Wedges

[NHFarrier]

Tuesday I am shoeing a QH mare with mild navicular changes. The horse was not used much in the past two years, so it passed the pre-purchase vet exam, though x-rays were not taken at that time. Now the horse has been ridden regularly for the past month and is lightly lame. The vet did x-rays and has prescribed a 2 or 3 degree wedge with a rocker/rolled toe using the shoe of my choice. We'll try different things until the horse finds something it likes. I am thinking an aluminum SC eventer, set back with the toe rolled with a 2 degree wedge, since lameness is light. The horse has really nice feet, very wide foot with good concavity, and nice wide strong heels, overall not a foot you'd expect to see navicular in. Would a bar wedge or a full wedge pad be better? I have not seen the horse yet to know if there is sensitivity with pressure on the frog.

Amy

[calshoer]

I always address trimming the foot ,especially paying attention to the heels and bars before even thinking about what to put on the foot.
Only after subtle heel distortion and bar curvature or jamming is addressed do you have the proper non distorted base to work with. In many cases, just doing that aand then settign the brewkover in the right place actually corrects the lameness.
After they are trimmed, and before the shoeing I walk them. If they land flat, with no sign of a toe first landing, I can usually forego the wedge because once the breakover point is set to the proper place relative to the cofin bine via the shoe, they usually land slightly heel first.
If after the trim they are toe landing , I will then decide on what kind of wedge.
And I hooftest them over the frog to decode if a frog support can be used, and if so how much support and exactly where on the frog it will be tolerated.
PS the vet may prescribe a certain amount of wedge but he is likely prescribing it to a foot that was XRayed with feet not yet trimmed. Trimming the foot will change everything.
Often just loading the back of the frog a little ,along with properly trimming the heels of the foot back far enough will align the coffin joint better than before the heels were trimmed shorter.
Patty

[Donald Ruff]

Amy,
What was the outcome of this horse?

Don

[tbloomer]

I would like to add to what Patty said . . . but I can't :)

[Donald Ruff]

Thats why i asked what the outcome was :D

Don

[the_unicorn]

What was the outcome, as I was just browsing for navicular stories.

I would have to agree with Patty as I just took a horse with a 2 year history of navicular pain. Trimmed out the bars and removed half an inch of dead sole from the fulcrum back to the heels and all the pain went away.

Wedging won't gain you anything especially if it puts more pressure on the junk on the back of the foot. It will also directly load the navicular bone as the heels rise upward you promote a toe first landing which tightens the DDFT against the navicular bone.


The owners are amazed as they bought the horse on a farriers recommendation he did not really pass his vet check. Just the comment he is sore but if you are only going to ride a little he will be OK. 2 years of trying to figure out what to do. In 2 weeks he is out being ridden on any terrain with out shoes.

[Tom Stovall, CJF]

the_unicorn in gray

I would have to agree with Patty as I just took a horse with a 2 year history of navicular pain.

Two year history? Diagnosed by whom and by what means?

Trimmed out the bars and removed half an inch of dead sole from the fulcrum back to the heels and all the pain went away.

Where exactly is the "fulcrum"? Is it the most distal portion of the phalangeal lever? Or, somewhere else?

Wedging won't gain you anything especially if it puts more pressure on the junk on the back of the foot.

IME, the answer to the advisabiliy of wedging is usually, "It depends."

It will also directly load the navicular bone as the heels rise upward you promote a toe first landing which tightens the DDFT against the navicular bone.

How exactly do wedges promote toe-down-first landing? Please explain why you believe toe-down-first landing tightens the DDFT against the distal sesamoid?

The owners are amazed as they bought the horse on a farriers recommendation he did not really pass his vet check.

IME, prepurchase exams are always, "Sound/unsound for purpose at time of examination."

Just the comment he is sore but if you are only going to ride a little he will be OK. 2 years of trying to figure out what to do. In 2 weeks he is out being ridden on any terrain with out shoes.

