Many horses suffer with unrecognised hoof pain. Chris Ware asks, Is yours one of them?

The Idiots Guide to Hoof Problems (no disrespect meant)!

by Chris Ware, Equethy Workshops, Equine Myofunctional Therapist.

Postures of Pain:  There are specific postures that are a dead give away that your horse has developed musculo-skeletal issues from long term hoof pain. This article is long but grab a cuppa and wade through it as I have tried to explain the chain of events thats leads to serious hoof issues.  Understanding these changes has allowed me to play a role in the recovery of many many horses.

As an Equine Myofunctional Therapist dealing daily with equine musculo-skeletal problems in my equine massage clients’ horses and through the hundreds of Equethy workshops,¬†I have had the pleasure of meeting many horse owners who¬†sought barefoot rehabilitation.

The comment I hear all the time is “I wish I had known how to spot the hoof problems earlier…. I could have helped my horse years ago. Instead I tried everything else and wasted so much time while he was getting steadily worse……I feel like such an idiot now I understand the hoof better!”

I tell them don’t feel that way because you cannot change the past but you can indeed change your horse’s future.

Many horse owners know instinctively that their horses are “not quite right sometimes years before they are lame.

They ask their farrier if it could be from their hooves which seem to be changing chape and developing long toes and under run heels.¬† The farrier often says “well he doesn’t have great feet but they don’t crack or split so they are OK.¬† This is just normal for many horses.”

So naturally the owner dismisses the hoof as a source of problems and moves on in their search…. and on…. and on…..and the horse is seen by a parade of¬†people.¬† All the time getting slowly worse and unless this horses owner is lucky enought to find a body worker who also has a good knowledge of a physiologically correct hoof and its relationship of musculo-skeletal soundness,¬†sadly¬†it is usually many many years before the horse receives the help it so badly needs.

Often the sad end to this story is when a vet diagnosis navicular syndrome and suggested corrective shoeing and even surgery.  This is the traditional treatment for this problem but it no longer has to be so.  Since the advent of barefoot rehabilitation it is possible to reverse even the nasty effects of navicular syndrome merely by working to restore the internal integrity of the structures surrounding the navicular bone.  This removes the cascade of problems that are seen on radiographs as navicular.


I have endeavoured to explain below a few of the vast number of secondary musculo-skeletal issues that arise from long term hoof pain. Recently  there has recently been a huge amount of research into the hoof by leading veterinary researchers that puts forward the science behind the outstanding rehabs being done by many trimmers.  This research has shone a light on the reasons our domestic horses are so afflicted with hoof problems.

Why horse shoeing is a problem:

Horse shoes slowly deform and distort horses’ hooves.¬† They alter the very integrity of the structures inside the hoof that were engineered by nature to withstand the huge weight of this animal in motion.¬†They weaken them and this weakness causes the deformation of the hoof and its inner structures.

Horses did not evolve to have their entire weight suspended around the rim of their hoof which is what happens when we shoe them.  Its a testament to the wonderful evolutionary engineering in the hoof that they remain sound for as long as they do.

Don’t think it’s possible?¬†Just look at our human own history and the pictures below from the practice of foot binding during the Tsang Dynasty. “Well, horses are different” I hear you say.

Actually the way living tissue and bone reacts to years of unnatural stresses is not as different as you may think, even the hoof will slowly distort undern unnatural loading. (refer Wolfes Law of Orthopaedics). Yes I used these pictures for shock value but actually some of the pedal bones I see in long term shod cadaver feet are worse!

Peripheral loading (loading only the outside edge of the hoof capsule) weakens and changes the tissues within the hoof.

The very structures that were meant to dissipate concussion at ground level and protect the horse are compromised and rendered dysfunctional.  Peripheral loading  deforms the hoof capsule, and as the capsule changes shape slowly over the years, it then crushes the inner soft tissue structures in the caudal hoof (back of hoof) area that it was meant to protect, resulting in caudal heel pain and deep seated inflammation.

