Negative P3 Palmer angle in hind feet

[Dianne Lemmon]

One of the things that intriqued me the most in Cincinnati was the discussion of Negative P3 palmer angles in hind feet.

Discussed was recognizing this horse; Low heels, bull nose toes, very sore back (which is difficult to remedy), and difficult to shoe behind (especially nailing). This definately describes several horses in my practice.

There were several shoeing techniques talked about, but I was unable to formulate a technique in my mind I felt comfortable applying. Discussed were the application of wedges and frog support. The question I still have is, that while most of these horses seem to lack Digital cushion density, they have an over developed frog. What would be the best way to apply frog support without over loading the frog? Is this a time thing, ie; Frog pads should only be left on for a short time, or can this just be put on and left to resolve itself. It was mentioned that the foot should not be wedged without frog support as there is not enough digital cushion to keep the coffin joint supported and without appropriate frog support it would cause further backwards collapse of the coffin joint.

Anyone have experience using this technique?

Dianne

[Jason Maki]

Look at the "why is this foot so bad" thread. this is a textbook case...that could not be wedged...
Jason

[Jaye Perry]

One of the things that intriqued me the most in Cincinnati was the discussion of Negative P3 palmer angles in hind feet........
........ Discussed were the application of wedges and frog support. The question I still have is, that while most of these horses seem to lack Digital cushion density, they have an over developed frog.

It's the horse's body response to "malfunction". Whether it is a bulbous frog, over-grown bars; a rebuilding / remolding of the foot to adjust to abnormalities and abnormal pressures onto the foot.



What would be the best way to apply frog support without over loading the frog?
Dynamic frog pressure is best IMO.

Is this a time thing, ie; Frog pads should only be left on for a short time, or can this just be put on and left to resolve itself.
Left to resolve? What has to happen first is a definite diagnosis of the problem. When the problem has a definite diagnosis, a plan of treatment and shoeing protocols can be made.
In the previous thread, the remolded sesamoids were inhibiting the full range of motion to the distal phalanges. The storage of energy and it's release are inhibited during movement. With this inhibited of range of motion the foot / foundation, has to remodel itself to accommodate this malfunction(s).
IMO when a horse has a bony or soft tissue lesions the feet will show the effects post onset of the lesion.



It was mentioned that the foot should not be wedged without frog support as there is not enough digital cushion to keep the coffin joint supported and without appropriate frog support it would cause further backwards collapse of the coffin joint.
Again the problem or possible lesion has to be diagnosed, then a plan with or with out wedges should be looked at. Frog support is a must, in a dynamic fashion.


Anyone have experience using this technique?
To much.:(

[calshoer]

I use one of several techniques to deal with these. (and I see a lot of them) It depends on the horse, the amount of sensitivity in the frog, and the available environment.

I hoof test them over the center if the frog to see how much sensitivity there is ,around the area of the impar ligament.
If they are extremely sore, there are a couple options.

One is:
If the horse has been in shoes and the frog is prolapsed, if there is an available environment suitable to barefoot for a week or so I pull the shoes, and place the horse on hard pack sandy loam, or (not as desireable) rubber mats with very little bedding, or a similar firm smooth surface. The surface must be firm, (not rock hard) and free of rocks or other potentially traumtizing material. The frog will mash back up in the foot on it's own in a few days and then you can shoe with a full ,firm, plain wedge pad to hold it in there.

Second treatment possibility:
If there is not a suitable surface available, or the horse is aleady barefoot and the frog already smashed level with the trimmed heels, I just go ahead and use the full wedge pad without the barefoot wait.
If the frog is extending past the heels I still don't worry about it.
I use a softer wedge material or a bar wedge. I let the pad bow out around the frog as I nail it on. It creates a supportive "sling" for the frog. Do NOT use support material (equipack or impresion material) around the frog under the pad because the frog needs room to move for awhile. Use soft packing like "sole pack" ,Magic cushion, or Forshners. The pad will "sling" the frog up, and in a day or two the frog will realign itself up in the foot, and realign the coffin joint.

Next possibility:
Use a front shoe on a hind foot to move the breakover point WAY back under the foot . That allows the toe of the hind foot to tip down into the ground easier thus aligning the coffin joint for more efficient push off.
I have also had at least one negative plane horse in my practice that had been barefoot with short feet for years, who corrected the negative plane (and the back pain) just by moving the BO point further back with shoes than he could have it barefoot. No pads or anything. Just a front eventer on the hind feet ,set back a little. Nothing drastic but that half inch more B.O. point worked like a charm.

