Have you ever wondered why, in spite of bodywork, veterinarian visits, X-rays, other diagnostics and regular hoof care, you still run across horses that seem mysteriously lame or lack power, balance and/or comfort in the front end and/or the hindquarters?

I’ve wondered the same thing. After a lot of observation and thought, I also wondered if problems of this kind just might have a common underlying factor, and therefore a common solution.

I started looking more closely at horses and more objectively, too. After a lot of investigation involving hands-on work, research, discussion with others and watching all kinds of horses doing all kinds of things, I noticed something and put it to the test.

And I found that a simple adjustment in the trim of the hind hooves eliminated this “mystery lameness” for nearly every such horse I trimmed. The best part is that I also learned of a telltale point (similar to those used in acupressure) that indicates when a horse has the need for this particular trim adjustment.

The Hoof Point

I’ve been calling this point the “hoof point.” It has not been identified to me by any acupuncturists, but it is somewhere near BL 30. This hoof point is a pressure point in a “hole” near the top of the hindquarters, on each side of the horse. It is very reactive in many horses. When you press a blunt-pointed object on it, the affected horse flinches, or the muscle tissue around the point twitches. In fact about two-thirds of the lame horses I see are reactive at this hoof point. A shortened stride and vertebral subluxation (misalignment) are often associated with it.

This point on the rump is near an area often used by bodyworkers to cause a horse to lift his back and round his haunches. The hoof point causes a similar reaction. But the hoof point is one specific spot and it responds to a press, not a stroke or a drag over it. Acupuncture points that may be in this area are associated with many things that could cause this hoof point area to be sensitive.

But the connection between the hind hoof imbalance and the hoof point reactivity is common, whether it’s muscle or energy related or some combination. There are also important acupuncture points at the coronet band and hock that could play a part in puzzling lamenesses. Just keep in mind that all systems and parts of the body are interrelated, so there may be a lot of interconnections going on. In the hoof point, I am seeing one of those connections.


WHAT TO LOOK FOR. Sighting down the suspended left hind leg, aligning hock and sulcus, reveals excess inside heel. The dashed line shows the current ground surface plane. The solid line shows the perpendicular ground surface plane. Note the height of inside coronet band compared to outside (white arrows). I’d lower this horse’s inside quarter to at least the solid line, and leave the outside alone for now. The horse’s inside quarter and heel will probably let down eventually to the black arrow, its natural height.

Common Imbalance

These reactive horses have a common imbalance in the trim of the hind hooves: high inside heels. Actually, I have found that if the hoof is high anywhere on the medial side, this point will be reactive. I started balancing the hooves accordingly and found it eliminated the hoof-point reactivity — immediately in some horses and over a short period of time with others. (There may be some cellular memory that needs time to go away.) I can tell if I have trimmed the hind hooves correctly on many horses with this problem when the point is no longer reactive. That means the hoof is properly balanced. 

Effects Of This Problem

A high inside heel has a major negative impact on a horse’s skeleton and movement. To put it bluntly, it cripples the horse. High inside heels, which are heels with excess length, do about the same thing to the horse’s hind legs that wearing a lift along the inner (medial) side of your shoes would do to your legs.

At first, it may be only as irritating to the horse as if a piece of bubble gum were stuck to the medial sole of your shoe. But because all the ankle, pastern and leg joints are put under stress sideways, in time it cripples. Try it — or stand and raise the arches of both feet. You can feel the tension immediately in your hips and ankles and elsewhere. In the horse, not surprisingly, hock, stifle, hip and sacroiliac tension can all occur.

Moving around and working in this posture, the horse’s hindquarter muscles are used differently and the hoof point area becomes sore and reactive. Trying to avoid or compensate for the pain, the horse shortens his stride, which can contribute to a loose patella (kneecap) at the stifle. When he halts, it is with a quick jabbing motion of the hind legs — almost a hop.

Long-Term Effects

Over time, he learns to overuse the front legs (he “goes on the forehand”) and the shoulders become overdeveloped. The hindquarters will lose muscle mass because he is trying not to use them. I have seen these horses end up with draft-like front ends and giraffe-like hind ends.

If only one hind hoof has a high inside heel, there will be knee and pastern problems and possibly hoof lameness on the diagonal front leg. Because the stride is shortened in this diagonal pair of legs, there is often subluxation somewhere in the lumbar-sacral area, at the withers, and therefore at the poll joint. Typically, there is subluxation at both ends of the spine whenever there is a side-to-side imbalance affecting the spine. One high inside hind heel affects the horse’s side-to-side balance.

I often find this high inside hind heel to be the major contributor to most knee problems, splints and bucked shins — especially in the 2-year-old racehorses I’ve worked with. This imbalance also causes tooth problems, because it affects the way the horse holds his jaw — walking around in constant pain or constantly compensating for it.

Double The Trouble


CHECKING FOR A HIGH INSIDE HEEL. To hold the leg and not interfere with its natural suspension when sighting, lift it up, but not out to the side, supporting the front of the hock area. Suspend the untouched lower leg and let it hang naturally.

