Immobilization or Stabilization?

The more we learn about the equine hoof the more we come to realize the importance of stabilization. The conformation of the hoof capsule becomes a wonder to behold when you examine each individual structure of its make-up. In my teaching I stress the importance of defining correct conformation and health of tissue for a given structure, knowing this enables us to define a structures function. The hoof wall in itself is composed of a number of structures, each being defined by its conformation and the make-up of its tissue.
When it comes to the hoof capsule, stability defines its health. The hoof wall is a matrix of epithelium and within that matrix are primary tubules originating at the coronary band and laminar derived inter-tubular horn originating at the lamellae.
The ratio of tubule to lamellae derived horn defines the walls primary function at any given location in the hoof wall. For example: The toe region of the hoof capsule has a high ratio of primary tubules to that of laminar derived horn, this when compared to the heel area of the hoof capsule. Primary tubules resist distortion, whereas lamellae derived horn is well suited to distortion and buffering. You see primary tubules provide the stability to the matrix much like re-bar to concrete. Primary tubules produced a the coronary band are quite dense.

Foundation, Foundation, Foundation 
We must look to the foundation of a structure to truly understand the why of its make-up. The foundation of the toe is the coffin bone, where as the heel has a foundation of cartilage. It is a fact that the foundation of the caudal (back) hoof is cartilage and the foundation for the dorsal foot is bone. With a high ratio of tubules to lamellae derived horn in hoof wall surrounding the coffin bone we can deduce that the function of the toe is one of support and protection. Not physical support, but rather to support locomotion. Protection comes in the form of stabilization, helping to reduce torque about the coffin bone and with a layer of lamellae derived horn between the coffin bone and the hoof wall matrix a buffer is created to protect the dermis.

Looking at the heels we find a foundation of cartilage. The hoof wall in the heel has a matrix comprised of a high ratio of lamellae derived horn to that of primary tubules. This ratio allows for distortion to occur in the caudal foot, while protecting the dermis by way of buffering the shock created at impact.
Why do we want distortion in the caudal foot? 
The simplest of answers is; because of the foundations of the foot. Cartilage throughout the body is often present to protect bone and this is true of the Ungular Cartilages of the equine foot. Cartilage health plays a major role in protecting the coffin bone and navicular apparatus from torque.
How did I come to this conclusion? By asking another simple question: Whys is the frog a triangle? Or Why is the Frog Stay a "V". As I stated earlier function is defined by a structures conformation and the property of its tissue. The foundation of the frog stay (inclusive of the bars) is essentially Ungular Cartilage. When I lectured at the National Farriers Conference in Normandy France I presented an analogy to help explain the function of the Ungular Cartilages.
I related the coffin bone to a tow vehicle and the ungular cartilages as a horse box (trailer). The union of the cartilage to bone was portrayed as a hitch with stabilizer bars. The function of the trailer hitch was to reduce or eliminate torque on the vehicle. The stabilizer bars (springs) provided elastic potential to stabilize movement and further reduce uncontrolled movement on the vehicle. Cartilage has the same function. Having a high elastic potential cartilage effectively reduces torque on the coffin bone and the navicular apparatus. I pointed out that stabilizer bars allow for optimal performance in towing and if they are removed excessive movement can occur placing strain on the vehicle. I also pointed out that if the hitch was to be welded solid the vehicle would be exposed to extreme torque and strain. I know this is a simplistic way of looking at function, but it often helps my students understand the difference between Stabilization, Instability, and Immobilization.
With this understanding my students are able to evaluate the vast array of bar shoes, flexible shoes, pad, and boots being used on horses today.
A foot stricken with instability due to weak cartilages will not do well in a flexible horse shoe, simply because unrestricted movement can be detrimental. Such a foot will not do well in a bar shoe either. The reason; because cartilage needs pressure to maintain or return health. Cartilage does not derive its nourishment directly from the circulatory system, so increasing circulation by loading the frog or allowing for expansion does not suffice. Cartilage needs to be stabilized not immobilized. How is this done? By providing stability through support with elastic potential. There are many products out there that can provide dynamic stability through elastice potentional to the weak hoof, using titanium shoes or steel (spring) shoes are two ways. The product pictured is  Perfect Hoof Wear, a polyester wrap. Our students learn that an unstable foot can be stabilized by using the PHW and adding a flexible horseshoe to the wrap
for performance.

