A horse that’s refusing to put weight on a leg is easy to spot, but the clues to a budding lameness problem are far more subtle. Recognizing these and knowing how to locate problem areas on the legs can lead to an earlier diagnosis and save you a lot of lost riding time.
Although you may not realize it, the horse will tell you there’s a problem brewing long before it’s glaringly obvious. Some nonspecific clues include:
• A ”sour,” depressed or preoccupied attitude when in the stall.
• Change in appetite.
• Difference in attitude toward work. Some horses get lazy and resistant, but others may become more hot and hard to handle.
• Less activity and play when turned out.
• Uneven shoe wear. Note: This may also be caused by the hoof not being properly balanced, which needs to be corrected before it leads to problems.
Alterations in the horse’s posture can be important body-language messages, too, such as:
• Habitually resting one hind leg more than the other. It’s normal for a horse to rest one hind leg when standing still, but they should spend an equal amount of time on each leg.
• Consistently resting one hind leg after work.
• Standing with a hind leg either rotated outward (suspect stifle) or placed in toward the middle of the body (suspect hock or hip).
• Resting or pointing a front leg.
• Standing with one or both front feet farther forward or back than normal. The horse should always stand with the front feet squarely underneath him.
• Reluctance to pick up a leg for hoof cleaning or for the farrier. Suspect either pain in the opposite leg or pain being produced by flexion or lifting of that leg.
Many times a lameness problem is most, or even only, apparent by a change in how the horse feels or moves when you’re riding. At this point, someone watching from the ground might not be able to notice anything in particular. Things to be observant about are:
• Change in head carriage — either higher or lower than normal for that horse. This can be a sign of back pain or that both front legs hurt.
• Rigid head carriage, without the full range of up and down movement at the walk and canter. This, too, can be seen with back or front leg/foot problems, or in a horse reluctant to engage the hind end well.
• Loss of the relaxed swing at the walk. When extreme, this feels like you’re perched on a fence post but there will be less drastic reductions in free movement before that point. This is a nonspecific but sensitive sign. It tells you that the horse is protecting an uncomfortable area.
• Hesitation to move off freely from a stop, common when both front feet are tender.
• Reluctance to go downhill. Common with either front-foot pain or hind-end problems.
• Reluctance to go uphill. Common with hind-end problems.
• Wanting to jump flat. Back or hind-end pain.
• Always landing on the same front leg after a jump. Pain in the opposite front is the most common cause.
• Reluctance to turn to one side. Look for pain up front on that side.
• Reluctance to take a lead. Look for pain in the front on that side, or in the opposite hind.
• Difficult to collect. Hind-end pain.
• Less thrust when posting on one diagonal. Suspect hind-end pain in the opposite hind (e.g. if right diagonal feels weak, suspect left hind).
It takes practice to pick up a lameness early, as it may be difficult or impossible to spot. That said, you’ll never see one until you look!
First, observe how the horse stands when in his stall or the field. Are all four legs squarely underneath him' If one leg is out of place, that’s your first clue.
Next, observe the horse walking from both sides, from the front and from the rear. With front-leg lameness, one of the first changes is a shortening of the stride on that side. If both front legs hurt, the stride lengths will be equal but usually short and the gait is stiff-legged or choppy.
When only one front leg hurts, the next most obvious sign is that the head will be elevated higher when the sore leg touches the ground, and will drop down when the sound leg contacts the ground. This is called a ”head bob.” The horse will also usually land harder on the sound leg, and break over quicker on the sore one.
If both front legs hurt, the normal slight swing to head when walking is often lost and the head is held rigidly and/or higher or lower than normal. (This seems to be a matter of the horse’s personal preference.)
It’s a little different in the hind end. Shortening of the stride isn’t as common as with a front-leg problem and, if they do shorten their stride, they will usually shorten up in the good leg as well. A sound horse, unless it has an overly long back, usually will reach up well to the point the hind foot lands in the print left by the front foot. If the horse’s stride length is considerably shorter than that, there may be hind end (or back) pain.
When observed from the front, a horse traveling normally behind will track straight and you won’t even be able to see the hind legs. When there is pain, the leg may be swung out more to the side. Changes in how the back legs are carried and put down are easiest to see from behind.
Swinging the leg in an outside arc and carrying it closer to the midline are both abnormal. Horses with hock pain also often have a prominent ”wobbling”/twisting motion to their hocks. If the horse is landing harder on a hind leg (the sound one), the top of the rump will rise higher when that leg is put down. However, there are several variations on that theme caused by moving the leg abnormally, or ”giving way” because of pain (like you would if one of your knees gave out on you).
