SHOEING - RAISING THE HEELS

[wjgfred]

Hi,

My horse has a current injuryto the DDFT. When x-rayed it was found that although it looks as if he has enough heel actually his pedal bones are completely flat.

It is thought that this contributed to the DDFT injury as obviously this caused more stress on the DDFT before he even did any work and he was also an eventer.

He was firstly shod with bar shoes and putty, and like a clingfilm type insole that went hard. He went even lamer on this although it was designed to raise the heel. He has for the past 4 months been shod with stromsholm (I think thats how you spell it), heel raises. They are plastic and also come across the back of the heel, as obviously do his bar shoes.

However my farrier says that these are only a temporary measure as they can cause concussion themselves. My horse is doing very well at the moment being sound in walk and trot on the straight and untested in anything else.

My farrier is working hard at trying to get his heels higher and he is due to be x-rayed next week to see what angle the pedal bones are currently at.

Does anyone have experience of problems using the stromsholm pads for a long period of time, or does anyone have any suggestions of something else that could be used instead.

Any help would be appreciated.

 

[RachelB]

Anything that raises the hoof-pastern axis will cause more concussion to be going through the legs. I have no clue whether this is the idea behind them, but are gel pads supposed to be better than plastic? TBH though looking at it logically and biomechanically I don't think there's any real way to limit the concussion when heel wedges are used. My horse never had wedges or anything of the sort as she is already too upright in front, so I have very little experience of them. All I do know is that it is vital to try to strike the balance between flat and upright hoof-pastern axes to try to balance the amount of concussion experienced by the legs with the amount of strain experienced by the flexor tendons.
prittstick is quite the expert on heel wedges

 

[wjgfred]

Thanks Silmarillion,

There is no question that at present my boy needs his heel raises. I am hoping that the farrier can raise his heels enough that he doesnt need the pads long term. Just worrying what happens if he cant get this to happen.

You may be right and prehaps It is just a trade off, I just wondered what peoples experiences were. I think at the moment getting his pedal bone at the correct angle is probably more important than worrying about concussion though.

I also dont really understand why raising his heels has to cause him concussion. In his case we are only putting the hoof/pastern back to where is should be normally.

 

[Flame_]

What have the vets recommended regarding surgical shoeing? In my limited experience, while farriers might do an amazing job they are trying to go against nature and if the horse has more than one foot problem eg collapsed heels and tendon injury, it can be too much for the horse to cope with and can cause more problems. My mare was crippled with those plastic heel raiser pads even though initally the farriers were thrilled with how they corrected the angles of her feet. She's just been turned out with no shoes on and its too soon to tell whether this will be a disaster or success!

 

[seabiscuit]

I can only speak from personal experience.

Completly buggered up my mare. Took her feet months to recover, It wasnt only her heels that were crushed, her back became so twisted and sore because she was standing in such an unatural way. She lost all her topline, and her temperment changed for the worse as she was so uncomfortable. I would recommend taking the shoes off for optimum heel growth plus farriers formula.

 

[wjgfred]

Thanks for your replies - If I take the heel raises off my horse then I may as well have him PTS now. His tendon cannot deal without them at present (unless the x-rays next week say differently and his heel depth has increased).

The shoeing he is having now with the plastic heel raises is the vets recommendation and he has been sound on them for 4 months. The fitting of them doesnt look at all like yours ouija board !!.

The question is whether there are any other varieties that cause less concussion.

 

[RachelB]

[ QUOTE ]
There is no question that at present my boy needs his heel raises. I am hoping that the farrier can raise his heels enough that he doesnt need the pads long term. Just worrying what happens if he cant get this to happen.

You may be right and prehaps It is just a trade off, I just wondered what peoples experiences were. I think at the moment getting his pedal bone at the correct angle is probably more important than worrying about concussion though.

[/ QUOTE ]
Oh gosh no, I think you mis-read my reply. I wasn't questioning whether your horse needed heel wedges at all, I agree that the best thing with tendons is to take the strain off them and to do that you have to compromise something else (hence the concussion/tendon strain balance thing)

[ QUOTE ]
I also dont really understand why raising his heels has to cause him concussion. In his case we are only putting the hoof/pastern back to where is should be normally.

