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The term “whole horse” has been used by many different professionals to describe a whole
to the fact that many professionals feel that the emphasis of treatment appears to be more
focused on symptoms rather than treatment of the insult or underlining source of the
symptoms.  

The term “whole horse” means taking a holistic viewpoint.  A holistic viewpoint is based on
the law of nature which implies that a being is a whole made up of interdependent parts.  
When one part is not working at its best, it impacts all the other parts of the being.  It simply
means looking at the whole picture in order to restore soundness and wellness to the
horse.  A holistic approach considers anything and everything that could affect a horse’s
health.  It means asking WHY the lameness is occurring, WHAT is the original insult or root
cause, and HOW can we treat the cause as well as the symptoms, not just the symptoms.  

A holistic approach can be accomplished in many different ways.  Too often some
individuals confuse holistic with an alternative or complimentary approach.  A holistic
approach can be accomplished by traditional methods of treatment, alternative methods,
and/or anything in between.  In reality, all veterinary medicine may be considered holistic in
that it should consider all aspects of the horse in the context of its environment.  The same
concept should also apply to the farrier.  For the farrier, it means recognizing that the
imbalances in a hoof are directly caused by the body and conformation of the horse.  
Examples of this may be returning hoof imbalances, hoof cracks in one hoof not due to
injury, crushed heels, hoof heel height differences, rotational deformities in one limb, etc.  It
also means that recognizing that many lameness problems are either directly caused by or
made worse by uneven body weight bearing.  Examples may be palmer-heel pain issues,
navicular issues, suspensory strains in one leg, laminitis/founder, club foot (not club feet),
etc.

Albert Einstein defined insanity as “doing the same thing over and over again and
expecting different results.
 

Farrier's will trim the heel down on a club foot or high heel and iwhen they returned in five or
six weeks, the heel would be completely grown back - insanity.  No shoeing options would
make this stop – insanity.  Why if a farrier did nothing to the heels of the club foot or high
heel hoof would they eventually just stop growing at some point?  They did not just keep
growing and growing.  What would cause the heels of one foot to grow more or stop at
some point?  The answer to these questions was not resolved by the many different farrier
and veterinarian treatment approaches.  The answer became simply, the insult was not
being treated, just the symptoms.

There will be a certain commonality among many types of lameness problems, especially
those with a club foot.  Most will have noticeable body imbalances such as a curved neck
and back spine, scapula height indifferences, and muscular indifferences.  It is no wonder
these horse's have problems in their limbs and feet.  You will observe that nearly every
navicular diseased horse, one legged palmer-heel pain horse, and club footed (not club
feet) horse, will have the same commonality.

This commonality of body imbalances is known as limb length inequality (humans) and
limb length disparity or bilateral asymmetry (in animals).   Limb length disparity (LLD) is an
observable body imbalance and physical deviation that manifests itself in a structurally
and/or functionally different limb length, and more than likely has been created due to
congenital, hereditary, injuries, environmental, muscular and/or spinal problems
(Esco
Buff, PhD, CF, 1999).
 There are two types of limb length disparities, structural and
functional.  Structural LLD is an actual anatomic short limb, is rarer, and I’ve only seen this
in a few horses.  Functional LLD is a limb that functionally behaves as a short limb and is
very common in humans and animals.  

Recognizing body imbalances will help you identify current and future lameness problems.  
Body imbalances may show up as mismatched hoof sizes and shapes, different heel
heights, different heel angles, different phalanx angles, chiropractic misalignments,
pectoral muscling differences, chestnut and knee height differences, shoulder size and
form differences, scapula height differences, to name a few.  In motion, body imbalances
may show up as a difference in the cadence or hoof beat rhythm, hip hiking more on one
side, hips sashaying more on one side, the horse turning better one way than the other,
unexplained behavioral issues.  For the farrier, body imbalances may show up as a shoe
pulled constantly on one foot more than any other, a hind limb that is easier to work on and
one that the horse is more rigid or difficult.

Here is what some recent researchers have found about having body imbalances, bilateral
asymmetry and limb length disparities.  
  • Remarkably, effective limb length asymmetry explains 98% of the observed variance
    in locomotor cost across a wide range of terrestrial species including mammals,
    birds, reptiles, and anthropods (H. Pontzer.  Washington University. Journal of
    Experimental Biology, 2007:210, 1752-1761).  
  • It was demonstrated that asymmetry in limb length of the equine limb were
    significantly associated with hoof spread and unequal loading of the limbs which
    contributes to injuries and reduced performance (G.H. Wilson; K. McDonald; M.J. O’
    Connell, University of West England, Gloucestershire.  Equine Veterinary Journal,
    2009, (3) 238-241).  
  • The fact that we are able to demonstrate a consistent negative correlation between
    asymmetry and performance in 336 Thoroughbred horses strongly suggests that
    bilateral asymmetry (limb length disparity) is a potentially important performance
    indicator in the horse (Barriball, K, Curry, MR, Williams, G, 2004 Conference on
    Equine Sports Medicine and Science.  2.2 Abstract, The Elite Race and Endurance
    Horse).

