The Hoof Point: A Simple Solution to A Crippling Problem
Notice this horse's tail-tucking and back-humping as the 'hoof point' on each side of the rump is pressed with a round-tipped narrow instrument. This response (be careful not to get cow-kicked!) happens when the inside heel of one or both hind hooves is too high.
Have you ever wondered why, in spite of bodywork, veterinarian visits, x-rays, other diagnostics, and regular hoof care, your horse still seems mysteriously lame, or lacks power, balance, and/or comfort in the front end and/or the hindquarters? Well I've wondered the same thing. After a lot of observation and thought, I also wondered if problems of this kind just might have a common underlying factor, and therefore a common solution.
So I started looking closer at horses, and more objectively too. And after a lot of investigation, hands-on work, research, discussion with others, and just plain watching horses - all kinds of horses doing all kinds of things - I noticed something interesting. And then I put it to the test - and found that a mere adjustment in the trim of the hind hooves eliminated the ‘mystery lameness' for nearly every such horse I trimmed. The best part is that I also learned of a tell-tale point (like in acupressure) that indicates the need for this particular trim adjustment.
I've been calling this point the ‘hoof point', and it has not been identified to me by any acupuncturists, but to help you find it, it is somewhere near BL 30. This hoof point is a pressure point in a 'hole' near the top of the hindquarters, on each side of the horse, and it is very reactive in many horses. When you press a blunt-pointed object on it, the affected horse flinches, or the muscle tissue around the point twitches. In fact, I find that about 2/3 of the lame horses I meet are reactive at this hoof point, and that a shortened stride and vertebral subluxation (misalignment) are often associated with it.
This point on the rump is near an area often used by bodyworkers to get the horse to lift his back and round his haunches, which is a similar reaction but not the same - the hoof point is one specific spot, and it responds to a press, not a stroke or drag over it. Also, acupuncture points that may be in this area are associated with many things that could cause this hoof point area to be sensitive. But the connection between the hind hoof imbalance and the hoof point reactivity is common, and that is what I've been seeing, whether it's muscle or energy related, or both. There are also important acupuncture points at the coronet band and hock that could play a part in puzzling lamenesses like I am referring to. Just keep in mind that all systems and parts of the body are interrelated, so there may be a lot of interconnections going on here. All I am saying is that I am seeing one of those connections. And I see it a lot.
These reactive horses have this common imbalance in the trim of the hind hooves: high inside heels. Actually, I have found that if the hoof is high anywhere on the medial side, this point will be reactive. I started balancing the hooves accordingly, and found it eliminated the hoof point reactivity - immediately in some horses, and over a short period of time with others. (There may be some cellular memory that needs time to go away.) In fact, one way I can tell if I have trimmed the hind hooves correctly on many horses with this problem is when the point is no longer reactive, the hoof is properly balanced.
What a high inside heel does to the horse's skeleton and movement
How to hold the leg and not interfere with its natural suspension when sighting: Lift up (but not out to the side), supporting the front of the hock area. Suspend the untouched lower leg and let it hang naturally.
To put it bluntly, it cripples your horse. High inside heels, which are heels with excess length, do about the same thing to the horse's hind legs that wearing a lift along the inner (medial) sides of your shoes would do to your legs. At first, it may be only as irritating to the horse as if a piece of bubble gum were stuck to the medial sole of your shoe. But because all the ankle/ pastern and leg joints are put under sideways stress, in time it cripples. Try it - or stand and raise the arches of both feet. You can feel the tension immediately in your hips and ankles, and maybe elsewhere. In the horse, not surprisingly, hock, stifle, hip, and/or sacro-iliac tension occurs.
Moving around and working in this posture, the horse's hindquarter muscles are used differently, and the hoof point area becomes sore and reactive. Trying to avoid or compensate for the pain, the horse shortens his stride, which can contribute to a loose patella (kneecap) at the stifle. When he halts, it is with a quick jabbing motion of the hind legs, almost a hop. Over time, he learns to overuse the front legs (he 'goes on the forehand') and the shoulders become overdeveloped. The hindquarters will lose muscle mass because he is trying not to use them. I have seen these horses end up with draft-like front ends and giraffe-like hind ends.
If only one hind hoof has a high inside heel, there will be knee and pastern problems and possibly hoof lameness on the diagonal front leg. Because the stride is shortened in this diagonal pair of legs, there is often subluxation somewhere in the lumbar-sacral area, at the withers, and therefore at the poll joint. Typically, there is subluxation at both ends of the spine whenever there is a side-to-side imbalance affecting the spine. One high inside hind heel affects the horse's side-to-side balance.
Interestingly, I often find this high inside hind heel to be the major contributor to most knee problems, splints, and bucked shins - especially in the 2-year-old race horses I've worked with. This imbalance also causes teeth problems, because it affects the way the horse holds his jaw - walking around in constant pain/ constant compensation.
If both inside hind heels are high, it has even worse effects, affecting the front-to-back balance. The hip rotates forward putting a hump into the back, the spine compresses as the weight on the forehand is increased. The jaw is pulled back, which often creates upper hooks on the first molars. The horse cannot drive off the hind end, so he runs on the front end causing the front end lamenesses mentioned earlier.