Take a Load Off (F=M x A)

How Body Condition influences Hoof Care Practices.

by Keith "KC" La Pierre, MIAEP, APF, RJF

Being the first week of the new year my thoughts focus on maintaining or achieving better health in the coming year, this not only for myself, but for my horses and the horses in my care as well. 

Close observation of the horse's body condition helps in my preparations for upcoming seasonal changes, and the riding season. Experienced horse people know that a heavy winter coat can hide a multitude of issues. Changes in water intake, diet and exercise all result in loss of conditioning. Some horses lose weight, others gain weight. 

As an Equine Podiatrist the horse's body condition is important in determining a reasonable treatment protocol and prognosis. Because of this, body scoring is included in the DAEP's (Diploma in Applied Equine Podiatry) Spectrum of Usability. 

When first called upon to work on a horse I always conduct a thorough evaluation of the whole horse, not simply its hooves. Let me give you an example of how body scoring helps in determining my course of action.

There have been occasion when I have been called upon to pull horseshoes off of a horse, this usually by a horse owner that wants to go natural or barefoot. However, when I see the horse and complete a thorough evaluation, which includes body scoring (we'll give the horse a 8) and the Spectrum of Usability of the hooves (we'll give the horse a 2), I find that my recommendation must be; do not pull the shoes. In this example the recommendation was not made because the horse had a low body condition score, but rather a high body condition score. A high body condition score coupled with a low Spectrum of Usability score. In the practice of Applied Equine Podiatry we utilize the Spectrum of Usability to assess the capability the horse's feet have to deal with force. Each structure is assessed and rated on a scale of 1/9, with 1 being poorest, unlike body condition scoring 9 is healthiest. In body condition scoring 1 is poor, 5 is healthy and 9 is poor. The horse in this example scored high on the body score, which means it was overweight. Also in the example the horse scored low on the S of U. A low score on the S of U indicates a foot that cannot easily cope with excessive force, (a weak, unstable foot). You may be aware that Force = Mass x Acceleration. When assessing whether a horse's foot needs stabilization and to what degree, is in part determined by body condition. Fortunately we now have alternatives to conventional horseshoes, (immobilization). We now have products that offer dynamic stabilization, such as Perfect Hoof Wear. In the not so distant past the recommendation for the overweight horse that had unstable hooves would be to stay in shoes for the time being, get some weight off the horse and remove the shoes when the environment was best for rehabilitation (drier summer months for example). Today we can apply products that offer stabilization and correct stimulus for the return of health to weak unstable structures (hoof wall, heels, bars, etc), while allowing the horse to be placed into a weight loss and rehabilitation program. Every hoof care provider should be well versed in Equine Body Scoring and should utilize this knowledge to keep the horses in their care safe and sound. 

Here is a video/power point that will help you to better understand body scoring and how our graduates (DAEP) utilize body scoring to help in the rehabilitation of your horses hooves.

    

Hoof Wall Matrix

The Matrix Loaded, Unloaded, Reloaded? 

by KC La Pierre

What on earth am I talking about? I'm about to expose you to the latest information on hoof wall health. Information that will, I hope change your entire perspective on hoof wall health.

For nearly a decade, I have taught the importance of inner wall health and the how inner wall health is vital to overall foot health. Where my explanation of hoof wall health may have been lacking is in the definition of the Matrix.

