Lowering Vs. Raising the Heel to Treat a Suspensory Ligament Injury

Q: “I’m shoeing a horse with a suspensory ligament injury. I want to lower the heel of the hoof to a lower angle. The vet says to put a wedge in the heel to raise the angle. Who is right?”

—Ohio farrier

A: I would need more information to adequately answer this question. First, are you and the vet in agreement on the injury and its extent? Are there other problems that might take precedence such as a prior injury, surgery or an osteoarthritic condition (deep flexor tenotomy, ringbone, etc.)? Is this injury acute or chronic? Does the horse have a fairly normal hoof pastern axis? Is the horse on hard ground or in a bedded stall?

Generally, raising the heels of a normal hoof pastern axis conformation doesn’t help heal suspensory ligament injuries. Raising the heels is contraindicated for suspensory sprains because of the way the lower leg is designed.

As a result of the inverse relationship of the hoof pastern axis, raising the hoof angle with wedges results in more tension on the superficial flexor tendon and suspensory ligament. Therefore, heel wedges are not generally helpful in healing common suspensory injuries. When one lowers the heels the pastern angle is increased, the fetlock joint straightens and tension on the superficial flexor tendon and suspensory ligament is decreased.

What we want to do with suspensory ligament and superficial flexor sprains is to relieve the tension of these structures to facilitate healing. One way of helping is to minimize dorsiflexion…

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