Navicular, Navicular, Navicular

by Keith Seeley

Every time I hear this word, I can’t help but remember Jan in an episode of The Brady Bunch. “Marcia, Marcia, Marcia. All I ever hear is Marcia!” For me it’s like ‘Navicular, Navicular, Navicular… Well, you get the picture. The problem is, this seems to be the ailment of choice these days. Navicular Disease, or Navicular Syndrome as it’s also known, isn’t really a disease as we’ve come to know the word. It’s not like cancer, it’s not like having a skin disease, it’s not like contracting an STD, but it IS a DIS-ease. The word in the ‘old days’ was meant to describe an ailment or illness that put the body at dis-ease, meaning to be in an uncomfortable state. Well, navicular is a situation that does put the horse in dis-ease, but it’s usually not medical, instead, it tends to be physical, or rather, it’s mechanical.

So why is it that the word Navicular is being thrown around so freely? Why is it that so many horses are diagnosed with this ailment? I’ve often related the diagnosis of navicular to that of a virus in a human. I am going to over simplifying the issues here mostly for the sake of pretending and clarity. Let’s assume there is a problem with your horse, the problem appears to be in the heel portion of the foot and nerving or wedging does seem to relieve the pain, but the vets and farriers can’t seem to quite put their finger on what the exact problem is, but since all the ‘tests’ for navicular have proven positive, the problem must be Navicular Disease or Syndrome. Likewise in humans, doctors run into situations where they can’t quite put their fingers on the reason for a fever or a loss of weight or some other unexplained symptom. Since the problem doesn’t appear to be physical, nothing is broken or the like and there isn’t any one culprit that stands out based on their training, the problem must be a virus. Which one? Caused by what? How was it acquired? It could be anyone’s guess, right? In my experience being around these issues, I’ve found that what is often prescribed to treat the virus are Antibiotics. Antibiotics?! For a virus? That didn’t make sense to me then and it doesn’t make sense to me now, but it still happens. Navicular is just about a crazy. What is ‘prescribed’ for navicular? Anything from antibiotics, to nerving the feet to some kind of pineapple-split shoe or New Fangled Balance shoe or some sort of rocking horse shoe or even egg bar shoes with some way out whacky plastics or lumber to lessen the speed at which the ‘disease’ over takes your horse. I don’t think the vet or farrier intends to do your horse any harm nor do I feel they believe your horse can be healed once this dreaded disease sets in either. Your horse is doomed to a life of misery and torture while one expensive treatment or another ‘latest and greatest shoe’ is tried. They treat and shoe over and over again until there is just no hope of ‘curing’ this ‘disease’ and your poor horse is recommended to be put down or made only as comfortable as possible while he waits out is final days.

This is all really quite scary, un-nerving and, to be honest, all quite un-necessary for you and your horse. So what IS navicular, anyway? Well, as I said before, it IS a DIS-EASE. But it’s not a disease. It does show up in the heel region of the hoof. It does involve inflammation, pain and possibly even swelling in the back part of the foot and the DDFT (deep digital flexor tendon) area right around the pastern joint. But why is this? What causes the pain and inflammation? Stress on the joints, stress on the tendon and stress on the coffin bone. Yep, stress on the coffin bone.

Let’s examine some fundamental issues with why this is. First, the whole navicular issue isn’t some great mystery. Often times, we humans create the situation that leads to this whole navicular issue. We often time keep our horses in environments that aren’t conducive to allowing the horse to self trim his feet. I know, very few of us have an environment like that. If you are lucky enough to live where the wild mustangs live, well, your horse might be able to self-trim his feet and he could ‘cure’ his own disease. So, the environment is a partial culprit. Second, we farriers are guilty of causing the problem. We don’t understand the mechanics behind the problem, we basically only know what we’ve been taught and we are suckers for trying anything that’s the latest and greatest new fangled gadget. The end result, we really don’t shoe horses as properly as we should. We often time allow the toes to get too long and the heels to get too low for too long of a period of time. We tend to maintain that situation shoeing after shoeing until your horse comes up lame and the vets are called in to diagnose the whole navicular disease issue. When the horse gets worse, not better (even though we have shod the horse repeatedly according to what we were taught and told), we don’t really know why. The feet go through many changes, very few of them good, and the horse’s behavior gets worse and worse.