Why the caudal (back) hoof area first? Because this is where all the soft tissue structures lay inside the hoof capsule. They fill the back half of the hoof and sit behind the pedal bone because the horse, like most mammals was meant to do a heel first stride landing. .

So…depending on the breed, the age shoeing commenced and the abilities of those shoeing to set up the foot correctly every shoeing, the deformation can happen very quickly, or slowly over many years, but it will happen.

What to look for:

Gait changes are often the first symptom that owners really notice. Usually because the horse is less forward going than he was.¬† Less responsive and if a sporting horse may go off form and even buck on jump landings.¬† This is because the inflammation in the caudal hoof area causes pain there.¬† Once the hoof capsule starts to deform, this is the part of the hoof where the leverage forces from the horse’s own weight begin to squash and compromise the internal structures.

The hoof will deform by either running forward and becoming splayed and flat, (the dinner plate look) or start to contract at the heels and become clubby and steeper. The type of deformation usually depends on the hoof shape particular to that breed.

Below are extreme examples of this type of deformation. Thoroughbreds & breeds with wider pedal bones tend to acquire under run, long low heels and forward over long toes, and breeds with more conical hooves such as ponies and Arabians tend to deform to become more contracted and steep.

Many horses diagnosed to have navicular syndrome actually have acquired caudal hoof pain stemming from their deformed hooves.¬†Every single case of navicular syndrome displays some degree of hoof deformation! Every single one! It is never seen in physiologically correct hooves!¬† Read that again……..its really important!

Andrew Bowe leading Equine Podiotherapist and Master Farrier www.barehoofcare.com¬† and owner of Australia’s leading rehabilitation centre for laminitis and navicular horses, specialises in this type of rehabiliation.¬† He openly states now that there is never any reason for any horse to undergo surgery for navicular syndrome because of the oustanding results you can achieve by just returning the hoof to physiologically correct form.¬†¬† Through the Austalian College of Equine Podiotherapy www.equinepodiotherapy.com.au Andrew now trains many veterinarians in this style of rehab.

Hoof Deformation is always worse in the front feet…why?

Why do the¬†front feet begin to deform first?¬†I believe it’s because of the unique role they play in the bio-mechanics of the horse which involves a lot of breaking and impulsion in an upwards direction.¬†The hind hooves seem to stay in a better shape for longer, due to their very different role in locomotion which is more about “digging in” and driving the horse forwards.

If you don’t know a thing about good hoof form and your horse

isn’t limping lame how can you know if the horses¬†are sore?

Firstly you will note musculo-skeletal problems.

Why? Consider this, if you have a sore foot yourself, you will walk ,and stand, always avoiding the sore area. If you have a sore foot for years you will adapt your posture and gaits so that avoiding the painful part of the gait becomes habitual.¬† But ……after a time you will find you have secondary problems such as a sore back or hip and usually before those you will suffer a great deal of muscular tightness and if you are a sportsman muscle tears.

Continue to adjust your posture for many years and eventually this will even lead to a checkerboard of soreness and changes throughout your body.  Long term even bony changes in joints etc. The same thing happens to horses who adjust their bodies to avoid constant heel pain.

What is normal?

To identify horses with hoof pain it is first necessary to identify the stance of a comfortable horse. We live in a world of sore horses and most of us have come to accept their various abnormal postures we see all around us, as normal. We need to look again armed with some knowledge of why horsers are choosing to stand as they do.

Whether a young foal or an old horse they should be able to utilize fully their “stay apparatus” muscles of his forehand and partial stay apparatus of his hindquarters.¬†To do so they must be able to keep their front legs vertical as illustrated below.

Normal Postures:

A comfortable stance is shown on both these horses fully engaging their front leg stay apparatus with forelegs locked vertically.

