaluate the horse’s muscles or perform a muscle biopsy for a more definitive diagnosis. That said, while vets play a pivotal role in diagnosing ‘tying up,’ as a horse owner, you also have a critical part.

No one knows your horse better than you do. You’re the first line of defense, and your ability to recognize the symptoms of tying-up and seek help quickly can make a significant difference in the outcome. You’re also the one who can provide your veterinarians with crucial information about your horse’s daily routine, diet, and recent behavior.

Remember, early diagnosis of tying-up is often the key to a quick recovery. Don’t dismiss or downplay any signs that something might be wrong. Don’t hesitate to call your vet if you think your horse could be ‘tying up.’

They’re there to help, and together, you can ensure your horse gets the best possible care. In the next section, we’ll discuss treatment options and management strategies for tying-up, so you’ll know what to expect if your horse is diagnosed with this condition.

What Are the Treatment Options for Tying Up in Horses?

When you notice your horse showing signs of ‘tying up,’ the steps you take can play a significant role in their recovery. First and foremost, it’s essential to remain calm and act quickly. Stop any exercise immediately and try to keep your horse calm and comfortable.

It’s also crucial to call your vet right away. As you await the vet, ensure your horse has access to ample fresh water. If feasible, find a calm, shaded area and gently sponge cool water over your horse to aid comfort and cooling.

Picture of a vet giving horse fluids.
Vet giving horse fluids.

Once your vet arrives, they may administer treatments to relieve your horse’s pain, reduce muscle damage, and restore hydration and electrolyte balance. This could include administering medicine, such as non-steroidal anti-inflammatory drugs (NSAIDs), IV fluids, and in some cases, sedatives.

Your vet might also use muscle relaxants or other medications, depending on your horse’s specific needs. Managing ‘tying up’ doesn’t end with immediate veterinary treatment, though. Long-term management typically involves adjusting your horse’s diet and exercise routine.

For diet, your vet might recommend reducing carbohydrate intake, especially from grains, and increasing the amount of high-quality forage. They may also suggest adding specific supplements such as Vitamin E, selenium, or magnesium to support muscle health.

When it comes to exercise, consistency is key. Regular, moderate exercise can help reduce the risk of future ‘tying up’ episodes. Your vet or an equine physiotherapist can help develop a tailored exercise plan that considers your horse’s condition, fitness level, and work requirements. It’s also essential to incorporate adequate warm-up and cool-down periods into each exercise session.

Lastly, remember that recovery can take time, and patience is vital. Every horse is unique, and their recovery timeline will be too. Stay in close communication with your vet, follow their advice, and observe signs of improvement or any changes that might warrant concern.

Most horses can recover from ‘tying up’ and lead healthy, active lives with proper care and management. In the next section, we’ll discuss prevention strategies to further reduce the risk of ‘tying up.’ Let’s continue this journey together for the love and well-being of our horses.

Preventing ‘Tying Up’

Now, you might wonder, “How can I prevent ‘tying up’ from happening to my horse?” While there are no foolproof methods, certain strategies can significantly reduce the risk. After all, prevention is always better than cure, especially regarding equine health.

Best practices to minimize the risk of ‘tying up’ start with regular veterinary check-ups. Regular visits from your vet can help detect any potential health issues early before they lead to more significant problems like ‘tying up.’ Don’t underestimate the power of preventative care—it can save you and your horse from unnecessary distress and medical complications.

Exercise is another crucial factor in preventing ‘tying up.’ A consistent exercise regimen that aligns with your horse’s fitness level is critical. Avoid intense workouts, especially if your horse is not conditioned for it.

Picture of riders warming up their horses.
Riders warming up their horses.

Gradual increases in workout intensity and ample rest periods can help maintain muscle health. Providing a thorough warm-up and cool-down during every exercise session is also important. Nutrition plays an equally important role.

An optimal diet for preventing ‘tying up’ is typically low in carbohydrates and high in quality forage. Consider working with a vet or equine nutritionist to create a balanced diet that meets your horse’s individual needs.

Certain supplements may also be beneficial, but always consult your vet before adding new supplements to your horse’s diet. Remember, these are general strategies, and what works best will depend on your horse’s specific needs and circumstances.

Regular communication with your vet will help you find the most effective prevention plan for your horse. So, there we have it—a comprehensive guide to understanding, diagnosing, treating, and preventing ‘tying up’ in horses.

Sample exercise routine and diet to minimize the risk of tying up.

Exercise Regimen:

A consistent, tailored exercise routine can prevent ‘tying up’ episodes. Here’s an example of a workout routine for a healthy horse:

  • Day 1: Light exercise, such as 15-20 minutes of trotting and cantering, followed by a cool-down walk.
  • Day 2: Rest day; turn out in a pasture if available.
  • Day 3: Moderate exercise. Include hill work or gentle jumping exercises, followed by a cool-down walk.
  • Day 4: Rest day or light exercise like walking and gentle trotting.
  • Day 5: Intense exercise day. Long trots or canters, advanced training exercises.
  • Day 6: Rest day; turn out in a pasture if available.
  • Day 7: Light exercise, such as 15-20 minutes of trotting and cantering, followed by a cool-down walk.

Please adjust this regimen based on your horse’s fitness level and consult your vet before implementing a new exercise routine.

