The horse, the "experts" and the heel first landing

I had a classic conversation with a vet this week. She had been to see a horse who was a rehab here a year ago with a palmar hoof problem. The horse had recently moved yards and lives several hundred miles away; he was new to the vet and she was understandably concerned because he was footsore.

I asked about the grazing at his yard (for reasons which will be apparent later on) but she told me this wasn't the issue. In fact, apparently the reason he was uncomfortable was because he had "dreadful pointed toe conformation" and because he was "walking on his heels".

I felt like asking her what she thought he should be walking on but I didn't have to. She told me a second later what this horse needed: the solution to the terrible problem of him walking on his heels was glue-on shoes at £800 a set plus - of course - box-rest and bute.

Fortunately for this horse, there is a Very Good Farrier in his area who was able to go and see the horse soon after. We'd already talked about the horse and I already knew the VGF wouldn't use glue-on shoes :-)

Meanwhile, since the vet's visit the owner had kept the horse off grass (ex-dairy pasture and very, very, rich) as she and I both suspected that his footiness (which came on within 48 hrs of him moving yards) was more likely to be related to the grazing than to him "walking on his heels" - which incidentally he had been doing soundly and happily for many months in his previous yard.

VGF and owner assessed the horse on concrete and walked him up and down. Landing was good (those heels again!), medio-lateral balance was good, comfort levels were improving, feet looked fine.

The Very Good Farrier trimmed a bit off the toe - which was a sensible idea because it immediately resolved the "dreadful pointed toe conformation" which was bothering the vet and since he was already "walking on his heels" he was clearly more than happy to load them(!). In fact, as the VGF said, the pointed toe had only occurred because the horse had suddenly been unable to work - in normal circumstances he was self-trimming.

Just to make sure, they got another farrier to have a look - the specialist in glue-on shoes - who also happened to be on the yard. He agreed; horse was comfortable, feet were looking good, no need for glue-on shoes.

Now, although I didn't mention it in my conversation with her, I was pretty surprised by this vet's comment. Most vets (including all the other, excellent vets I've spoken to this week) and most people who have spent any time studying the anatomy of a horse and how it moves have no difficulty understanding why a heel first landing is beneficial for the horse. 

Its something I've blogged about many times so I won't repeat it, but the anatomical explanation is here and it details why a toe first landing stresses the DDFT and other soft tissue, leading to injury and damage if its continually repeated. 

All horses will  - unless they are in pain - land heel first when the limb is fully extended. It doesn't happen when horses are moving in a very collected gait (or going uphill) but in a normal or extended stride (or when on flat ground or going downhill) a horse should and will land heel first. 

I've occasionally heard people suggest that a heel first landing is a sign of laminitis but to be honest there is a huge and noticeable difference in gait quality and demanour between a laminitic horse (above, footsore, tense and short-striding even if loading the heels) and a sound horse working in full extension with a correct and comfortable landing.

Equine anatomy and soft tissue trauma can be complicated to get your head round but there is another, very obvious problem when a horse lands toe first, which most owners will already be aware of: shock absorption. 

It doesn't take a rocket scientist to realised that there is one part of the hoof which is supremely well designed to shock-absorb, even when the entire bodyweight of the horse lands on one outstretched foot. 

In fact, shock absorption is the "DUH"oh-so-obvious explanation of why horses need to land heel first. Its something which should be immediately clear to anyone who has ever picked up a horse's foot  - and its doubly apparent when you pick up a healthy bare hoof.

Come on children - can you guess which bit of the foot has evolved to shock-absorb? Is it the flexible, rubbery bit at the back which has superb proprioception and is able to expand, contract and adapt to uneven terrain or is it the hard pointy bit at the other end? 

No gold star, I am afraid, if after looking at a real, live hoof on a real, live horse you think horses have evolved to land anywhere other than the palmar hoof.

Certainly no gold star if you are an "expert" who is happy to state, as Katie Jerram did in a showing magazine about spotting a promising horse: "I want the toe to come down slightly before the heel does...I don't want to see the heel come down before the toe, as this puts strain in the tendons" Really Katie - and exactly which tendons would those be? 

Try picking a horse with a decent landing, Katie - you never know, he might last a bit longer, like dear Ginger (above and below) a former rehab who not only struts his stuff on the beach but went home to regularly win in veteran classes in his twenties even though his showing career had supposedly ended when he was lame with navicular syndrome and had a toe first landing. 

I'm not asking you to take my word for it - this isn't my idea, after all. All you have to do is look at a sound horse moving fluently and in the way it has evolved to move over millions and millions of years. 

In fact, you don't even need to look at a horse. You can watch your dog or cat or a sheep or cow or even a person walking about. Not one of them (unless they have heel pain) will be landing on the front of the foot and then loading backwards - though it would be fun to watch some people try :-)*

*There is sometimes confusion because we use the same term - heel - in both humans and horses but  anatomically the 2 structures are different. The horse's heel is actually closer to being the palmar aspect of one finger. 

Humans land heel first walking but human runners  - particularly when barefoot - often land midsole rather than on the heel. Horses landing "heel first" are actually still doing something similar to human runners - landing on the palmar aspect and breaking over dorsally. 

But the point is the same - whether you are a human walker landing on your heel, a human runner landing midsole or a horse, dog, cat, sheep or cow landing on the palmar aspect of the foot, the comfortable - and anatomically correct - way to move is then to roll forward and breakover at the toe. Not the other way around...

You'll find, if you look at enough horses, that a horse who is unwilling or unable to land heel first is a horse with palmar hoof pain. 

