Lameness: Prevention and Treatment


Sooner or later, nearly every rider will have to deal with some degree of lameness in her horse.

Lameness is a gait abnormality caused by a variety of conditions. It’s most often caused by pain in the musculoskeletal system – the joints, muscles, and bones – and is by far the most common reason for inadequate performance in a horse.

Lameness can range from very subtle decreases in performance to a very apparent non-weight bearing lameness. Head bobbing lameness is quite apparent to most horse owners. Subtle changes in performance, hind end lameness, or multiple problem areas are more difficult to notice. Unfortunately, a lot of horses are asked to perform when in pain because their owners simply don’t recognize there’s a problem.

Spot check
Take a step back from your horse and look at how he is standing. A sound horse usually stands with limbs perpendicular to the ground. It can be normal for a relaxed horse to rest one hind limb while keeping equal weight on both front ones. If a horse has a sore foot, he will usually point the affected foot forward. If a horse’s hind limbs are camped under him (farther forward than normal) or parked way out behind him, he is likely in discomfort and standing in a compensatory manner. If the lameness is in a hind limb, he will most likely lean on the sound side and have a hip hike on the lame limb when walking or trotting.

Other indications of pain:
•increased sensitivity to being brushed in areas he’s usually fine with
•not standing well for the farrier
•not performing normal tasks as well
•uneven shoe or hoof wear

Forelimb lameness is typically easier for riders to spot. A horse with a lame forelimb will move unevenly, raising his head when the painful limb is on the ground. The painful limb will also have quieter foot falls. Sometimes the lameness is quite visible at a walk, other times it may only be visible when the horse is trotting in a circle.

When there is lameness in both fore or hind limbs, you may notice that the horse’s gait is short and choppy. Or he may slowly or suddenly stop performing movements he was previously fine with. If your horse does not want to do certain exercises, starts refusing jumps, acts cranky when getting tacked up, or bucks and acts rank in corners, he may be in pain and deserves to be looked at by your veterinarian.

Sources of lameness
Lameness can be caused by conformational deficits, performance stresses, trauma, and improper saddle fit, hoof maintenance or training. It can also be caused by a mechanical problem such as upward fixation of the patella (locked stifle). Less common causes include neurological problems caused by EPM (Equine Protazoal Myelitis) or Wobblers Syndrome.

Conformation should be looked at, especially if the horse is meant to be a performance animal. There is a strong correlation between faulty conformation and the development of lameness. These faults can put excess stress on joints and cause a lameness problem, especially if the horse is meant for a particular sport. An exam by a veterinarian prior to purchasing a horse is invaluable in identifying these conformation problems and helping you understand the issues you may need to be aware of down the road. Horses with conformation challenges can and do excel and have long careers in their sport, but they may benefit from preventative treatments to help them deal with joint stress.

Certain sports are associated with particular types of lameness. For instance, a more advanced dressage horse puts a lot of stress on the hind limb suspensory apparatus due to the collection required for movements like piaffe, passage and canter pirouettes. The propulsion needed by show jumpers and the flexion of the hock joints and extreme forward placement of both hind limbs during sliding stops in a reiner puts a great deal of stress on the hocks.

Correct foot balance and breakover point are essential to proper posture and movement. Talk with your farrier and veterinarian in collaboration to make sure your horse’s foot is balanced and centered properly. Sometimes radiographs are needed to visualize the angles in the limb.

Poor saddle fit is a common problem. An improperly fitting saddle can pinch or concentrate pressure in certain areas, leading to back soreness. A horse with back pain will normally contract his back muscles and hollow out his back. This leaves him unable to engage his hind legs effectively and puts excessive strain on his feet, tendons, ligaments, hocks and stifles, causing lameness and soreness.

Screen Shot 2014-04-02 at 3.01.16 PMExamination time
A lame horse should be evaluated as a whole. In addition to looking at the potential causes of lameness, you should always look at joint flexibility, range of motion, effusion in joints, neck and back flexibility and reaction to palpation of tendons. When checking for lameness and its causes, you always want to start at the bottom (the foot) and work up.

A systematic lameness exam is always necessary and usually involves watching the horse in motion, whether on a lead line, lunge line, in a round pen or under saddle. The only time this would be contraindicated is when a horse is unable to bear weight on a limb and/or a fracture is suspected.

