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 when 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.
