Farm Ireland

Sunday 21 January 2018

Foot woes will cause serious equine problems

Vet Marcus Swail and top farrier Jeremy Stanley tell how and why

Foot woes will cause serious equine problems
Foot woes will cause serious equine problems
PROBLEMS: Getting to the bottom of a horse’s foot problems can sometimes require in-depth checks and in some cases, can highlight lameness in the horse
Recently retired retired Team Ireland vet Marcus Swail
Caitriona Murphy

Caitriona Murphy

'No foot, no horse' is an old saying that all horse owners have heard and one that vet Marcus Swail and farrier Jeremy Stanley are all too familiar with.

Swail, the recently retired Team Ireland vet, runs a sports medicine veterinary practice in Co Kildare called EquiVet Ireland, where much of his work involves assessing and treating equine orthopaedic issues.

Speaking at the Connolly's Red Mills Showjumpers Club seminar in Co Kildare recently, the vet said foot pain was a common reason for lameness in the horses he treats.

"It's not surprising, given how hard horses' feet have to work on a repetitive basis," he remarked. "The feet come under immense pressure particularly when jumping, both at the take-off and at the landing."

The vet said foot pain could manifest itself in numerous ways, ranging from obvious lameness in one or both feet to more subtle signs such as only being lame on a circle. Some horses, despite the pain, don't even show mild signs such as heat in the foot.

"Sometimes there is nothing about the foot that would show it is the source of pain - no heat, no swelling, no reaction to a hoof test, nothing at all," remarked Mr Swail. "But the pain is in there, hidden within the hoof wall."

While a horse with foot pain may not be obviously lame, there are a number of ways that a performance horse can show he is in trouble.

"The horse's performance falls off. He might lose scope and start having poles down, maybe not be as quick off the floor as usual or not be able to make the distances in combinations as easily as it used to," he explained.

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Lameness in the foot is confirmed using regional analgesia or nerve blocks.

"With humans the doctor can just ask the patient where it hurts but obviously we can't do that with horses," said Mr Swail.

If the horse's pain is reduced or disappears when the nerve block is applied, this confirms that the pain is in the foot.

"But this almost generates more questions than I had when I didn't know where the lameness was coming from," said the vet.


"The foot is a very busy place anatomically and there are lots of possible sources of pain in the foot so we are really only at the start of the journey."

The first step in the investigation is usually to examine the bony structures of the foot, which is done through X-rays.

"Ten or 20 years ago, if a horse had foot pain, everyone said it was navicular disease," remarked Mr Swail.

"But now we understand that there's a lot more in the foot to look at."

Pain in the bony parts of the foot can be related to the coffin joint, the navicular bone and the pedal bone. The vet will examine the X-rays for signs of arthritic changes and to check the size, shape and density of the bones.

However, the X-rays may appear normal, in which case the pain is more likely to be caused by a soft tissue problem.

"MRI is the only way to take an image of these soft tissues," explained the vet.

The most common soft tissues injuries involve the deep flexor tendon, the impar ligament and collateral ligament of the coffin joint.

When the source of the pain is identified, the vet can then advise on treatment. In some cases, oral joint supplements may be enough to relieve mild discomfort.

For problems within the coffin joint, the joint can be medicated to relieve the pain, while medication is also an option to treat navicular problems. If there is a strong suspicion that the horse is suffering from navicular bone pain, the drug Tildren can be administered intravenously or injected locally.

For soft tissue injuries, rest is the most effective treatment.

"Sometimes owners struggle to understand how long a rest period is needed to help a problem in the foot," said Mr Swail.

"When a tendon on the leg is injured, it is easy to see that the tendon is still swollen, painful or hot to the touch but you can't see that in the deep flexor tendon or collateral ligament because they are hidden deep in the foot.

"But just because the problem can't be seen doesn't mean you can ignore it. Recent advances in veterinary medicine include the introduction of regenerative medicine such as PRO and stem cell therapy.

"This is a very exciting area at the moment," he told the conference delegates.

"It involves taking blood and bone marrow and turning it into something that can be injected into the foot that will change how the injured structure heals."


For many horses, shoeing can help to change the physics of the foot and reduce the forces acting on it dramatically.

Farriers can help the horse by reducing the length of the foot, changing the break over point of the toe and by changing the shape, size and weight of the shoe.

Speaking at the seminar, farrier Jeremy Stanley, chairman of the Irish Master Farrier Association said 70pc of all sports horses would sustain at least one musculo-skeletal disorder in any one season.

"It may come as some surprise that as many as three quarters of those injuries are caused, or contributed to, by imbalance in the feet," said Mr Stanley.

"When we talk about foot balance, I want you to think of the horse's foot as an upturned drinking cup - the cup is symmetrical on the top and bottom, which represent the coronary band and the ground surface of the hoof wall," he explained.

"But if you look at a lot of horses' feet, they are not symmetrical or the same at the coronary band and ground surface," pointed out the master farrier.

"In fact, up to 95pc of all horses have some form of foot imbalance which predisposes them to injury."

So what is good foot balance?

"Good foot balance is achieving a foot which is of a shape and strength to support the weight of the horse whilst providing the base for optimum movement," said Mr Stanley.

Incorrect foot balance can be caused by a several factors, he told the conference.

"Chronic bad farriery and management leads to stress in the hoof capsule which eventually result in fracture lines," he said.

"Leaving toes too long and using shoes that don't give enough cover at the heels will cause you problems."


Longstanding imbalances in the feet will result in cracks and twisting of the hoof capsule, according to the farrier.

So if your horse has an unbalanced foot is it a natural defect or man-made?

"Very few hoof imbalances are caused by farriers," said Mr Stanley.

"If they were caused by the farrier, you would see similar problems on every horse shod by an individual farrier."

However, he conceded that farriers could be guilty of not recognising the conformation or its effecton the hoof capsule and therefore not taking the necessary action to correct it.

"The farrier needs to be aware at each shoeing of any hoof distortion.

"Then he can reshape the foot to bring it back into alignment," he said.

Faulty foot balance can have severe implications for the horse, including chip fractures, navicular disease, arthritis, back trouble, shortened stride, stumbling, bruised heels, hoof cracks and sheared heels.

There Irish Master Farriers Association (IMFA) has around 150 members, including masters and apprentices.

A full list of members is available on

Irish Independent