Good for you.:)

[tbloomer]

Where exactly is the "fulcrum"? Is it the most distal portion of the phalangeal lever? Or, somewhere else?Um, I think it is below the "knuckles". . . you know the knuckles they talk about on that "hoof rule" thingy they sell on eBay? Yea, it's somewhere below the knuckles. :)

[Ronald Aalders]

Where exactly is the "fulcrum"? Is it the most distal portion of the phalangeal lever? Or, somewhere else?


Unless I've stayed misinformed for over a decade, a fulcrum is a pivot. Related to the horse's foot you'd be looking at the navicular bone.

In general guys, there is no way to pinpoint palmar hoofpain to the navicular site. So let's all never ever use navicular pain again and stick to palmar/plantar hoofpain.


Ronald Aalders

[calshoer]

In general guys, there is no way to pinpoint palmar hoofpain to the navicular site. So let's all never ever use navicular pain again and stick to palmar/plantar hoofpain.Well gosh....be picky....I usually say Navicular AREA pain....based on hooftest reaction over the center of the frog (impar ligament ddft intersection) or into the sides of the frog commisures. Otherwise it is generalized caudal hoof pain .

[Tom Stovall, CJF]

Ronald Aalders in gray

Unless I've stayed misinformed for over a decade, a fulcrum is a pivot. Related to the horse's foot you'd be looking at the navicular bone.

A fulcrum is the point at which a lever pivots. As I see it, the proximal and distal sesamoids redirect work (force) from the flexor muscles, but they do not form an actual fulcrum (pivot point) for the phalangeal lever, the pivot point for the lever is the ground.

In general guys, there is no way to pinpoint palmar hoofpain to the navicular site. So let's all never ever use navicular pain again and stick to palmar/plantar hoofpain.

CRAFT has got me, but didn't somebody figure out how long it takes for anesthetic injected into the distal interphalangeal joint to diffuse across the navicular bursa? If so, that would suggest the possibility of pinpointing heel lameness to a particular site. I kinda like "heel lameness" as a descriptive term: Clients can readily understand it, it doesn't sound like farrierspeak, it's ambiguous enough to cover the necessary territory and specific enough not to be confused with the toe. :)

[Ronald Aalders]

Well gosh....be picky....I usually say Navicular AREA pain....based on hooftest reaction over the center of the frog (impar ligament ddft intersection) or into the sides of the frog commisures. Otherwise it is generalized caudal hoof pain .


In Holland we have this condition called PIP, translated it would be PIF.

Pain In Foot....... :D



Ronald Aalders

[Andalucian]

I just took a horse with a 2 year history of navicular pain. Trimmed out the bars and removed half an inch of dead sole from the fulcrum back to the heels and all the pain went away.
Would that be why the foot in your avatar looks red and sore? :mad:

[tbloomer]

Unless I've stayed misinformed for over a decade, a fulcrum is a pivot. Related to the horse's foot you'd be looking at the navicular bone.What structure(s) pivot over the fulcrum of the navicular bone?

I thought that the navicular bone and the coffin bone combined to form the distal articular surface of the coffin joint. AND those bones pivot (articulate) around the distal end of P2 during various phases of the stride with the exception being the breakover phase.

At the breakover phase of the stride, the entire distal limb pivots as a unit against the fulcrum of the pivot point (breakover) established at the toe at heel lift-off.

So which phase of the stride are we talking about when we say pivot point? Also, which joint are we talking about during a given phase of the stride? Regardless of any of this, a pivot point is generally considered the center of articulation between two objects. I'm having a hard time envisioning the navicular bone at the center of articulation of any combination of anatomical structures.

[jvzieger]

Would that be why the foot in your avatar looks red and sore? :mad:


Ouch, it does doesn't it??? Not the greatest picture perhaps for the "dare to go bare"

[Ronald Aalders]

What structure(s) pivot over the fulcrum of the navicular bone?



