Hoofcare for the New Millennium:
On May 4th and 5th, 2002, history was made, for the horse. Tufts University, in Grafton, Massachusetts, USA, sponsored a landmark conference by inviting veterinarian Hiltrud Strasser of Germany to present her hoofcare ideas at their School of Veterinary Medicine. This event materialized thanks to Fran Jurga of "Hoofcare and Lameness" journal and Dr. Robert Cook of Tufts University, and was sponsored by Tufts' Hospital for Large Animals and Tufts' Center for Animals and Public Policy.
According to the Tufts brochure, this was the goal of the conference:
"To enhance our understanding of the controversial bare foot hoofcare methods proposed by the German veterinarian Dr. Hiltrud Strasser and to provide a public forum for their fair but vigorous review by a panel of expert veterinarians and farriers."
'Controversial' ? That was a very kind word. More precisely, Dr. Strasser and her methods have been 'persecuted'. When hearing of this conference I admit I had visions of medieval times and their 'trials', stoning, tomato-throwing, and honky-tonk beer joints like in "The Blues Brothers" with chicken wire to protect the stage from hurled beer bottles. But I also knew that Dr. Strasser and her methods have been embraced and revered as well, by many horse lovers, and mostly by those of us who own or have experienced a chronically lame horse with a poor prognosis and witnessed miraculous recovery. Many of our horses' feet had been shod for years, then 'correctively' shod, and still were worsening, with no hope for recovery, according to conventional/ traditional standards. Dr. Strasser's barefoot trim methods, however 'controversial', provided an alternative and offered hope, as long as the natural living conditions were met and a physiologically correct trim was frequently applied. Whether these owner- and clinician-applied trims were exactly to Strasser's specifications or physiologically correct, we may never know, because for many, the job of trimming became the owner's or caretaker's job, or obliging farriers who gave in to our pleading (all the while grumbling about fearing the loss of their 'license' for attempting this).
There was no 'scientific' proof of how these success story trims were applied or whether the natural methods were carried out. All we know is that there were many positive results, for once, and hope for recovery. Who wouldn't be interested in trying this? Who wouldn't be excited? Here's who: For one, scrutinizing scientific types, those who want to see precise, accurate, consistent PROOF. For another, those who have an investment in another way of doing things. Another, those who do not want to stop using the horse, even if his use is limited or he may be hurting, because that is preferable to laying him up for any length of time. And, logically, those who have heard of bad experiences resulting from 'the Strasser trim'.
But for those interested, Dr. Strasser was a Godsend. Hope at last. Many learned how to use knife and rasp who had never dreamed of using them before. With determination to help their horses, and with nowhere to turn for help, many took on the role of hoofcare provider for their horses. And guess what – hopeless founder and navicular cases were beginning to recover. Shod horses were converted to barefoot and still went sound, or went sound where they hadn't before. Information spread over the internet like wildfire, and more and more people adopted Dr. Strasser's ideas, who she clarifies are not all her ideas but those of others in the past, and that her methods are based on these and her own findings.
The rewards of the Strasser trim and lifestyle methods come only after a list of tough commitments have been met, many a total upheaval or impossibility for the 'stable boarded' horse – 24-hour turnout, with other horses, daily hoof soaks, lots of exercise and movement even for the horse in pain, regular trimming, and more. That is tough enough, not to mention the peer pressure of other boarders, and taking a 'loss' in riding/ using time while the peers clip-clop off muttering about cruelty under their breath. Emil Carre of the AFA journal wrote columns angrily criticizing Dr. Strasser and her ways, and seemed to be attempting to rally members against her. But the results spoke for themselves and were very rewarding for many of those who fulfilled their commitments, and even though they may have been only close to what the 'Strasser specifications' are, they were in a better direction and there were reportedly many happy rehabs, and many happy new barefooters, with more on the way. Others fell by the wayside and went back to shoes or adopted other styles of barefoot trimming, but much was improved for the lifestyles of many horses. For that we can be eternally grateful to Dr. Strasser's teachings, which stress the importance of natural living for the horse.
