What Can We Do About Navicular? Can Barefoot Rehab Really Help?

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Can Transitioning To Barefoot Aid In Navicular Recovery?


Over the years, Scoot Boot has received countless inquiries from horse owners wanting to learn more about transitioning their horse to barefoot as a treatment for navicular. Traditionally, navicular is viewed as a debilitating disease which has no cure. When a horse is diagnosed with navicular, it very often means the end of their career and typically sentences them to live out their numbered days, only somewhat comfortably, in the pasture. 

Brown and white horses grazing in a green pasture

 

Dr. James Rooney, DVM, Professor Emeritus of the Gluck Equine Research Centre, Department of Veterinary Science at the University of Kentucky, renowned equine pathologist and author of 'The Lame Horse', has spent most of his career studying navicular in horses. His research showed that the traditional understanding of navicular was incorrect. He worked tirelessly throughout his life to educate more veterinarians about his findings and put a stop to the thousands of horses being put to death each year as a result of misunderstandings about navicular. 

The lame horse book cover by Dr. James R. Rooney DVM

(Dr. J Rooney, 1998)


If you have a horse that has been diagnosed with navicular, it is understandable that you might be searching high and low for a shred of hope and good news. Our goal with this article is to help spread the word that navicular does not have to be a death sentence for your horse. In fact, with proper treatment, your horse can even return to a life of exercise and riding. 

 

The following article discusses Dr. Rooney’s findings as well as practical information about how to help your horse through their navicular diagnosis.

Brown horse laying in green grass with flowers

 

 What is Navicular?

Navicular is a 'syndrome of soundness problems' in horses. Navicular can be described as inflammation, or degeneration, of the navicular bone and surrounding tissues. Usually it occurs in the front feet only, and often leads to disabling lameness. There are two different terms for navicular that you may hear:


  1. Navicular Disease generally means the condition where there are changes to the navicular bone seen on x-rays/MRI scans. X-ray of navicular disease in a horse's hoof        (Johnson, 2016)
  2. Navicular Syndrome generally means no bony changes can be seen but the pain is located in the back of the foot/heel area.Veterinarian examining a black and brown horse's hoof

The navicular bone is a small bone in the horse’s foot that sits between the coffin joint and the flexor tendons. The 'navicular apparatus' is a term that describes all of the structures surrounding the navicular bone, as well as other small ligaments in the area.

The anatomy of a horse's hoof

(All-Natural-Horse-Care.com, 2006)

The anatomy of a horse's hoof

 (Kauffmann, 2006)

 

Navicular might appear as slight lameness in your horse at first. Your veterinarian might identify signs of heel pain with a hoof tester exam. As with most lameness, there is variability in how navicular first presents.

Veterinarian examining a black horse's hoof

 

What is the Traditional Treatment?

Navicular has traditionally been considered incurable. The long-held belief is that it can only be managed for some period of time, but that it cannot be corrected. The aim with traditional treatments is to postpone the inevitable. These treatments only aim to restore some level of comfort for a limited time. There are two main types of traditional treatment:


  1. Corrective Shoeing - Corrective shoeing is based on raising the heels to take the pressure off the navicular apparatus. It treats the symptoms and not the underlying cause. It does not solve the problem. Often joint injections and anti-inflammatories, like bute, are used to help with the pain., other commonly prescribed medications include Isoxuprine, Equioxx and Previcox. Typically, this treatment method actually hastens the progression of the disease and eventual demise of the horse. By raising the heels and removing any pressure, the ‘diseased’ parts of the back of the foot are taken further out of work and the natural balance of the foot is disrupted. The more the frog and digital cushion are protected, the worse they will fall out of function. These tissues must be used or they will degrade. Even worse, by adding shoes and raising the heels, we stop the natural expansion and hydraulic shock absorption in the foot and a toe-first landing is forced.A farrier putting metal shoes on a horse's hoof


  2. A Neurectomy or 'Nerving' - In severe cases, the navicular bone begins to remodel which can be incredibly painful for the horse. Sometimes neurectomies (surgical removal of a portion of the nerves to the foot commonly known as 'nerving') is recommended for the horse to be comfortable. When this is done, the horse is no longer able to feel pain (or anything) in the heel area. This does not solve the problem, but is rather a temporary solution. Without correcting the underlying issue, the bone and tissues will continue to degrade.  
Veterinarian surgeons performing a neurectomy on a horse
(Horsetalk.co.nz, 2015)
A diagram of a neurectomy on a horse

(Cornell University, College of Veterinary Medicine, n.d.)

