11/25/2024
This post is making the rounds on Facebook. Take it with a grain of salt. Notice the images are of the same foot, but one has been photo shopped. There is no source cited for the claim, and no definition as to what constitutes a "long" toe.
Here are a few thoughts on the SL:
The suspensory ligament confuses most professionals due to it's orientation. Coursing down the back of the leg it is easy to associate it's function with that of the deep flexor tendon or the superficial flexor tendon. The SL is different. The main body of the SL bifurcates then inserting on the proximal sesamoid bones with each branch then coursing distally but forward to the front of the pastern where it merges with the common extensor tendon, creating a hammock or sling that cradles the fetlock in it's descent (thus helping to "suspend" the weight of the horse when the limb is loaded). When we isolate an injured SL via manual flexion of the distal interphalangeal joint (the coffin joint), we can solicit a pain response and this should be a clue that if flexion produces pain, maybe we should not "set" the coffin joint into a flexed position via a wedge when treating SL injuries. The SL endures a greater assumption of force when the deep flexor's suspension force is decreased. Force does not and cannot disappear, it can only be reallocated to other structures. Lessening the static force of the deep flexor (specifically by raising the hoof angle) increases the load on the suspensory ligament (SL). The opposite is also true though, by increasing the force on the deep flexor (by lowering the hoof angle) the force exerted on the SL decreases. This is counterintuitive for most equine professionals and owners alike. The industry is so convinced of what must be true based on the repetitious emphasis placed on breakover and phalangeal alignment, that critical thinking is virtually nonexistent. It may be better for a farrier to not understand these things and then he or she would suffer less in an atmosphere where they are typically expected to do the opposite. With tincture of time, what can heal will heal, confinement, rest, and patience are the crucial components to promote healing. In all honesty, I cannot say any shoeing protocol, or treatment modality expedites this process despite claims made. It just cannot be demonstrated. Every horse presents with different conformation and no two SL injuries are identical to compare. You cannot replicate the exact injury and treat one differently to dare say one preferred treatment outperforms another. We don't know that anything we do genuinely results in a better or faster healing process (at least not to any measurable or appreciable extent). We cannot say that x, y, or z will heal the injury 3% faster, we cannot even say that an SL injury will ever heal to satisfaction. They can be a frustrating and debilitating. I've shod these horses with Denoix style suspensory shoes and I remain unconvinced that it was worth the effort and expense. I've shod them with wedges as well (more times than I can recall), hoping to be wrong. Neither alternative offered much more in my opinion than a gesture for the owner's sake. You see, whatever is on the hoof when elapsed time allows for some degree of healing to occur will often get the credit, but correlation does not infer causation. Healing can occur in spite of us just as it can occur sometimes because of us. The plural of anecdote is not data. SL injuries take a long time to heal and they don't always heal very well.
Farriers can often be the canary in the coal mine when it comes to suspensory ligament problems. We hold the hind hoof in such a position during the shoeing or trimming process that this is essentially an extended flexion test. The farrier can often tell that a suspensory is bothering a horse months to even years before it becomes apparent enough to be diagnosed.
DID YOU KNOW…?
1. Long toes increase the risk of suspensory ligament injury by 3.5 times!🤯
2. Toe grabs increase the risk of suspensory ligament injury by almost 16 times!😳
Talk to us about how to help your horse stay injury free!