Soon after the graduation of the United States' first Certified Strasser Hoofcare Specialists (CSHS), which was awaited with much eager anticipation, all were welcomed back to the US by many horse owners anxious to employ them. Upon their return, after discreetly sharing stories of what went on in Germany, after applying what was taught in the field, and after several (apparently sound) horses suffering from total hoof breakdown or severe lameness as a result of CSHSs trimming them 'precisely as they had been taught', three of the US CSHSs returned their certificates. Yet the spark of interest in this alternative burned brighter, and clinics continued. More horse caretakers began adopting the methods of Dr. Strasser and implementing her teachings, however questionable, into their trims with varied success. Dr. Strasser's reputation ranged from one end of the spectrum to the other.
It became clear that conventional hoofcare, with its poor prognoses and limited options for the 'incurable', was no longer satisfactory to the horse caretakers who sought ways to help their horses recover rather than just maintain. Although the lay-people caretakers were in much greater number, several farriers and veterinarians, clued in by their clients, attended Dr. Strasser's clinics. These critical eyes questioned what they saw that differed from previous education. Some tried it, some refused to try it. Either way, it exemplified the crucial need for cooperative communication among the hoof-knowledgeable.
Somehow the 'opposing sides' needed to be brought face to face, putting hearsay and prejudices aside. Fran Jurga and Dr. Cook took on this delicate task of enormous proportions and somehow, with Tufts accommodating, managed to pull off the conference of the century. This hard-working group brought together owners, farriers, barefoot practitioners, and veterinarians, all in one room. In spite of the expected energized atmosphere, the professional in everybody was apparent. Since the conference, commentary over the Internet has been non-stop.
"…to provide a public forum for their fair but vigorous review by a panel of expert veterinarians and farriers."
Panel members were Judith Shoemaker, DVM; Tia Nelson, DVM; Mike Wildenstein, AWCF, CJF; Henry Heymering, CJF, RMF and President of the Guild of Professional Farriers; Craig Trnka, President of AFA; and Pete Ramey, barefoot hoofcare specialist who operates a ranch with a busy barefoot trail string. There couldn't have been a better moderator - Dr. Carl Kirker-Head, with ground rules and light humor, kept things going in the right direction while holding responders to the questions asked. If a question wasn't sufficiently answered, the question was repeated.
Over the two days, Dr. Strasser presented her methods and the reasoning behind them. There was ample opportunity for the panel to comment and question, but for lack of time, not all panel members could voice all their comments, and not all topics (of course) were covered. Although there were some impolite and unfair (in my opinion) comments or gestures by one or another panel member at times, and questions posed on hearsay and not what was presented by Dr. Strasser, her methods were fairly and vigorously reviewed. So the Tufts Conference goal was indeed met.
"Through a process of presentation and open discussion, Dr. Strasser, our panelists, and contributing members of the audience will strive to debunk the myths of traditional and alternative hoofcare, and present practical and scientifically based methods for managing horses' hooves in both health and disease. Medical ethical, practical, and philosophical aspects of hoofcare strategies will be examined. Special emphasis will be given to the management of high performance horses' hooves and those afflicted with laminitis or navicular disease. The practical application of the Strasser method will also be demonstrated."
Coming to agreement on a working plan for hoof trimming and care would have been a lofty expectation, yet I had hoped some effort would be made in this direction, and I think it was. There were no '…practical and scientifically based methods for managing horses' hooves in both health and disease' presented, other than by Dr. Strasser. Other hoofcare 'strategies' were presented in the form of preserved, bisected and hinged hoof specimens on a display table both days. These hooves, belonging to Allie Hayes, previously on display at other events, had been trimmed (on only one half for comparison to 'before' trimming) by several well-known farriers and barefoot experts – Dr. Strasser, Gene Ovnicek, KC La Pierre, Jaime Jackson, and Lyle 'Bergy' Bergeleen, to name a few.
There was little emphasis on 'high performance horses' hooves' in comparison to 'laminitis and navicular disease'. The 'practical application of the Strasser method' was indeed performed, a trim on a live horse, but on only one front hoof.
