13/03/2026
We hear it often- “they’ll grow out of it”
For my own horse, intervention was key as he started to struggle in his transitions and bends. For him, a work up, simple surgery and LOTS of physio rehab and water treadmilling was the key 💪🏼
PART 1: Upward Fixation of the Patella : “They’ll Grow Out of It”… Will They?
I remember the first time I watched a young horse “lock” behind.
The limb was stuck in extension, toe dragging slightly as he tried to step forward. A sudden jerky release. A click. And then walking as if nothing had happened.
The owner shrugged.
“He’s always done that. They say he’ll grow out of it.”
And maybe he will. But what if he doesn't?
Upward fixation of the patella isn’t just a quirky mechanical glitch. It’s a very specific failure of the patella to disengage from the medial ridge of the femur - a structure that is meant to lock as part of the stay apparatus. That locking mechanism is brilliant design. It allows horses to stand for hours with minimal muscular effort.
But brilliance in one context can become dysfunction in another.
When the patella fails to release appropriately, we’re not just looking at a momentary “stick.” We’re seeing altered biomechanics, disrupted flexion, changes in muscle recruitment, and potentially altered loading patterns through the entire body.
And this is where it becomes uncomfortable.
Because we’re often told - by tradition, by anecdote, by well-meaning advice - to wait.
“They’ll strengthen.”
“They’ll mature.”
“Just give it time.”
Sometimes that’s appropriate. But sometimes what looks mild is quietly shaping compensation patterns that become much harder to unwind later.
The question isn’t simply "Does this horse lock?"
It’s "What is this doing to the rest of the system?"
I’d love to hear - when you see a young horse with intermittent fixation, what makes you decide to monitor versus actively intervene?
If you want to learn more about Patella Luxation in Equines, we have a great blog on the subject here: https://onlinepethealth.com/upward-fixation-of-the-patella-do-i-leave-it-or-treat-it/