The Hyoid and First Rib Connection
Share this post:
Before we get started, let’s establish some basics. What is the hyoid? The hyoid apparatus is a collection of bones and muscles in the horse’s head and controls the balance, coordination, and movement of your horse. It’s suspended from the temporal bones, which are located just under the horse’s ears, and you can actually feel the horse’s hyoid in the soft hollow in the horse’s mandible.
Before we get started, let’s establish some basics. What is the hyoid? The hyoid apparatus is a collection of bones and muscles in the horse’s head and controls the balance, coordination, and movement of your horse. It’s suspended from the temporal bones, which are located just under the horse’s ears, and you can actually feel the horse’s hyoid in the soft hollow in the horse’s mandible.
Many people talk about the hyoid as the cause of an issue. The equine industry has established that the hyoid is connected not only directly to the tongue, forelimb, and poll but also indirectly to the hindquarter. Therefore, a restriction, pain or any dysfunction in the hyoid may have a direct impact on the mobility of the horse, leading to a shortened or stilted gait.
However, looking at this from a holistic perspective, it is also important to consider what else the hyoid is affected by. The prominent first rib misalignment, as we talk about so often here at Holistic Horseworks, will not only impact the front end of the horse but also bacl to the hind end and even all the way up to the hyoid. And so our vicious cycle ofimbalance and misalignment continues in a never ending feedback loop.
To understand how the hyoid works together with the rest of the body so that it can all be brought back into balance, let’s take a closer look at the three important connections.
The sternohyoid muscle is the first connection: it connects the horse’s tongue & mouth to the chest of the horse. From here the fascia connections and muscular connections carry through the pectoral muscles along the lower inside of the horse, together with the abdominal muscles, and into the pelvis. This is often referred to as the bottom connection of the horse.
The omohyoid muscle is the second connection: it connects to the shoulder joint, linking into the fascial connection that runs from the head, along the lower inside of the neck, middle of the shoulder, and all the way to the toe on the hindlimb.
The occipitohyoid muscle is the third connection: it connects the hyoid to the poll, creating a direct connection from the shoulder through the hyoid to the poll, and from there through the nuchal ligament, the dorsal muscular connection. Back to the hindquarters. This is commonly known as the top line of the horse.
At Holistic Horseworks, all of our students understand the impact of the first rib on the totality of the horse, and with Equine Musculoskeletal Unwinding we learn how to release the first rib. With all of this information, we can also understand the impact of a misaligned first rib on the hyoid, its connection, and linkages.
When a misaligned first rib impedes the movement of the shoulder and through the second connection the omohyoid, then it also extends to affect all three connections including the sternohyoid and the occipitohyoid.
It is important to take a holistic view to treat the entire body as it is all interconnected from the hind to the front and tongue through the top line and the bottom line and all those all so intricate connections.
In Holistic Horseworks classes from level 1 all the way through to level 3 we teach our students how to address all aspects impacting on the Hyoid. And ultimately your horse’s ability to perform at its best and in total comfort with joy and ease up into its 30’s. A horse should not need joint injections or be retired early if everything in the horse’s body is working correctly and efficiently. We invite you to join us in learning all about this at our next hands-on horse bodywork clinic.
HOLISTIC HORSEWORKS GLOBAL CLINICS
Holistic Horseworks has a team of global instructors who teach hands-on horse bodywork clinics all over the world! Head on over to our schedule page to see the Level 1: Equine Musculoskeletal Unwinding, Level 2: Cranio Sacral Unwinding and Advanced Applied Kinesiology, and Level 3: Equine Cranial Decompression clinics coming soon.
Author and Holistic Horseworks Instructor
Marisa Levitt
Magic Hands Horseworks
Horse rider since childhood. Had a break from horses. When I came back to horses in 2013, I bought a little mare that was in trouble. She stole my heart. She is the reason I went down the equine practitioner path. Once I was introduced to the Holistic Horseworks Level one workshop there was no stopping. I went on to qualify in the human side of things too as I soon realised through my own experience that the rider and the horse can impact the balance of each other.