Examining The Horse
Once you’ve determined the horse is lame, and maybe even have an idea as to which leg it is, it’s time to examine the horse to see if you can pinpoint it further. Do not focus all your attention on the leg you think is hurting or you could miss other issues. In fact, horses often will develop an obvious lameness or problem in one leg because they’ve been compensating for another less-obvious problem for a long time.
Begin by trying to slowly move the horse’s head to both sides. Reluctance to move to one side can indicate pain in that front leg. Check muscles for tension. Tension in the chest, back of the upper leg, shoulders and back can indicate front leg pain. Isolated back-muscle tension may be caused by a back problem or by compensating for hind-leg pain. With the horse standing square, look from directly behind to see if his rump is symmetrical or if one side is higher/lower. Walk around the horse to determine if all muscles are equally developed from side to side.
Now it’s time to move on to the legs. Using fairly firm pressure, run your fingers over the point of the shoulder to see if the pressure causes the horse to stiffen or move away. Next, move to the upper leg and using both hands sweep down the leg slowly to the foot. Be alert to any areas that feel warmer or have swelling. The skin overlying the tendons, joints and ligaments should be taut and flat, with no puffiness.
When you get to the foot, cup a hand across the front of the hoof wall and the opposite front at the same time to compare temperature. Also compare the front hoof to a hind foot. Inspect the coronary band, heel bulbs, sole and frog.
Next, pick the leg up a few inches off the ground, hold the tip of the toe and gently flex the ankle. Then grasp the cannon bone, letting the ankle hang free, and flex the knee. Be alert to the horse flinching or trying to pull the leg free, which can indicate pain.
Relax the knee again, hold the front of the cannon bone in one hand and with the other hand use your fingertips to feel the outline of the flexor tendons and suspensory ligament from below the knee all the way down to the fetlock. You should be able to feel these structures easily and palpation — feeling the area — should not cause any pain. If the horse pulls away, wait until he relaxes then start again to make sure it was a true pain response at that spot and not just irritability.
Move to the hind leg on the same side and repeat the same procedures, with firm pressure around the entire stifle area (careful, if the stifle joint or ligaments are sore, the horse may kick!), then move to the lower leg, hoof evaluation, ankle flexion and hock/stifle flexion. Repeat on the other side. Write down what you find and any reactions the horse had.
When to Call the Vet
When you decide to call in the veterinarian will depend in large part on how experienced you are with horses and how confident you are in locating problems. As a general rule, you should always call the vet for a grade 4 or 5 lameness or a grade 3 lameness that doesn’t improve within 48 to 72 hours (see the AAEP Lameness Scale sidebar, page 13).
Our Common Findings chart on page 12 lists some of what you may see, what these signs mean in terms of lameness, what you can do and when you need help. It’s also often advisable to call the vet and ask for a complete lameness exam is your horse if showing a variety of the more subtle signs of lameness, including if the horse just doesn’t ”feel right” under saddle. Once a horse starts compensating for low-level pain somewhere, it can lead to a variety of secondary problems and a situation that is difficult to sort through to find the primary problem.
The Lameness Exam
When your vet examines your horse, he/she will do all the same things described above in a visual and hands-on exam. Your vet may also do flexion tests, which involve holding a joint in a flexed position for 30 seconds to a minute then jogging the horse in hand to see if that worsens the lameness. (Note: We have not discussed how to do flexion tests yourself in this article, as it’s a topic in itself. Watch for this topic in an upcoming article.)
When foot problems are suspected, the horse may be asked to stand with the toe and/or heel elevated on a small block then jogged off. The next step, which is indispensable, is doing nerve blocks. Your vet will do a series of anesthetic injections into local nerves to block pain first at the foot level then traveling up the leg until the lameness is eliminated.
The final step is imaging, which involves X-rays, ultrasound or more sophisticated testing like bone scans or MRI to try to determine exactly what is going on so that a treatment plan can be formulated.
If you are unsure or nervous about what you’re seeing, by all means call the veterinarian immediately. However, some mild lamenesses that might occur from minor over exertion will clear themselves fairly quickly with some rest, ice/cold-water hosing or poulticing and basic care. The important thing is to be able to make a responsible decision.
Trying to save a few bucks with a wait-and-see attitude can totally backfire on you, especially if you’re dealing with a rapidly deteriorating condition like laminitis or a bowed tendon. Educate yourself before your horse is injured by learning the steps to evaluating a lameness and practicing conducting your own lameness exam on a healthy horse. Even if you still call the veterinarian, your early efforts are going to make his or her job that much easier and speed up getting the treatment your horse needs.