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Contracted Heels: Cause for Concern

By Adam Whitehead Resident Farrier – UFVMC

Contracted heels are found throughout all breeds of horses and can affect horses from any discipline at any age. The contraction is generally secondary to a variety of ailments. Navicular disease, caudal foot pain, laminitis, club feet, tendon contractions, conformational abnormalities, and injuries to the affected limb are some of the underlying ailments that predispose to or cause contracted heels. Any series of events that result in inadequate weight bearing on the caudal aspect of the digit and failure to properly load the digital cushion can result in a contraction of the horses’ heels.

Foot Function
To understand why the contraction occurs, we must first understand the functional anatomy of the caudal aspect of the foot and the role it plays in the horses stride. The digital cushion is an elastic network of collagen, fibrous tissue, and blood vessels that lie between the Deep Digital Flexor Tendon (DDFT) and frog, extending from the bulbs of the foot to just in front of the point where the DDFT attaches to PIII and extending outward to the lateral cartilages. The primary function of the digital cushion is thought to be dissipation of the energy from the ground reaction force. As the bare foot strikes the ground in a normal heel first fashion, the heel, frog, bars, and sole are loaded. The digital cushion is compressed and the foot is expanded. This loading transfers energy and concussion through these structures to the digital cushion. The energy is then dissipated up the limb through hemodynamic transfer (movement of blood), as the digital cushion is compressed and the blood flows out and up the limb. Once the weight bearing is removed from the limb, the digital cushion returns to its static shape and negative pressure enables refilling of the vasculature before reloading. This continual loading maintains a healthy foot of normal size and shape.

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This horse is suffering from contracted heels. Notice the atrophy of the horse’s frog.

Shock Absorbers
Once an ailment is present that changes normal weight bearing on the limb and/or discourages a normal heel first landing, the digital cushion is no longer loaded properly, therefore reducing it ability to dissipate concussion. The concussion of the ground reaction force is not effectively absorbed and dissipated by the digital cushion and the boney column is forced to then absorb the shock of the landing. This amplified concussion has the potential, over time, to produce the degenerative changes associated with Navicular Disease and other ailments of the foot. Also, the elastic network of collagen and fibrous tissue of the digital cushion are not fully expanded each time the limb is loaded, causing them to atrophy over time. Once this atrophy occurs, the heels begin to contract and lengthen, further reducing the ability of the digital cushion to function. The result is a foot that functions poorly and is much more upright with heels that are contracted.

Diagnosis & Treatment
A specific diagnosis should always be the foundation for treatment. A veterinarian can perform a lameness exam as well as a variety of diagnostic procedures such as radiographs, nuclear scintigraphy, ultrasonography, CT and MRI. Once a diagnosis has been made treatments can vary greatly. Most treatments should be aimed at restoring normal weight bearing and alignment of the boney column. Encouraging proper foot function and reducing the mechanical stresses on the affected area are also of equal importance. This is accomplished by first balancing the foot using the aid of radiographs and/or structural markers of the foot and secondly by moving the break over (the point when the heels lift and the foot begins to leave the ground) closer to the center of articulation. Heel elevation as well as incorporating a cushion material in the solar surface of the foot can be beneficial. No universal method is effective for all ailments; however a farrier with a working knowledge of the functional anatomy of the distal limb and an understanding of the diagnosis should be able to offer a broad range of shoeing treatments. By combining the work of a veterinarian and farrier a successful outcome is generally achieved.


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Corrective treatment begins with balancing the horses hoof and encouraging proper foot function.



References

Mike W. Ross, Sue J. Dyson: Diagnosis and Management of Lameness in the Horse, 2003, Saunders.

Adam Whitehead is the resident farrier at the University of Florida Veterinary Medical Center. Whitehead completed farrier school in Tennessee and studied animal science at Abraham Baldwin Agriculture College in Tifton, Ga. Prior to joining the UF team, Whitehead successfully practiced in the field for 10 years

 


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