June 16, 2022 
Horses naturally have one front heel that is higher than the other, but when the degree of “high-low” syndrome is more severe, can it resolve itself?
Professional farrier Jude Floiro, who is also a graduate of the University of London’s Royal Veterinary College in Applied Equine Locomotive Research, thinks it can.
High-low syndrome presents questions for veterinarians and horse owners alike, especially concerning how much intervention should be taken. In the Sport Horse Podcast, hosted by Nicole Lakin and Tim Worden, PhD, Florio discuss all the (foot) angles, including how in some cases less is best.
“People may see a bit of a difference, and in our world any kind of difference or asymmetry is flagged as an issue, but it does sound like it exists in every horse. Just like how in humans one foot is a little bit longer than the other, or one leg is a little bit longer,” said Worden.
While the varying angles in horse’s feet can be attributed to their respective sports, it’s often a natural occurrence, caused by things like standing postures or grazing positions. Horses, like humans who are usually right or left handed, also have a preferential side.
“There is four-limb dominance in horses and the estimate is about 70–80% left fore-limb dominance, meaning that the left front is the foot that the horse holds back and bares most of the weight, and the right front is out in front of them as they’re grazing,” explained Florio.
When considering the forces and pressures on the foot in this posture, the right front puts the majority of the weight on the heel. For the left front foot, most of the weight is in the toe, though this is dependent on a horse’s conformation and where their neck balance is set.
So, high-low syndrome is commonly a natural force. Do you always need corrective shoeing to balance the horses?
“Sometimes I’ll use some pads, and different things like that, to try and set the pressure off of the heel of the low foot,” said Florio.
“If we are addressing the higher heeled foot, I’ll take it down with a trim. One of the things I have [started to do] is treat each foot independently. Years ago, if you did a pad on the left front, you would also do a pad on the right front.”
Corrective shoeing is an option, and often the preferred one for sport horse owners who need to maintain perfect soundness over long show seasons, but it isn’t the only one. Depending on the case, it’s not always the best one either.
“A steel shoe or an aluminum shoe, for example, strains the hoof a little bit, whereas if they’re barefoot there is a little bit more possibility to expand and contract,” said Worden.
“That shoe, again is not natural to the foot, and the foot is always working to get it off…you’ll be surprised to hear I actually think that shoeing is detrimental in some ways. It is a necessary evil because we can see that some horses just can’t compete at these upper levels without being shod, but I think the reality is the shoe becomes a bit of a crutch,” said Florio.
Take that crutch away and many horses end up growing the heel over time.
“A lot of horses that I’ve dealt with over the years with varying degrees of this high-low syndrome will see the low foot ends up growing heel over time [when you remove the shoe],” said Florio.
The less-is-more solution isn’t only true for high-low syndrome, either.
“I’ve seen horses with navicular, for example, where they’re constantly doing different types of interventions, pads or adjustments to the shoe to create some sort of an artificial angle,” said Florio.
“Then, when you take those shoes off and turn them out, every month I would come back and low and behold this foot has healed. Why is that? Because I believe that nature often fixes the problem.”
Want to hear the full in-depth discussion? Listen to the Sport Horse Podcast on Horse Network.
