Galls in Horses - More than Just a Cosmetic Issue

Galls in horses are a familiar term to many horse owners, the typical "leg swellings." But what exactly are they? Are they harmless or a warning sign of serious joint problems? In this article, we examine the causes, symptoms, diagnosis, treatment, and prevention of Galls.

What are galls?

Galls (also known as hygroma or hydrops) are lump-like thickenings on joint capsules, tendon sheaths, or bursae in horses, caused by an increased accumulation of synovial fluid. Synovial fluid, often referred to as joint lubricant, is essential for healthy joints. It cushions movements, supplies cartilage with nutrients, and transports metabolic waste products away.

If the formation or breakdown of this fluid is disrupted, for example by irritation or inflammation, overproduction can occur, manifesting itself in the form of visible swelling. Bumps can be very soft and movable, but they can also harden over time as connective tissue is deposited. In many cases, they are purely cosmetic and do not cause pain, but in other cases they can also indicate deeper-seated problems.

Where do gall occur in horses?

Galls can occur in various places on a horse's leg (but also on other parts of the body). Common locations and their names are:

• Cruciate gall: Swelling on the ankle joint (ankle bump)
• Curb gall: Protrusion on the side of the ankle joint
• Egg gall: Swelling on the heel bone (between the Achilles tendon and bone protrusion)
• Piephacke: Swelling of the skin bursa on the heel bone
• Knee sponge: Thickening on the tarsus – front
• Neck lump: Swelling between the nuchal ligament and atlas (first cervical vertebra)
• Wind galls: Soft, synovial fluid swellings typically near the fetlock joints or tendon sheaths.

💡 For a better understanding: An overview of equine anatom:

Causes: How do galles form ?

The development of galls is complex. It is often not a one-time event, but rather the result of repeated or chronic irritation. Here are the most important risk factors:

Mechanical stimuli and overload

• Joint chips (bony or cartilaginous fragments in the joint) stimulate the joint lining to produce more synovial fluid.
• Flooring that is too hard, too soft, or uneven puts a lot of strain on the joints.
• Starting to ride before the age of 3 increases the risk.
• Misalignments of the limbs or hooves can cause pressure peaks.
• Incorrect shoeing: e.g., shoes with long shanks or studs put strain on sensitive areas.
• External pressure: Tight bandages, gaiters, or a stall with hard walls can cause mechanical irritation.
• Microtrauma: Kicking the stall, collisions with obstacles, insufficient warm-up.

Inflammatory processes

• Inflammation of the joint capsule, bursa, or tendon sheaths leads to increased synovial fluid production.
• Chronic irritation, e.g., from “grabbing” or “stroking” (when one hoof hits the other), stress due to anatomy or movement.
• In some cases, infection is the trigger, e.g., Lyme disease involving joints and bursae.

Tissue weakness & metabolism

• Weak connective tissue (e.g., genetic) promotes fluid accumulation.
• Lymphatic drainage disorders: If fluid is not properly drained, it can accumulate in the joints.
• Lack of exercise: Horses that spend long periods in stalls have less joint movement, which hinders the drainage of synovial fluid.
• Nutrition: Imbalances in minerals or vitamins or an excess of protein (e.g., in fast-growing young horses) can lead to joint problems.
• Degenerative joint diseases such as osteoarthritis promote excessive fluid production.

Symptoms: How can you recognize galls?

Not all galls cause symptoms, but there are typical signs to look out for:

• Swelling: on joints or bony prominences.
• Size: Some gallstones can grow to be fist-sized.
• Consistency: Often soft and movable at first, later hardening may occur due to connective tissue deposits.
• Pressure sensitivity: If the gall is warm or sensitive to pressure, this may indicate active inflammation.
• Lameness: If the gall is poorly positioned or large, the horse may become lame or change its movement pattern.
• Altered gait: short strides, uneven footing.

Diagnosis of galls in horses

Gallstones are usually diagnosed through a combination of visual inspection, palpation, and veterinary examination:

Clinical examination

The veterinarian palpates the affected area, checking consistency, mobility, warmth, and pain response.

Comparison

Both limbs are compared to identify differences in circumference or consistency.