Well maybe this is a matter of definition rather than anything else Tom. However I always considered the navicular bone's tendon surface as a true fulcrum. In it that the navicular bone redirects the forces the DDFT is applying on the coffin bone.


Ronald Aalders

[tbloomer]

Well maybe this is a matter of definition rather than anything else Tom. However I always considered the navicular bone's tendon surface as a true fulcrum. In it that the navicular bone redirects the forces the DDFT is applying on the coffin bone.

Ronald AaldersMaintains the angle of insertion of the DFT on the palmer process. So I guess we could call it a gliding fulcrum, yea? Seems that toe angle, base length (location of heel butress), and breakover position at the toe have an affect on the forces which are experienced by this navicular interface. So I must agree that it is definately the bearing surface upon which we focus much attention about LEVERAGE.

However, is this the fulcrum of which the OP speaks? And what about those knuckles? Do they play a role in our discussion of geometry? :)

[the_unicorn]

That is a lot of responses but not many of much use or providing a conclusion to the case I asked about, I suppose the list has been to quiet for too long.

Well gosh....be picky....I usually say Navicular AREA pain....based on hooftest reaction over the center of the frog (impar ligament ddft intersection) or into the sides of the frog commisures. Otherwise it is generalized caudal hoof pain .

Once again patty you rise above the average. Navicular disease is nearly impossible to prove pre mortem, Navicular syndrome ie: navicular disease like pain can come from anywhere in the back of the hoof. Hence the resounding success that the barehoof brigade have when dealing with shod horses with navicular like pain. Once you get the shoes off, clean up the back of the hoof and get the heels to function properly, you suddenly have a happy healthy horse. Given the time to move with no shoes on, the back of the hoof will develop the correct tissue to support the horse properly.

To solve the confusion created earlier a fulcrum is the line made by a pointy triangle that sits under a plank of wood to create a seesaw. ie: the point where it takes little energy to tip the balance one way or the other. A simple analogy but useful in figuring out how distorted a hoof has become.

To make it less confusing for you guys & gals I probably should have refered to duckets dot as the reference point as this point is visually close enough to show the point where they old style farriers had not realised the reason the horse had to be drugged the night before and the morning of the shoeing.

To answer Toms questions I can first refer to the AAEP studies about 6 years ago, on corrective shoeing and their effects. The study notes that as the horse feels pain in the back of the hoof it pre tensions the DDFT to reduce to transfer of energy to the back of the hoof. This means as the hoof touches down the force on the distal sesamoid is increased as the horse is trying to walk with all the energy at the toe similar to the point of break over.

Also beyond that if the toe lands first it creates a moment that pulls the tip of the DDFT forward thereby tightening it against the distal sesamoid. You can see that at home when studying cadaver legs.

As for why wedges would increase heel pain you only have to look at the width of the shoe and compare that to the total area of the back of the foot. It is probably about a 1:10 ratio this means that 10 times the normal force is put onto one 10th the area that should bear weight at the back of the foot.

[BS-Horseshoeing]

Darren, what does MHG stand for and where do you get your info on farriery? When and where did you get the idea farriers had to drug horses the night before and the morning of shoeing? Must be some dang nasty horses or some pi*s*s poor horseshoers. Never seen that done in the almost 39 years I have been around horses (that constitutes my whole life). This is a very broad and demeaning statement and unless you have proof of this being done by all or a majority of farriers nation wide, I feel you need to retract that statement. And what does Duckett's dot have to do with drugging horses for shoeing. An explanation of that would be nice. And why would a wedge put that much strain on a hoof, the amount of hoof touching the wedge is no more than the amount touching the ground. Explain the difference you see and how that much pressure is applied when the same surface area is being used for support and the other area of the wedge is used to disperse more pressure to other parts of the foot to take pressure off the wall. So how can this put more pressure on the one area of the heels. Please explain your views and quit acting so condecending and trying to act as if you must **** things for us to understand. I look forward to your reply so I may learn something new.