Notice the good definition of the musculature in the older horses neck & shoulders; the deep indent in front of the scapular (shoulder blade) in front of the withers. These forehand muscles are as they should be. Soft and flexible and normal size.  In horses who constantly adjust their posture they are large and overdeveloped.

What is abnormal?

Sore horses lean forwards to unweight their sore heels.

Most of us are familiar with identifying limping lameness but what is so insidious about hoof deformation from shoeing is that it is slow to develop, and the horses don’t technically limp as pain develops equally in both front feet!¬†So these horses can’t limp in the clinical sense.

Even if you don’t know a single thing about the hoof except where it fits on the leg you can clearly see horses who adopt this forward posture.¬†It’s a huge warning light.¬†If you see it in your shod horses they have been very sore for a long time and probably have advanced caudal heel issues.

The chest is clearly be seen to be held forward ahead of the legs to take the weight off the caudal hoof (heel area).

The gaits of these horses are often clumsy and they begin to trip.  Dressage riders find their horses begin to loose impulsion, show jumpers find they will start to run out on jumps or buck on landing, trail riders find their horses unwilling to travel downhill and tend want to creep down slowly or try to go down sideways.

Sore horses do Toe first stride landings at the walk.

Beware - the toe first landing - also a clear warning sign.


How can you spot a toe first landing? If you look closely at a horse with hoof deformation land a stride you will see a little spray of dirt shoot out ahead of the toe as the horse lands toe first.

These toe first landings cause the tripping and stumbling when the toes dig in and butt against something solid in the ground surface. These horses may also buckle at the knees occassionally due to contracted and weakened foreleg musculature due to postural adaptations from long term problems.


Many racing thoroughbreds like the fellows at right, suffer early onset hoof deformation due to the practice of very early shoeing so common in that industry.

They are often shod when their hooves are barely past foal development. The bones of a horse, no matter what the breed do not mature till the horse is at least five years of age, this includes the bones of the hoof.  Some bones in the spine even later when they are nearly six. So shoeing horses as yearlings puts them on a fast track to hoof problems.

This early shoeing in the race industry has implications for both horse and rider as tripping and falling is not something that you would like to have happen to valuable horses who work at speed and carry a human life atop them.

Hoof imbalances such as under run heels and over long toes also cause horses to over reach and become unco-ordinated.  So these young horses often knock themselves about and rip off their shoes when put into work.

Another sinister consequence of toe first landings is the snapping effect that it causes to the tendons.

This “whip lash” effect occurs as the horse drops its weight onto the hoof after a toe first landing.

In sore horses this tends to be a quick, uncontrolled and badly co-ordinated drop.  Done without the slow dampening of a controlled yeilding as should happen in normal biomechanics it will cause continual micro-traumas to the centre of the tendon. This cumulative damage often leads to serious tendon tears.

Note the very evident toe first landings (front and rear) on these three year olds!

These young horses carry a multitude of secondary musculo-skeletal problems.   This fellow is already flexing his knees to avoid heel pain.

Great heel first landings!


The picture (left) of Carol Layton’s booted endurance horse clearly shows him ready to move onto that forelet with a great heel first landing..¬†He is working in harmony with his biomechanics and wearing hoof boots.

Most of the concussive shock is being absorbed in the caudal hoof and dissipated at ground level first, which will lead to less injuries during his performance career.

Amazingly long distance riders often notice that they also suffer less knee pain themselves when they ride barefoot & booted horses!

At left is Louise McCormack and Duo Park Ume.  Louise turned to barefoot trimming to rehabilitate  Ume who had been suffering lameness problems when competing shod.  It was discovered by vets that Ume had bone spurs on her pedal bones and a 90 percent tendon tear and they suggested that she be retired as she would never be competition sound again.  Not everything is as it seems!

At left, after barefoot rehab.  Louise and Ume successfuly completing the 400 Klm Quilty Endurance ride.  Louise used no boots throughout the ride!  Louise and Ume went on to enjoy many more competitive rides after this photo was taken and she remained sound and free moving.