[/ QUOTE ]
Like I said, concussion and tendon strain seem to be at opposite ends of the scale with horses' legs. On one hand you may have a horse with the flattest feet in the world and very long, sloping pasterns - this horse would experience very little concussion in its legs as the flexor tendons would be taking all the strain, but there you have the problem... as concussion is reduced, flexor tendon strain is increased. Then you may find a horse like mine with almost vertical pasterns - she experiences a vast amount of concussion up her legs, but the flexor tendon strain is decreased when she moves.
Technically a horse who has "perfect" legs should strike a good balance between the amount of concussion and the amount of flexor tendon strain in the legs. Therefore he is not being overloaded with concussion or tendon strain and can cope with both sets of "wear and tear" on his body much better than the horse having to cope with a large amount of tendon strain with less concussion, or vice versa.
The other problem is then the individual horse's conformation, as obviously no horse is perfect! So again taking my upright horse as the first example, although I said her upright conformation should technically reduce the strain on her tendons, it actually didn't because unbeknown to us her hoof-pastern axis was broken back even though she looked upright on the outside. It took X-rays to show us this, and a broken-back HPA increases DDFT strain and hence she tore hers. Therefore striking the concussion/tendon strain balance is even harder, because the farrier's natural reaction is to lower her HPA but this would increase strain on the tendon more and more. She actually needs to be kept ridiculously upright to reduce the strain, and I am compromising the vast amount of concussion on her legs in order to help her already damaged tendon.
Then your horse is the opposite and should be a much easier case to help with raised heels - your horse has a broken-back HPA (as his pedal bone is parallel to the ground) which is something that as I said, increases DDFT strain. To solve both these problems he needs heel wedges, which yes will cause increased concussion but it shouldn't be too much for a "normal" horse to cope with, because as you said you are trying to set the HPA to "normal". Once the heel wedges are on his HPA is normal and the strain on the DDFT is reduced, but there will be a slight increase in concussion - it shouldn't be anything to worry about though as it's all relative and it's only an increase to what he has known before, not an increase over what is normal

I hope that makes sense and I haven't rambled too much or told you anything you already know!

 

[hussar]

I'm interested in this discussion as my younger horse has also recently suffered a DDFT injury to a hind leg and three weeks ago was shod on the vets' recommendation with what sounds like the stromsholm pads. Goodness knows whether it's having a beneficial effect as he's also on box rest.

My other horse has navicular in both front feet and until recently was shod in elevated heels too but these were achieved by simply rasping down the toes of the shoes. His heel growth was steady and has now reached the stage where the farrier's happy with the heels and is now going to try Natural Balance shoes to improve the break-over point.

These two horses could hardly have more different lower-limb conformation - the old boy is very upright with boxy feet - which contributed to the navicular; the youngster has great feet but longer sloping pasterns - which contributed to the tendon damage!

Ouija board - I was surprised by the amount of elevation shown in your photos - could it have been too much hence the heel-crushing?

 

[sassyequine]

Wjgfred,
I feel for you as I have been going through this for 8 months now. My 4 yr old warmbloods heels dropped only 2 months after starting basic work, several different methods of treating later she was MRI'd at Newmarket 6 weeks ago. She has navicular bursitis in both feet and a lesion in her left DDFT. Medication in any of the surrounding joint spaces makes little difference. She has been shod twice using solar flexible pads and packing material, yes some concussion but like yours she cannot walk without them. After re assessment on Friday, Newmarket and my vet and my farrier have concluded the last chance is to give her a year off. We will keep her shoes and pads on for two more cycles, then try to remove the pads and over the next few months hope to bring the heels up. I have my fingers severely crossed.
If you have any more q's about the whole think I am happy to hear from you

 

[air78]

I'm just going to post a link, which you might find makes interesting reading (as do all the other case studies on there). I shall say no more, other than all my horses are shod, but it's still very interesting

http://www.performancebarefoot.co.uk/jessica.html

 

[wjgfred]

Silmarillion,

Thanks, that posting is really helpful in particular about the extra concussion thing and I now completely understand.