[Tom Stovall, CJF]

the_unicorn in gray, deletia

Once again patty you rise above the average. Navicular disease is nearly impossible to prove pre mortem, Navicular syndrome ie: navicular disease like pain can come from anywhere in the back of the hoof. Hence the resounding success that the barehoof brigade have when dealing with shod horses with navicular like pain.

LMAO! Whatever gave you the silly idea that the BUA has had any notable successes in the palliation/treatment of heel lameness? In my end of the sandpile, "success" is defined as "the return to service at or near former levels" and the efforts of the BUA have been notable only for their singular lack of success. Pulling shoes after taking a horse out of service and crowing about the "success" of the protocol is beyond silly. That said, if you really think you, or any other member of the barefoot brigade, can pull the shoes off a sound horse I think needs them to maintain soundness, I've got a little proposition that will determine the efficacy of any barefoot protocol. I've offered to bet the farm on the outcome, but for some reason, the barefoot folks invariably start making excuses when they find out it's in real time.

Once you get the shoes off, clean up the back of the hoof and get the heels to function properly, you suddenly have a happy healthy horse. Given the time to move with no shoes on, the back of the hoof will develop the correct tissue to support the horse properly.

I fear you've overdosed on the silliness of the BUA.

To solve the confusion created earlier a fulcrum is the line made by a pointy triangle that sits under a plank of wood to create a seesaw. ie: the point where it takes little energy to tip the balance one way or the other. A simple analogy but useful in figuring out how distorted a hoof has become.

No confusion here: A fulcrum is the point at which a lever pivots. For conformation, see any high school physics book.

To make it less confusing for you guys & gals I probably should have refered to duckets dot as the reference point as this point is visually close enough to show the point where they old style farriers had not realised the reason the horse had to be drugged the night before and the morning of the shoeing.

Drugs? How did drugs enter the fray?

To answer Toms questions I can first refer to the AAEP studies about 6 years ago, on corrective shoeing and their effects. The study notes that as the horse feels pain in the back of the hoof it pre tensions the DDFT to reduce to transfer of energy to the back of the hoof. This means as the hoof touches down the force on the distal sesamoid is increased as the horse is trying to walk with all the energy at the toe similar to the point of break over.

As I see it, farriery is chock full of junkscience, so I'm afraid I'm not much on "studies" until I've read the cited material. Until I read the hypothesis, determine if the study's testing methodology conforms to the scientific method and whether or not the empirical evidence confirms the stated hypothesis, I tend to be a bit skeptical of their validity. Most of what folks call "studies" are actually observations that may or may not conform to the scientific method. That said, I was taught that the distal sesamoid is placed in compression by the flexor muscles, not by impact, so I'm understandably skeptical of your interpretation of the missing study.

Also beyond that if the toe lands first it creates a moment that pulls the tip of the DDFT forward thereby tightening it against the distal sesamoid. You can see that at home when studying cadaver legs.

I fear your reliance on cadaver legs unattached to muscle has led you astray. In reality, compression of the distal sesamoid by the DDFT is effected by the flexion of the flexor muscles, not by the distal phalanx "pulling the tip forward" at impact.

As for why wedges would increase heel pain you only have to look at the width of the shoe and compare that to the total area of the back of the foot. It is probably about a 1:10 ratio this means that 10 times the normal force is put onto one 10th the area that should bear weight at the back of the foot.

"Should?" According to whom? Are you aware that there are many different types of wedges offering varying degrees of increased angulation, with and without frog support? Do you understand that any wedge pad increases phalangeal angulation, thereby decreasing compression of the navicular bone by the DDFT? If so, please be kind enough to explain the exact means by which you believe wedging somehow increases compression of the navicular bone at any phase of movement at any gait.