WHAT WAS DISCUSSED
Differing opinions on particulars were aired with little headlocking, but there were obvious disagreements on a number of Dr. Strasser's trim guidelines. Coffin bone parallel to the ground? None on the panel agreed it should be that way. Bar trimming to one centimeter? That was largely disapproved of by the panel, yet Gene Ovnicek (in audience) agreed with a straight, trimmed bar. Panel thought toe should be trimmed back. Dr. Shoemaker repeatedly voiced the importance of breakover, neurological function, and posture, which she proposed to be more critical than some basics of the trim. Dr. Nelson disagreed with the wall being the main weightbearing surface (thinks wall is only partially weightbearing because she has seen sound barefoot horses walking on only soles). Mike stated that the moisture factor shouldn't be generalized (but that well-hydrated feet will resist cracks better). Craig disagreed on shock absorption (he thinks the hoof works more like a hydraulic cylinder). Pete disagreed with hoof wall angles (said wild horses studied have steeper angles and one can't say 'always' for angles). Henry disagreed that the shoe causes contraction and that nails cause damage (he said there is a 'more contracted' state because a held hoof can be hand-squeezed even narrower, and that nail-hole blackness is reportedly due to the iron in the nails reacting with the hoof).
Other disagreement areas included the usual - hoof function and mechanism (Dr. Strasser's 'Bucket Model' didn't hold water), treatment of pathologies (unfair 'bad farriery' examples used), grooving (Henry insisted he has had great success with grooving; Dr. Shoemaker said it is like a natural abscess and Dr. Strasser was quick to correct that an abscess would go to coronary band, not out the wall), soundness (unable to function without shoes but fine with shoes is not soundness), postural effects (what comes first – the chicken or the egg?), where weightbearing should be (many opinions), traction ('suction cup' theory was disregarded because of no complete seal), neurology (does the navicular bone have nerves or feel pain, and does returning blood flow allow the feeling of pain), shock absorption function of the hoof (some said other parts of the body help to a greater extent), blood circulation through the hooves (are they auxiliary pumps; some disagreed that shoes interfere with circulation), navicular forehoof depicted was believed to be a hind hoof (Dr. Strasser, explained that it was over-concave from navicular syndrome and misshapen from pathology), thermoradiographs (not an accurate representation per Dr. Shoemaker who stated posture affects the circulation in the hoof more), vibrational effects of the shoe (Mike disputed that saying the study she used as evidence of that theory had since been disproved by another study), whether we have or haven't bred bad feet into horses (mixed opinions on that), live sole (Dr. Strasser seemed to consider the corium the 'live sole' and the panel considered it sensitive sole), bar (agreed it is for support, but disagreed on how to trim it and whether it has anything to do with navicular syndrome), moisture being good for hooves (various opinions on that), and heel height (varies according to terrain and horse).
There was much healthy discussion, even though common ground among trim details was minimal. The major part of common ground, interestingly, was that horses are better off barefoot and in a natural environment. Pete Ramey, who sees Dr. Strasser's trim method as 'doing too much' and disagrees with those who think 'all farriers are bad', believes in the healing power of the bare hoof and disagrees with shoes (he uses boots if 'protection' is needed). He thanked the farriers in the room for not being too negative toward Dr. Strasser.
The mood was serious but not inflamed; Mike Wildenstein's comment (about not considering the barefoot movement as a threat to the farriers' livelihood because it meant more horses for him to repair after the barefoot owners had their go at it) went over without outright attack.
LANGUAGE DIFFICULTIES AND LACK OF EVIDENCE
Certain terms were not necessarily being used with the same definition by all, but little if any language barrier existed other than that some of the questions were drawn out and confusing. Translators were present and were helpful but not necessarily versed in hoofcare language. When Dr. Strasser was asked to comment about the possibility of the horse dying within a couple months after the trim, I don't think she answered that as well as her book explains the possibility, but she reiterated the need to follow the entire method, not just the trim method, that healing involves the whole horse, not just the hoof.