More Posts
Horses That Roar and How To Avoid Tie Back Surgery
Ruger struggled to breathe on hills and was diagnosed with grade-three roaring, with surgery being considered. Watch April Love evaluate his cranial structures, first rib, posture, pelvis, hooves and movement as his owner explores a whole-horse approach alongside veterinary care.
How to Keep Your Horse Healthy, Sound & Rideable for Life
From a 30-year-old endurance horse recovering from a sudden illness to a 10-year-old horse with years of unexplained lameness, pain, hoof problems, biting, and kicking, April Love explores what can change when you stop chasing individual symptoms and start looking at the whole horse.
Why Your Horse’s Neck is Stiff: Pullback Trauma & the First Rib
Why does your horse have a stiff neck, bite when saddled, or keep developing problems elsewhere in the body? Watch April Love evaluate two horses and explore pullback trauma, first rib restrictions, posture, hoof imbalance, and whole-body compensation.
Young Horse Care: Hoof Imbalances, Cranial Compression, Posture & Behavior
Why does your young horse toss their head, stand unevenly, or develop high-low hooves? Watch April Love evaluate two young horses and explore how posture, hoof balance, old injuries, and whole-body patterns may be connected.
Why Your Horse’s Lameness, Spooking & Hoof Problems Keep Coming Back
Is your horse dealing with recurring lameness, spooking or hoof problems? Watch April Love explain how body imbalances and compensation patterns may be connected.
Your Health Now: May 27th, 2026
Chronic pain, nerve issues, jaw tension, recurring soreness, hormone imbalance, and fatigue often seem like separate problems. But what if they're connected? In this episode of Your Health Now, April Love explores how structural imbalances, toxins, mineral deficiencies, hidden infections, and compensation patterns throughout the body can contribute to symptoms that never seem to fully resolve. Through live audience questions and real-world examples, April shares a holistic perspective on wellness and why looking beyond symptoms may be the key to lasting improvement. If you've been searching for answers to ongoing health challenges, this episode offers a fresh way to think about what's really happening inside the body.
Stetson’s Transformation: What Aggressive Horses May Be Trying to Tell You
Pinned ears, biting, kicking, and explosive reactions are often labeled as behavior problems, but what if the horse is actually in pain? In this Holistic Horseworks session, April Love and Tia discuss Stetson’s transformation and why nervous system stress, hoof pain, and physical discomfort may be driving behavior many horse owners misunderstand.
How Tiki Is Still Trail Riding at 30: Holistic Horse Care, Craniosacral Work, and Supporting Senior Horses Naturally
Most horse owners expect horses to slow down dramatically with age, but Tiki is still lightly trail riding at 30. In this Holistic Horseworks session, April Love shares the bodywork, nutrition, craniosacral therapy, and holistic horse care practices that helped support Tiki through decades of endurance riding, recovery, and healthy aging.
Protected: Your Health Now: April 15th, 2026
There is no excerpt because this is a protected post.


![Complete Level 1 & Level 2 Home Study + Private Training Package [NO DVD]](https://holistichorseworks.com/wp-content/uploads/2022/08/Level-1-and-Level-2-complete-home-study-and-training-package-400x400.jpg)
![Level 1 "Equine Musculoskeletal Unwinding" Home Study -Watch Instantly [NO DVD]](https://holistichorseworks.com/wp-content/uploads/2022/08/Level-1-Home-Study-400x400.jpg)
![Level 2 “CranioSacral Unwinding & Advanced Applied Kinesiology” Home Study - Watch Instantly [NO DVD]](https://holistichorseworks.com/wp-content/uploads/2022/08/Level-2-Home-Study-400x400.jpg)




![Equine CranioSacral Energy Work -Watch Instantly [English and French]](https://holistichorseworks.com/wp-content/uploads/2022/09/equine-cranial-sacral-energy-work-watch-instantly-400x400.jpg)