02/11/2026
๐๐ฒ๐ฎ๐ฑ ๐ฆ๐ต๐ฎ๐ธ๐ถ๐ป๐ด >>๐๐ต๐ฒ๐ป ๐๐ต๐ฒ ๐ต๐ฒ๐ฎ๐ฑ ๐ถ๐ ๐ป๐ผ๐ ๐๐ต๐ฒ ๐ฝ๐ฟ๐ผ๐ฏ๐น๐ฒ๐บ......
Olive is a grey mare with a long history of head shaking.
She has been thoroughly investigated by her veterinary team, including advanced imaging. A CT scan revealed no structural pathology that could explain her symptoms. Electroacupuncture had also been trialled, without meaningful improvement.
The owner described a clear seasonal pattern: Olive is significantly worse in winter, particularly with wind and rain. There was also an important historical detail โ when Olive was first backed, she would retract her tongue so far back that she appeared close to choking, and a tongue tie was introduced to manage this behaviour.
So for me often the question is not โwhat is wrong with her head?โ
It was โwhat is her head responding to?โ
๐ ๐ช๐ต๐ฎ๐ ๐ ๐ณ๐ผ๐๐ป๐ฑ
Assessment revealed restriction at the cervico-occipital (CO) junction, held in extension with a slight sidebending pattern to the left. This transitional region between skull and spine has a strong influence on neurological tone and is highly sensitive to strain.
The left ear was notably reactive to touch including specific sutures. The distribution of sensitivity corresponded with recognised sensory territories of cranial nerves VII (facial), IX (glossopharyngeal) and X (vagus), alongside contribution from the CO/C1 spinal nerves. This immediately suggested a cranial nerve involvement rather than a localised ear issue.
The jaw and cranial base provided further clarity.
The left mandible was held in an ascending pattern, with cramping through the left masseter. The hyoid apparatus was drawn forward and left. The temporalis bones were asymmetrical, with the left held in endorotation and the right in exorotation.
Within our osteopathic training, this is clinically significant: endorotation of the temporal bone is associated with vascular compromise, while exorotation is associated with neural tension or potential neural entrapment.
In Oliveโs case, the left temporal endorotation may subtly influence venous and arterial flow in the cranial base, particularly the internal jugular vein and internal carotid artery, contributing to local congestion. Here we can also start to consider CN V11, & CN V111, as possibly involved.
The right temporal exorotation reflects compensatory neural strain (more on this and froamen lacerum further down). This pattern is further influenced by environmental factors like wind, rain, and cold, which can accentuate vascular and neural tension.
These cranial base patterns link directly to hyoid, jaw, and tongue mechanics, influencing head carriage, swallowing, and airway dynamics.
๐ข๐๐ (๐ข๐ฐ๐ฐ๐ถ๐ฝ๐๐-๐๐๐น๐ฎ๐-๐๐
๐ถ๐) ๐๐ผ๐บ๐ฝ๐น๐ฒ๐
:
The trigeminal nerveโs sensory nucleus extends into the dorsal horn of the upper cervical spinal cord (C1โC3). Dysfunction or "blockages" at the OAA can create abnormal sensory "noise" or tension that the brain interprets as facial pain.
๐ ๐๐๐ฐ๐๐น๐ฎ๐ฟ & ๐๐ฎ๐๐ฐ๐ถ๐ฎ๐น ๐ง๐ฒ๐ป๐๐ถ๐ผ๐ป:
The muscles of mastication (masseter, temporalis, pterygoids) are directly innervated by the mandibular branch (V3) of the trigeminal nerve. Chronic jaw tension or TMJ dysfunction can cause these muscles to shorten/contract, potentially tugging on the facial fascia and putting pressure on the nerve as it exits various skull openings.
๐๐
๐ผ>๐๐ป๐ฑ๐ผ ๐ผ๐ณ ๐ง๐ฒ๐บ๐ฝ๐ผ๐ฟ๐ฎ๐น๐ฒ ๐๐ผ๐ป๐ฒ๐:
The foramen lacerum region, functionally, involves CN IX (glossopharyngeal), X (vagus), XI (accessory), and V3 (mandibular branch of trigeminal), affecting sensory, motor, and autonomic functions to the head and hyoid/tongue complex.
The tongue was not incidental
The historical tongue retraction suddenly became anatomically coherent.
The tongue is a highly organised muscular structure with a strong central core, intimately linked to the hyoid apparatus, mandible, soft palate, and upper airway. Its coordination depends on balanced input from cranial nerves IX (glossopharyngeal), X (vagus), and XII (hypoglossal).
When tone within this system is disrupted, (TMJS, OAA complex, sphenoid, SSB, Temporales)......the tongue may draw caudally and dorsally as a protective response, narrowing the airway and interfering with normal swallowingโbreathing coordination.
In Oliveโs case, the tongue behaviour appears not as a training issue, but as a compensatory pattern within a strained cranialโTmj-hyoidโneurological system.
The palatine bones, forming part of the roof of the mouth and boundary of the nasopharynx, are also relevant in such presentations. Restriction here can further affect tongue position and airway comfort. Any internal assessment or treatment of this area would appropriately require veterinary or dental involvement, with a gag in place.
๐ง๐ต๐ฒ ๐ฏ๐ผ๐ฑ๐ ๐๐ฎ๐ ๐ถ๐ป๐๐ผ๐น๐๐ฒ๐ฑ ๐๐ผ๐ผ......๐ช๐๐ข๐๐ ๐
๐๐ฉ๐ช๐ด ๐ธ๐ข๐ด ๐ฏ๐ฐ๐ต ๐ข ๐ฉ๐ฆ๐ข๐ฅ-๐ฐ๐ฏ๐ญ๐บ ๐ฑ๐ข๐ต๐ต๐ฆ๐ณ๐ฏ.
The diaphragm was restricted in an inspiratory state. The mid-thoracic spine showed right sidebending, and the pelvis demonstrated asymmetry, with the right ilium held in dorsal inflare and the sacrum organised around an oblique axis pattern.
The lumbar spine showed mixed compensations rather than a clean biomechanical response, indicating reduced adaptability within the system.
From an osteopathic standpoint, this matters deeply. In many of my posts I talk about how the dura mater forms a continuous tension system from the sacrum to the occiput. Pelvic and sacral strain does not remain local>> it is transmitted cranially, influencing the cranial base and the neurological structures housed there.
In this context, Oliveโs head was not misbehaving.
It was responding intelligently to the demands placed upon it by the rest of her body.
๐ช๐ต๐ ๐๐ต๐ถ๐ ๐บ๐ฎ๐๐๐ฒ๐ฟ๐:
These cases highlight how functional restriction, particularly involving the diaphragm, pelvis, and cranial base, can produce significant neurological and sensory symptoms without leaving a structural footprint on imaging.
๐๐พ๐๐ถ๐ป๐ฒ ๐ผ๐๐๐ฒ๐ผ๐ฝ๐ฎ๐๐ต๐ ๐ถ๐ ๐ป๐ผ๐ ๐ฎ๐ฏ๐ผ๐๐ ๐ฐ๐ต๐ฎ๐๐ถ๐ป๐ด ๐๐๐บ๐ฝ๐๐ผ๐บ๐.
It is about understanding relationships.
And when the anatomy is allowed to tell its story, the horse often makes perfect sense.
Image: Found on google, the asterisk mark the foramen lacerum > https://www.equus-soma.com/apollo-part-five/
Shared with permission of owner.