The Matrix The hoof capsule and the components that comprise it consist of zones (areas of differing matrix); each matrix is responsible for a multitude of functions. The Matrix is a blending, or combination of different types of horn that constitute a structure (hoof wall, sole, white line, or frog.) The outer hoof wall that you see consists mainly of horn tubules and provides protection against moisture loss and toxin ingress. It is also responsible for the storing of energy created by the stride, to be released during breakover. The outer wall must be strong and hard to resist the leverage forces that occur throughout the stride. The outer hoof wall however is only one part of a more complex matrix. The matrix of the hoof capsule is made up of tubules that originate at the coronary band. These tubules are bound tightly together by a specialized Intertubular horn that acts much like super glue. As we move deeper into the wall's matrix, we find horn produced by the lamellae blending with the newly developed tubules. This blending takes place just below the coronary band, in those areas covered by the periople. Periople is known as the stratum externum, and serves to protect newly developing wall. Progressing further inward, the ratio of tubules to Intertubular horn (horn produced at the lamellae) is reduced, until we reach the zone of matrix known as the stratum internum, also known as the inner hoof wall. This inner most hoof wall, often described as the water line, is far more pliable than the outer wall, and is well suited to distortion without breakdown. The inner most wall is easily identified by its lack of pigment. Research has provided strong evidence that the Intertubular horn of the inner wall originates at the laminae layer of the foot, and grows from the inside out, blending with the tubules of the outer wall to form the matrix. The healthiest of hooves contain a strong Matrix (blending) of both types of horn. The inner most wall having fewer tubules is far more pliable than the outer most wall. This inner most wall (Stratum Internum) acts as a buffer zone between the sensitive structures of the foot and the dense matrix of the hoof capsule known as the (Stratum Medium). When the foot is asked to distort, it is the inner wall's responsibility to absorb much of the pressure created by the lever forces created by the outer wall and stride. Our research points to poor matrixing as a primary cause for reoccurring hoof wall cracks, wall separation, and white line disease.

Cause and Effect After much research, the logical conclusion is that hoof wall disorders are most commonly seen in those horses where correct foot function is lacking. The need for proper balance and distortion is very important to proper foot function and the resulting matrix . As stated, the matrix that is characteristic of the healthy hoof occurs just distal to the coronary band, in those areas covered by the periople, and grows distal to the ground. There can be several causes for poor matrix to occur, and often it is a combination of causes.• Lack of distortion, most commonly caused by shoeing or lack of exercise.• Imbalance resulting in improper distortion.• Poor hydration, leading to acidity, and ph imbalances.• Compromised nutrition, and vitamin/mineral imbalances.• Compromised immune system, often resulting in infection of periople, and hoof wall.• Damaged periople, caused by toxins (toxic hoof dressings, shampoo, oils), or injury. Matrixing also occurs in other areas of the hoof capsule, including at the white line, frog, and sole. Wherever the mechanism needed for correct matrixing is lacking, areas of infiltration of bacteria and other micro-organisms can occur, this leading to horn failure (hoof wall cracks, wall separations, white line disease, frog infections, and sole cracking). Balance can play a huge role in hoof wall health. A weak matrix, coupled with imbalance in the shoeing process, cause excessive stresses to be placed on the hoof wall leading to cracks. It is not uncommon for the farrier to suggest removing the shoes for the winter, "to give the foot a break from shoeing." What often happens is that the foot is not given enough time to see a healthy matrix reaching the ground, and the wet spring environment plays havoc with the increased inner wall that is presented to the ground. The inner wall is very susceptible to infection when not matrixed correctly. With the matrix occurring higher up the hoof wall, it does need adequate time to grow down, and those hooves that do not present a strong matrix at the ground are more likely to develop infection, cracks and separations.

