# barefoot or shoes for horse with collateral ligament injury?



## jessicabeau1 (28 July 2010)

Ted has reinjured his MCL, I am gutted and am even thinking retirement but then again I think he ould come right with box rest and rehab...I just dont know...barefoot or shod first step??


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## Jennyharvey (28 July 2010)

Im a barefoot advocate, so obviously would say barefoot.  But i dont know a lot about MCL so not 100% sure what would be best.  Worth talking to your vet.  
Barefoot has the ability to help any horse with or without injury, so it is a very viable option.  I would say to do a bit of research yourself and find as much info on it.
Im sure someone here will be able to give you a more definitive and constructive answer.


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## Oberon (29 July 2010)

It may be worth emailing Nic Barker of Rockley Farm for advice.


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## Ludi-doodi (29 July 2010)

As part of Ludo's rehabiliation after he did his collatoral ligement he had to have a special shoe - it was wider on one side (can't for the life of me remember if it was inside or outside!), and normal width on the other.  It was all about spreading the load on the side of the foot where the damage was.  The vet was so impressed with the quality of the shoe the farrier made he requested it when we went back to normal shoeing so he could show others what he meant when describing a wide web shoe.  I think we did shoeings with this type for nearly a year, but once signed off vet agreed normal shoeing would be OK and has been ok ever since.


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## cptrayes (29 July 2010)

Well box rest won't be necessary if you go the barefoot route, in fact they stay in work at whatever level they are initially comfortable at.

If you do talk to a vet for goodness sake make it one who has already seen barefoot work on collateral ligament damage, or a VERY open minded one. You are otherwise extremely likely to be told that your horse won't manage barefoot or even that you will damage him if you try it. Be prepared to make changes to his diet to get the right hoof quality.

Since you talk about RE-injury why on earth would you stick with shoes? They obviously do him no favours.


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## Amymay (29 July 2010)

Well box rest won't be necessary if you go the barefoot route, in fact they stay in work at whatever level they are initially comfortable at.
		
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Really?  Even though a tear in MCL should be treated with as much rest as the horse will tollerate to allow the injury to heal?

And shoes _don't_ cause the problem (necessarily).  The cause can be attributed to a few things, some of which could be uneven hoof angles (barefoot or shod), ridden on uneven ground, lacking the musculature to support the joints and ligaments. Something as simple as a tough landing or playing in turnout can cause an MCL tear.

In this case, a previous MCL makes re-injury more likely.

OP - you need to discuss this with your vet and farrier ultimately.


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## cptrayes (29 July 2010)

amymay said:



			Really?  Even though a tear in MCL should be treated with as much rest as the horse will tollerate to allow the injury to heal?
		
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#

Who says it should Amymay? The same vets who say that navicular syndrome can't be cured, when we have dozens of them out doing full work with no shoes on? The same vets who don't know what is being done at Rockley Farm on a regular basis with collateral ligament injuries?

If you take away the shoes causing the imbalance that caused the injury in the first place, the horse can work itself sound, as a horse I recently rehabbed did in ten weeks after having been lame for over a year with a maxed out insurance claim for all his failed treatments.


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## Amymay (29 July 2010)

But surely if a hole exists in a ligament or tendon the absolute first thing you should do is rest that injury - whilst obviously considering the wider implications of how it's shod / trimmed.

Navicular is close to your heart - but is different from a damaged tendon.  And whilst I don't doubt your success and others with some navicular diagnosed horses, I do think it's a little rash to advise the OP to keep the horse in work.

And equally who says that the shoe has caused the inbalance - do you know what the overall foot conformation of this particular horse is?  Do you know what work was being done with this horse prior to re-injury?  Do you have personal knowledge of whether or not he is well shod.

Barefoot is certainly an option, I don't disagree.  But to cast aspersions at every instance on the lack of benefit of a shod horse is just not balanced.


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## cptrayes (29 July 2010)

amymay said:



			But surely if a hole exists in a ligament or tendon the absolute first thing you should do is rest that injury - whilst obviously considering the wider implications of how it's shod / trimmed.

Navicular is close to your heart - but is different from a damaged tendon.  And whilst I don't doubt your success and others with some navicular diagnosed horses, I do think it's a little rash to advise the OP to keep the horse in work.

And equally who says that the shoe has caused the inbalance - do you know what the overall foot conformation of this particular horse is?  Do you know what work was being done with this horse prior to re-injury?  Do you have personal knowledge of whether or not he is well shod.