I wasnt having a go at you about the heel raises it just seems that everytime I mention them someone tells me how terrible they are and how they caused so much damage to their horses. It is just very frustrating (and it worries me i guess), because I just dont have any choice about this at the moment. My boy is so good with them and so lame without them. But I still worry about the long term.

Although I have to say my boys are nowhere near as high as the ones on the photo and are alot more gradual and fitted to the foot, which looks extremely neat.

Thanks again Matey.

 

[wjgfred]

Sassy, I am not sure what you have tried with your horse. I think sometimes you have to try lots of different things to find out what is best for your horse.

My horse was hopping lame with solar pads and packing and came sound straight away with the plastic heel raises he currently has. Also cartrophen injections worked really well for him.

I think if I have learnt anything on these forums it is that all horses are individuals, but these forums give you other options to think about.

Good luck with your horse, I wish you all the luck in the world and know how difficult this type of injury is.

 

[lucemoose]

My horse has been off for exactly a year and for half of that we had the 3rdmillennium heelwedges on. Although yes the vet said to put them on to take the pressure off the DDFT my farrier wasnt keen to do so and explained that in taking pressure off one area of the limb we put the pressure on somewhere else higher up the leg. I did do my hours hack in walk everyday in them but every time he was shod it was apparently that the heels were constricting more and more and he ended up looking like a flat footed TB (he did have heels to start with! Just flat soles..)
He has now been barefoot out 24/7 on Formula4feet, cornucrescine and kevin bacon (trying everything!) and his feet are beginning to widen and de constrict. Time will tell, but he is having all the time in the world. Oh we have had cartrophen injections too, but my beasty was never more than a fraction of a tenth lame..except the day after the injury..

 

[RachelB]

I don't imagine that heel wedges are intended for long-term use. What is probably a better course of action than forever having "false heels" on your horse is to use the wedges initially to take the strain off the tendon and let it heal. This (as you more than likely already know!) takes one to two years, although most of the healing is done within the initial stages (very quickly in the first two weeks or so, most of it "finished" within six to nine months). So once the tendon has been given a chance to repair, then the wedges will probably come off and he can be allowed to grow his own heel. My horse's feet have done well without shoes for the last year, she has kept her toes short and heels high by moving how she feels comfortable in the field. My temporary farrier over the winter did make a bit of a mess but now I have my regular farrier back (moved my horse back into his area) they are looking better. Maiden is also walking around the yard on the concrete now so she is wearing her feet how she wants them to be. The only reason I have to put shoes on soon is because she is sore on the stones - otherwise she'd be barefoot as long as possible because I'm sure it's helped her heal.
The most important thing is not to listen to other people unless they agree with your vet and farrier. Those two people and yourself are the most important people in the world right now when it comes to giving your horse every chance of recovering so, ahem, sod everyone else!!

 

[Doublethyme]

I don't like heel wedges, think they do cause problems elsewhere, BUT I was under the impression that with DDFT injuries it was kind of a required compromise, as the wedges are definitely needed to take the pressure off the tendon and so its a bit of a trade off against other problems arising because of the wedges.

Very difficult, but you do kind of have to deal with the most important thing and try to manage the rest maybe.

On the negative pedal bone issue on its own, it will be interseting to see what my mare's x-rays shown next week. She had some in January as part of a work up on a SDFT and annular ligament injury and it showed she had flat pedal bones (rather than negative). She's barefoot, so we have tried to treat her barefoot. We think she has improved, but only the x-rays will tell the truth, so we'll see. Will be interesting to see if barefoot can get her heels back in the same time frame as say shoeing with wedges would though.

A friend's horse also has negative pedal bones and is shod by probably the top natural balance farrier in the country (or at least one of them) and whilst he put wedges on for the first shoeing (or possibly 2nd as well), he was adament they came off quite quickly, as he said that whilst they can help short term, they are not good for long term use, as they will crush the heels over time (or something like).