Treatments Now that we have a better understanding as to the cause of hoof wall problems, what can we do to cure or better yet prevent them? With the understanding that environmental stimulus (distortion) is responsible for the health of the matrix within the foot we can develop a treatment plan to cure an existing problem or develop a preventative strategy to prevent future problems. First and foremost, use a hoof disinfectant to rid the foot of harmful bacteria. I highly recommend a product called Clean Trax. Clean Trax is a deep penetrating hoof cleanser that is often effective in one treatment. Follow up with a daily treatment of Silvetrasol Hoof and Wound Wash, our non-necrotizing topical anti-bacterial solution. I recommend staying away from products that contain formaldehyde, bleach or other necrotizing ingredients. You may have come to the conclusion that I promote going shoeless for the health of the matrix, and for a foot with a hoof wall problem this is no exception. I have successfully treated toe cracks, wall separations, and white line disease shoeless for many years now. Though there are excellent products that can provide dynamic stability to the unstable foot.  I, like many farriers, have tried resections, patching, lacing, and corrective shoeing. Don't get me wrong, there will be times when the foot has lost so much structure that the only course of action is to stabilize the capsule. We now have Energetics Brand Perfect Hoof Wear for cases where stabilization is needed. A balanced stable foot that is exposed to the proper environmental stimulus (distortions) for the return of healthy matrixing will be a foot that is not likely to develop severe hoof wall issues. What is the proper environmental stimulus you ask? Exercise! Provided stability exist or can be achieved, hand walks over uneven surfaces will do wonders for the horse with a lack of horn matrixing. Balance in the foot is critical allowing for correct distortion to occur, thus providing the necessary pressure for correct growth and matrixing to occur. Often thirty minutes a day of hand walking for eight weeks will produce visibly healthy growth of the stratum internum (inner most wall). It should be noted that it will take several months for the hoof wall to fully matrix, as the matrix is formed just below the coronary band and must grow to the ground before it is evidenced.

Diet as a Factor

Evaluate your diet program. A well balanced diet will go a long way to developing a healthy matrix within the hoof capsule. It is best to consult with your veterinarian on dietary requirements for you horse, as requirements vary from region to region.

Regardless of the diet you have chosen for your horse, hydration is the most important factor in correct matrixing. Hoof wall cracks, and separations that occur in early spring can be signs of mild chronic dehydration having resulted in a poor matrix.

Conclusion

Your role in hoof care as an informed owner is to provide a dry, clean environment that is conducive to the health of the foot. Begin with a well balanced foot, treat for infection, and provide a balanced diet, plenty of water and exercise.