 

Navicular syndrome is typically a progressive disease, and most horses will become more lame and increasingly difficult to manage over time. Some horses can continue at their original level of performance after this diagnosis for years, and some horses decline rapidly. With traditional treatment, the goal is not recovery, but rather management of a chronic condition and worsening problem.

 

Why is Barefoot the Better Option? How Does it Better Assist the Foot in Recovery?

Traditionally, it was believed that navicular began with the bony changes. The cause was not understood but it was believed to be from a lack of blood supply to the bone, poor circulation and a long toe/low heel hoof conformation.

 

However, the research of Dr. James Rooney has shown that the condition begins not with the navicular bone, but rather with soft tissue damage at the back of the foot, most usually to the deep digital flexor tendon and/or the impar ligament. The damage, if left untreated, eventually results in degradation of the navicular bone. 

A healthy hoof compared to an unhealthy hoof

(Henderson, 2015) 

 

In a research study undertaken by Dr James Rooney of the American College of Veterinarian Pathologists consisting of thousands of horses, he found not one single case in which the damage to the bone was the beginning of the condition. Prior damage to the tendons and ligaments were always present.

 

So, What Does This Mean for Horses With a Navicular Diagnosis?

In short, the take home message from Dr. Rooney’s work is that the navicular bone does not begin to remodel on it’s own. Problems with the tissues surrounding the navicular bone happen first, which eventually lead to issues with the navicular bone. 


Pain in the heel area and degradation of the tissues surrounding the navicular bone is caused by, and exacerbated by, a toe-first landing. The long-held notion that raising the heels to provide 'slack' to the deep flexor tendon and decrease stress on the navicular bone is ineffective. While it may help a standing horse feel less pain (for a week or two until the muscles adjust their tension), it does not help a horse in motion. By raising the heels, a toe-first landing is forced which causes the navicular apparatus to fall out of function and lead to more extensive damage in that region.

A brown horse trotting on the road in metal shoes

  

What is the Other Option for a Navicular Horse? 

Fix the real problems. Bring the frogs and the digital cushions back into work. Barefoot trimming is the most effective way to restore correct function and balance to the hoof.

A barefoot trim on a horse's hoof


The sole of the horse must be left alone while the heels are gradually brought down to increase frog pressure as the horse can stand it. There is a fine balance involved in this process, so working with an experienced barefoot trimmer or farrier is essential. If you do it too fast, the horse will be over-sensitive in the back of the foot and walk on his toes and you will make no progress. If you go too slow, the navicular apparatus may remain out of work for too long and damage will continue to occur. When shoes are removed, some horses will go sound immediately, but for others, with a greater degree of damage, the process will take longer. The goal is to remove the discomfort and encourage correct movement to allow the foot to function as it was intended. A simple solution to a complex problem that has been baffling horse care professionals for many years.

Rasping a hoof in a barefoot trim on a horse

 

While much of the success from using barefoot to rehabilitate navicular horses is spread by word of mouth from horse owner to horse owner and farrier to farrier, research projects are beginning to be conducted around the world, adding validity to these claims. One such study took place in the United Kingdom, involving Professor Peter Clegg at the University of Liverpool, Jeremy Hyde of Eqwest Veterinary Hospital and Rockley Farm on Exmoor. The published results so far are based on 13 horses, 10 who have completed their rehab and three who are at various stages throughout it. Eight out of the ten have already returned to full soundness and are back in work, including jumping. Jaime Jackson, a farrier and natural horse care advocate in the United States of America, reports that he has never known a navicular horse to not become sound once its metal shoes were removed.


