High/Low Hooves: a Whole-Horse issue    11-10-13     Pete Ramey   

Horseback Magazine

It is fairly common for horses to have mismatched pairs of front feet. When the lower-angled foot seems to be the "problem foot," most people call the horse a high/low or refer to that foot as having under-run heel or long toe/low heel syndrome. Others will say the horse "can't grow heel," when in fact an excess of heel length is typically being grown - it is just growing forward, instead of down toward the ground.

When, instead, the more upright foot appears to be the "problem foot," people tend to call it a "club foot." While routine, competent trimming is important to horses with mismatched hooves, it is important to also understand that if the solution was simply trimming the feet to match each other, these conditions would not exist. Like most issues, the first step to helping the horse is to understand "why" this is happening.

The hooves are constantly adapting to the way they impact the ground. If a horse repeatedly carries a limb farther forward than normal, the foot will tend to develop the long toe/low heel form. If the horse repeatedly carries the limb farther back than normal, the upright club foot form will persist. So when you see mismatched feet, it is important to figure out why the horse is moving in an imbalanced way. If you can identify and fix the true problem, the feet will adapt toward better balance as well. On the other hand, if you treat it as a hoof problem only, you will find yourself "spinning your wheels" because you are addressing a symptom instead of the true cause. For a more detailed discussion, read http://www.hoofrehab.com/ClubFoot.htm.


The first step is to have a lameness exam done by a competent veterinarian. Often these horses are simply compensating for pain from a current injury and/or dealing with a lack of mobility from an old injury. If this is the case, find out if the pain can be relieved or the injury healed. If so, the feet will tend to become more balanced as the horse becomes able to move in a more balanced way. If pain or reduced flexion from the injury is permanent, so should be the mismatched feet - in fact this hoof imbalance may be very important to the horse's ability to get around - an important adaptation designed to help balance an imbalanced situation. That said, it is often beneficial to warm up and stretch areas of past injury. If you can increase and maintain mobility, you will find that the feet readily become more balanced. The most common example is simply offering forward stretches to the limbs of club feet.

Professional Sports Massage Therapy is very important to success with most high/low horses. These folks tend to be very good at finding areas of stiffness or reduced mobility and setting up daily treatment programs for the horse owner to do. This can rival the very best farrier and veterinary care for most of these horses.


Injuries aside, normal horses tend to use the different sides of their bodies in different ways, just as we are right- or left-handed. For instance, when horses canter they tend to naturally favor one lead over the other. When they graze, they tend to favor placing one foot forward more often than the other. These tendencies can have dramatic effects on the hoof form.

For example, think of the way the front feet hit the ground during a left lead canter: the left foot reaches farther forward, completes its cycle and then leaves the ground just as it reaches a vertical position. The right foot braces the horse's weight by staying more underneath and the entire cycle of each step occurs farther back (relative to the horse's body). So you might visualize what would happen if all a horse did, everywhere he went, was a left lead canter in a straight line; he would develop a low left and high right front feet. This would also affect the musculature of the horse - he would be strong, but have less flexion on the right and perhaps be weaker, but more flexible on the left. Mentally and physically he would resist the right lead and bending to the right.

This is where balanced training and sports massage are at their most valuable. An imbalanced adult horse can only be corrected if all the pieces come together. Although the farrier work is an important part of this process, it is only one of many parts. Achieving balanced movement is the key - this means good training of both sides of the horse. The farrier work should be designed to get the hoof problems "out of the way" of balanced movement.

This Hanoverian had a low left/high right conformation. Front left above, before and after 13 months of treatment. At the time of the left photo, the horse resisted right canter leads, and was usually too unsound for riding. A better trim and padded boots put her in work immediately. At the time of the right photo, she is in dressage training/competition (barefoot), does not significantly favor either lead and is sound. On this foot, growing out the capsule rotation and optimizing breakover was prioritized. This improved heel and toe angles significantly over time. Photo reprinted from the book Care and Rehabilitation of the Equine Foot. 