Information for Equine Body Workers

Adopting a continual forward lean has horrendous consequences for the musculo-skeletal system.¬†Firstly it creates dysfunctions in the “stay apparatus” muscles of the forehand.¬†Later their entire musculature becomes involved from one end of the horse to the other with secondary compensations.

The “stay apparatus” in the forehand works to lock the leg straight, from shoulder to pedal bone by exerting equal and opposite forces down through a system of muscles and tendons. ¬†This lock allows the horse to sleep and rest in a standing position. It is also utilized when they are jumping.¬† This locking is just something nice for horses to do, but an evolutionary necessity to avoid fatigue for an animal that lives most of the time on its feet.

When the horse has physiologically correct hoof form they hold the leg effortlessly in this lock, with practically no muscular effort; but the foreleg MUST be vertical for this system to work efficiently.

Once heels run forward or become too high it changes the way the foreleg articulates and more muscular effort must be exertied to hold the leg locked. Even more muscles are engaged when they adopt the leaning forward posture (which looks like the circus elephant standing on the box)!

These extra muscles would normally be involved
in locomotion, and taking on a continual support role causes them to over develop, become fibrotic,
contracted fatigued andsore.

Performance horses with this type of secondary problem are more likely to sustain an injury when exerting themselves.

Most of the injuries I see in racing thoroughbreds stem directly from their hoof deformation.

Many horses are undergoing continual body therapies and chiropractic manipulations for problems that will only return again and again as the source of theses problems remains undiscovered and unchanged…. the deformed painful hooves.

Many equine body therapists are not trained to identify hoof deformation so unless they have developed an interest in barefoot rehab, theymay not consider the huge impacts of dysfunctional biomechanics.

Often to them, if the hooves look tidy and well shod and the horse is not limping lame they won’t suspect hoof pain as the cause of musculo-skeletal problems. I cannot stress how important learning about natural hoof care can be for any equine therapist.¬† It opened up an entire new world of healing for me and the horses I came into contact with.¬† ¬†If you are working on horses and don’t have this knowledge you have become part of the problem instead of part of the solution.I beg equine vets to explore barefoot trimming they will be amazed at what they find possible now.


As time goes by!

As the years pass and the hooves deform further, the pain increases.

Muscles of the shoulders and upper legs become so fatigued and stressed from trying to maintain this lean that some horses actually adopt a bent knee stance to gain some relief.

By now it’s obvious to their owners that they have a serious problem and veterinary attention is finally sought.

We live in extraordinary times where the changes have outpaced the traditional education system.  So often vets will not have the latest information on barefoot rehab so hoof deformation is not considered as the source of the problem. If you suspect your horse may have hoof deformation its so important to seek out a vet who practices barefoot rehab.  It might make the difference between recovery and expensive surgery and corrective shoeing for life.

Yes you will see bony changes on the radiographs the vet takes but these are preceeded by many many soft tissue changes.  It is possible to reverse these and re-create a physiologically correct hoof, but not with corrective shoeing which is more of the same thing that caused the changes.

Secondary hind quarter muscle problems from hoof pain:

“Reversed Angles” ¬†and their associated body issues.

As time goes on and the horse struggles to overcome a litany of problems and develops a checkerboard pattern of compensation throughout his body. The changes eventually affect the hind feet too.

Often what is noted is hind quarter muscle issues, and lumbo-sacral pain and hock and stifle issues.  This is due to the horse shifting greater amounts of weight onto their hindquarters to maintain that elephant ona box stance.

With this constant transference of weight to the hind quarter the hind hooves become involved in the deformation process too, developing abnormal hoof angles and low heels. The horse is then adopting the “box stance” (just like the circus elephant).

Maintaining this stanace causes the gluteals located in the rump to become so stressed and overdeveloped that they appear like little pillows bulging up on both sides of the rump, even on thin horses.

What are the biomechanics of this “box stance” ?

