The low down on High/Low syndrome

Sharing these before and after photos today of this high/low horse. Left is before, right after. Above is before, below after.

What is high/low? - High/low is where one front hoof has a steeper angle than the other front hoof. The steeper hoof is the "high" hoof and the less steep one is the "low" hoof. Either one of these hooves could be the correct one; it depends on what caused the difference in the first place.

Why is high/low a problem? - In the front hooves, the height of the hoof capsule directly impacts the height of the scapula and the arc of the stride of the leg in movement. A high-angled hoof will have a shorter stride, and the scapula will be sitting higher up than the opposing side. This will create an imbalance for saddle fit, with the rider often complaining that they lean to the side with the shorter hoof. This also presents a problem with symmetry riding one direction vs the other because the stride lengths will be different, and it can create a canter lead problem as well with the horse struggling to take the lead on the higher side. Not to mention, the horse will be uncomfortable and feel imbalanced in their body. They might even feel pinched in the shoulder under saddle on the higher side.

What causes it? - There are a lot of reasons for high/low to show up. The most common cause I see is what we call a grazing foot. This is where a foal prefers to graze with one hoof forward and one hoof back, and they are always in the same position, i.e., the front left is always forward and the front right is always back. With proper trimming, the hooves can be maintained in balance, but with improper trimming, the hooves will develop differently, with the outstretched front hoof becoming low and the other growing in at a higher angle. A coffin bone does not finish growing until a horse is 3-4 years old, so proper trimming is crucial from about 3 months old to keep the hooves in balance and to prevent asymmetry.

Another cause of high/low is a club foot. While this is not a true case of high/low, but rather the pathology of a club foot, it often presents with the same implications and must be managed as a high/low scenario. It is very common for clubbed hooves to be trimmed ineffectively and allowed to flare so that they appear more "normal," and unfortunately, this exacerbates the problem.

Previous injury, conformational faults, or muscle weakness can also cause high/low as they can cause a horse to be stronger or more flexible on one side of the body than the other. This imbalance in the body will directly impact the weight distribution going down the legs and can create more pressure on one side than the other, which can also alter the shape of the hooves.

How do we fix it? Can we? - "Fix" isn't really the correct word as it implies we can completely remedy the problem, but can we improve high/low? The answer is most of the time it can be improved to some degree with a combination of correct trimming, bodywork, and physical rehab for the horse.

In the case of the horse pictured here, he needed a more effective trim to control the flaring hoof wall, proper management of his club foot, and he needed the heels on the low foot left alone and the heels on the high foot trimmed as low as possible but without thinning the sole, and without overstretching his tendons. Heel changes need to be made gradually, not all at once, or they can be a shock to the system and cause discomfort or injury. His rehab will be a work in progress and will take time, but he is already moving better and starting to grow in connected hoof wall attachment.

Interested in learning more about proper hoof care and management? Check out our online hoof care course where you can delve deeper into these topics and gain valuable insights for your horse's well-being.