Soapbox Post: Medic-lateral Hoof Balance
Other professionals may relate to this… sometimes in our lives the same issue keeps popping up over and over again in different horses.
It feels like we have common “themes” of diagnoses or lack-of-diagnoses at different times.
I’m not sure if it’s just because that’s what I’m paying most attention to, some kind of psychological bias, or if the universe is telling me it’s time to buckle down and figure this thing out.
Either way, gently over the last year and now heavily in 2024 the theme has been navicular-type horses, often with a set of radiographs being labeled “normal” that look something like what is going on below.
(They’re also pretty much always toe first landing - but that’s not what this post is about. If you want more on why toe first landings are no bueno, I have a YouTube video about hoof landing mechanics)
I hope it’s apparent both in the heel view and in the radiographs - once you take a moment to really look, how one heel is longer than the other and how much more apparent this is with the addition of the wedge shoe.
Left Front
Same feet from radiographs - shoes removed
Right Front
Same feet from radiographs, in what was sold as a therapeutic shoe package for Navicular disease
This imbalance creates an altered spacing in the joints, visible in the radiographs in our distal limb (see how on one side the spacing between the joints - the black space between bones in the radiograph - is narrower than on the other side?), but also present throughout the rest of the limb.
My friend Hannah has a great way of explaining this that really resonates with me and I hope it will help you all, because the millimeters matter in hoof balance.
She said think of it like shimming up a door
You prop up the bottom a quarter inch and the top corner has now shifted over 3inches.
Here’s another great visual from David Landreville showing how far out of square a penny pushes this level:
This is what’s happening with this seemingly slight heel imbalance and the rest of your horse’s leg (and sometimes the imbalances I see are not to slight…)
I think the image of before and after shoe removal really makes this clear. It’s a couple millimeters off, but you just add 1/2 inch of shoe and suddenly it’s very obvious.
Then you look at that dorsal radiograph view and see joint spacing and I think it should be smacking us right in the face.
Sometimes we will also see sidebone with horses like this - and one side of the coffin bone will have sidebone that is quite visibly taller than the other. This is another sign of imbalance, one side is taking on more concussive force than the other, creating more calcification.
Asymmetrical sidebone with mediolateral hoof imbalance
So all of it boils down to this:
A beautiful shoe job on an imbalanced trim is not helping your horses and that’s putting it just about as nicely as I can.
I really don’t want to throw all of the farriers or vets under the bus…
Sometimes it’s as simple as they’re right handed and end up swiping heavier on the left side and aren’t checking their work closely before moving on.
Sometimes I’m being told these rads are normal so it’s likely a lack of education surrounding this issue and a lack of understanding of the severity of this problem, especially up the limb.
Sometimes it’s because we needed the whole team in place so the body can be addressed alongside the hoof balance to fix the problem.
At the end of the day, as horse owners y’all are your horses’ best advocates. The best thing you can do is learn to recognize imbalances.
You don’t have to know how to fix it, but please do keep working to educate your eye so you can ask the right questions of your professional team and get the right help when an issue comes up!