Social norms are a collective representation of acceptable group conduct and an individual’s perception of their particular groups conduct. They are unwritten rules, expectations, behaviours, thoughts and beliefs of a certain group, underpinned by tradition, anecdotal influence, identity and peer pressure. Add to this the human nature of inertia, the tendency to remain unchanged, and the habitual prerogative of our basal ganglia to keep us doing things that are safe and within our comfort zone, and it’s easy to understand why questionable norms perpetuate, unquestioned. What is perhaps a more apt question is why do accepted group norms perpetuate despite people knowing they are not the ideal and when the ideal has been quantified? Familiarity breeds complacency.
What does this have to do with the horse and hoof care? In my work I am presented daily with horses presenting with conformations, postures, hoof morphologies and diseases that have been overlooked as norms, until such a time as they no longer could, when they became painful or pathological. Granted some things are congenital or acquired early on that are parameters for management, but many of these issues could have had much earlier interventions that may have halted the pathogenesis.
Firstly let’s talk about pain, because at the end of the day, the ethos of this article is that we, as keepers of the domestic horse, have an obligation to conscientiously ensure our horses are getting what they need in every aspect, from their tack, to their feet, head to toe, in order to be comfortable. This therefore also applies to the practitioners involved in all aspects of their management.
Horses are a prey animal, if they show pain they are likely to be picked off from the pack and put on the dinner menu, their instinct is to act as normal. This is shown by the studies of Dyson (2019) which took a random convenience selection of 20 horses, presumed sound, that were in regular work and found 16 of them to be lame, that’s a whopping 80%! This was quantified using a pain ethogram (Mullard et al 2017). The equestrian world has an obligation to familiarise themselves with this ethogram to recognise subtle indications of pain in our horses. This clearly shows an unacceptable norm within the industry, horses are working in discomfort with their changes in behaviour or performance unrecognised as possible indications of being in pain.
Fig.1 The unacceptable norm of unrecognised pain in association with behavioural or performance issues. Horses are generally genuine animals and changes in their behaviour or drops in performance should be investigated with the available technologies.
With that in mind, we have an obligation to constantly monitor our horses to pick up early physiological changes, to be addressed before they become pathology and we have a situation where a horse in pain is being asked to “work through it”. We must remember that our horses are athletes, they, just as human athletes will suffer musculoskeletal injury or discomfort. We can talk and express a niggling pain, go to the doctor or physio, they cannot! We need to recognise those discomforts for them by knowing their baseline and monitoring. There are modern technologies that can enable us to do this objectively. Two technologies that, in my opinion, are the future of objective monitoring, when used correctly, are thermography and objective gait analysis.
We must consider that in order to make preventative interventions we need the ability to detect changes that would be too small for the human eye, and certainly not observable enough for diagnostic analgesia. When the horse is “lame enough” for this method, we could have already missed the progressive worsening of the subtle signs. It is an unacceptable norm that we wait until horses are sufficiently uncomfortable to investigate. What makes it worse is that the observer recognition of lameness is questionable amongst experienced vets, let alone amongst the general equestrian population (van Weeren et al 2017). As objective gait analysis enables recognition of smaller and smaller asymmetries in locomotion, this raises the question of when is that asymmetry associated with pain. The marrying of gait analysis and veterinary grade thermography can clarify asymmetries associated with physiological dysfunction, as thermography can detect the bodies physiological response to the genesis of pathology way before structural changes. Used regularly these modalities could detect and therefore help eradicate another area of unacceptable norms, horses breaking as a result of training, workload and the failure to recognise degenerating issues. These modalities highlight the development and onset of pathology allowing changes to training, shoeing and other management interventions.
Fig.2 Objective gait analysis and thermography are two examples of modern technologies that will help end the unacceptable norms of allowing horses to become increasingly lame without recognition.
As well as dynamic response to early pathology, postural adaptation can be an early indication of discomfort and kinetic chain dysfunction and indeed predispose the horse to injury. It has been clearly documented in the human that antalgic posture is both caused by and causes physiological dysfunction, yet in the horse these postures become unacceptable norms and even classed as conformations. Studies are emerging discussing the importance of vertical metatarsals and in my experiential opinion non-vertical metatarsals, associated with camped under posture, is always concurring with pathology and/or poor hoof balance. Yet this posture is stated, even in the textbooks, as a conformation and horses presenting with this “conformation” are just the way they are. However, when I have treat the associated hoof morphology and the higher pathologies have also been addressed, the posture changes! Another unacceptable norm is uncovered here, the statement “That’s just how this horse is.”
