Musculoskeletal examination, often referred to as a lameness exam, is conducted by a thorough evaluation of the horse’s clinical history, conformation, physical examination and gait. The history is reviewed with the rider and we check the horse for obvious problems with conformation. We like to evaluate the horses gait at hand and while the horse is lunged or worked under saddle. Palpation of the limbs, joints, back and neck are important as they allow us to look for pain, inflammation, and range of motion. Hoof testing is performed to test for pain or inflammation in the hoof. Flexion tests are an important part of the musculoskeletal exam as they stress various joints of the body and often help identify subtle lameness. On horses that are significantly lame, we often choose not to exercise the horse until we have examined the horse at rest so that we don’t exacerbate a serious injury.