While we’re on the subject of the horse’s behavior, let’s look at some of the ways this whole situation can be overlooked. It all depends on what discipline you and your horse ride, but regardless of that, there are some similarities. It can start out very simple and very easily overlooked. You horse may start out not exhibiting his usual perkiness. He may not trot or canter as freely or as easily as he used to. When you ride, he may become difficult to motivate. Instead of moving forward, he may back up. He may want to buck you off; a trait he has never exhibited before. You try new saddles, new bits, perhaps even new shoes, but the behavior issues continue. Are these traits and behaviors associated only with navicular? Unfortunately not. This is one of the reasons why it gets misdiagnosed and so many other options are tried for the behavior, such as harsher bits, bigger spurs, harsher training, etc. Most of us forget to listen to the horse and what he’s trying to tell us. It could be teeth related, it could be saddle fit, it could be skeletal imbalance, OR it could be his feet!

So, if humans created the issue, why can’t it be easily treated or why can’t it be discovered BEFORE it becomes such a debilitating problem. Actually, it can be. Navicular can be reasonably easily spotted and treated. Did I just catch your attention? I bet I did. Ok, let’s go back to the fundamentals that make up the situation that causes this whole navicular issue. I’ve already given away part of the mystery. It’s really not a mystery at all, but you have to think that it is since there are so many horses being diagnosed with it. The primary situation is balance, or lack there of, of the leg and hoof. Virtually every horse that is ever diagnosed with navicular has LONG toes and LOW heels. (Some horses have very high heels and long toes, just so you know). It doesn’t matter if the horse is shod or not, though most horses with navicular are shod. Actually there seems to still be more horses shod than not, but that’s another issue. A shod horse is likely to test more absolutely positive for navicular just because of the nature of the shoes of the feet. Long toes, low heels you say. Why is that?

I’m glad you asked that question. You see, if a horse has long toes and low heels, the weight bearing point of the foot is shifted towards the back of the foot, towards the bulbs. This begins the ‘heel pain’ issue that the vets test for and find. Second, the long toe causes the foot and leg to go through more stress as the foot tries to break over with each stride. The muscles and tendons have to work overtime with ‘each’ step just to get the knee to begin it’s break over, then the coffin bone has to work harder to break over because of the extended toe and all of this stress and strain begins in the shoulder. Plus, since the heels are low and the toes are long, the joints all the way from the foot to the shoulder are placed in a state of hyperextension. This in itself puts the body in a state of dis-ease. You can test this theory yourself. Stand up, place your right hand on the table top with your fingers extended and your palms down against the table. Your arm should be almost straight and vertical, just like a horses leg. Now, place a bit of weight into your hand. Keep your elbow straight as you exert the pressure on your hand. You should notice that the majority of your weight is in the heel of your hand, not the center of your hand. Now pretend that your hand is a hoof and you’re going to take a step forward. Notice where the pain is in your arm as you go through the break over process? Now imagine this being your horse’s leg. If you were a horse, would YOU want to lunge or run or jump fences? I know I wouldn’t want to try to run or jump with swim fins on or with ski tips on the toe of my boots. Now then, to relieve the affects of the hyperextension, try extending your hand more forward, so that your arm is no longer exactly vertical. Does this help relieve the discomfort? It should. But now your weight is even more in the heels, which does what? It causes the heels to become crushed, rolled over or even under-run and it causes the quarters to become more extruded out the sides. It can cause the quarters to be weak, cracked or break out all together.

Let’s go back to your hand on the table again. With your palm face down and your arm vertical again, try raising the back of your hand, as though you had a little bit of heel and a shorter toe. Notice the pain of your muscles and joints goes away, almost completely and almost instantly. If you continue to adjust the angle of your hand to mimic the angle of a hoof with something close to a proper pastern angle, you should notice that all the pain and affects of the hyperextension goes away. Interesting, eh?

Now let’s relate what you just experienced with your hand on the horse. If he has been diagnosed as navicular, you should see a long toe with a low pastern angle. You should see very low, crushed and/or under-run heels. You should see bars that are likely laid over and not providing good support. You likely have a horse that has been said has thin, flat soles. Sounding familiar?

