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[RC] Query #2: why are low heels bad? - Steph Teeter

Here's a good technical article on 'long toe - low heel' problems:

http://www.equipodiatry.com/topics.html

Steph

(here's the text)

LONG TOE-UNDER RUN HEEL

A SEVERE PROBLEM

Stephen E O'Grady, DVM MRCVS
Long toe -under run heel foot configuration is one of the most important and
common foot abnormalities facing the horse industry today. This type of foot
conformation is so common that it is often thought to be within normal
limits. The long toe-under run heel has been defined (by Dr Tracy Turner) as
occurring when the angle of the heel is 5 or more degrees lower than the
angle of the toe. It is often accompanied by a broken-back hoof pastern
axis, which means that the slope of the foot exceeds the slope of the
pastern (Figure 1). This condition could also be referred to as a
dorsopalmar imbalance of the foot.

This long toe-underrun heel is of major concern to both veterinarians and
farriers. For veterinarians, this abnormal hoof conformation is known to
contribute to many foot related problems such as navicular syndrome, chronic
heel pain (bruising), DIP joint (coffin joint) synovitis, quarter and heel
cracks, and interference problems. The farrier is confronted with the
essential task of prevention, correcting and/or maintaining this type of
foot conformation.

Many causes may lead to the development of a long toe-under run heel. There
may be a genetic basis for this problem, since many offspring appear to be
born with or acquire the same foot conformation as one or both parents. In
recent years, it appears that an increasing number of foals are born with a
low heel. Over or under trimming foals or the frequency of trimming foals
may contribute to this type of foot. Are we lowering the heels on foals too
quickly? Environmental factors may predispose a horse to long toe-under run
heel. Well known farrier Eddie Watson has often stated, "A horse's feet are
the product of its environment". The type of climate and footing a young
horse is raised in whether dry and hard or wet and soft may play a role. On
a hard surface, a youngster will wear its feet normally as opposed to soft
footing where the foot sinks in the ground. Horses that are subjected to
continuous or excessive moisture may be affected due to softening of the
hoof. Horses with forelimb conformation such as long pasterns or short
straight pasterns may be more likely to develop this type of foot. This
problem is particularly common in Thoroughbred horses but is present in all
breeds. At the racetrack, there is a tendency to maintain a low heel coupled
with a long toe with the erroneous thought that this increases stride
length. The use of a toe grab increases the severity of the long toe-low
heel. Farriers, in an attempt to prevent shoe pulling in the front feet will
use a shoe that is smaller than necessary. This places the bearing surface
of the foot in front of the vertical axis of the limb, creating the same
mechanical effect. Over time the foot grows in this configuration. Finally,
if the toe is continually allowed to grow excessively long, the heels will
follow in the same direction. The long toe I am referring to is the one seen
when viewed from the bottom of the foot, where the distance from the apex of
the frog to the point of breakover is increased. This distance can and does
increase in many horses over time as a result of shoeing.

The pathogenesis of this process is logical. Many underrun heels have their
genesis in a long toe. Direction of heel growth follows that of toe growth
i.e. as the toe becomes long, the heels grows forward and hence lower. This
causes the pastern to move forward, creating a broken back hoof-pastern axis
(Figure 2). As the heels become low, the horn tubules at the heels bend
until they reach the point where they are parallel to the ground. At this
point they are unable to support weight and will begin to thin, separate,
collapse and roll underneath the foot. The heels are further damaged during
expansion where the heel of the foot moves against the shoe. Evidence of
this can be seen by examining the solar surface of the shoe and a noting a
trough that is worn in the heel area. This prevents any growth of hoof wall
in the heels between shoeing intervals yet toe growth is unaffected. The
compromised heels lose the ability to support weight causing more weight to
be placed on the frog, deep digital flexor tendon (DDFT), and digital
cushion. If the digital cushion becomes damaged, the frog atrophies and is
pushed out of position toward the rear of the foot. The long toe sets up a
mechanical lever arm, resulting bending of the horn tubules and laminar
tearing. This causes the soles to descend and flatten. Bending of the horn
tubules seen in the toe area results in a concavity of the dorsal hoof wall
("dish"), often accompanied by a full thickness toe crack. The severity of
the long toe-underrun heel conformation depends on the anatomical changes
that have occurred within the foot.

It is easy to see how the altered mechanics of the foot can lead to
lameness. The acute hoof angle, which occurs with a long toe-under run heel
increases the tension in the deep digital flexor tendon. Increased tension
in the deep digital flexor tendon increases the pressure on the navicular
bone and bursa. This is accentuated by the lack of support in the palmar
portion of the foot as a result of the heels moving forward. The compromised
heels lose both the ability to support weight and to transfer concussion to
the supporting structures above the heels, leading to bruising within the
heels and the adjacent soft tissue structures. Hoof wall separations, corns,
quarter and heel cracks may further compromise the damaged heels. The long
toe causes a delayed breakover, which causes further tension to develop in
the deep digital flexor tendon. The delayed breakover keeps the foot on the
ground longer, often leading to interference problems such as overreaching,
forging, or scalping. The long toe sets up a mechanical lever arm, which
exerts an abnormal bending force causing the hoof wall at the toe to deform
hence the appearance of a concavity or "dish". Internally, the lamina
stretches or tears allowing the sole to flatten. The sole now becomes more
susceptible to bruising, especially if heel pain is present as it promotes
landing on the toe. This toe landing often accounts for stumbling. Because
of the toe first landing, the sole wall junction (white line) becomes
widened, decreasing protection and allowing easier penetration, which may
lead to abscesses.

From the foregoing discussion, one can see the significance of maintaining
proper toe length, a normal hoof angle and a parallel hoof pastern axis in
order to prevent lameness associated with this type of foot. In order to
treat this problem, it is essential to understand the mechanism, which leads
to this abnormal hoof conformation.



-----Original Message-----
From: ridecamp-owner@xxxxxxxxxxxxxxxxx
[mailto:ridecamp-owner@xxxxxxxxxxxxxxxxx]On Behalf Of Marv Walker
Sent: Monday, February 20, 2006 9:23 PM
To: ridecamp@xxxxxxxxxxxxx
Subject: Re: [RC] Query #2: why are low heels bad?


At 07:15 PM 2/20/2006 -0800, Mary Krauss wrote:
Are some horses better off with low heels?  Why not?  Assuming the farrier
isn't doing something odd to the horse that could be changed, would you
avoid buying a young horse with low heels?

Low heels are bad because they cause the structures
at the back of the legs to be dragged down.

Tape a roll of pennies to the bottom of your shoes
just behind the toes and walk around like that for
awhile.  That'll show you how low heels work.

This not only affects the backs of the legs, it can
affect hindquarters and shoulders as well which in
turn affects the back and prevents optimal use of
the circle of muscles.

Marv "I love horses, let's exchange recipes!" Walker
Horse Info & Training Videos ~ http://MarvWalker.com


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Information, Policy, Disclaimer: http://www.endurance.net/Ridecamp
Subscribe/Unsubscribe http://www.endurance.net/ridecamp/logon.asp

Ride Long and Ride Safe!!

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Replies
Re: [RC] Query #2: why are low heels bad?, Marv Walker