What does "long toes" really mean?
‘LONG TOES’ are usually LOW PALMAR P3 ANGLES and places the horse at GREATER RISK of INJURY, TRAUMA, DISEASE AND INFECTION!
When I am told “my horse has long toes”, and there isn’t a dish to the dorsal wall, my thoughts immediately go to the back of the hoof. Why?...
The pedal bone or P3 should align perfectly with the rest of the bony column which makes up the digit and its ideal position would make a straight hoof pastern angle (HPA) when viewed from the side. This makes the back of the pedal bone higher than the front and the angle would be determined by the natural length and slope of the pastern and also the size of the pedal bone.
When we assess a hoof, we are looking to see if it falls into the healthy ideal which we consider to be:
• Positive palmar (front hoof) or plantar (hind hoof) P3 angle of typically between 5-8 degrees • Straight hoof pastern angle or HPA (when viewed on a horse standing perpendicular to the ground) • Healthy posture – where all 4 cannon bones are typically perpendicular to the ground in a resting position • Phalangeal (foot and limb bony column) and capsular (outer hoof capsule) alignment • Appropriate vertical depth of foot and hoof • 3-dimensional medial/lateral balance of the hoof around the centre of rotation (COR) of the foot around the axis of the limb (phalangeal/capsular alignment) • Heel:toe ration of close to 50:50
We would also assess both STATIC and DYNAMIC balance and function.
Maintaining healthy ideals ensures OPTIMUM FUNCTIONALITY, balance, posture and movement and offers RESILIENCE AGAINST INJURY, TRAUMA, DISEASE AND INFECTION.
So if a horse has LESS THAN IDEAL SHAPE, POSTURE and MOVEMENT, it is therefore not functioning optimally and is at RISK of TRAUMA, INJURY, DISEASE and INFECTION!
A palmar P3 angle of less then ideal for a horse would be called LOW PALMAR P3 ANGLE and a palmar P3 angle of less than 0 degrees would be called NEGATIVE PALMAR P3 ANGLE and is more common in the hinds (which would be called the PLANTAR P3 angle) We can determine phalangeal and capsular alignment and palmar P3 angle by radiographs, however the horse and the hoof tell their own story and we suspect a low palmar P3 angle by visually assessing:
• The dorsal wall angle in relation to the ground • The coronet band angle in relation to the ground and dorsal wall • The height of the capsule, especially at the back of the hoof • The heel and digital cushion height, proportion to one another and angle to the ground • The conformation of the ungular cartilages • The HPA • The conformation of the sole • The conformation of the bars and frog • The posture • The gait/biomechanics • The heel:toe ratio • Signs of distortion versus pathology
Signs of low palmar or plantar P3 angles differ in the front and hinds and in both, there is often the impression of’ long toes’. This is due to the:
• unhealthy proportions between the heel and dorsal wall (with the dorsal wall being longer) • The sloping angle of the dorsal wall when viewed from the side • The sloping angle of the coronet band • The lack of height to the capsule at the back of the hoof
If you imagine a healthy HPA and plantar P3 angle, or even better, have access to a model of a digit, what happens when you lower the angle at the back but keep the centre of rotation around the joint in the same position? The dorsal aspect of the pedal bone moves forward, and the angle reduces both in the back and the front of this bone when viewed from the side. THIS IS WHY THE TOES APPEAR LONG!
We believe most horses in domestication have unhealthy ideals including palmar P3 angles and HPA. It isn’t entirely clear why but we do believe that certain shoeing and trimming practices can create it and also keeping and riding horses in environments which do not support healthy ideals and wear the heels too low for instance. Sometimes, simply not trimming appropriately to maintain ideals can create distortions which lead to broken back HPA and low palmar P3 angles.
A low palmar P3 angle means there is increased strain especially on the deep digital flexor tendon (DDFT) and associated structures (navicular, ligaments, DIP joint) and because of the longer toe:heel ratio, the increased leverage and torque this creates increases the force on both the tissues at the back of the foot and limb and also the tissue on the front. It also contributes to compensatory ‘goat on a rock’ posture which is depleting and places the horse at increased risk of trauma, injury, disease and infection elsewhere in the limbs and body. Research has demonstrated that for every 1cm of toe length in front of the ideal P3 position within the capsule can create an additional 50kg of strain on the DDFT!
We assess the horse, the hoof as well as the current and expected environment and weight this against the horses history, size, age, health and intended use. We then seek to provide healthier ideals or maintain these and will provide recommendations which may include interventions such as:
• Trimming to return to or maintain ideals • Booting (with or without orthoses/pads) • Shoeing (not the traditional open heeled shoe which we believe contributes to caudal heel collapse and distortions which lead to low palmar P3 angles) • Environmental changes inc physical footing in the rest and work areas • Management changes inc. Diet • Veterinary investigation • Dentistry • Therapy
It is possible to create positive changes using one or several of the interventions listed and we advocate for the intervention which we believe will provide the best opportunity for the horse to experience comfort and heal, in the short and long term.
In this example here, the previous trim method applied to the hinds before we met Saffy nearly 4 months ago created less than ideal proportions and this may have contributed to her soft tissue injury and posture issues affecting her hind limb function. However, since we applied a trimming technique which helps create ideals which provide a healthy base of support, the soft tissue injury has healed and Saffy no longer has the challenges she previously experienced. In this example, the owner helped maintain and promote positive ideals by trimming her weekly to reduce leverage and torque on the joints and encourage caudal hoof restoration. Lucky for Saffy, her owner Rachel Hamer is a skilled therapist so has been able to further assist with the integration of the trimming and morphological changes! Teamwork makes the dreamwork!
We have documented many times the positive palmar P3 angle changes when recommendations are implemented and in most cases, maintaining the horse safely barefoot and trimming alongside management and environmental changes are all that are required. However, shoes which are fitted appropriately to support healthy ideals and in a fashion to support the sole and caudal hoof structures can offer a suitable intervention where this is warranted and other intervention options simply aren’t viable.
Look out for our new educational events, products, services and resources coming very soon at our new website – you too can learn to recognise healthy ideals and provide a healing environment for your horse to become and remain healthy, sound and resilient!
To book Saffys owner Rachel Hamer- Mctimoney Animal Chiro & Craniosacral Therapist BSc hon, Msc for Chiropractic and cranio-sacral therapy for your horse or dog, visit: http://mctimoneynorthwest.co.uk/