Barefoot is certainly an option, I don't disagree.  But to cast aspersions at every instance on the lack of benefit of a shod horse is just not balanced.
		
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The treatment in tendon and ligament injuries for a human is not rest Amymay, it is to use it within the bounds of what will not damage it further. Keeping it immobile just results in a scarred repair that loses its stretch. The French, apparently, don't box rest tendon injuries as we do in this country.

The horses with collateral ligament damage in the only professional rehab unit in the country that I know of ARE kept in work, and they recover. Why would the OP's horse not?

There is no point in seeing this horse shod. Whether it is "well shod" cannot actually be known until you take the shoes off. Some horses are incorrect somewhere higher up in their bodies, and if you shoe those horses so that they look as if they have perfect balance, they can be lamed by it. 

It's not until you allow the horse to work barefoot that you can see the foot that the horse really needs to be in the best available balance for its own body. They may not then look "balanced" to us but it's what the horse knows it needs. A horse with spavin in the hocks, for example, will grow a collateral groove on the inside of the hind foot of the affected leg which is deeper than the one on the outside. Guess what - the shoeing treatment for a spavined horse is  an inside wedge - why bother with the shoe if the horse knows how to do it for itself?

It doesn't matter how good this horse's feet look in shoes, the fact is that TWICE now he has had an injury while in shoes and surely it's time to try the alternative that has already been shown to work in other horses? Maybe without shoes he will have 1)sufficient proprioception (feel of where his feet are on the floor) or 2) bend in his foot, or 3) blood supply to repair minor damage before it builds up to a lesion, to enable him to cover rough ground in a hooley without tearing a ligament again?

As Tommy Cooper said "Doctor, I broke my arm in two places" - "Well don't go to those places then!"


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## Marchtime (29 July 2010)

I'll jump in here and probably get my head bitten off but...
I completely and whole heartedly agree with AmyMay. I don't see how working a horse with a damaged medial collateral ligament is of any benefit. (And having had two with this injury I've done a lot of research). Sammy had a ruptured MCL - no amount of box rest/work/barefoot approach would have healed it. He ruptured it turning awkwardly when eventing, it was an accident not caused by shoes. We had him pts shortly after diagnosis in 2003.
Jepser had damage to MCL caused by his natural foot conformation which was NOT as a result of shoes. I know this because he'd only be shod very recently when he was first x-rayed and his pedal bones were in completely the wrong position. The vet agreed this was his natural confirmation. Unfortunately after 3yrs of working life the strain on his MCL was too much and MRI confirmed damage. Barefoot was not an option - this was a horse who could not walk round his stable barefoot. Working him would have been cruel.
Whilst barefoot works for some horses it is not a miracle cure. It is like all other treatments (including box rest, IRAP, catrophen, etc) and has it's place but is not some save all approach.
Talk to your vet about what is right for your horse. Horses are individuals.
However, the last thing I would do is work a horse with MCL, you risk it rupturing or you risk putting more strain on the 'good' leg or other structures within the leg causing compensatory damage.
I have seen Rockley Farms results (after requesting) and am afraid I'm not impressed. I requested them as I hoped it might be the miracle cure everyone is looking for but the results actually aren't convincing. Very few of the horses who have completed their rehab are sound on a circle but are in full work. This is something I personally don't agree with.
*runs and hides*
PS We lost Jesper on Friday so this is an issue very close to my heart.


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## touchstone (29 July 2010)

I won't bite anybody's head off 

  I don't think  that a horse should be worked with a tendon injury    However, gentle movement and exercise can be beneficial.  

My vet is pro barefoot and recommended turning a horse with a deep digital tendon injury out, the horse pootled around in a small paddock (not worked) and is now sound as a pound and can do everything as well as before the injury.   The horse was kept on minimal pain relief to avoid over using the damaged leg and was much happier than on complete box rest.   

Sorry to hear about your horse Marchtime.


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## Marchtime (29 July 2010)

I think controlled turn out definitely can be beneficial for the horse both mentally and physically. I opted to box rest Jesper initially for six weeks (some of which was whilst waiting for diagnosis) and then he was turned out on small paddock turn out for nine months. He did return to work as a hack for a year so it definitely didn't do any harm and suited his personality and temperament far better than box rest. However working a horse... I still can't get my head round that.