This why owners often report that becoming shuffly down hill is one of the first things they noticed in horses later diagnosed with navicular syndrome or DDFT/impar ligament damage.  In fact, a toe-first landing is often the first sign of problems to come. 

This is also why - very often - the horses who come here aren't landing heel first when they arrive. Its not rocket science - with a lameness which blocks to a palmar digital nerve block this area is painful so the horse won't engage it if possible. No coincidence then that a change in landing is frequently the first sign of improving soundness.

But don't take my word for it - let the horses demonstrate. 

Steady progress - Mina's 8 week update

 Mina arrived here 8 weeks so time for another update  - I posted about her at 5 weeks but there are of course more changes happening all the time.

She arrived in reverse shoes and having been on box rest and on 2 bute per day with lots going on in her feet.

I posted an early update on her because so much changed in her first week here and since then I am glad to say that she has continued to improve.

Its equally interesting to compare her feet at 5 weeks (above) and at 8 weeks (below). They weren't bad feet to start with  but they have certainly improved and changed with work. 

Lateral shots -nail holes gone even though they were fairly high up the foot and a pretty chunky looking hoof at the moment. 

Where's Wally? Nearly there...

Many of you blog readers will already be familiar with Wally, the smart dressage horse who arrived here in February. 

If you search the blog for Wally you will find a lot of posts, not just because he has been here longer than most rehab horses but also because he decided to add to the mix by throwing in a new problem - a LH suspensory strain - on top of his original front limb lameness. 

Our own vets did a great job of treating that and, combined with the fabulous good vibes from the blog readers, at 20 weeks things were looking good. 

So back to his feet. Thanks to his wonderful owner, I have the luxury of having Wally here for 6 months - long enough to just about grow in a full new hoof capsule. These photos were taken at around the 5 and a half month mark. 

Looking at the sole shots the biggest difference between day one and today is the much healthier frog. Wally had a persistent and stubborn central sulcus infection when he arrived but after a few months its in retreat. Another critical difference is how much further back and more supportive his heels and bars are today. 

Looking at his toe things look a bit messy but a glance at the lateral shots explains why...

 

Day one, a long toe, under-run heel and weak, collapsed palmar hoof even though the hoof capsule didn't appear conventionally weak (nice strong hoof wall and a good hoof pastern axis, for instance). 

Today, you can see the last little bit of old hoof capsule at the toe together with a much stronger palmar hoof. I hope you can see that the natural strength that he is developing in the back of his foot is giving him more "support" than a remedial shoe ever would. 

The rest of his hoof capsule has grown down and the half inch of toe that is left isn't bothering him at all. It would make the hoof look prettier to trim it off, but as you can see from the sole shots, Wally already has his break-over in the right place and even though his palmar hoof is much stronger there is no need to put extra load onto it before Wally is ready - he will get there in his own time within the next few weeks. 

Jumping and more jumping - rehabs do it bare!

Great updates from the weekend again.

Lucy and Amanda have had another successful outing competing BE90:

"We had such a brilliant time yesterday at Skipton, with a fair amount of rain the night before the ground was perfect going again. 

We managed a 35.5 dressage, unfortunately had 2 down in the SJ but went clear XC, had a fair few time faults but super chuffed we made it round. Time was very tight only 4mins .18 secs and very few came in the time. 

It was a very hilly course with some steep down hill runs at some points but Lucy coped exceptionally well, very sure footed and balanced (who needs studs in this game???!!!). She faced some bold fences and jumped her little heart out, so proud!"

And Buddy and Krista also went jumping:

"What a day, Buddy's first XC ride.. 10 miles, 25 odd jumps and fabulous going. 

We've had our first XC fences since going lame and he was a super star and loved every second (even got a compliment on how capable his new feet are)!"

Yes, you can jump barefoot...

I posted earlier about Lucy and Amanda who competed BE last weekend and I believe are going again this weekend - GOOD LUCK to them! 

 Meanwhile here are a couple of lovely photos - this is Lucy's second affiliated event since she left Rockley and she looks an absolute picture, I am sure you agree.

Congratulations to Sam, Amanda and Lucy on a very successful rehab!

Aleska's update

Its been a mad week and there is lots to tell you about but for the moment let's just focus on Aleska's update. She arrived at the beginning of June so has been here 8 weeks now. 

Here are her feet the day she arrived.  Compare with the lower photo today - a very different hairline, shorter toe and much stronger palmar hoof. The nail-holes have also grown down but the most important thing is the much tighter angle of new growth and the more balanced hairline.  

This is a much more business-like hoof - and in fact Aleska seems to be relishing her new-found ability to stomp about and in her work so far is going from strength to strength. 

Here is her RF - already a much better and more functional foot today (below) than it was on the day she arrived (above). 

The most interesting thing for me is that her sole is becoming steadily more symmetrical and essentially her frog is resuming a critical role. That's the way to build a stronger palmar hoof. 

Here is her LF - again a big change in hairlines already, a much better angle of growth and a stronger palmar hoof. 

You wouldn't have said that her LF was terrible when she arrived...

But look how much better it is now-  and look at how the orientation of her limb has changed. More on Aleska, including footage, soon...

Good girls!

A couple of nice updates...

Amanda and Lucy competed at BE90 last weekend and clearly had a wonderful time, finishing 19th in their first affiliated event together. Many congratulations to you both!

Meanwhile a lovely photo from another Amanda, this time with Itsy. Amanda's message simply says "the best view in the world" - and I don't think she means the haylage bales or the oil tank... :-)