A Redden Banana shoe would be something to consider too. I dont know how well they would work on hind feet. Ronald could answer that better.he does a lot of them.

I find that after the initial correction with something very passive like a pad to sling the frog up, then later I can go to a frog support wedge pad with no problems.
The pain in the middle of the foot normally settles down by the second shoeing and the frog will take more support.
Patty

[Ronald Aalders]

Hi Dianne,

I like a banana on hinds with a negative PA. I've had great success using that protocol.

However there are a few things to consider. What is the horse supposed to do? You don't want to shoe a reiner with a banana sliding plate :p But also I doubt a banana will offer the same amount of traction as regular shoe does.

Further in my version of the banana the wedge is related to the amount of roll. I have shod horses with a banana without any wedge, but that would be horses with decent feet that just need to get rid of knee action. Such horses have banana shoes with a very limited roll. On all other horses I use wedges when the banana really gets to be a banana with a distinct roll IMO you need wedges to fill up the negative space caudal of the roll. If the banana is very agressive, I may well end up with 6, 7 degree of pads. I'm not sure if Dr. Redden would readily agree with me here though, but thats the way the banana worked for me more than once :cool:

This amount of wedging can not be used on every horse. The thread Jason referred to is about a horse with a negative PA and proximal sesmodian trouble. I don't think a horse like that could handle the lift.

If you feel like using a banana shoe to bring back breakover, you should realize that the place of the roll should be at the centre of articulation. Not in front of that spot, not on a negative PA that is. Note that that spot is way, way, way back on the foot. Much further back than you may realize. Also you'll need an pretty agressive roll and you'll need a stack of wedges too.

My first try would be a wedged aluminum bar shoe, with a 3 degree pad. Draw quarterclips to keep it on. I don't know about the hoofpack, I'd give it a try without, provided the frog rests nicely on the pad.


Ronald Aalders

[Dianne Lemmon]

Patty,

Thanks for the concise answer to my question. (Defense shields now lowered).

Ron,

I think banana shoes have their place, but not on the hind ends of actively competing 3 day event horses.

Jason,

Are you going to the AFA convention in Omaha? A little bird told me the Bob Pethick is doing a heck of a presentation to dispell the "myth" of over flexion of the fetlock when raising heel angle.

Jaye,

Sorry that you have so much experieince with this condition.


Thanks again all who answered,

Dianne

[Jason Maki]

Dianne,
Sadly, I am not going to Omaha. Do you have any insight into how a broken forward HPA does not load the suspensory ligament?
That would be interesting...
Jason

[Dianne Lemmon]

Dianne,
Sadly, I am not going to Omaha. Do you have any insight into how a broken forward HPA does not load the suspensory ligament?
That would be interesting...
Jason


Perhaps it was my misinterpretation of your answer (to see the thread "why is this foot so bad")...

Bob is going to dispell the myth that raising the heels causes excessive dorsi-flexion (hope I got my terminology right, or I am going to pay for it) of the fetlock. Ie; raise the heels the fetlock drops, lower the heels the fetlock raises.

I only overheard this in conversation, never got to see the footage or lecture.

Dianne

[Jason Maki]

Maybe because the "heels" have little to do with the HPA. The hpa is create dby overall hoof balance and health. However, a PIII angle that is to low(obtuse) will cause PIII to rollforward (subluxate?) within the coffin joint. An acute PIII angulationwill cause PII to roll rearward within the dipj and drop the fetlock to a degree. This however will be limited unless "Yoder heel stacks" are present. The fetlock (MPJ) is stiff due to colatteral ligaments, the attachments of the sesamoids, and the dorsal branches of the suspensory ligament coupled with their proximal attachments to the sesamoids creating a sling(perhaps vice) around the MPJ.
In the case of Jayes foot(or atleast Barkins foot that he posted) it was the hypothesis of Jaye, and the vet that the near detachment of the lateral proximal sesmodian attachmentreduced the spring and absorption capabilites of the limb. The pounding of her job literaly mashed PIII flat because almost all of the impact was absorbed by the foot, not the apparuatus of the limb. Pushing the internal structures gently up would help, but reloading the damaged suspensory attachemtn would aggravate the cause...
Jason