Lameness in horses: spotting it early, what not to do

Lameness is not a diagnosis, it is a sign. Behind it can be anything: a stone in the frog, an abscess, a strained tendon, a joint, the back, the saddle.

The owner does not establish the cause. The owner notices it, stops the work and calls the person who will.

Early signs

Real lameness does not start with the horse refusing to put a foot down. Before that there is usually a week or two in which you can catch it.

• a shortened stride on one side, the movement flatter and shorter;
• the horse goes into one rein harder than the other, having been even before;
• changing behind at canter, refusing a lead;
• taking longer to warm up: uneven for the first five minutes, then loosening off;
• a leg filled after a night in, that goes down in ten minutes of movement;
• not standing square in the stall, resting or shifting a leg;
• heat and a digital pulse in a foot that had neither yesterday;
• a change in how it lies down, or a horse that has stopped lying down.

Working out of it is not a sign of health. It is a sign that something is there and movement is masking it for a while.

Which leg

You look at the horse in hand. The conditions matter as much as the trot-up itself.

• at walk and at trot, because walk shows less;
• in a straight line at least 20 to 30 metres long, away and back;
• on a circle both ways — lameness is often visible on one rein only;
• on hard ground and on soft: foot pain is worse on hard, tendon and suspensory pain worse on soft;
• the horse led on a long lead, with the head loose, or the nod cannot be read;
• one person watches, another leads.

A front leg. The head works as a counterweight. Landing on the sore leg the horse lifts the head; landing on the sound one it drops. The short version: down on the sound leg.

A hind leg. You watch the points of the hips from behind. On the side of the sore leg the hip rises higher and hangs longer — the quarter is thrown up. Add to that a shortened stride and a shorter track on that side.

One thing on its own: a horse equally short in both front legs may not look lame at all. A bilateral problem reads as tightness or as an unwillingness to work, and that is one of the reasons a horse's character gets blamed for something that is not character.

What you do not do yourself: flexion tests. Holding a joint flexed for a minute and trotting the horse off is a vet's tool for narrowing down the region. It is easy to over-read and easy to make a horse sorer with, and you will see it done properly at the pre-purchase exam.

The AAEP lameness scale

The scale English-speaking vets grade on is the AAEP one, 0 to 5. It is worth knowing so that you can describe the horse on the phone in the same words the vet uses.

British vets often grade on a 0 to 10 scale instead, so ask which one you are being given before you compare notes.

From grade 2 the work is cancelled. Not reduced, cancelled.

What you must not do

Do not work a horse through lameness. It compensates with the other legs and with its back. Two weeks of riding like that adds a second problem in a leg that was sound, and then the whole lot is treated together.

Do not give painkillers yourself. They do not treat anything, they remove the signal. A horse on bute feels better and loads the damaged leg fully — a strained tendon becomes a ruptured one, a stress fracture becomes a fracture. On top of that, a medicated horse arrives at the vet with no picture, and the work-up starts with waiting for the drug to clear. What to give and when is decided by a vet at that particular horse. I am an owner and I put nothing into anyone else's leg.

Do not heat or rub a fresh swelling, apply ointments blindly, or bandage a leg tightly so that it "holds".

Do not wait a week. An early tendon injury and a neglected one are different lengths of recovery, and the difference is months.

What you can do before the vet

There are not many actions, and all of them are safe.

1. Stop the work and put the horse in a stall with its movement restricted.
2. Pick the foot out and look at the sole: stone, nail, foreign object. A nail is not pulled out — its position gives the depth and direction.
3. Feel the leg with your hand for heat, swelling and pain, comparing with the opposite leg.
4. Check the digital pulse — more on that in horse hoof anatomy.
5. Write down: when you noticed, on what footing, after what work, whether the shoeing changed, whether the feed changed.
6. Take boots and bandages off, if there were any.
7. Phone the vet and describe the grade on the scale above.

Tendons in particular

The flexor tendons run down the back of the leg from the knee. Two of them matter most. The superficial digital flexor tendon (SDFT) lies closest to the skin and is the one that bows. The deep digital flexor tendon (DDFT) lies beneath it and runs on down to the coffin bone. Behind both sits the suspensory ligament, which fails in the same kind of work and takes longer again.

An injury looks like this:

• heat and swelling along the line of the tendon, not over the whole leg;
• pain when you press with a finger on a lifted leg;
• a changed outline — the tendon bows backwards;
• lameness that can be slight on day one and marked on day two.

A tendon heals in months, not weeks. Ultrasound at diagnosis and again through the rehabilitation is what the schedule is built on: controlled walking, then trot, scans at the intervals the vet sets. A full SDFT injury is commonly 9 to 12 months of rehabilitation, and the repaired fibre is never as elastic as the original. Going back to work because the horse has stopped limping is the commonest reason for a re-injury in the same place.

Prevention

All of it is routine, none of it is equipment.

• Footing. Deep sand and a broken, uneven surface hit tendons harder than anything else.
• Warm-up. Ten to fifteen minutes of walk before work and the same after.
• Trimming on time. A long foot breaks the hoof-pastern axis, and a broken axis loads the tendon.
• Gradual loading. Add one variable at a time, not three at once.
• Weight. An extra hundred kilos is carried on the same four legs.
• Movement every day. A horse that stands in for five days and works on the sixth injures itself more often than one that lives out.
• Boots and bandages where they are needed, and off again after work. A badly applied bandage damages more tendons than no bandage.

What I do

I run my hands down Godo PM's legs every day: heat, swelling, soreness, digital pulse. It takes thirty seconds, and those thirty seconds are what give you the early grade, the one that still resolves with rest.

I do not diagnose lameness and I do not treat it. My actions end at "cancelled the work and phoned the vet".

When buying a horse, lameness is the one thing that makes me stop a deal until the pre-purchase exam, whatever the seller says. How that is arranged and what the check covers is in the section on finding a horse.