A lameness exam typically starts with checking foot sensitivity with hoof testers, followed by flexion tests. If the affected area is not easily identifiable, the exam will then progress to other tests like nerve and/or joint blocks. These blocks reduce or eliminate lameness by anesthetizing a joint or small region of your horse’s limb. This enables a veterinarian to narrow down the area of interest and identify the area to be imaged by x-ray, ultrasound, MRI or Nuclear Scintigraphy. Based on the diagnosis, treatment options are then identified and discussed.

With more complicated lameness issues, a diagnosis sometimes can’t be made even with all the available tests. Sometimes an affected area, such as the pelvis, is quite difficult to image. In other scenarios, a diagnosis is made but the treatment options are a difficult choice for the owner; or perhaps the therapy is not helping or hasn’t quite got the horse back to 100%. In these situations, acupuncture and chiropractic can be very helpful.

Screen Shot 2014-04-02 at 2.49.49 PMPinpoint the problem
Acupuncture becomes an excellent diagnostic aid when trying to unravel a horse’s lameness. Traditional Chinese Veterinary practitioners can identify a disorder by feeling for sensitive acupoints or meridian pathways. A needle cap can be used to “scan” specific pathways on the surface of the horse’s body to evaluate lameness. Sensitivity at particular acupuncture points can indicate soreness and help pinpoint the area of pain.

 Acupuncture also relieves muscles spasms, stimulates nerves and the body’s defense systems, and increases circulation.

Acupuncture is also wonderful for treating most lameness. The area to be treated determines which acupuncture points will be used. Stimulating these points stimulates the afferent nerves that transmit impulses to the central nervous system, releasing many neurotransmitters and neurohormones (i.e. endorphins, which help relieve pain).

Animal Chiropract ic Another great modality for the diagnosis, treatment and prevention of lameness is chiropractic. A trained animal chiropractor will incorporate posture analysis, motion asymmetries, inability to track straight and a lack of propulsion within a basic lameness exam. After watching the horse’s movement, the chiropractor performs a spinal exam by palpating each vertebral complex for motion, pain and abnormal muscle tension. Chiropractic focuses on the relationship between structure (primarily the vertebral column) and nervous system function. Most people don’t realize the spine is intended to have movement between each vertebra; this is essential for optimal functioning. When there is immobility and the vertebral complex is not motioning properly, a subluxation is usually involved. A cascade of events follows and can include not only a change in joint motion but also pressure on spinal nerves nerve roots, muscle weakness, spasms, inflammation and autonomic changes.

A lot of people assume a chiropractor only works on bones, but it goes much deeper than that. Adjusting a subluxation allows normal motion and nerve function within the vertebrae, which in turn allows normal nerve firing to muscles and tendons and consequently good joint stability to the lower limbs.

A joint’s stability is directly related to the muscles and tendons going across it, and a muscle or tendon will not be strong if the nerve innervating it is not firing properly. Think about that next time your horse is said to have osteoarthritis in his hock, or has weak stifles. Why does he have instability in that joint to begin with? It very well may be that his caudal lumbar vertebrae have some subluxations, causing improper firing of one or more of the nerves from the lumbosacral plexus, which innervate all the muscles, tendons and ligaments of the hind limbs.

Remember, if your horse is lame or seems uncomfortable, consult with your veterinarian sooner rather than later. The sooner there is intervention, the happier and longer your horse’s career will be, whether in the show ring or on the trail.

Dr. Jacqueline DeDeo is currently practicing Traditional Chinese Veterinary Medicine and Animal Chiropractic in NH, MA and limited trips to NY. After graduating from Ross University Veterinary School in 2001, she completed an internship in Equine Medicine and Surgery at Oklahoma State University, then worked in Edmond, OK at Equine Medical Associates. During this time she received her initial acupuncture training and certification with The International Veterinary Acupuncture Society. In 2004 she moved to Rhinebeck, NY and worked at Rhinebeck Equine. In addition to continuing her education in Traditional Chinese Veterinary Medicine with more advanced acupuncture courses and herbal therapy at the Chi Institute in Florida, she also completed her training and certification in animal chiropractic at the Healing Oasis Wellness Center in Wisconsin. After three and half years at Rhinebeck Equine, she and her husband moved to New Hampshire where she started her business Equine Wellness, PLLC, practicing Traditional Chinese Veterinary Medicine and Animal Chiropractic.