Diet plays a crucial role in preventing ‘tying up.’ Here’s a sample diet plan:

  • Forage: At least 1.5% of the horse’s body weight should be good quality hay or pasture. For a 1,000 lb horse, this means at least 15 lb of hay or equivalent.
  • Grains: If necessary, provide low-starch, high-fat commercial feeds designed for horses prone to ‘tying up.’ These should be given in small amounts split over multiple feedings.
  • Supplements: Vitamin E and Selenium supplements can support muscle health, but always consult a vet before adding new supplements to your horse’s diet.
  • Water: Unlimited access to clean, fresh water is essential.

Again, this is a general plan, and the best horse diet is dependent on the individual horse’s needs, workload, and health. Always consult with a vet or equine nutritionist before making major changes to your horse’s diet.

Case Studies

In this section, I provide a couple of real-life case studies featuring horses who have successfully managed ‘tying up.’ These examples not only highlight the effectiveness of various treatment strategies but also underscore the resilience of these animals.

  • Topper (Quarter Horse Mare)

“Topper,” a Quarter Horse mare known for her lively spirit and barrel racing skills. One day, after a more intense workout than usual, I noticed her standing unusually still, her muscles stiff, and her demeanor unusually subdued.

Recognizing these symptoms as potential signs of ‘tying up,’ I quickly called the vet, who confirmed the diagnosis. “Topper” was treated with pain relief medication and fluids to support hydration. The vet also recommended a diet lower in grains and higher in hay and added a vitamin E supplement. With a slow and steady return to exercise, Topper returned to her energetic self in a few weeks.

  • Joey (Thoroughbred gelding)

In another instance, Joey, a Thoroughbred gelding, had recurrent episodes of ‘tying up’ after intense training sessions. I sought advice from my vet, who ran tests and diagnosed Joey with EPSM Equine Polysaccharide Storage Myopathy, a genetic disorder that can lead to ‘tying up.’

Upon evaluating Joey’s condition, the vet prescribed a low-starch, low-sugar diet. This major shift in dietary habits aimed to curtail his carbohydrate intake significantly. Coupled with this, a regular exercise regime was proposed, emphasizing the need for consistent and well-planned workout routines.

The vet underscored the critical role of thorough warm-up and cool-down periods before and after each exercise session. Implementing these changes, Joey began to show signs of improvement. His episodes of ‘tying up’ became increasingly rare. With the right management plan, he was not just able to return to racing but continue to build his career as a spirited racehorse.

The lessons from these case studies are clear. Quick action at the first sign of ‘tying up’ is crucial for minimizing muscle damage and pain. A balanced diet tailored to the horse’s specific needs and a consistent exercise routine can significantly reduce the risk of recurrent episodes.

Moreover, regular check-ups and tests can help identify conditions like PSSM that might predispose a horse to ‘tying up.’ These case studies illustrate that with knowledge, observation, and proactive care, horses with ‘tying up’ can lead healthy and active lives.


As we reach the end of this guide, let’s take a moment to recap the vital points about ‘tying up’ in horses. Tying up is laymen’s term for exertional rhabdomyolysis, a condition that causes painful muscle cramping in the horse.

Recognizing the symptoms, understanding the causes, and knowing how to respond are crucial skills for every horse owner. We’ve journeyed through the complex world of ‘tying up,’ exploring everything from symptoms and diagnosis to treatment and prevention.

Managing ‘tying up’ involves more than just immediate care—it requires long-term strategies for diet, exercise, and routine vet check-ups. Modifying your horse’s diet to be low in carbohydrates and high in quality forage, maintaining a consistent exercise regimen tailored to your horse’s fitness level, and scheduling regular vet visits for preventative care are all part of an effective management plan.

The lessons from the case studies remind us that each horse is unique, and their response to treatment and recovery will be, too. As horse owners, we play a vital role in recognizing symptoms, seeking help, and implementing changes necessary for our horse’s health. Our actions, driven by knowledge and compassion, can make all the difference.

So, keep observing, stay informed, and remember: when it comes to your horse’s health, you’re not alone. We’re all on this journey together, dedicated to ensuring the well-being of our horses. As we conclude, let’s remember that the goal is always a healthy, happy horse. Thank you for joining us on this educational journey about ‘tying up’ in horses.


What causes ‘tying up’ in horses?

‘Tying up’ can be caused by various factors, including intense exercise, high-grain diets, dehydration, stress, or underlying health conditions. Certain breeds of horses may also have a genetic predisposition to the condition.

How can I tell if my horse is ‘tying up’?

Common symptoms of ‘tying up’ include stiffness or reluctance to move, sweating, rapid breathing, and muscle tremors. The horse’s urine might also appear dark. In severe cases, the horse might be unable to move at all.

Can a horse recover from ‘tying up’?

Yes, with appropriate care, most horses can recover from ‘tying up’. Recovery time will depend on the severity of the episode and the horse’s overall health. It’s crucial to follow your vet’s advice for treatment and recovery.

How long should a horse have off after ‘tying up’?

The recovery time after a ‘tying up’ episode varies. Some horses may require a few days of rest, while others may need several weeks or longer. The horse should not return to work until they are free of pain and any muscle damage has healed, as determined by your vet.