If both inside hind heels are high, there are even worse effects involving front-to-back balance. The hip rotates forward, putting a hump into the back. The spine compresses as the weight on the forehand is increased. The jaw is pulled back, which often creates upper hooks on the first molars. The horse cannot drive off the hind end, so he runs on the front end causing the front-end lameness mentioned earlier. 

On a hind hoof of a horse with hoof point reactivity, the inside heel is higher, but you may not notice it at first glance. When an inside heel is left higher than the outside heel, because the heel structure has no bone in it and is flexible, it gets compressed and pushed upwards so that the bottom surface of the hoof appears flat. However, if you get down on the ground and look at the hoof from behind, you can see that the inside bulb is pushed upward and is higher than the other bulb. This might be visible in the coronet band heights, too.

Looking For A High Inside Heel 

A more reliable way to see this imbalance is to look at the heels off the ground. Stand beside the horse’s rump facing backward. Hold the hind leg up (but not out to the side) by supporting the front of the hock area rather than the hoof. Suspend the lower leg and let it hang naturally. Avoid touching the cannon bone or anything on or below the hock, so as not to affect the natural alignment.

Lift higher and the hoof will naturally tuck toward its ergot. Lift or lower the leg so you can see the plane of the ground surface of the hoof. Looking, with one eye from the hock straight down the cannon bone to the back of the hoof and the ground-surface plane, you can then see if the ground-surface plane is perpendicular to the sight line, or if one bulb and heel is higher than the other. You can also visualize a V from the ergot to both heels (ground surface contact). One side of the V will be longer.

I’ve observed that many of these horses with excess inside hind heel actually sound different running down the track and I can see how it affects their gait. I’ve also seen that if a horse has a high inside left heel and is running around the track on the left lead, he will throw the opposite front awkwardly. There appears to be a wobble in the right foreleg.

Even standing around, the posture of horses like this is affected. They will not stand square, and they tend to rest one hind foot or the other almost all the time.

Once balance has been achieved, they stand square immediately. Another indicator, obviously, is that the shoe will show more wear on the inside than the outside, from the inside quarter to the inside heel.

How To Trim And Balance A High Inside Heel

We are aiming for balance for a particular horse and by balance, I do not mean achieving equal heel height. We will probably need to go beyond that, to a lower inside heel. Many horses will have a reactive point until the inside heel is actually much lower than the outside heel. Most horses do have a naturally low inside heel. I have yet to find a horse that goes better with any amount of higher inside heel, and very, very few can run down the racetrack with a higher (or even an equal-height) inside heel and stay sound.

We have to trim for the horse. Trimming or shoeing to have perfectly level heels may be people-friendly, but it is not horse-friendly. We cannot shoe or trim a horse with the goal of having perfectly level heels and still have them go sound. Just because it looks balanced doesn’t mean it is balanced for the horse. And I have yet to see a high outside heel causing such problems.

There are different ways to trim off the excess heel, depending on the hoof. Most of the time I trim the inside heel first and take off as much as I can to the outside toe-end of the quarter. When eyed from above, the outside heel will be naturally level with the inside quarter. You may have a different way of removing heel.

This will be a wedge removal, with the wedge getting deeper and wider toward the heel. Rasping off this wedge of heel makes room for the compressed heel, bulb and frog to “let down” until the heel comfortably meets the ground. Recheck the hoof point for reactivity and rasp off more as needed.


REACTIVITY. Notice this horse’s tail tucking and back humping as the “hoof point” on each side of the rump is pressed with a round-tipped narrow instrument. This response happens when the inside heel of one or both hind hooves is too high.

Adjust As Needed

It might take only four strokes of the rasp if the inside heel is only slightly high, or it might take 40. If you aren’t experienced enough or don’t feel comfortable removing a lot of hoof in one trimming, then don’t. Better to err on the side of caution. You can recheck the point reactivity and sight down the leg daily to see how much more you need to do. You will see how it is dropping and soon you will see how the horse’s posture and way of going are improving.

But avoid prolonging the problem. Don’t let hoof growth get ahead of you. I have removed as much as an inch of excess heel in the first trimming when it was needed, with no problems — just a lot of relief for the horses. Several years later, these horses are still doing great in maintaining those heel heights.

If a heel is only slightly too high, making room for it to let down will result in almost immediate improvement in the reactivity of the hoof point. If it was quite a lot higher than the outside heel, it may take overnight or up to about 4 days for the heel to let down to ground level. Reactivity of the hoof point could take that long to subside, too. 

When I can, I leave the shoes off a racehorses for 4 days after lowering the heel, to let it find its natural balance. I then recheck the point for reactivity and adjust accordingly. 

Generally, once you have achieved optimum let-down on the heel, the hoof point will no longer be reactive. It’s as simple as that. And if you continue to trim horses this way, they will stay sound and comfortable. It is no surprise to see major improvements within a few days. They can rebalance quickly.

Once the hooves are balanced, skeletal imbalances might just fix themselves. It would be a good idea to get them checked out by a qualified professional.