Proper restraint: Employing the best techniques for handling a horse will ease the horse's anxiety as well as yours. (KATHRIN ZIEGLER/GETTY IMAGES)

"When horses are hurt, injured or diseased, they may be more nervous anyway, but then a strange person—a practitioner—approaches them, and that may make them even more tense," says Jennifer Williams, PhD, president of Bluebonnet Equine Humane Society in College Station, Texas. "I've seen a couple of veterinarians get hurt because they haven't paid attention to a horse's behavior. They obviously focus on their work and forgot to watch the whole horse. I think veterinarians need to take time to observe what's going on with a particular horse and what works and what doesn't."

This article concentrates on physical restraint methods for handling and treating horses. Look for an upcoming article on chemical restraint methods.

The handler, be it a veterinary technician, owner or groomer, can assist you in keeping a close eye on a horse's behavior. "What the veterinarian has to do is instruct owners and handlers how to recognize fear and aggression, especially before a hoof has landed on their body," says Katherine Houpt, VMD, PhD, Dipl. ACVB, Cornell University's College of Veterinary Medicine.

"Sometimes veterinarians are working with horses in good confinement settings," Williams says, "but other times they may be working with loose horses in a pasture and would need to have eyes around their head to observe every aspect of the horse they're working on and the other horses in the pasture."

Williams recommends that while you are concentrating on a particular procedure, someone else should keep his or her eyes on the horse to warn you when the horse is getting upset. The owner may be an especially good choice since he or she should be savvy about the horse's behavior. "The owner may realize well before the veterinarian does that the horse is getting nervous, unhappy or frustrated. The veterinarian can ask the owner to let him or her know how the horse is behaving," Williams says.

"The handler should be restraining the horse near the head, not several feet down the rope, with a proper fitting halter, lead rope and tack that is safe," says Jeannine Berger, DVM, Dipl. ACVB, University of California-Davis' School of Veterinary Medicine.

The handler should stand at the horse's head at a 45-degree angle on the same side of the horse as you are on. This person should maintain eye contact with the horse and position him or herself to bend the horse's neck toward you and stop the horse from moving forward or make it step back if necessary. If you are working at the hind end, it is especially important for the handler to watch the horse at all times. He or she can observe a change in breathing patterns or notice other subtle signs of distress and communicate that to you.

It is best for you to be close to the horse, keeping contact with it at all times. "The practitioner, when approaching the horse, should start out at the shoulder," Berger says. She suggests starting at the shoulder and neck, even if you need to go to the hind end. Keep your hands on the horse, running them backward and talking to the horse, as you walk toward the area to be examined. If you need to change sides, make sure the handler does as well. "If you're up close against the horse, then your risk of getting kicked is fairly small," Berger says. "The closer you are with a hand on the horse, the better, even if you need to step back and look at the hips or symmetry."

Most horses, though used to being handled, react to sudden movements. So stay close by, let the horse know you are moving from one side to the other with close touch and gentle talking and keep your hand on the horse to let it know your position, realizing there is a small blind side to the rear. "I always make sure I rub my hand over the other side first, leave it there, and then move from one side to the other," says Berger. "If you want to move, and if it's a nervous horse, then step away at that hip, at a 90-degree angle and walk a wide half circle around the horse—the length of the leg and then some—and then you're within a safe distance of not being kicked. As you go from one side to the other, it's good to go up to the shoulder and work your way back, keeping your hands on the horse as you move to the rear. If you have an antsy horse, make sure you're at that safe spot at the shoulder when you start out."

As far as positioning the horse, you need to be careful to not get trapped between the horse and a solid object. "Always move your horse around, especially if you're in a stall, so the horse is close to the wall and you have the majority of space within the stall to maneuver," Berger says. The horse should not be blocking the doorway so if anything happens, you're able to quickly step out of the stall to safety, if necessary.