Steve Karshner and Chance
by Steve Karshner
I was surprised to learn that some of the brightest stars in this industry don’t use boots in their approach to Navicular rehab. I have to say that over the years I too have rehabbed many Navicular cases without boots, but have found it to be a much longer and bumpier process than the method I use now. Getting a Navicular horse to put his heels down first, immediately after pulling his shoes is virtually impossible without boots, and watching the animal in pain at the beginning of the process is hard on the owner, and is probably the main reason that a lot of these rehab attempts fail. These attempts end in a few days with the owner putting the shoes back on, because they can’t stand to watch their animal suffer. How many times have you heard that story? For that reason alone I would think that anyone that could use boots, would. There are going to be rehab attempts that fail, but let’s not let it be because we thought so much of our personal skills, or philosophy, that we didn’t use all the tools at our disposal to relieve the horses’ pain. If the boot fits, wear it!
I am convinced that the significant reduction in the time it takes me to relieve a horses heel pain is directly related to the improvements in our boot and pad products. There was a time when I thought six or eight months was a reasonable time frame to relieve Navicular pain. Then, I did it in six weeks using a Boa Hoof Boot and Frog Pad set up, with most of the pain subsiding in just three weeks and an entire inch of heel decontraction in four weeks! Seeing that kind of results in a horse that was likely one of the most severe cases I’d ever seen was quite a wake-up call.
I’ve been using the Boas for years because they can be used for rehab and are a very good boot, for the right foot, on the trail after the rehab or transition is done. I am also using the Easyboot Rx now and having great results with it. At present I have three horses in rehab, and all the boots are holding up great. It’s not recommended, but I have used the boots for light workouts in the round pen and have allowed the horses pasture time in them as well. To date, each and every one has held up nicely. One set of Rxs have been in constant use for over three months with no problems. Just make sure the fit is good if you plan to let the animal move around a lot in them. Sometimes they will twist if too loose and then the frog support can be compromised.
Some other reasons I’m getting quicker results is that in certain conditions using the boots allows me to be a little more aggressive. For instance, taking toe off of a foot with an underslung heel and a minus three degree palmar angle is often the only way to get the coffin bone close to ground level and initiate the process of getting the toe and the heel back under the leg where it belongs. How many times have you herd your farrier say or have you said, “I just can’t grow any heel on this foot.”? Whether you are dealing with a Navicular rehab or an asymmetry problem, giving the animal the comfort, support, and pain relief that a good boot and pad set up provides is crucial to keeping the rehab progress moving forward and keeping the owner happy and confident.
I think that most hoof care practitioners and barefoot farriers know that reversing a straightforward Navicular case is fairly easy to do with the right techniques. But what about the horse that has been given a severe Navicular diagnosis, but does not have any substantial heel pain at the test, and when blocked does not come up sound? I would like to share a recent case with you that I think might shed some light on this problem, and I’ll try to make this brief…
A seventeen year old gelding that has been under the care of a vet for the last five years, has been receiving regular chiropractic and acupuncture treatments, on and off Navicular shoeing, and for about three months was even under the care of one of our brightest equine practitioners, never getting any better. No one, vet or hoof care professional, could give this horse any real relief or definitive diagnosis. At the walk and at the trot this horse was head bobbing on the right side, and the front and hind quarters looked as if they were on two different horses. I knew the horse did not test hot in the heels, but he would land toe first at the walk. Of course, he was also very short strided up front and would always turn his head away from the turn he was in while being worked in the round pen. At the beginning, he was so turned away I thought he was going to hook his nose in the round pen railing.
