A case series of 27 horses with navicular syndrome treated by extracorporeal shock wave therapy was reviewed with comparisons of pre- and post-treatment lameness and radiographic scores. Most horses in the study were Quarter Horses and the median duration of lameness was 12 months. Follow-up was obtained at 6 and 12 months after treatment.

French equine veterinarian Philippe Benoit says one of the keys to dealing with situations that require opening up the heels is to promote proper heel expansion. He told attendees at the 21st annual Farriers Conference at Cornell University that one way to do this is by trimming the edges of the frog with a hoof knife to open the edges in a narrow V-cut, even cutting the bars. Benoit believes there can be problems with a loop knife or a hoof knife with a hooked blade, since you may not get deep enough to allow the heels to expand. He uses a straight knife.