Fig.3 The unacceptable norms of antalgic posture being labelled as conformations. This image shows how farriery and treatment of higher pathologies changed what was labelled as poor conformation.
Further quantification of antalgic posture vs conformation and its evidence of kinetic chain dysfunction, coupled with the knowledge of parameters that are within farriery and veterinary limits of intervention, will mean ending perpetual cycles of pathology.
This brings us nicely onto another unacceptable norm, the compartmentalising of the hoof and the rest of the body. Studies are beginning to show links between the hoof and higher pathologies, especially in the hind. The myofascial system is a relatively new concept in the horse, studies into its complexity show us just how interconnected the anatomy of the horse is. The myofascial lines go right into the hooves. Considering every anatomical point along a line directly affects every other and the position and orientation of every point will affect the position and orientation of every other, we can see how much influence the hoof will have on the body and vice versa. The concepts of bio-tensegrity, kinetic chains and myofascial lines will bring a new holistic outlook on the relationships between the hoof and the body and help to end perpetuating cycles of poor hoof morphology and pathology.
Fig.4 The myofascial lines.
In Fig.4 You can clearly see how many of the lines go all the way into the foot. Any anatomical point along these lines can affect every other, the unacceptable norm of compartmentalising the horse’s structures means concurring issues are overlooked and whole system health is not achieved. We have to treat horses and not symptoms. Holistic care will over-take conventional methods as the technologies emerge to quantify full body interactions.
Finally on to the hoof, poor hoof morphology and unhealthy structures have become so widespread that this unacceptable norm is a daily frustration and with the statement “no foot, no horse.” a huge factor in all of the unacceptable norms we have outlined. Firstly, outlining the ideals will help us to recognise the unacceptable norms.
Fig.5 Solar assessment of the hoof. Photo adapted with permission of barefoot-south.com
Looking at the hoof from the solar aspect, ideally, we have symmetry around the centre of rotation. The medial and lateral sides are mirror images of each other and the dorso-palmer balance ranges from 50/50 for the perfect ideal and up to 60/40 as a maximum acceptable range. Looking at more subtle ideals we have the frog as a symmetrical triangle with mirrored lateral grooves and a shallow impression as the central sulcus, it is also on the same plane as the heels and has nice proportions. The bars are straight and the white line is the same width all the way round. The bulbs of the heel are balanced and there is a shallow valley between them.
The reality is, what we see here is rare in the barefoot and even more so in the shod foot. We are so used to seeing contracted and prolapsed frogs, deep central sulci with thrush, split bulbs and bent bars that they are on the whole ignored and labelled as “normal”. Often when I describe these to a new client they are discombobulated as they had never been told! If they are not told about thrush, how can they treat it?
Fig. 6a+b common poor morphologies that have become normality.
Looking at the back of the hoof is something often overlook (Fig.6b) but can tell you so much about the health of the hoof. An unacceptable norm is contracted, prolapsed frogs, heels and bulbs. Bottom right hand picture courtesy of https://www.facebook.com/HoofStudies/.
Fig. 7 Lateral view of the hoof and pastern.
Fig.7, a shoeing job of mine. I think I’m right in saying this would be considered a good shoeing job, many of the ideals are met. It has a straight hoof pastern axis, good dorso-palmar balance, sufficient caudal support and nicely nailed on and finished, if I do say so myself. But let’s look closer, look at the hairline pathway, you can see how it begins to fall at the bulbs of the heel. The horn tubules follow and there is bordering on more than 5-degree difference between the heel and the toe angles. While farriery focuses on the parameters I have listed above, the unacceptable norms slide under the radar.
Fig.8 The unacceptable norm of caudal hoof prolapse. The image on the right courtesy of Progressive Equine.
The norm of prolapsing caudal structures (Fig.8) could be attributed to the traditional open heeled shoe with no frog support. The authors illustration shows how the caudal hoof structures can migrate through the shoe with non-frog contact because the descending body weight is not counteracted by the frog on the same plane as the heels. The heels suffer excess load, the haemodynamic system is not utilised efficiently and the caudal structures will inevitably prolapse. Another theory could be that the increased shock and vibration forces on just the heels at first impact create their eventual collapse, either way the reality is that much of the poor hoof morphology we see could be due to the way we shoe and the materials we use. One of the biggest factors, in my experiential opinion, on the cause of poor hoof morphology is this lack of haemodynamic function and the mechanisms of the caudal hoof structures. This poor caudal hoof conformation is very often responsible for another unacceptable norm, a Broken back hoof pastern axis/phalangeal alignment, a conformation predisposed to navicular syndrome.