When I started his rehab I’ll admit that I wasn’t completely sure what his real problems were, but I was sure that it wasn’t just one thing. On the first day I pulled his shoes – he had been shod Navicular with wedges and pads, but even in shoes I could see that he was severely asymmetric and that his knees were out of balance by nearly an inch and a half. After the shoes were off I could clearly see the asymmetry in his feet and showed his owner the difference in his legs and the way he had been muscling more on his lower side at the wither. Now remember, this horse has been under the care of a 
vet for the past five years, getting regular chiropractic and acupuncture treatments over the last eight months, and during this time no one had even suggested that the horse’s knees were not in balance and that that could directly affect the shoulder balance and other skeletal problems. The owner was told by the chiropractor, “..this horse is out of balance everywhere”, and her farrier said, “we can’t do anything about the club foot, so we must leave it alone”. The final piece of the puzzle is that years before the new owner bought him he had sustained a puncture injury at the shoulder on the “club side”. No one thought it could be the reason for his lameness or head bobbing. In the end, the vet blamed the lameness on severe Navicular syndrome and said there wasn’t really anything more that they could do aside from the normal Navicular shoeings and pads and continued chiropractics and acupuncture.
Granted, much of the horse’s history has been lost, but let me tell you what I think happened and more importantly what we are doing about it: I believe that this horse was asymmetric either as a result of the injury to his right shoulder or possibly before the injury. Because he had a high heel on his right front foot and as farriers we are taught to leave a club foot alone, the club foot was allowed to become more pronounced and increased the height of his right front heel to the point that it put his knees, and in turn his shoulders, out of balance. After years in this condition, his body and muscles adapted to the imbalance by strengthening his left side (or his low side), causing him to have a consistently shorter stride on his right front and the head bobbing became more noticeable. The imbalance worsened over time until he was pronounced lame at the normal well checks and was next to impossible to ride without jarring the fillings out of his owner’s teeth. She could tell her horse was in pain so as soon as he would start the head bobbing she would stop the work out, and this continued for years. I believe that at first the head bobbing was the result of the imbalance in the horse’s feet, then knees, then shoulders, and then the whole body got into the act. At first, he wasn’t lame because of pain, but became so as the result of all the years of imbalance. I believe his shoulders and especially his neck muscles became knotted and sore and he may even have some nerve damage as well due to the years of skeletal imbalance.
My approach to rehabbing this horse was simple, and was the exact opposite of his previous course of treatment. Instead of blaming his head bobbing on Navicular pain or on an upper limb problem, I started at the ground where I believe the problem started in the first place. I started with a dramatic trim on his feet to start bringing balance to his knees and shoulders, and then added boots and pads to relieve any pain in his feet.
After two weeks of booting and light exercise, he began landing heel first out of the boots and started to lower his head a little and focus in the round pen work. As he relaxed and lowered his head, and began taking more sound steps, the head bobbing would decrease. Over the next two months his daily rehab routine included daily round pen work with neck massages in between side changes, and an emphasis on lateral flexing during the massages. These sessions would last about forty minutes and by the end of the session he would be relaxed at the trot with his head down and the head bobbing ceased. This horse is now back at home where the owner is continuing his daily exercise and massage treatments.
This was a problem with many facets, but the bottom line was simple. I refused to accept that his right foot was a true club foot, and began taking the heel thus lowering his knee, bringing it closer into balance with his left front knee. On the left, which was a long toe underslung heel, I took toe dramatically to promote rebuilding of the heel on the low side. Within weeks he was already building heel, thus aligning the lower side knee with the right side knee. After two months, his knees are balanced, and you can hardly tell any difference between his two front feet. I will also mention that this horse also had a very large bulge of muscle on his left wither which has begun to recede, all the while he is building more muscle on his right wither, bringing balance to his shoulders. His recovery is the result of first dealing with the asymmetry in his feet, which then balanced his knees, and eventually shoulder balance that this horse has not known for years. He now can muscle up evenly and because his body is now balanced, the pain in his neck and shoulders should go away completely with time and exercise.
In my next article I will talk more about asymmetry and the techniques I use to resolve this problem. Until then, remember, NO HOOF, NO HORSE.
Steve Karshner
May 19th 2009
