Common Foot Injuries of the Equine Athlete

or platelet rich plasma PRP in order to provide antiinflammatory andor regenerative therapy in conjunction with remedial shoeing to improve longterm success.
Soft tissue injuries usually present as acute lameness during work or immediately following competition. The deep digital flexor tendon in the foot acts to help flex the foot and attaches to the bottom of the pedal bone within the hoof capsule. The deep digital flexor tendon can be strained or torn and when this occurs we see acute lameness. The tendon cannot be palpated in the foot and tendon injuries in the foot cause lameness without heat but deep palpation in the heel bulbs or just above may cause horses to react. Horses usually show significant lameness in a straight line. Horses will be negative to hoof testers but there will be pain following flexion tests with increased lameness. Both nerve and joint blocks will be very important in fully localizing the lameness. Ultrasound and MRI are essential in the diagnosis of these cases and treatment depends on the structure injured and the severity of injury. Treatment can include rest antiinflammatory medication such as nonsteroidal antiinflammatory drugs NSAIDs or corticosteroids remedial shoeing IRAP PRP stem cells or surgery coupled with a specific rehabilitation program.
Most horses will present with a lowgrade lameness which waxes and wanes during the competition season. The lameness workup will localize the lameness to the back of the footheel region with no clear soft tissue injury seen after ultrasound. In some cases obvious changes can be seen on radiographs but this may not be the case for younger horses that have been in work only a short time. MRI can also pick up bone edema swelling that cannot be seen on xrays. Navicular disease cannot be cured but it can be managed with remedial farriery heartbar or eggbar shoes NSAIDS bute banamine Isoxsuprine a vasodilator periodic rest TildrenOsphos bone pain modification ESWT acupuncture and navicular bursa injections. 
Fractures are less common and a quick and accurate diagnosis often allows a full return to function. Horses will often present with an acute lameness and radiographs will show a fracture line. Many fractures heal in three months with rest but some may require surgery. We commonly use remedial shoes and casts in combination with rest or surgery