Dr. Strasser didn't provide convincing enough evidence that her trimming methods have merit, or that shoes do harm. What she presented as the ill effects of shoeing were regarded as bad farriery and unfair examples. Although Dr. Strasser reportedly has hundreds of studies, she didn't present pictorial or factual case histories, from beginning to present, of her trimming. Had she done so, had she trimmed the horse all the way around, and had we been able to witness an improvement in the horse after the trim, things might have been a little more convincing. However, one horse trimmed once would really not have been enough proof.
Evidence was what many had hoped to see, and this is what is necessary to convince the farriers and veterinarians. Good, solid case studies. Three well-documented founder case histories showing recovery with Strasser ideas (trimming was performed by non-CSHSs), where traditional farriery and/or veterinary expertise failed miserably, were made available by Natural Horse and The Horse's Hoof (on display in the lobby). But they prove nothing to the critical scientific examiner, even though they clearly show that applying ideas 'different from the traditional' saved these horses' lives.
One direct question, which could have been posed at Tufts had there been time, still needs to be worked out, because to me it is at the heart of the controversy and persecution. Why have some CSHSs experienced disaster and others great success? What, other than external factors, might be investigated so this doesn't happen again? Is the teaching in need of improvement or is the trim in need of improvement? I realize there are many factors that come into play and could also be considered, but when more than an isolated incident happens, something could possibly be improved upon. If the CSHSs were indeed well-instructed, then any disaster would logically point to the trim itself and the trim itself is what needs to be examined. If the CSHSs were not carrying out the trim correctly, then it is the teaching that needs to be addressed. After all, the "Strasser trim" does define and differentiate itself by its 'physiologically correct' trim - specific coffin bone placement, hairline angle, hoof wall angles, heel and bar height measurements, sole concavity parameters, and frog/ bulb alignment specifics.
The trim could encompass addressing each hoof individually, in varying terrain situations, leaving room for interpretation of the trimmer to adapt it to external conditions such as the work the horse performs. But is that what is taught to the CSHSs? Or are they taught rigid guidelines that must not be altered? Is the trim a 'starting point' getting the hoof back to square one, and from there the hoof should be monitored for the horse's individual needs? Or does the trim bring out the optimum shape that the hoof should be, regardless of other factors? These questions were not sufficiently answered at Tufts and hopefully can be addressed in the future. Perhaps there needs to be a stricter teaching regimen and less strict of a trim guideline, or at least a clear explanation that there are times when the trim should be followed to the degree and times when it shouldn't (and how to know). However, only through consistent application can a method be evaluated.
The live trim was performed the first day, and unfortunately there was limited time for trim review and examination. When Dr. Strasser trimmed the horse, she had time to do only one foot. It was a low-heeled hoof, approx 30-degree hairline with 'incorrect' toe angle (that she left alone because she couldn't do anything about it yet). The bars were long and laid-over and the horse was lame, and had been barefoot. After she trimmed, (mostly the bars and some of the sole and frog, minimal opening cuts), one of the farriers was asked what he would have done differently, and he said he would probably have left the bars alone and put a shoe on (well, what did we expect?) Gene Ovnicek was asked for comment on how Dr. Strasser trimmed the hoof and he agreed with what she did, saying that it was a good trim to start, and that she was definitely headed in the right direction with what she did. Others commented that they would have brought the toe back. The panel said they thought Dr. Strasser did a less radical trim for the Tufts audience, but Dr. Strasser said it was not possible to go deeper on this horse because it would be too sensitive.
Another question asked if she thought it was ok to cut into the hoof and draw blood and she said "NO". (She is against resection and grooving, but indicated that in some circumstances blood might be encountered when removing excess or displaced bar and sole.) She named several common practices and why they are counterproductive, and presented her stance on ethics saying that she is for the overall cure and not just 'maintaining' and palliating the horse. Contrary to what some panel members mentioned (that they do what the owner wants), audience members voiced their concerns for the welfare of their horses and related their experiences with failed traditional approaches and their successful barefoot rehabilitations inspired by Dr. Strasser. Perhaps things will get better for the horse if some of the panel adopt this stance over the pleadings of owners who merely want to 'manage' the condition and get on with using the horse.
