Effect of heel elevation on breakover phase in horses with laminitis.
Authors: Al Naem, Litzke, Geburek, Failing, Hoffmann, Röcken
Journal: BMC veterinary research
Summary
# Editorial Summary: Heel Elevation and Breakover Mechanics in Laminitic Horses During the breakover phase of stance, laminitic horses experience maximal loading through the already-compromised toe region—a biomechanical vulnerability that orthopaedic management aims to mitigate. Al Naem and colleagues used the Hoof™ System to measure vertical force distribution and kinetic parameters across three hoof regions (toe, middle, heel) in eight horses with acute laminitis, comparing loading patterns whilst wearing a hoof cast with heel wedge (HCHW) versus immediately after its removal in barefoot condition. Heel elevation produced substantial protective effects: vertical force and contact area in the heel region increased to 63% and 61% respectively, whilst the breakover phase compressed from 6% to just 2% of the stance duration, with significantly reduced vertical force applied to the toe at breakover onset. By shifting the centre of force from the middle hoof (barefoot) to the heel region (with HCHW) and redistributing weight-bearing across the palmar sole and frog structures, heel-elevated orthopaedic devices effectively decrease lamellae stress during this biomechanically critical phase. These kinetic findings suggest that hoof casts with heel wedges represent a mechanically sound intervention for acute laminitis management, though practitioners should recognise these data reflect loading on concrete and may warrant validation across different surfaces encountered in clinical practice.
Read the full abstract on PubMed
Practical Takeaways
- •Hoof casts with heel wedges reduce breakover duration and decrease peak forces on the toe region during the critical breakover phase—key for acute laminitis management
- •This orthopaedic support works by increasing frog and sole weight-bearing contact, effectively offloading damaged lamellae and redistributing forces posteriorly
- •Kinetic data supports heel elevation as evidence-based supportive therapy; recommend continued use through acute phase rather than early removal to barefoot condition
Key Findings
- •Heel elevation with hoof cast and heel wedge (HCHW) significantly shortened breakover phase from 6% to 2% of stance phase compared to barefoot condition
- •Vertical force in heel region decreased from 63% to 43% after removal of HCHW, while contact area in heel decreased from 61% to 28%
- •Vertical force at onset of breakover in the toe region was significantly lower with HCHW compared to barefoot condition
- •Centre of force shifted from heel region (with HCHW) to middle hoof region (barefoot), redistributing loading away from compromised lamellae