The Truth about Applied Equine Podiatry

The Naked Truth about Applied Equine Podiatry by Robyn La Pierre  

 For the more than fifteen years, the popularity of barefoot horses has increased in volumes. The frustration of horse owners with the traditional farrier sciences has increased as well. Horse owners are looking for their own answers, answers to questions about balance and lifestyle, as well as how the hoof itself works and grows. Herein lays the problem. Currently, there is no real true model for farriers and veterinarians to follow, other than the practice of balancing the hoof to the lower limb and shoulder, which is a variable at best.  From this, horses have been suffering and developing syndromes, and diseases that could have been prevented had the horse owner known what to look for.
 Systematically, the barefoot craze has taken off. Often labeled as "designer trims"of the decade, these barefoot trim styles are offering an alternative to the traditional farrier practices. However, what are they based on? Most are based on the hoof of a wild horse and are concentrating on the exterior of the hoof. Some of these trims are extremely radical and are considered damaging to the hoof, with consideration given only to circulation and support. So what is the answer? This question explains the over abundance of internet sites and chat rooms that exist today where thousands of people question the different trims and the results they produce. Why all the confusion? Simply this, there is no true model that will support the greater majority of the hoof care industry. Not until today.
 At the Institute of Applied Equine Podiatry, KC La Pierre has begun to answer many of the questions surfacing on the internet. KC has been a registered Journeymen farrier for over a quarter century. However, he was never satisfied with the traditional farrier sciences, or the results he obtained in his practice of that science. His new theories and models on hoof wall growth help bridge the gap between the farrier sciences and the barefoot movement. What he teaches through his school, the International Institute of Applied Equine Podiatry, is how to define proper structure for the hoof and foot of the horse. Yes, there are two separate structures, a hoof and a foot. Most neurological and circulatory issues that plague our horses today are present due to an imbalance between the hoof and foot. Where the structures contact the ground is paramount to the soundness of the horse. KC is able to balance the foot using what he terms "the internal arch of the foot." This arch is not simply the coffin bone and whether it is ground or close to ground parallel. The internal arch includes soft tissue, lateral cartilages and all connective and sensitive structures within. His HPT (High Performance Trim) Method is his tool for achieving proper structure within the hoof. He balances to four dimensions, and utilizes the fifth dimension of time (T). Many farriers' today balance to only two dimensions, proximal/distal and rotational balance, however they label proximal/distal balance as medial/lateral balance and anterior/posterior. The fact of the matter is that medial/lateral and anterior/posterior balance as viewed by these farriers is actually proximal/distal balance (up and down) of the medial/lateral and anterior posterior planes. What about proprioception? Proprioception is the ability of the horse to know where its hooves are at all times, in relationship to its own body. Within the horse's foot there are five locations that have been identified where proprioception is heightened.. Heel placement is a key element in allowing the horse the ability to know where its hooves are at all times and how to correctly execute the stride. Most horses we see today have underrun heels that are naturally contracted due to forward movement of the hoof capsule. The frog, having a triangular shape will naturally cause the heels to move in or contract as the foot print moves out from under the horse. KC La Pierre addresses the functions that are present within the foot, and works to aid the horse in bringing back proper structure once it is lost due to incorrect stimulus.
 What has all of this information meant to the horse owner today? Yes, it has caused one more barefoot trim to exist and it has raised yet another question in their minds. However, please take this fact into consideration; KC does not consider himself a barefooter. This somehow confuses people. How can you not put shoes on and not be a barefooter? Being in the barefoot sandbox has not been an ally to KC and his work. Currently, many barefooters are against the farriers and many farriers are up in arms about the barefooters. Why can't we all just agree to help the horse? Isn't that what it is all about? Applied Equine Podiatry being the study of the hoof encompasses all of the cutting edge research and proven results that aids the horse in healing itself, and perform as it was meant to perform. Utilizing a spectrum of usability KC places the hoof onto a scale identifying where each structure lies at that present moment. Educating farriers, veterinarians and horse owners on proper structure, how to recognize it, and rehabilitate it is the practice of Whole Horse Hoof Care. Being an Applied Equine Podiatrist has nothing to do with barefoot foot per say, it has to do with creating the proper environment for the horse, allowing correct pressure to be the correct stimulus for growth. Once proper structure is returned, then apply a shoe if you choose, having the knowledge that by locking the foot into an environment such as a shoe, you are no longer promoting proper function or proper structure, and could quite possibly dissipate the structure you had stimulated to grow. Remember, most people shoe their horse to allow that horse to perform in a discipline, not for the health of the horse itself. KC has invented a viable replacement for the steel shoes. His design, Perfect Hoof Wear Pro Wear allows proper bio-mechanical and neurological function to occur. It does not however allow the hoof to wear naturally when applied; therefore it is imperative that a regular trim schedule be maintained. KC's Perfect Hoof Wear was originally designed for those who working towards returning proper structure to the foot, but didn't have the necessary structures to work over extreme environments where rocks, rough ground, or asphalt may cause damage to the hoof capsule. The PHW Pro Wear replaces all types of performance and remedial type shoes.
 In order to help the most horses, Applied Equine Podiatry needs to go main stream into the barefoot realm, farrier sciences and the veterinarian realm. KC La Pierre is working toward helping as many horses as possible in order to correct what he terms "DHS" (Deformed Hoof Syndrome). Being in the barefoot niche' will not enable KC to do so. Most people think that simply being barefoot is the responsible thing to do. However, often the environment that is present does not allow for the horse's ability to heal itself, and problems often arise. KC has dedicated his work to educating people about the science of Applied Equine Podiatry. KC's theories have opened many doors for many veterinarians and farriers the world over. But there are many more doors that need to be opened before we start to see a significant change in what has become acceptable in the equine hoof care industry. Applied Equine Podiatry is truly the cutting edge alternative to the farrier sciences.

 About the Author: Robyn La Pierre is the General Manager of the Institute being responsible for admissions, and overall daily business operations. Robyn has owned horses most of her life. Robyn began trimming horses nearly two decades ago and began studying AEP in 2001. Robyn is a published author, and devoted horsewoman. www.equinepodiatry.com