Effects of heel and toe elevation upon the digital joint angles in the standing horse
Authors: CREVIER‐DENOIX N., ROOSEN C., DARDILLAT C., POURCELOT P., JERBI H., SANAA M., DENOIX J.‐M.
Journal: Equine Veterinary Journal
Summary
# Effects of Heel and Toe Elevation on Digital Joint Angles in Standing Horses Altering foot orientation through heel or toe elevation produces predictable, linear changes across the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints, with the distal interphalangeal joint showing the most substantial response (29.5° maximum range between 15° toe and 15° heel elevation). Five sound horses were evaluated using radiography and two-dimensional kinematics as their left forelimb was positioned in seven different orientations, revealing that whilst individual horses varied considerably in conformation, the magnitude of joint angle change remained consistent across the group—a finding with important implications for standardising therapeutic or corrective shoeing protocols. Critically, heel elevation triggered measurable elbow flexion whilst toe elevation induced slight extension (mean amplitude 3.6°), meaning that proximal compensation occurs even with modest hoof angle adjustments, with potential consequences for flexor tendon loading patterns. Radiographic measurements differed substantially from kinematic data derived from skin markers, suggesting that soft tissue displacement masks true bony movement and practitioners should remain cautious about inferring internal joint mechanics from surface-level observations. For farriers and veterinarians, these findings provide biomechanical evidence that foot angle modifications have whole-limb effects rather than isolated joint consequences, warranting consideration of proximal structures when prescribing therapeutic shoeing.
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Practical Takeaways
- •Heel elevation flexes the elbow and reduces palmar angle at the distal joints, while toe elevation extends the elbow and increases palmar angle — both alter flexor tendon loading in predictable ways that farriers can leverage therapeutically
- •The consistent biomechanical response across individual horses suggests that standard hoof modifications (heel/toe elevation) produce reliable angular changes regardless of initial hoof conformation
- •When using radiography to assess joint angles, expect significant differences from real-time kinematic measurements due to skin marker movement — radiography better reflects true skeletal position
Key Findings
- •Toe elevation produced linear increases in palmar angle at PIPJ (7.3°) and DIPJ (29.5°) compared to heel elevation across the T15-H15 range
- •Heel elevation induced elbow flexion (mean 3.6° amplitude) while toe elevation caused slight elbow extension, with potential consequences for flexor tendon tension
- •Angular variations between conditions showed no significant individual horse effect despite large hoof conformation differences, suggesting consistent biomechanical responses
- •Radiographic measurements of digital joint angles differed substantially from kinematic data, likely due to cutaneous marker displacement during motion