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## Amymay (29 July 2010)

I think controlled turn out definitely can be beneficial for the horse both mentally and physically. I opted to box rest Jesper initially for six weeks (some of which was whilst waiting for diagnosis)
		
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Yes, I've done this myself.  My previous horse had two lots of 4 month box rests, and I vowed never again - that it would be a maximum of weeks, then small paddock turnout.  It can work very well for a horse that can be relied upon to be quiet.


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## kibob (29 July 2010)

I'm not going to get into the barefoot/shod discussion for this particular injury as I have no experience.  My horses are all barefoot and shoeing would never be considered.

A long-in-the-tooth,  no-nonsense vet I knew once told me that a "horse has to heal for what it is going to be required to do",, if you want your horse to be ok standing still then leave him on box rest, if not turn him out and let him heal for (and with) movement.  I wouldn't say work him, but get him out of his box.  As someone else said, it helps them mentally too.  One of my mares cut her leg very badly and was on box rest.. the healing, initially went well, after a while though it ceased all together.  She had just lost the will, as we tend to after a long spell in hospital.  Once turned out and back to her normal happy life she healed quickly.

Good luck with your horse


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## cptrayes (29 July 2010)

Marchtime I think you have not read the Rockley results properly? They bear no relation to what you report, please read them again. One horse is not sound on a FIVE METRE circle (how many people's horses would not go short on a circle of that size on hard ground???)  but with the supervision of its vet it is working when it could not work previously. One arrived 1/10 lame in one leg and is still 1/10 lame in that leg, while the much worse lameness in the other is completely gone. Again with the supervision of its vet it is working when it could not before rehab. And Rockley Farm only started offering rehabs because of the other successes by people owning horses that vets and farriers told them to give up on due to long term foot lameness. Rockley has the only scientifically monitored trial but they are far from alone in treating foot lame horses with barefoot rehabs, there are hundreds of us around the country.

A ruptured MCL is a completely different kettle of fish to a damaged one. Of course you cannot work a horse with a ruptured ligament.

If your horse who had the injury which was "not related to shoes", but to his foot conformation, had been allowed to grow the foot he needed to in order to support the bones that on xray were not in the right place, he might have grown an extremely odd shaped foot, but been sound. I take your point that he would have been sore without shoes and of course he would have needed very difficult management to enable him to go shoeless, which might simply have been impossible in his case. But until he was allowed to grow a foot without a shoe on it you have no idea whatsoever whether shoes caused his problems by preventing him from growing a foot to match his bones or not. 

I think people are getting mislead by the word "work". Work is only exercise under the direction of a human, which might be as little as a walk out in hand in a straight line on flat tarmac. In other words, not box rest. "Gentle exercise" IS work.


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## criso (29 July 2010)

Marchtime - can't comment on what techniques the other vets in the study used but mine assessed frankie by trotting him on a 10 metre circle on concrete. A test that had never failed to show up lameness before.


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## Marchtime (29 July 2010)

cptrayes said:



			If your horse who had the injury which was "not related to shoes", but to his foot conformation, had been allowed to grow the foot he needed to in order to support the bones that on xray were not in the right place, he might have grown an extremely odd shaped foot, but been sound. I take your point that he would have been sore without shoes and of course he would have needed very difficult management to enable him to go shoeless, which might simply have been impossible in his case. But until he was allowed to grow a foot without a shoe on it you have no idea whatsoever whether shoes caused his problems by preventing him from growing a foot to match his bones or not.
		
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He had been allowed to grow a foot naturally for four years. He had only been shod once before we bought him as a very freshly started four year old off the field. His damaged foot was indeed a slightly odd shape - larger than the other and a little splayed but the vet actually commented at vetting that this was not unusual and he did not foresee any issues (haha!). From day one he was always very footy without shoes, hence I think shoeless for him wasn't the answer. His pedal bones simply couldn't cope (agreed by multiple vets and farriers) and his soles were naturally paper thin even when living a 'natural' lifestyle.

With regards to Rockley I'm not saying they don't have some success, but what I am saying from my point of view the success rate isn't that much higher than the success rate for those who use IRAP, turn away for a year, etc. Jesper returned to dressage after his initial injury, it was actually his 'good' leg that eventually gave out and he retired due to other issues. Bare foot has it's place and is definitely worth a try with some horses but I do get frustrated when people act like it is the answer to everything. I think you need to assess each horse as an individual and barefoot isn't suitable for all, nor will it heal everything.

