Physiotherapy is the use of movement, manual therapy, education and advice to promote health, facilitate recovery, prolong function, enhance performance and maintain independence.

Physiotherapists use a holistic approach, taking into consideration the physical, psychological, social and environmental factors affecting their patients.

Hilltop Veterinary Physiotherapy can provide equine, canine and human physiotherapy, the latter two in the comfort and convenience of your own home.

Equine Physiotherapy

Some horses, especially native breeds, are stoical and, when faced with aches and pains, maintain what evolution has taught them: that to survive it is necessary to hide weaknesses. Compensations are adopted so few outward signs of problems are displayed. These can include recruiting different muscles or adopting subtle changes in movement patterns which can mask stiffness, muscular weakness and pain.

However, with the increasing demands put on domesticated horses, even the most stoical horse can reveal pain and discomfort through deterioration in behaviour or performance. Whether your horse is displaying subtle or obvious changes in gait, attitude or performance, a professional opinion is necessary for your horse’s well-being.

Particular indications for physiotherapy include:

  • Acute or chronic injuries
  • Soft tissue injuries
  • Back pain
  • Behavioural issues thought to be pain related
  • Changes in performance levels or lack of progression
  • Uneven wearing of shoes
  • Muscle imbalance
  • Joint conditions
  • Post-operative rehabilitation
  • Lameness and the secondary complications it can cause
  • Poor flexibility
  • Maintenance of high levels of performance

For horses without a particular musculoskeletal problem Natalie can provide an assessment to ensure they are performing at their optimum.

The Sport Horse

  • To improve flexibility and mobility pre-competition
  • To enhance soft tissue recovery post-competition
  • To maintain the level of performance by rapid recognition of potential problems before they deteriorate

The Older Horse

  • To help relieve the aches, pains and stiffness associated with ageing
  • To increase muscle strength to provide support for joints
  • To maintain joint range of motion
  • To improve quality of life

The Leisure Horse

  • To maximise comfort
  • To prolong a happy, healthy working career
  • Techniques can be taught to improve the bond between horse and owner

The Injured Horse

  • To enhance wound healing and minimise scar tissue formation
  • To help prevent muscle atrophy during the recovery period
  • To re-educate muscles and restore normal gait patterns
  • To maximise the level of function the horse returns to

Treatment techniques include:

  • Manual therapy
  • Soft tissue mobilisation including myofascial release, trigger point work
  • Rehabilitative exercise therapy
  • Muscle stimulation
  • Long term management advice
  • Reflex and reciprocal inhibition using the hoses natural reflexes to stimulate
  • Joint movement and soft tissue stretch
  • Stretches
  • Proprioception work and re-education
  • Equine Sports Massage, in which Natalie is certified

In general, treatments aim to reduce pain, address muscle imbalances, increase or maintain range of movement, ensure the horse is working optimally and to prolong their working career.

Within a physiotherapy session, a detailed subjective history will be obtained followed by gait analysis and clinical palpation. Treatment will be provided as necessary. ‘Homework’ may well be given and this is vital to positive outcomes as things don’t change overnight.

This may include exercises and/or advice which Natalie will explain thoroughly. Support is available between sessions, if needed, via phone or email.

As a Chartered Physiotherapist, Natalie is used to working as part of a multidisciplinary team and is happy to undertake joint consultations with your vet, farrier or saddler as required.


As Natalie’s human client base is predominantly riders, she has undertaken additional training to become an Equipilates™ Biomechanics Teacher and is currently completing the course work to obtain her Advanced certification.

An Equipilates™ session can be mounted or unmounted.


A series of biomechanical screens, specifically designed to test body functions required for riding, are completed after a thorough subjective history. These allow Natalie to create an individualised treatment and exercise plan aimed specifically at your issues and weaknesses, always with your performance in the saddle at the forefront of considerations.

Muscle energy techniques (anti spasms) are often used which can lead to an immediate difference in your function. Home exercise programmes are always given and Natalie is available for support throughout.

Sessions take up to one and a half hours.


This is not a riding lesson but a biomechanics analysis and performance enhancer.

Natalie will watch you warm your horse up and ask to see some specific movements, for example straight lines or anything you are particularly struggling with. She will then work though some exercises with you, both with the horse standing and during movement, constantly asking for feedback from yourself and how you feel the horse is responding.  You have the opportunity to work through specific lateral movements if required.