So what can we do to help your horse at this point? Is there any hope of soundness ever again? Will he ever be able to run and play without discomfort ever again? Are shoes the only answer? Is your horse destined to a life of unrelenting pain? Has every possibility been exhausted? Are the Caped Crusaders bound, bewildered and baffled? Are they truly doomed this time? Can Commissioner Gordon or Batgirl reach them in time? Have the Joker and Penguin finally outsmarted Batman and Robin? Don’t go away. Stay tuned to find out, same bat channel, same bat time. (oh, sorry. I think I got my delusions of grandeur mixed up with childhood memories of old Batman episodes. Hmm. Let’s try a less dramatic approach, shall we?)

As with founder, shoes are most often ‘prescribed’ for your horse because it’s what was taught in school and it’s how farriers earn their living. Shoes are ‘required’ and / or ‘necessary’ to manage or cover up the pain and discomfort. Often, egg bar shoes are used with varying degrees of wedge pads. The wedge pads are used because it elevates the back portion of the foot, which reduces some of the tension on the DDFT, which has been tight and strained and is causing the navicular bone to become jammed in the coffin joint. If you will remember the hand exercise we just went through, you can understand why using wedges help and why they seem to make sense. On the surface, this seems like a really good idea. I used to do this myself. But just raising the heels doesn’t correct the problem. Raising the heels with wedges does relieve tension of the DDFT, but it doesn’t correct the hyperextension of the joints, it doesn’t adjust the feet to the horse’s conformation and it doesn’t reverse the navicular issue. If only relieves the pain felt by the horse for that day. See, the problem with shoeing and wedging is, the farrier most likely didn’t do anything to correct the balance of the hoof or the horse. What I tend to see is, the toe is left long, the heels are left pretty much under-run and all that’s done is the foot has a shoe with a wedge pad on it. Just so you know, not all navicular diagnosed horses are shod. Some are barefooted, but the same stresses and strains are at play. So why not make adjustments to the hoof wall to make corrections to the imbalance? Because farriers are taught that they are to trim to the horses conformation and if the toe is long and the sole is flat, that must be the horses conformation, especially if the feet have been this way for a long time. They are taught in some schools that removing outer wall will cause the foot to fall apart, which it doesn’t, and they are likely taught by some that, as with founder, it can’t be reversed. Once you have a horse with navicular, they only way to rid the horse of pain is by having expensive and possibly complicated shoes applied and in the worst cases, nerve the feet, which entails cutting certain nerves leading to the back part of the foot. Make sense to you? It doesn’t to me. Just because that’s what it looks like today, or perhaps for the past few years, it doesn’t mean that this is your horse’s conformation and it doesn’t mean that it can’t be changed. It will likely take time to retrain the feet to grow differently and it might require reworking the feet at shorter intervals for a while, but the feet can, and do, change for the better over time, if trimmed correctly. With a well-balanced trim and a logical rehabilitation program set for the navicular horse, the feet can, will and do change for the better. The walls will grow in good alignment with the pastern angle, the soles will thicken and will become more concave, the frog will become healthier and will function better, the heels will become less and less under-run over time and, in general, the foot will look much more normal. At that point, all that will be required is a good regular touch-up of the feet. Sound good?

I’ve been working on navicular cases for quite a few years now using the method of balancing the feet with the body, and I haven’t had any trouble recovering horses from this ‘ailing’ disease or syndrome yet. It’s really quite easy, it’s logical and, for me, it’s worked time and again. This method doesn’t involve any kind of strange shoes (or any shoe for that matter); it doesn’t involve plastic wedge pads, any kind of lumber or any kind of composite material. It simply requires a good, proper, well-balanced trim. Instead of working against Nature and natural angles / conformations, we work ‘with’ them.

The basics for the way I trim navicular horses shares the same basic fundamentals I use for trimming foundered horses or horses with under-run heels or even just a plain ol’ ‘normal’ footed horse. Lower the heels, back up the toes, keep the feet flat and level and round off the ground edge of the wall. These are the basics for almost every horse I work on. These ‘should’ be the basics for any farrier working on any horse. It’s what I was taught some 15+ years ago, plus the fact that I have had the opportunity to learn much more information about the feet, inside and out, how the environment, nutrition, exercises and general health of the horse all interconnect and interact to affect how the trim should be applied. All of these factors come into play with each and every horse for each and every foot at each and every appointment. Each day and each trim is only a point in time. Everything is only a point in time. Therefore, the trim has to be ever changing and ever evolving for every horse every time. It’s only a moment in time! Make sense? What it means is, even though I have the basics of backing up toes, lowering heels, etc., it doesn’t mean that the feet get the exact same trim every time. Nor does it mean that every horse gets the exact same trim as the horse I just trimmed minutes before. The basics remain the same, but the way the basics are applied is dictated by so many variables to the point that every trim I’ve ever done is a ‘one of a kind’ trim. Now, does that help make sense? I hope so. It seems more complicated in writing than it really is in person.