What a hind hoof looks like in a horse with ‘hoof point' reactivity
The inside heel is higher, but you may not notice it at first glance. When an inside heel is always left higher than the outside heel, because the heel structure has no bone in it and is flexible, it gets compressed and pushed upwards so that the bottom surface of the hoof appears flat. However, if you get down on the ground and look at the hoof from behind, you can see that the inside bulb is pushed upwards and is higher than the other bulb. This might be visible on the coronet band heights too.
A more reliable way to see this imbalance is to look at the heels off the ground. Stand beside the horse's rump facing backwards. Hold the hind leg up (but not out to the side) by supporting the front of the hock area rather than the hoof. Suspend the lower leg and let it hang naturally. Avoid touching the cannon bone, or anything on or below the hock, so as not to affect the natural alignment. Lift higher, and the hoof will naturally tuck toward its ergot - lift or lower the leg so you can see the plane of the hoof's ground-surface. Looking, with one eye, from the hock straight down the cannon bone to the back of the hoof and the ground-surface plane, you can then see if the ground surface plane is perpendicular to the sight line, or if one bulb and heel is higher than the other. Or, visualizing a V from the ergot to both heels (ground surface contact), one side of the V will be longer.
I've observed also that many of these horses who have excess inside hind heel actually sound different running down the track, and I can see how it affects their gait. I've also seen that horses running around the track on the left lead, if they have a high inside hind heel on the left side, will throw the opposite front awkwardly, not naturally for that horse - there appears to be a wobble in the right fore. Even standing around, their posture is affected - they will not stand square, and they tend to rest one hind foot or the other, almost all the time. Once balance has been achieved, they stand square immediately. Obviously, the shoe will show more wear on the inside than the outside, from the inside quarter to the inside heel.
How to trim to balance a high inside heel
Sighting down the suspended left hind leg, aligning hock and sulcus, reveals excess inside heel. Dashed line shows current ground surface plane; solid line shows perpendicular ground surface plane. Note height of inside coronet band compared to outside (white arrows). I would lower this horse's inside quarter to at least the solid line, and let the outside alone for now. This horse's inside quarter and heel will probably let down eventually to the black arrow, its natural height.
We are aiming for balance, for that particular horse and his well-being, and by ‘balance' I am not talking about achieving equal heel height - it will probably go beyond that, to a lower inside heel. Many horses will have a reactive point until the inside heel is actually much lower than the outside heel. Most horses DO have a naturally low inside heel. I have yet to find a horse that goes better with ANY amount of higher inside heel, and very, very few can run down the racetrack with a higher (or even an equal-height) inside heel and stay sound. We have to trim for the horse. Trimming or shoeing to have perfectly level heels may be people-friendly, but it is not horse-friendly. We cannot shoe or trim a horse with the goal to have perfectly level heels and still have them go sound. It just doesn't work that way. If it looks balanced to us, it doesn't mean it is balanced for the horse. I have yet to see a high outside heel causing such problems.
There are different ways to trim off the excess heel, depending on the hoof. Most of the time I trim the inside heel first and take off as much as I can to the outside toe-end of the quarter. When eyed from above, the outside heel will be naturally level with the inside quarter. You may have a different way of removing heel.
This will be a wedge removal, the wedge getting deeper and wider towards the heel. Rasping off this wedge of heel makes room for the compressed heel, bulb, and frog to 'let down' until the heel comfortably meets the ground. Re-check the hoof point for reactivity, and rasp off more as needed.
It might take only 4 strokes of the rasp if the inside heel is only slightly high, or it might take forty. If you aren't experienced enough or don't feel comfortable removing a lot in one trimming, then don't. Better to err on the side of caution. You can recheck the point reactivity and sight down the leg daily to see how much more you need to do. You will see how it is dropping, and soon you will see how the horse's posture and way of going are improving. But avoid prolonging the problem - don't let growth get ahead of you. I have removed as much as an inch of excess heel in the first trimming, when it was needed (I'm a seasoned farrier), with no resulting problems - just a lot of relief for the horses. Several years later, these horses are still doing great with maintaining those heel heights.
If a heel is only slightly too high, making room for it to let down will result in almost immediate improvement in the reactivity of the hoof point. If it was quite a lot higher than the outside heel, it may take overnight or up to about 4 days for the heel to let down to ground level, and reactivity of the hoof point could take that long to subside, too. When I can, I leave the shoes off the racehorses for 4 days after lowering the heel, to let it find its natural balance. I then recheck the point for reactivity and adjust accordingly.
Generally, once you have achieved optimum let-down on the heel, the hoof point will no longer be reactive. It's as simple as that. And if you continue to trim them that way, they will stay that way. It is no surprise to see major improvements within a few days - they can rebalance quickly. Once the hooves are balanced, skeletal imbalances might just fix themselves, and it would be a good idea to get them checked out by a qualified professional.
For your horse's sake, check out this point and check those inside hind heels often. Talk to your trimmer, farrier, equine bodyworker, and others about this, because it works.