Caudal Heel Pain

Here are the KEY POINTS about the navicular syndrome in horses:

  • The current term is “Caudal Heel Pain” because of the many different causes, but 1 area is affected.
  • Much research has gone into accurately diagnosing the origin of caudal heel pain.
  • The overall root of caudal heel pain can be associated with a steep pastern angle and a low heel / long toe hoof.
  • Understanding the vector forces on the hoof is not complicated and can help in understanding how to prevent caudal heel pain.
  • Prevention is important because once a horse develops caudal heel pain, it usually is degenerative and has a lifetime of pain.

A demonstration of the long toe and low heel as a cause of caudal heel pain.

Navicular disease (caudal heel pain) – Part 1

Navicular disease (caudal heel pain) – Part 2

Navicular disease (caudal heel pain) – Part 3

A foot sore horse in this video from hoof trimming is similar to all other causes of hoof pain. In the beginning, you can see the broken pastern-hoof axis.

An hour-long webinar on caudal heel pain.

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  1. Very informative..My horse had on and off again bilateral foreleg lameness for 7 years. Eight veterinarians 7 farriers and not one of them considered navicular syndrome. My horse suffered from lack of knowledge from both fields. He also had contracted heels and I was told over and over again by the vets that it was thrush… it was not..So disappointing.. I figured this out on my own about a year ago… First I put him in a frog pad which helped tremendously.. Then I discovered Twin shoes.. a shoe developed out of Belgium that is cut down the middle at the toe.. where it becomes separate hence twin shoes. Not only do I have a sound horse but his contracted heels have disappeared..

    1. I am sorry to hear of your story with vets and farriers not being able to help. It is why I put out information like this for horse owners so they can become advocates. I’m glad you found a solution that is working. I have not heard of these twin shoes, but my goal isn’t to follow all the available treatments. It is more to help prevent these problems from happening.

      Thank you for taking the time to comment, and (hopefully) share this with others. Doc T

  2. When you say parallel is ideal…I assume you mean after the heel has expanded under full weight during movement. When the horse is moving especially at the canter the heels will expand and lower even with adequate frog support or protective shoeing …setting-up a zero palmer angle with the horse standing will result in a negative palmer angle when moving.

    Most of the leverage you describe at the toe has little consequence in arena footing…the major culprit here is the toe first landing which causes the deep flexor muscle to be engaged during the impact phase of hoof flight applying excessive pressure to the tendon and navicular bone. Learning to recognize when this muscle is engage during hoof-fall is crucial in understanding how to forecast and prevent navicular problems.

    If I where to prioritize your five things to look for it would be: 1. Tubulars Parallel to each other 2. Short Toe 3. Low Heel is fine…under-slung heel VERY BAD 4. Broken hoof axis …should not effect soundness especially in arena footing (symptom…not root cause) 5. Radiographs only to check bone loss…should NEVER be used to balance the hoof…learn to read the five basic hoof structures.

    1. My analysis is based on static forces and not dynamic which would include axial rotation, deformed hoof capsule from normal or abnormal loading, or riding surface.

      Looking at the static vectors of force however tells a lot in predictive value for future ability to withstand the dynamic changes in vectors. But there is more.

      The reason the broken pastern-hoof axis is so important (as well as long toe and low heel) is that it leads to muscle fatigue of the flexor tendons. As the muscle fatigues with work the tendons begin to “snap” leading to heat production and subsequent injury. In addition, resonating soft tissue from limb fatigue also leads to heat production and damage. This leads to an overall instability – all on a level not seen by our eyes until the fluid leaks into the tendons and ligaments and seen with the ultrasound.

      1. You are correct on symptoms of navicular, “muscle fatigues with work the tendons begin to “snap” leading to heat production and subsequent injury”…and that a healthy hoof should not have a broken pastern-hoof axis. But one should never make any judgment in a static view of the broken pastern-hoof axis which has little effect most times on the leverage..thus my point about soft arena footing.

        More importantly static view should never used as judgment to raise the heels. While it’s very important to shorten the toe, the heels cannot be raised until the internal structures are ready to accept it Excessive raising of the heels when the internal structures (lateral cartilage) are not ready to accept the changes can cause articular fracture of the palmar process (wing) of the distal phalanx. Raising the heels too soon most times creates more caudal hoof pain caused by the shoeing to raise the heel, the horse will often develop a “stabbing” or toe first landing.

        It is best to determined and fix the heel palmer location and the amount of distortion in the bars. If we see a zero palmer angle or broken pastern-axis assessed in static view after trimming we need to control the terrain (pea gravel footing) so the horse can position the heel and move comfortably and safely.

        It is more important that we assess the hoof dynamic, the toe first landing is the root cause of navicular…period. Fixing the stride by relieving caudal hoof pain is the only way to resolve and most times reverse this condition. It’s the same approach you use in dentistry relieve pain to balance the horse’s bite.