I still don't agree with any sort of 'forced' exercise for an injured horse. Ambling round a field is one thing - they have choice in the matter and they can balance themselves. Riding an injured horse is IMO not the way forward. A horse is lame because something hurts, it is up to us as owners to listen to our horse. Riding a horse that is lame (even gently) is in my mind equal to low grade abuse.

*disclaimer - this is my opinion, I'm not claiming to be right but I can't get my head around how someone can exercise/work a lame horse.


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## cptrayes (29 July 2010)

Marchtime said:



			I still don't agree with any sort of 'forced' exercise for an injured horse.
		
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Who does?

And who said anything about riding a lame horse? You might have to start with walking in hand, or long reining slowly on a good surface, and build up. A horse that is sound ridden  in walk can usually be safely ridden in walk even if it is unsound in trot.  The exercise is both mentally and physically beneficial.

With some injuries, notably tendon and ligament injuries, lameness wears off with exercise and in those cases exercise is usually beneficial if not overdone. The current treatment for a severe tendon strain in the cannon bone area, for example, is to get the horse into walking work as quickly as feasible after the acute inflammation is under control. Before it is turned out. This ensures the strongest possible repair of fibres with the correct crinkle in them that makes the repair stretchy instead of inelastic scar tissue.

I'm sorry you lost your horse and clearly he was a hopeless case with a longstanding problem from a very young age who you did your absolute best for. That doesn't mean that the original poster has anything whatsoever to fear from attempting to rehab her horse barefoot, which was her question. 

Though I would advise her that if her horse has thin soles and foot sensitivity she may need to make very significant changes to his diet to get him comfortable. Many horses cannot, for example, cope with 24 hour access to grass. In fact the horse I have just rehabbed came  (with xrays) with paper thin soles that I could bend with my fingers and had been footie at the age of four, was ridden in boots and later shod. At ten he is rock crunching for the first time in his life, with soles that are good and solid - BUT- he is a metabolic disaster area and it took complete removal from grass, which is effectively poisonous to him, to achieve this. The OP's horse may not be a problem but she should not start down a barefoot route unless she has him on  a high fibre, low sugar diet with the right minerals and  is able to restrict his access to grass if he needs her to.


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## cptrayes (29 July 2010)

Marchtime said:



			With regards to Rockley I'm not saying they don't have some success, but what I am saying from my point of view the success rate isn't that much higher than the success rate for those who use IRAP, turn away for a year, etc.
		
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You are missing the point. The vast majority of barefoot rehabs, have, like mine and all of Rockleys, been through multiple treatments and were still unsound. That makes it all the more astonishing that barefoot rehabs are so successful.


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## Ted's mum (29 July 2010)

what is the cost of sending a horse to rockley farm for rehab of a medial collateral ligament injury? it maybe my only glimmer of hope...


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## Oberon (29 July 2010)

I think livery and rehab costs are on their website. 

If you wished to rehab by barefoot, it is possible to do it at home with the right support. Your horse doesn't necessarily need to go away and it doesn't need to be expensive.

A trimmer of good training and reputation can support you both at home.


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## nicbarker (15 August 2010)

Marchtime said:



			I have seen Rockley Farms results (after requesting) and am afraid I'm not impressed. I requested them as I hoped it might be the miracle cure everyone is looking for but the results actually aren't convincing. Very few of the horses who have completed their rehab are sound on a circle but are in full work.
		
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Marchtime, I don't know who you are, but you must have contacted me to get the results - its a shame you didn't email me personally if you had questions.  

If you want to report the results, thats fine, but you need to do so accurately rather than just posting misleading and untrue comments.  We don't work horses unless they are moving and landing comfortably and correctly on that surface, and we don't put horses into full work if they are unsound.   

Of the horses who have completed the research project, 8 out of 10 are in full work.  One was re-vetted in trot on a 5m circle on gravel was rated as slightly short-striding - ie not extending - by his vet.  He was perfectly level however.  He was in full work at the time and the vet was happy with this.  I later spoke to a friend who is a professional event rider and she said she didn't think any of her (shod) eventers would have been extending in trot on a 5 m circle on gravel either(!)

I am happy to email the results to anyone who is interested in seeing the unvarnished truth 

ETA: If you were hoping for a miracle cure, perhaps you had unrealistic expectations anyway...?


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## tommy30 (15 August 2010)

Ive had success with treating this type of injury both barefoot and shod. Each individul case will be different, and as such I dont recommend one method over another, it really is something that only the person examining the horse should decide.