[Donnie Walker]

[QUOTE=the_unicorn in gray] ( Hence the resounding success that the barehoof brigade have when dealing with shod horses with navicular like pain. Once you get the shoes off, clean up the back of the hoof and get the heels to function properly, you suddenly have a happy healthy horse.)

Would this occur in "all" cases?


(To make it less confusing for you guys & gals I probably should have refered to duckets dot as the reference point as this point is visually close enough to show the point where they old style farriers had not realised the reason the horse had to be drugged the night before and the morning of the shoeing.)

Where would the "old style farriers" have been located?



(As for why wedges would increase heel pain you only have to look at the width of the shoe and compare that to the total area of the back of the foot. It is probably about a 1:10 ratio this means that 10 times the normal force is put onto one 10th the area that should bear weight at the back of the foot)

Would these be findings of fact and where might they be found?

[NHFarrier]

Sorry! You're right, I never posted follow up, although I did take pictures. The horse was shod with a 2 degree wedge, some basic aluminum shoes, brought the toe back a bit and rolled the shoe. She is doing very well and has not showed any soreness since (it's been 3 resets!). So far so good. Here are a few pics:

http://www.geocities.com/amy4_tinny/IM000729.jpg

http://www.geocities.com/amy4_tinny/IM000728.jpg

http://www.geocities.com/amy4_tinny/IM000731.jpg

Since the photos, I have got much better heel with lots more support. She had the classic long toe, low heel foot. I think that was causing most of the soreness. Thanks for reminding me to post pictures!

Amy

[SlowShoe]

Nice job Amy. Man those are some upright pasterns eh?

[Bill Adams]

Amy, nice work.
The proof is in the pudding, the horse is sound and corected and protected. This is the way I go about with my footware and clothing, quite unnatrual, but utilitatarian.
Bill

[the_unicorn]

Sorry! You're right, I never posted follow up, although I did take pictures. The horse was shod with a 2 degree wedge, some basic aluminum shoes, brought the toe back a bit and rolled the shoe. She is doing very well and has not showed any soreness since (it's been 3 resets!). So far so good. Here are a few pics:

Since the photos, I have got much better heel with lots more support. She had the classic long toe, low heel foot. I think that was causing most of the soreness. Thanks for reminding me to post pictures!

Amy

Many thanks Amy.

It is rare to get some real pics of work done and where the horse is headed.

The pics show me a few of the things I expected to see though the rise in the coronet at the quarters is less than I expected.

I am worried about the contraction in the heels, though the NF does not seem as contracted as the OF.

The upright pasterns that a few noticed would be an interesting guide to check for muscle soreness high up in the body.

Thanks again for a look, it helps bring things into perspective.

[the_unicorn]

To answer the gaggle of questions.

The drugs entered into it, because that is the way the horse had been shod for a number of shoeings. I left that fact out of the original message as it would be inflammatory if taken to heart or considered an attack, the drugs were just an example of the damage. My personal opinion would be that if that is the only way the horse could be shod, then why continue trying. The owners were encouraged to drug the horse because he was so sore that the act of nailing on the shoe was more pain than that horse could handle. He is not a nasty animal as I can trim him easy as pie. To my mind if the shoe was causing the damage why keep trying. It is not a quality of farrier issue though some may be able to get the shoe on with less pain. P... Poor farriery may have occurred once but most horse owners I know would immediately move onto a better farrier so I don't expect that to be the horses bane.

The horse was de-shod by the owners at the suggestion of a friend. The pain in the horse foot was worse without the shoes due to the constricting nature of horse shoes. This pain was in addition to the original problem and is most likely to be the hoof returning to a more natural shape without the forces the shoe applied.

3 Weeks later the extra pain went away and the horse was moving in the same motion that he had displayed over the owners 2 years. I first saw the horse about 8 weeks after the shoes came off.