The second day, upon the moderator's poll-taking, it was clearly decided that there would be a change in plans and we would continue to do discussion rather than see more trimming. Todd Merrell, CSHS and Dr. Strasser's activities coordinator, later trimmed the other three hooves on the horse while the audience and panelists were taking a break inside.
YES OR NO
The rest of the afternoon involved more questions and answers. The audience's 'yes or no' questions were submitted on paper and read by Dr. Kirker-Head. Each panel member was given YES and NO cards to hold up for their responses (too many questions, too little time). Todd Merrell was asked to come down with Dr. Strasser to help decipher and answer some of the less succinct questions. Todd was also asked how he was faring with the methods, and he said his experiences were favorable and that there were even better results once he installed the rubber floor mats. Lisa Walker, CSHS, related good experiences, Ray Shamus, CSHS, tried to show a videotape but it wasn't compatible with the system. Heike Bean (former CSHS) reported the problems she encountered and didn't recommend the trim as she learned it, says she does a modified version with higher heels, is backing up toes, and is leaving the sole alone, which is working much better for her horses. (Two of her horses, previously sound, are still rehabilitating from dropped coffin bones.) Pete Ramey read a statement that he said was submitted by the two other former CSHSs, Joan Adams and Marjorie Smith (neither attended) stating unsuccessful results from the trimming method. One attendee who does endurance racing commented on how her horses are trimmed to Strasser specifications and they do extremely well; this was verified by Todd, who also confirmed that other endurance horses have the same success.
In answer to questions, Dr. Strasser said that if a horse that was barefoot and sound didn't match her trim parameters, it may be fine now, but that it might not stay sound. She also said that variations from her specifications are found, and that if a hoof is sound, leave it alone. Dr. Strasser recommends working with a veterinarian if possible, but added that veterinarians are sometimes not supportive. She also mentioned that her clinics have always been open to veterinarians and farriers, and when later asked about the use of research money might she get some, she said she wants to teach veterinarians. However, the research and documentation must be correctly in place before that will happen. She also stated she is still learning new things about the connection between the hoof and the body, and is looking for better hoof models, but that the anatomy will not change. How true – it is there, it just needs to be further examined. New studies will always come in to replace old ones.
At the beginning of the conference, when Dr. Carl Kirker-Head introduced Dr. Strasser, he mentioned how she 'got us involved in yet another dimension of shoeless hoofcare'. This dimension should be thoroughly and carefully examined in the proper settings for peer evaluation, because little was presented in actual 'scientific studies' that were satisfactory to the discerning peers. More scientific and properly carried out studies were requested and I hope some institutions will involve themselves in such studies. The trim may be able to be examined in a laboratory setting, but the trim is only part of the method. Will institutions be willing and able to provide the natural setting like her method describes? To give a credible report it must. Will there be variations in terrain? Can studies be done starting from foalhood? (This could clear up the misconception that horses are born with toe-notched coffin bones.) It is unfortunate that not enough research is done on unshod hooves; there are just too many shod hooves everywhere. Few domestic horses have been barefoot and unstalled for life, so that is why we look to the wild horses for barefoot examples.
The panel and audience were clearly reminded/informed by an attendee just how disappointed many of the general horse public is with current choices in hoofcare and veterinary care, stating that it is the reason she started attending Dr. Strasser's clinics. The fact that Dr. Strasser cared enough to bring her methods to the US to teach all interested is the main reason Strasser became so popular among us – she fulfilled a need, and changed the way horse caretakers look at hoofcare forever. Dr. Strasser makes it clear that her efforts are for the good of the horse (not necessarily the horse industry), and that the welfare of the horse comes first. Horse caretakers will attend these seminars as long as their farriers and veterinarians won't. Hopefully more universities will take a look at the options of barefoot, natural lifestyle, and cure. In the meantime, the horse caretakers have options from which to choose when deciding what suits their horses best in barefoot trimming and natural care.
Near the end, the moderator asked the panel if any had learned something from Dr. Strasser, and all said YES. Then he asked if they would be trying any of it, and they all said YES.