It is easy to understand if you think about it.¬†If the farrier is shoeing to match the increasingly deformed hoof shape.¬† The heels are folding down towards the ground and are called “low” but in reality they are now long and low.

Then as the heels crush and become lower the steel shoe prevents any wear or natural correction from happening.  So the horse is always sore.

Shod like this the horse is forced to bring his hind hooves further and further underneath him to counterbalance his forward lean.  With more weight on the hinds the hind caudal heels distort too.

If you see horses with corrective shoes with trailers these are supposed to move more weight back to where it should be………..this is impossible and they will just speed up the deformation.¬† To the horse it feels like living in snow skiis would to us and puts abnormal torque on the hock and stifle joints. Wedges are also unsuccessful as they just add more pressure to the collapsing caudal heel area.

The pedal bone (P3) of the forefeet, and hind feet have evolved to be slightly different in their shapes and the angle on their anterior surface is also slightly different. This is due to their different role in the equine biomechanics. The forefeet are basically used for braking and impulsion in an upward direction whilst the hind hooves are more trowel shaped to dig in and push, so providing the huge powerful thrusts necessary for speed.

For the horse to function effectively and in harmony with his bio-mechanics hoof angle must be within normal ranges.  Once the heels collapse or become overly steep they change and then the horses are fighting their own biomechanics for every step.

This change cannot be artificially addressed as it is the actual alignment of the pedal bone inside the hoof capsule that dictates the hoof shape and dictates the way each joint above is forced to articulate.

These horses with “reversed angles” need to GROW more heel height in the correct alignment! They need the trimmer to slowly encourage the weight bearing part of the heel to move backwards to its correct physiological position.¬† They must have their “fulcrum point ” in the hoof capsule returned to the correct position so that their weight pivots at the anatomically correct point.¬†This can only be done by addressing the hoof deformity and encouraging the growing of a correct hoof form again. It may take time but it is well worth the effort.

It usually takes about six months and they MUST be regularly trimmed every four weeks, but the rewards are great. Often the entire topline of the horse will change and redevelop. Many owners say that their horses look and move better after rehab. gives them back physiologically correct hoof angles than they have since they were young.

Secondary Hock & Stifle problems:

Horses with reversed hoof angles in their hinds often suffer patellar problems and hock and stifle issues. Often this is mistaken for locking patellar by owners and veterinarians who are unfamiliar with physiologically correct hoof form. The hock and stifle joints work with reciprical action - flex one and the other flexes equally but in the opposite direction.

Lumbo sacral pain: What is not commonly known is that there is also a role played in patellar action by the tensor fascia latae muscle and the lumbo-sacral joint. All of these are affected by abnormal reversed angles as they are unable to work in concert as they should. In fact they are foced to work in opposition to each other. Working in opposition creates tight hamstrings and lumbo-sacral pain. This hock and stifle pain is often mistaken for arthritis in older horses.

Rehabilitation Therapies:

Barefoot rehabilitation is aimed at halting and reversing the hoof deformation.

It can be done and you will be astounded at how powerful a tool this can be even for horses with serious hoof problems.¬†¬†Its best done with the guidance of a Professional Trimmer such as an Equine Podiotherapist, but if you don’t have access to a professional there are many great books and dvds available now that will help you and your current farrier make a start in the right direction.

Don’t be afraid to ask him.¬† Like any professional it should be in his interest to learn new and up todate skills.¬† Its an animal welfare issue that farriers and vets must look at the new research and gain the anatomy knowledge that underpins good barefoot trimming.¬† The last few years of research have overturned much of what they would have learned in their early careers.

If you can’t find help then doing something is better than doing nothing. If you don’t have access to help then¬† Pete Ramey’s books on barefoot trimming will guide the novice through basic trimming.

Over the next few months and via a series of regular trims, you will notice how the hooves are slowly encouraged back into the correct form. It’s important that they are regular trims, no longer than four weeks apart or you will be right back where you started every time the trimmer comes.¬†Regular trimming re-establishes the correct break-over point, hoof balance and will return a normal range of motion to the joints.¬†As this happens the musculature also responds positively.