The horse was better in sand than anywhere else, this gave me the first clue as where the pain was in the foot. With or without shoes on a hard or grass surface the horse could not bear the weight of a rider while standing still. The horse could not move down slope as the heel became the point of impact, the second clue as to what was wrong with the horse. This level of trauma is why the horse shoers had a big issue getting the shoes on.

The issue was a lack of trimming of dead tissue in the back of the hoof a very common problem that leads to "NS - heel pain". I see it a lot and the removal of such material is a simple process and can be done by anyone with an eye and a quick lesson, just to make the horse happy.

I could get on a high horse and blame everyone who does not understand the importance of cleaning the bottom of the hoof for all the worlds ills. I just hope that by letting people know that some of those niggling problems are not about tighter shoes or higher wedges, but more about using new info to find a new long term solution.

I don't mean that to be a condescending remark especially since I have already been pinged as looking down on all farriers world wide. I know a number of farriers that are happy to look at alternatives, even one of whom is a teacher at the college who as a farrier did the BF thing 15 years ago when all else failed. He said he had to hide the horse for fear of ridicule from his peers, 15 years has seen some acceptance of barefooting.

I have a number of horses here for rehab, purely because the little problems grew into big problems.

IMHO the ignoring of scientific studies is not a good way to learn more. The AAEP study and others I read was done on many many horses lame or sound. The aim was to provide info on how and why corrective shoeing is supposed to work. Taking a sound horse and adding wedges or trailers to see what effect they have irrespective of what problem the horse has. The negative impacts of each are noted for what problems may occur long term. The studies also used force plate loadings to detect how the foot impacted the ground when wedged and normal. This loading was also tested on how the foot responded to these changes.

Sure some studies are junk, if you know how the study was done and there are others that show similar results then just maybe there is something to learn.


As to wedges I have never seen a steel full width wedge so the weight bearing of the hoof cannot be said to be supported all the way across rather than at the shoes rim. I have seen various modified shoes with raised heels to wedge up the heel, or built in thicker heels, or even aluminium egg bars with massive wedging. Though after reading about 12 degree wedges by stacking them I grant you that you will get no flex in the wedge so yes the load will be spread across half the back of the foot. At 12 degrees it won't be much of the horses weight though as the toe will be doing all the work.

In answer to the comment will it make all horse's perfectly sound. No, I have one clients horse that due to badly contracted heels for a long time has not made the perfect recovery. There is something in those feet that is not following the normal routine, without X-rays I don't have an answer for that one. I just recently found a very weird cause to a problem with one of my own horses that was showing up as crumbly feet and toe cracks, so the learning curve is still going. So my own problem horse is now on the cured list and not the one I tell clients about when asked if barefoot is perfect.

So yes the Barefoot Uber Alles or Orthopedic Professionals can fail (yes Phil we are human), I don't mind admitting it as one day someone may come along and tell me what I missed, if indeed it is fixable. I know shoes will make the horse appear sound. I hope in the future there won't be feet that badly changed from their true form. Given oodles of money and time, I should be able to do better for that horse but in the real world you can't win every battle. The horse is happy and sound but not capable of crunching rocks or roads like the others.

I was wondering if the poster that commented he wore boots wore them 24 hours a day, while sleeping etc. It was rather an amusing comment, though that is another solution for horses to have boots on only when needed and off for the rest of their normal life.

I don't know wether to be upset or not that the local farrier supply guy refers to me as the barefoot shoer. It is a common name I get, even though I don't nail on shoes. When I learn more about clip on boots I can maybe change him over to barefoot booter.

There is a science and an art to using horse boots that I have yet to learn fully. The ability to have removable shoes for horses will be a step forward from the nail on version. Just learning which shoe for what event will be another learning curve.

For Polo it would be tricky to pick a boot, I know polo can be played barefoot or shod with certain rules on nail types and placings as well as studs. There are new boots with lots of traction but is too much traction a bad thing for such a sport.

In a weeks time I will be trimming the horse again, so any people wanting pics let me know and I will post them for review :-).