For the farrier, as time passes and our understanding of the horse increases, it becomes
all the more important to take the entire horse into account before trimming or shoeing.  As
farriers we need to remember some principles of biology.  The first is “function follows
form,” which means the horse’s body conformation and spine control the way that it moves,
not the hoof.  The second is “form follows function,” which is a secondary effect to “function
follows form, “ and means that the hoof does not control the way the body moves, rather the
hoof capsule distorts due to uneven loading.

Being in balance is obviously important to many farriers and in the best interest of the
horse.  A whole horse approach or holistic approach is to use the entire body to determine
the balance of the foot, not the hoof or lower limb or T-Square method.

When determining how form effects function and therefore hoof balance; you will need to
first analysis the form for conformational issues.  Each leg has a center of gravity.   Its
position can be determined by dropping a plumb line from the point of attachment of the
limbs to the body trunk.   Ideally, this will pass through the center of the insertion of the deep
flexor tendon on the semilunar crest of the distal phalanx.   Any deviation of the foot from the
plumb line indicates a defect in limb conformation that will affect hoof balance.  

An understanding of conformation will help you start to recognize how it affects the hoof.  
How does conformation issues affect your farrier treatment?  Do both front limbs have the
same conformational issue or are they different?  If the same, how can you provide farrier
treatment?  If the front limbs are different, how is this possible and what is it telling you (try
looking at top line and you will see a whole body imbalance and more than likely a LLD).
Conformation can also be documented on each horse with the aid of photography and/or
computer programs.  Providing documentation will allow you to be able to access you farrier
treatment in order to make sure the horse is progressing forward.

The next step is to observe the horse walking away and towards you in order to access the
body movement and how any conformational or whole body imbalances are affecting the
gait of the horse.   Note how the tail hangs and moves as the horse is walking directly
away.  Does the tail equally appear to move from side to side; or lies motionless in center of
body; or off to one side; or move to one side more than the other?  Note how the belly or ribs
of the horse moves as the horse is walking directly away.  Does the belly or ribs equally
appear to move from side to side; or more pronounced or further out on one side more than
the other?  Note the straightness of the front limbs from the shoulder joint or point of
rotation perpendicular to the ground as the horse walks towards you.  Does each limb
appear straight and perpendicular to ground as the horse moves; or does one limb appear
to move inside a perpendicular line, or outside?  Note the tracking of the hind limbs in
relation to the front limbs as the horse walks directly towards you. Does each hind limb
appear to land directly behind, inside or outside the front limbs; or does one hind land to
one side of the front limb and the opposite hind limb to the other side of the front limb?  
Standing behind the horse, observe the hips of the horse as the horse walks directly away.  
Does each side appear to equally move the same or up and down as other side; or does
one side appear not to move; or hip hikes more?  Standing behind the horse, observe the
point of hips of the horse as the horse walks away from the observer.  Does each side
appear to equally move forward or sashay the same as the other side; or does one side not
move or sashay at all?  Does the cadence sound uniform or in beat; or does one limb
sound heavy or lighter?

As you can see, there is a lot more time involved when assessing the whole horse.  Farrier
treatment of lameness issues due to body imbalances is not a simple, “do this-do that”,
shoeing answer.  Over the years, some individuals have presented hard and fast whole
horse farrier treatments, which have had mixed results.  It is not that simple but it is not so
hard either.   It takes some knowledge and observational skills in anatomy and locomotion.  
Increasing your skill level and knowledge in chiropractic, massage, and other related fields
will help you along this learning curve.  Often I think equine professionals forget that the
front limbs and hind limbs are attached via a body that greatly affects both as well as one
end affecting the other end of the horse.  An example of this is just because one front foot
has a more upright heel does not mean that the issue is a front end issue.  It is more than
likely a front and hind end issue, and could have been totally created by a hind end issue.  I
have seen horses receive chiropractic treatment for pelvic issues, go completely sound,
and watch the upright heel disappear over a couple trimmings.  The hoof was deforming
due to the imbalance created in the body.

Some key points to remember about the whole horse approach.  
  • Body asymmetry is often the first clue that the horse may have future lameness
    issues.   
  • Understanding the prevalence of LLD and how these differences can contribute to
    lameness issues will yield important clues in helping you provide successful
    treatment outcomes for the horse’s biomechanical problems.  
  • Addressing the chief lameness issue without looking at the interrelationship
    between the injury and the rest of the body can allow some problems to slip by
    without being properly identified.  A Holistic Approach needs to be adapted.  
  • Learning how to assess the whole horse can be an easy addition to your
    biomechanical exam of the horse.  Integrating this assessment into your diagnostic
    work-up will yield beneficial results.
Limb Length Disparity and
The Whole Horse Approach
Esco Buff's Professional Farrier Service, LLC