So, by doing a balanced trim, which resets the pastern angles and relieves stress from the DDFT, the coffin bone and the navicular bone with relation to the coffin joint, and by allowing a much smoother and easier break over, the foot is able to grow from the hairline down with much less deviation from it’s normal angle of growth. And since the break over is easier, there is less irritation to the inner sole due to the coffin bone not working harder, which reduces the chances for unnecessary abscessing. Plus, with each and every step, the break over helps take undue pressure from the heels, which allows them to begin growing more downward and less forward. The heels have to be trimmed though, so that the strongest and furthest point in the back of the hoof wall is bearing weight and not being forced under pressure to run forward. In short, the bony column of the leg and the foot are balanced to the point where there is little or no undue stresses or pressures on any one part of the hoof that prohibits the foot from growing more normal again. The ultimate change for the navicular horse is, the DDFT is no longer stretched and tight and it’s not causing the navicular bone to be jammed into the coffin joint. If that’s not happening, then there is less reason for pain in the heel area. If there is less pain in the heel area, then the horse is more willing to bear weight on the heels in a more natural manner and not simply because he is being forced to. And, since his toes are shorted with an easier break over, the whole leg is able to have a more natural range of motion with less effort. In short, the navicular pain is gone and the horse is able to move more easily and more willingly.

It’s not the shoes, the drugs, or any other compound or substance that ‘cures’ navicular disease or syndrome, proper trimming does. Whether you desire to have shoes applied to your horse is up to you, but the shoes, in my opinion, hinder the function and purpose of the foot and they don’t allow the foot to become as healthy as they should be or as they could be. But again, if you have shoes applied to your horse, they will only be as affective as the trim itself and of the farrier’s skill level that applies them. The proper trim is a key! Not the shoes.

This is the LF foot before and after pictures of a navicular horse that was also very difficult to handle due to his level of pain. This was the best first trim that could be done. Even so, you can see how the changes to the feet have begun. As this horse gains trust and is in less pain, the trim will get better and will be more dramatic; not invasive, but more dramatic.

Left Front – Before & After First Trim

The pictures below are the before and after of the RH. The changes to the pastern angle are more noticeable and more dramatic in these pictures. The trim basics will be performed each time, but the end result of the trim will be modified for each and every appointment. The flares will continue to be addressed and stress taken from them. The cracks and splits will be cleaned and trimmed to reduce stress and increase break over so as not to cause them to get larger. Rasping across the cracks will do no good what so ever. It’s a myth and a practice borrowed from the glass industry. Glass is inert and not moving, living or growing tissue.

Right Hind – Before & After First Trim

This is another horse that was diagnosed as being navicular. The feet have the classic ‘long toes / low heels’ most often associated with testing positive for navicular. You should be able to see that the weight of the foot comes down on the heels, not the center of the foot. This jams the heels into the hairline, forces the heels to grow more and more under-run, creates much greater stresses on the coffin bone, navicular bone, coffin joint, joints of the leg and even causes pain in the shoulder where the DDFT is attached and it certainly causes the sole to become less convexed due to the break over action of the coffin bone and can, in time, cause the coffin bone to remodel with a ski tip.

The pictures below are from the same horse as the one directly above. The pictures are exactly 5 months apart. The sole has become more concave and the sole is getting thicker. It’s harder to detect any softness of the sole by applying thumb pressure. The horse is less sensitive to the gravel driveway, though she still isn’t ready to handle larger single rocks. They still hurt and cause her to gimp for a few steps. Over all, her hoof condition is improving, though it will be several more months before she is able to handle most any surface without flinching. By March of next year, she should be ready to handle virtually any surface, providing the rehabilitation, or transition period, is maintained.

I hope the information and pictures provided in this article will help show that proper trimming and care can return your horse to a useful, happy life without pain.

If you have questions you would like to discuss, I would be more than happy to talk with you. You may contact me 770-312-6909 or I look forward to helping you to get your horse happy and healthy again.