Same horse: The high right foot, 13-month duration. A "heel rocker" was used to help lengthen stride. Making gradual increases to stride length (trimming, stretching, training) eventually forged a more normal foot. Meanwhile, the trainer and owner were exercising the right leads, focusing riding/training on the stiff right side of the horse. As her strength became balanced, so did the feet. Note that the feet/limbs still do not exactly match - trying to force them to completely match would negatively affect movement and reverse the progress. [Each trim/shoeing is available on DVD in That's My Horse #2 available from http://www.hoofrehabstore.com/thats-my-horse-2/ ] Note: A significant distal descent (sinker) reversal also occurred on both front hooves - this accounts for the shortening of the overall hoof length, even though the soles were thicker at the end of this 13-month period. Photo reprinted from the book Care and Rehabilitation of the Equine Foot.

Rider and Saddle

Kerry Ridgway, DVM, a veteran equine biomechanics expert came to ride with me and look over the horses in my care. I took him to a horse that had recently started trying to develop an upright front-right foot. He briefly evaluated the horse for injury, found a sore area high on the horse's right side and then asked to see the horse's saddle. The owner brought out a $3,000 English saddle she had just bought a few months earlier. Dr. Ridgway flipped the saddle upside-down, sighted down it from end-to-end, and said, "Here's the problem. Your saddle is built crooked." Sure-enough, once he had pointed it out, it was easy to see - the saddle was built with a left bend in its shape. Of course the horse owner was in tears, but in the end, the saddle company replaced the saddle with a straight one and the hooves quickly became balanced again.

Imbalanced riders can imbalance the horse as well. These factors have dramatic effects if most of the horse's exercise occurs under saddle.


Once a horse reaches two-years-old with a club foot or high/low conformation, it is very likely that it will remain, to some degree, for the rest of the horse's life no matter what you do. By then, the joint surfaces, bone shapes, muscles, tendon and ligament lengths have become more set in their ways. Don't get me wrong, balance can be improved in adult horses - but it can be truly fixed or prevented in foals! Routine and competent trimming of foal hooves is critical, but too-often overlooked or procrastinated.

It is common to hear that this or that bloodline of horses has clubby feet or high/low syndrome. But in my experience, foals often show these tendencies but they are generally easy to keep in check if you start early enough. In other words they try to be imbalanced, but I don't let them.

Usually, if it is started within 2-3 months of birth, routine hoof trimming alone can keep foals from developing mismatched limbs provided that they are turned out - not stalled. In more severe or persistent cases, I sometimes also recommend moderate amounts of ground work, in circles, focusing on strengthening the weak lead (caution: this can be important, but also over-done).


If you try too hard to trim the feet to match each other, you will probably make the situation worse. Very often, people with good intentions trim too much sole from the toe of low foot (trying to make it match the more upright foot). This causes the horse to avoid sensitivity at the toe and overwork the heels; they carry the limb more "out front." This makes the original problem worse over time. It is equally common for people to trim the heels of the high foot too low in an attempt to match the opposing low-heeled foot. This often causes sensitivity at the heels of the high foot, shortens stride length, and makes the foot adapt into an even more upright form over time.

Instead, everything you do to the feet should be geared at balancing the movement. Good form will follow good function. On the low side, preserve sole thickness and keep the breakover back as far as possible (without overexposing the corium to bruising http://www.hoofrehab.com/Breakover.html). This helps the horse keep the foot on the ground longer (farther back relative to the body) and helps grow out any toe flaring or capsule rotation. On the high side, rocker the heels to enable the horse to extend the foot farther forward, while being very careful not to cause sensitivity at the heels (as this would shorten stride, forcing the horse to carry that limb even farther behind http://www.hoofrehab.com/HeelHeight.html).

Other than that, treat each hoof as an individual, and don't try to force them to match. Just try to grow out wall flares and encourage thick soles and frogs. Work the feet into balance subtly, nudging them in the right direction at each trim. If the rest of the training program is encouraging balanced development, the hooves will become more balanced over time as well.