The conference was brought to a close when Dr. Tia Nelson thanked and praised Dr. Strasser for bravely presenting in the face of much opposition. The entire room started clapping, and Henry Heymering stood up and clapped. The entire room gave Dr. Strasser a standing ovation, and she beamed appreciatively.
It was heartening to hear at the outset that all the panelists agree barefoot is best for the horse, even though that statement was quickly followed with 'unless the horse needs shoes…'. I do think that Dr. Strasser was successful in opening some of their minds to the possibility of 'not needing shoes'. Though we got closer to the answers, these questions still remain: 'What exactly IS the Strasser trim?' and 'Is it really physiologically correct for all feet in all situations?' All things considered, the conference made a great start toward debunking, presenting, and examining, but there is much more to be done, certainly more than what can happen in a weekend. I felt the time was enough, however, to get things going in an appropriate direction - toward recognizing the value in much of Dr. Strasser's barefoot beliefs and investigating her trim methods. The panel and audience have more information now than they had before the conference, which for some may have been based on only rumor.
I had hoped that every member of the panel had read Dr. Strasser's books, "A Lifetime of Soundness" and "Shoeing: A Necessary Evil?" prior to the conference, but that wasn't the case. Knowing that Dr. Strasser was going to present a good portion of that information, I can understand why some hadn't. Henry Heymering came totally prepared, however, apparently having read her books (including the practitioner's manual) and having visited with former CSHSs. At Heike Bean's he looked closely at her horse's hooves and reviewed many photographs. He also came prepared with many quotes from articles that brought up interesting and often conflicting information. At one point Henry said he thought the minimum education for one who trims hooves should be 4 years. A farrier in the audience said he has been a farrier for 15 and is still learning. However, what is learned needs to be helpful for the horse or we get nowhere; the amount of schooling is less important than what is taught. A little of the right information is worth more than a lot of the wrong information; years of experience or schooling mean little if they are incorrect or ineffective.
Although most seemed to hold onto the same beliefs, the people coming away from Tufts came out with much more than just knowledge; they came away with increased awareness, new friends, and a sense of comradeship. For once the barriers had been cast aside for the good of the horse, and while some folks may hold true to the good of the horse industry, they at least showed concern for the welfare of the horse. I think it was very positive for the barefoot movement.
There was plenty of time and opportunity at breaks for people to talk to one another. To be able to openly discuss opinions and ideas with hoof experts KC La Pierre, Gene Ovnicek, and others, as well as the panel members, was enlightening and educational. I enjoyed talking with Dr. Cook, and meeting in person many of the people I have heard so much about and dealt with before the conference – Todd, Fran Jurga, Tara Felder, and so many more.
The overall outcome of the conf was victory for the horse, in that a natural option in hoofcare has been officially recognized and the validity of barefoot as an option for hoof and horse rehabilitation does exist. Barefoot is here to stay, and always has been; it has just been misunderstood and underrated.
My thanks go to those who had read Dr. Strasser's
books beforehand and who came prepared to ask productive and helpful
questions. Many thanks also to Tufts University (who opened the
door to awareness in this avenue) -
Susan Brogan, Dr. Carl Kirker-Head, Dr. Robert Cook, Gary Patronek - the Strasser Certified and unCertified Hoofcare Specialists, the panelists, the attendees, and most of all, the horses, who have been the real heroes in letting us try out all these methods in an effort to help them and their species.
Congratulations, Dr. Strasser, and many enormous thanks for your perseverance and fortitude, and for putting the emphasis on the welfare of the horse. I am really looking forward to future conferences.
This conference qualified for 12 hours of continuing education credit.
Tufts' Center for Animals and Public Policy is a leading institute for the study of animal welfare, and has been involved in key studies related to the public's perceptions of appropriate animal care.
Tufts' Hospital for Large Animals is New England's major referral center for the veterinary care of horses, providing a full-service facility offering advanced diagnostic modalities and the latest medical and surgical treatments.
For more information about the conference:
Tufts University School of Veterinary Medicine
200 Westborough Road
North Grafton, MA 01536