With her physio background, Natalie can utilise Franklin balls, kinesio taping, theraband and the equicube to facilitate you achieving your optimal position.

Feedbacks sheets with exercises to continue will be emailed out after the session.

Sessions are 45mins.

Human Physiotherapy

Natalie has worked in private practice since 2010 and provided pitch side physiotherapy and first aid for a rugby union team from 2014-2016. She provides mobile physiotherapy services, coming to your home at a time that is convenient to you. Full subjective and objective assessments are completed prior to treatment and the formulation of an exercise plan, based on the patient’s goals.

Rider Physiotherapy

An unbalanced horse makes the rider work harder than a well-balanced one. The reverse is also true. An unbalanced, out of sync rider makes the horse’s job more difficult and can cause discomfort to the horse, affecting its performance and function. Posture dysfunction, poor alignment and muscle imbalance are common problems affecting riders.

As a Chartered Physiotherapist, Natalie is able to treat both members of your team, increasing the potential for better outcomes. Additionally, as a rider, Natalie understands the frustrations of musculoskeletal restrictions affecting a rider’s progression, which non riding physiotherapists might not fully appreciate. Sessions will include a thorough assessment, treatment if necessary and a home exercise programme as required.

Common problems include:

  • Unable to sit to the trot
  • Tipping to one side
  • Pain or stiffness during / after riding
  • Minimal progression with riding work
  • Unwanted limb or head movement

Treatments available include:

  • Joint mobilisations
  • Soft tissue work including massage and trigger point release
  • Core stability exercises
  • Strengthening and stretching programmes

Canine Physiotherapy

Canine conditions often treated with physiotherapy include:

  • Post-surgery rehabilitation e.g. Cranial cruciate ligament repair
  • Rehabilitation post fractures
  • Joint problems for example dysplasia, degenerative diseases and stiffness
  • Spinal pathologies
  • Sort tissue strains and sprains
  • Neurological conditions
  • Pain and discomfort
  • Changed function, for example unable to do stairs or jump in the car
  • Lameness
  • Change in behaviour for example reluctant to play or exercise
  • Guarding of a limb or area to touch
  • Changes in temperament

Working & Sporting Dogs

These dogs are athletes and need to be managed as such. Only by being in the best possible physical condition will they achieve their maximum performances and potential.

Pre- and Post-Operative Rehabilitation

If a surgical intervention is planned, for example cranial cruciate repair, “pre-hab” can enhance recovery, reduce the risk of complications and reduce recovery time, post-operatively.

Post-operative physiotherapy can aid return to “normal”, help with pain management and find ways to stimulate a demotivated dog.

Injured Dogs

Unfortunately, as with humans, injuries can occur, for example following road traffic accidents or strains during exercise. Physiotherapy can help reduce pain, enhance healing, restore movement and aid return to function.

Congenital Conditions

These conditions, including elbow and hip dysplasia, can reduce your dog’s quality of life. A Chartered Physiotherapist can provide advice on management strategies and pain control whilst providing exercises to maintain available function and facilitate improvement where possible.

Neurological Dogs

Whether a surgical or conservative treatment approach has been taken, dogs with neurological complications require physiotherapy, including passive range of movement exercises and stretches, to limit deficit and reduce side-effects. Gait re-education and exercise programmes can reduce pain and improve movement capabilities. Sensory stimuli can be applied to reawaken neural pathways and aid in proprioceptive training.

Family Pet

Changes in your dog’s behaviour or function, such as reluctance to play, or reduced ability to climb stairs or jump in the car, can indicate that he is in pain or experiencing restrictions somewhere. Assessment by a physiotherapist ensures that your dog is in the best possible health.

Dogs are generally more relaxed in familiar, quiet environments so assessments and treatments are usually conducted in your home. This allows for a fuller, more accurate assessment and reduces your dog’s stress levels.

Within a physiotherapy session, a detailed subjective history will be obtained followed by gait analysis and clinical palpation. Treatment will be provided as necessary. ‘Homework’ may well be given and this is vital to positive outcomes as things don’t change overnight. This may include exercises and/or advice which Natalie will explain thoroughly. Support is available between sessions, if needed, via phone or email.

Treatments include:

  • Soft tissue work – massage, myofascial and trigger point release
  • Stretches
  • Joint mobilisation techniques
  • Electrotherapy
  • Gait re-education
  • Proprioception
  • Strengthening

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