Proprioception - the role it plays in recovery.

Right from day one of rehab. provide a comfortable stride landing when ridden.

I cannot stress how important this is!   You must provide boots and pads as part of the rehab process.  Its not a matter of letting them just tough it out as this causes more issues than it cures.

Proprioception is the name given to the chain of events that allow our brains to “feel” the things our body experiences.¬† Our skin and the horse’s sole are richly innervated with sensors that send messages to the brain about heat, cold, pressure,¬† and pain.¬† These are called proprioceptors.

These proprioceptors help mammals to experience the world around them in their daily lives but remain safe.  They tell the horse not to load the hoof with his entire weight when he stands on a stone. They also tell him not to load his sore caudal  hoof area when ever possible.

Horses that have had to deal with years of hoof pain will habitually do toe first landings.¬†Their brain has become hard wired to move this way from years of negative messages.¬† Eventually the horse doesn’t think about the way he moves as it becomes a habit to avoid the sore areas. He just adopts gaits and postures that help him to that but this is very bad for his hooves and his body.

When you remove their shoes for the first time their dysfunctional caudal hoof area, richly innervated with nerves all yelling to their brain “we hurt” will be super senstive.¬† They will hunch their shoulders when ridden trying to protect their sore feet.¬†This “hunching” adds to their upper body muscle problems and slows down their recovery.

Right from their first trim it is time to help their brains “relearn”¬† how to move properly and over-ride all those years of information telling them to guard their heels. Providing comfort and new sensations opens new channels to the brain and speeds up this process.

Hoof boots with therapeutic pads are the very best thing to give hoof confidence to these horses.

They don’t need them in the pasture because when at liberty¬†they can take their time to move about and pick their footing, and its actually very good for them to be exposed to varying ground textures.¬† But they do need them for any ridden work or lunging you do.

Why? Dr.¬†Bowker’s recent research using Ultrasound has shown that the greater the peripheral loading of the hoof (as with shoes) the worse the blood flow throughout. With less peripheral loading, the greater the perfusion of blood flow through the hoof. Better blood flow equals healthier hooves and faster regeneration of damaged tissue.

Solar loading by putting pads in boots¬†provides constant all over contact and mimics the stimulation that the hoof would receive naturally.¬† Professor Bowker’s studies show that blood perfusion through the foot is highest when a hoof is on pea gravel and on foam pads, both rating at 90 on his index.Proprioception and blood flow are closely linked.

The very best and quickest way to regain physiologically correct hoof form and thus a sound horse without any musculo-skeletal problems, is to have regular trims and to give the horse gentle exercise in boots with pads.¬†The horse’s own weight in motion will strengthen the internal tissues of the hoof, and break up adhesions. For horses with shrivelled, non functional frogs there are even special therapeutic pads from Easycare for extra stimulation.

It is pointless trying to rehab. serious hoof problems without providing hoof comfort as well, as you will be undoing your good work every time the horse is ridden.  Unless they can comfortably land heel first again they will never rebuild the tissues of the digital cushion and caudal heel area that have become dysfunctional and painful.

Once the horse is comfortable its time to think about some “core strength exercises” to rebuild their musculo-skeletal strenth and create self carriage again.¬† I don’t mean¬†exercises that require collection, ¬†I mean exercises that will create suppleness and length in the areas of overdevelopment.

Barefoot is not about being “bare”. ¬†It’s about a better quality of life……. for the horse’s entire life.¬†Good luck with your rehab. You will be greatly rewarded for your efforts.

Chrisann Ware  EMT & UHHGM

Equethy Barefoot Educational Workshops (Australia)

Equine Myofunctional Therapist for Easycare Down Under.

email equethy@bigpond.com

Posted on 10th February, 20148:38 pm by admin