03/14/2026
Rehab or a Bandaid
The X-rays came back positive for navicular changes, your heart sinks as the attending veterinarian delivers the news. They are optimistic about recovery and recommend your farrier apply a wedge pad shoeing package. A reasonable question in your situation would be:
What is the underlying cause of these navicular changes and what steps is the recommended shoe package taking to resolve those underlying issues?
Take a look at those feet, what do you see?
☑️Under run heels as shallow as a wedge door stop
☑️Crushed heel tubules
☑️Toe first landing
☑️Weak digital cushion
☑️Upright under developed ungular cartilages
☑️Possibly sensitive to hoof testers all around or at the navicular points
You may hear it called navicular, negative palmar angle syndrome, or broken-back hoof pastern access, but they all describe the same issue, poor caudal foot health. How did they get that way?
There are almost as many unique reasons for poor caudal foot health as there are individual horses struggling with it, but we can look into the environment of the horse for answers. Environment is the circumstances, objects, or conditions by which one is surrounded: the factors and influences that affect the growth, health, progress, and functioning of someone or something.
🥾A shoe
💉An anaerobic bacterial infection
🦵A limb difference or other conformation issue
🩹An old injury
🚶A compensation pattern or pain
💊A mineral imbalance
🏃➡️A lack of correct movement
These are just some environmental factors that can affect caudal foot health. Identifying and correcting the cause for each individual horse can start the healing process. The horse has the innate ability to heal itself provided the environment is conducive to healing.
What does the recovery time look like? That depends, are you looking at rehab or a Band-Aid? The caudal foot foundations are avascular cartilage and digital cushion. They take longer to build up because they do not have a direct blood supply and receive nutrients from diffusion. With controlled movement (not too much, not too little) in multiple directions we promote that diffusion to build stronger foundations. We will see
✅Thicker digital cushion
✅Dense frog growth
✅C shaped ungular cartilage that supports P3 in the hoof capsule
✅Flat or heel first landing
✅No longer sensitive to hoof testers
And as these things improve and pain is reduced we start to see our heels improve and a hoof capsule that looks healthy enough to support the weight of the horse without collapsing. Since progress isn’t linear and each horse is an individual with unique challenges, this could take any where from 6 months to a couple of years, but in the end the horse has a healthy foundation to support itself.
What about that wedge pad and shoe? The wedge is used to artificially correct the hoof pastern axis and the shoe immobilizes the heels, both of which are likely to reduce pain in the foot immediately and improve moment for a time. With this application we are addressing the symptoms not the cause. Without that controlled multidirectional movement we have locked that foot in an environment not conducive to healing.
Rehab or Bandaid is a question each owner has to answer for themselves and their horse, hopfuly with the help of a skilled care team. I hope this post has given some important insight to the rehab process, how important every little environmental factor can be, and allows you to make a more informed decision about the care provided to your horse.