With more and more studies showing the link between this hoof conformation and pathology a more proactive and idealistic view of farriery intervention is perhaps indicated.
Shoeing is a necessity and many horses have to be shod and are better for it, but if we can look at the facts, supported by peer reviewed studies, of improved barefoot morphology and ask why, maybe we can make changes to the ancient art of farriery that will mean these unacceptable norms and side effects are addressed. Rather than arguing barefoot vs shod, we have the technology now to provide the benefits of shoes while still providing the optimal mechanisms and functions of the barefoot. The future of farriery is creating an intervention that more closely mimics the barefoot providing the best of both worlds.
To understand the wrong, we have to have a clear understanding of the right. Although the ideals are taught, a lack of understanding of the importance of those ideals is what has allowed unacceptable norms to perpetuate. Unacceptable norms are changeable parameters that are overlooked, simply because they are ubiquitous. You have to look to see, you have to want to see to look and sometimes that means going against human nature and being self-critical. This is something I believe the whole equestrian industry needs to do. There needs to be a paradigm shift, for the sake of the horse.
In the light of the technological advancements in horse assessment, diagnostics and farriery, it is no longer acceptable for the unacceptable norms to perpetuate. This statement applies to the horse owners just as much as the professionals as they dictate who and what happens to their horses and the budget available to monitor and provide. The inevitable, needed paradigm shifts are that.
Horses will be monitored and treated preventatively - Instead of being reactive, with our increased knowledge and attention to the horses responses to pain and the technologies available to quantify these subtle changes, we will have a preventative, proactive approach to their management. Detecting, treating and making training amendments before these dysfunctions become pathological. Obviously, this hugely depends on the willingness of the owner to budget for preventative measures.
We will have a more holistic approach to treatment – These same technologies and the research into the interconnectivity of the horses systems will mean primary, concurrent and complimentary pathologies will be treated together with the understanding that there is no such thing as a pathology in isolation. Also, farriery will become an integral part of this treatment and vice versa as the links between the hoof and the entire musculoskeletal system are quantified.
Farriery will enter a new era of evidence-based practice – Just as with the preventative, proactive approach in managing the horses' musculoskeletal system, instead of farriers waiting till the horse has pathology to provide more optimum biomechanics and function, they will take a proactive approach, providing the things needed for a healthy hoof as default. Farriery will recognise the limitations and negatives of its age-old practices. Instead of disregarding the voice of the barefoot movement as quixotic, it will recognise the truths amongst the sometimes, dogmatic rhetoric, behind its utopian ideology and work toward creating the best of both worlds. It will look to the barefoot for inspiration and find ways to protect it while keeping it as natural as possible in its function.
Mainstream farriery must enter an age of evidence based self-contemplation. It needs to stop focusing on shiny shoes and mirror finishes and turn its attention to functionality. In the light of the modern materials and technologies available it should be open to questioning the ancient application of a steel, open heel, perimeter fit shoe. Not that it should disregard something that has stood the test of time, but it should allow science to cast its objective eye and suggest alternatives that may better suit natural function. Of course, the ability of the farrier to utilise modern techniques relies on the education and budget of the owner. That brings us to another change that is happening and I am certainly trying to push. The horse owner will be an altogether more educated entity!
With all of these unacceptable norms and their alternatives there is a re-occurring theme, no longer is it acceptable to wait till horses, or their feet are broken to try and fix them. Instead we should fulfil our obligation as their keepers in using technology to keep them healthy. The ideas of integrative, natural and holistic practice may seem hippie in essence, but look through history and see that first adopters and pioneers were always considered delusional. Looking at things more holistically inevitably makes things more complexed, but the reality is, it has to be done in order to create or maintain optimum physiological state. The seemingly small things that are overlooked could be having much bigger effects than we understand, keeping the ideal in our minds as our jiminy cricket will push us to aim for it in our daily practice. If we aim for ideal and miss it, then perhaps we will be within a working tolerance. Aim for the unacceptable norms…..well, I refer you back to the opening paragraph.
This article briefly outlines the unacceptable norms for the sake of concision, further reading and references can be found by clicking on blue linked words.