Gait analysis

Observation of the horse in motion: walking, riding, lunging, to determine whether the gallbladder affects movement.

Imaging / further diagnostics (if necessary)

In some cases, X-rays, ultrasound, or joint lavage may be useful, especially if joint chips, chronic inflammation, or cartilage damage are suspected.

Treatment of galls

Whether galls need to be treated depends largely on their cause, size, consistency, and symptoms. Here are some common treatment options:

Conservative measures

• Rest/training adjustment: Rest periods can help reduce irritation.
• Cooling: In the acute phase, cooling (e.g., with a healing clay bandage) can help relieve inflammation.
• Exercise: Moderate exercise-walking, grazing-supports the drainage of synovial fluid. Compression:
• Compression bandages promote lymph and blood drainage and can be particularly effective for soft gallstones.
• Physiotherapy/lymphatic drainage: Manual lymphatic drainage, physical therapy, or gentle mobilization can be used as supportive measures.

Medication

• Anti-inflammatory drugs: Anti-inflammatory drugs may be used to treat painful or inflamed galls.
• Injections: In advanced or chronic cases, intra-articular (into the joint) injections with corticosteroids or hyaluronic acid can help.
• Joint lavage: In cases of bleeding or inflammatory processes, lavage with isotonic solutions may be useful.
• Antibiotics: Only if an infection is suspected (e.g., in cases of purulent gallstones).

Surgical/interventional measures

• Puncture: Direct drainage of the fluid is possible in principle, but is often viewed critically by veterinarians.
• Risks associated with puncture: Risk of infection, as germs can be introduced; the gallbladder may then fill up again.
• Further procedures: In rare cases, surgical procedures are necessary, e.g., removal of joint chips.

Long-term therapy/aftercare

• Regular monitoring: Observe the galls in terms of size, temperature, and sensitivity.
• Adjust training: Long-term joint-friendly training, soft/balanced ground conditions, good warm-up riding.
• Support joint metabolism: If necessary, use supplementary feed or joint supplements (e.g., with hyaluronic acid, sulfur) – always in consultation with a veterinarian or feed consultant.

When is a gall cause for concern?

Not all galls are harmless.The following warning signals should prompt you to consult a veterinarian:

• The galls are warm or sensitive to pressure.
• The horse shows lameness or changes its movement pattern.
• Rapid growth of the galls or sudden onset.
• Repeated swelling after exercise, despite adjustments to training.
• Accompanying joint problems such as osteoarthritis or known joint chips.

A veterinarian can use targeted diagnostics to determine whether there is a cause that requires treatment.

Prevention: How to avoid galls

The best treatment is often to prevent galls from developing in the first place. Here are some proven measures:

Joint-friendly training

• Balanced training structure with gentle warm-up.
• Variation in ground conditions, no prolonged stress on very hard or very soft ground.
• Slow training build-up, especially with young horses.

Equipment and posture

• Properly fitting bandages/gaiters to prevent pressure points.
• Regular hoof care and correct shoeing to minimize pressure from shoes.

Promote exercise

• Sufficient grazing or open stable housing to enable natural movement.
• Physiotherapy, lymphatic drainage, or compression to support the drainage of joint fluid.

Optimize nutrition

• Balanced mineral and vitamin supply to support joint development and bone metabolism.
• Avoidance of excessive protein in young horses to prevent excessive growth.
• Possibly targeted joint supplements (after consultation with a feed consultant/veterinarian).

👉 Further information can be found in the article: Horse feeding: basics, tips, and common mistakes

Regular monitoring

• Make a habit of regularly checking your horse's legs, e.g., when cleaning out the hooves or grooming.
• React quickly at the first signs of swelling—cooling, rest, and possibly veterinary examination.

Conclusion

Galls in horses are very common and harmless in most cases – they are often considered an aesthetic flaw without significantly affecting the horse's quality of life. Nevertheless, they are an important warning sign for chronic irritation, overload, or joint problems. Close observation, regular care, and veterinary advice, if necessary, help to minimize potential risks.

With targeted prevention, appropriate equipment, and adapted training, many gallstones can be avoided – keeping horses healthy and mobile. If there is uncertainty or the appearance changes, a professional examination by a veterinarian is recommended.