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## traceyann (16 August 2010)

my horse at severe collateral ligament damage was  the worse he had ever seen this was the words of the newmarket vet and told me to take him and put him down  if im honest i had never heard of it before  he had five injections irap six months box rest and went barefoot he now nineteen and still sound his treatment cost me 13 thousand pound still paying the loan but he wasnt ready to give up and neither was i im very sad people have lost their horses to this and count myself as very lucky i dont think there a right or wrong way its what suits your horse there all different and only the owners know best for their horse my horse could not wear shoes anymore as they caused him huge pain me and the vet fought hard over this as he wanted him to have them i had all ready tried the wedges and the egg bars he was crippled after seeing my horse sound he said i was right to argue with him im lucky horse got feet like rocks i think its all down to the horse some come good and some dont its hard slog a lots of tears you may be another lucky one but i wish you luck


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## almorton (16 August 2010)

'If you take away the shoes causing the imbalance that caused the injury in the first place''

now THIS i have a problem with!
some of my horses are shod, some arent.
BUT
shoes dont cause imbalances! farriers / trimmers do! shoe are there to support the foot /limb. applied incorrectly, they can do damage. as a barefoot trim can!

a good workman never blames his tools ;-)


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## cptrayes (16 August 2010)

You are not entirely correct Almorton. There are lots of horses out there being shod perfectly balanced - in the foot - by their farrier. Unfortunately, like most of us, the horse is not symmetrical somewhere higher in his body. Left to build the foot he needs without the restriction of a shoe, such horses will build a foot which would not be classified as "balanced" for someone looking to shoe the foot, but is in fact perfectly balanced for the imperfect limb which is standing on it.  That is what the comment meant to convey.

Shoes do, for some horses, cause imbalance. Such horses may, in the absence of a shoe, grow a very funny looking foot with lateral extensions, and be sound where they were unsound in shoes with much "better balanced" looking feet. 

If shoes are not a general cause of imbalance, then I would also question why so many horses, if shoes are not causing their imbalance, come sound so very soon after removing the shoes? In my case, it was less than eleven weeks to soundness, after more than a year's lameness, adequan, HLA, tildren and bar shoes.

The point is not that farriers are causing imbalances (though plenty of them are!) it is that the application of a shoe is preventing the horse from growing the optimum foot to suit its own imperfect body.


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## courage_uk (17 August 2010)

have you tried looking into boots instead of shoes? im not sure about the medical side, but my boy is bearfoot and i use Old Mac 2 boots instead of shoes, and proven to be the best buy of the century - they are like trainers for horses, and give more cushoning to the foot then a shoe would, have a look on the easy care website (google it'll come up) they have lots of different options from Oz and usa on there, might be worth a look


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## amandap (17 August 2010)

cptrayes said:



			There are lots of horses out there being shod perfectly balanced - in the foot - by their farrier. Unfortunately, like most of us, the horse is not symmetrical somewhere higher in his body. Left to build the foot he needs without the restriction of a shoe, such horses will build a foot which would not be classified as "balanced" for someone looking to shoe the foot, but is in fact perfectly balanced for the imperfect limb which is standing on it.
		
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I think this is something many people cannot grasp or agree with even very experienced Professionals and owners. To me it makes perfect sense though. We seem to be obsessed with making horses conform to what we consider as balanced and altering the balance to make the horse look and move as we wish not as he wishes or needs. I'm not talking about deformities here btw just normal individual horses.


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## cptrayes (17 August 2010)

amandap you are so right, unfortunately. When a vet came to give my hunter his flu jab he could not see a wonderful rock crunching hunter who is sound on every imaginable surface, who loves his job with a vengeance, thinks hedges were put there solely for him to fling himself over with gay abandon and whose shoes cannot now be nailed back on because his feet are too small for them to fit. 

All he could see was one front foot which is not completely symmetrical, but has a small deviation to the outside. The horse himself is the most one-sided youngster I have ever backed, and I have no doubt that this foot is simply coping with his asymmetric body, caused I believe by being barn reared with insufficient movement when a baby.  I dread to think what spasms we would set up in his back if we were to shoe that foot in a "perfect" balance.  Meanwhile, the more months he is schooled and the straighter he gets, the smaller the deviation becomes. Speaks for itself really.


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## LucyPriory (17 August 2010)

Had a horse with severe injury to fore limb as a youngster - which consequently came in short.  Hoof grew to compensate. Perfectly sound, unless a numpty came along and tried to trim the fronts to match.


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