Pete Ramey performing a barefoot trim on a brown horseDr. Rooney maintained throughout his career that once the bone damage of true navicular disease begins, it is irreversible. That being said, farrier Pete Ramey says this, “[While it is true that perhaps the bone will not return to its previous form], I have seen [horses with bone remodelling  returned to use and apparent happiness with my own eyes with consistency. I use myself as an example. I got in the wrong car one night as a teenager and earned three vertebrae in my lower back that are now fused into one mass by surgeons. My wrists are permanently damaged from hanging by my fingertips during my rock climbing days. Dirt bikes claimed my shoulders. Daily runs in a dry river gorge got my knees. Would it be possible to make me clinically sound? No. My radiographs will always reveal the errors of my past and a good flexion test would probably cripple me for three days. I’m very happy though, and I perform one of the most physically demanding jobs known to man every day with a big smile on my face. That’s good enough for me and probably for most navicular horses as well.”                 


 

With barefoot rehab, the outcome has been so consistently successful, that word is spreading about barefoot as a treatment option. If barefoot rehab was to be widely adopted, navicular disease would cease to be the devastating diagnosis it has traditionally been. There is probably no reason for a navicular horse to be nerved or euthanised.

Girl riding without her hands on a brown horse

  

How and When Should Hoof Boots be Used to Aid in Recovery?

During rehabilitation, the goal is to restore correct balance and comfort so the foot can begin functioning properly once more. Hoof boots, such as Scoot Boots, can help provide the needed support and comfort sore horses need to regain correct movement. By adding Scoot Pads inside your Scoot Boots in the early stages of healing, the horse is given immediate comfort and is able to move naturally, restoring proper function to the foot. The more the horse is able to move correctly, the more quickly healing will occur. 

Scoot Boot Pads

 

Moving forward, hoof boots will continue to provide support and protection while allowing the foot to function naturally. When riding on terrain that forces a toe-first landing or causes tenderness, boots or boots with pads are a great option to keep the horse comfortable and moving properly. 

 

Horses wearing orange, green, red and blue Scoot Boots on a trail ride

 

What Does Life After Recovery Look Like for Horses That Have Transitioned to Barefoot?  

Unlike traditional treatments, which only aim to prolong the inevitable, the goal with barefoot as a treatment for navicular is true recovery. Horses are often able to return to their lives as they once were prior to their diagnosis.


Using barefoot as a treatment for navicular means returning to soundness and returning the foot to proper function. Recovered navicular horses have returned to lives that include arena riding, trail riding and even show jumping.

Rider wearing matching blue clothing riding a horse wearing blue Scoot Boots

 

If it Works so Well, why is Barefoot as a Treatment for Navicular not More Widespread?

Dr. Rooney first published his findings in 1974. He continued to publish papers and research supporting his findings until his death in the early 2000’s. More recently, other universities and professors have built on Dr. Rooney’s work and proven even further the effectiveness of barefoot as a treatment for navicular. The evidence is hard to refute.


So, why has the equine industry as a whole not transitioned to this recovery method for all navicular cases?


It’s staggering and heartbreaking to think of the many thousands of horses that have been wasted due to a navicular diagnosis between 1974 and today. Science is slow to change. One research study, or even a handful of research studies, do not lead to immediate industry change. It takes many years and many advocates to change a long-held treatment method for a disease as widespread as navicular. In fact, most veterinary schools today are still only teaching the traditional methods of treatment and do not talk about barefoot as a viable option. 


Our hope is that with continued research and more widely publicized success stories, industry professionals and horse owners alike will begin to lean on barefoot as the go-to treatment for navicular. When this happens, countless lives will be saved. 


Navicular does not have to be a devastating diagnosis for your horse. If you or someone you know has a horse that is diagnosed with navicular, share this article with them. Then, find a barefoot trimmer or farrier in your area. It will be very important in your horse’s healing process to work with someone who is experienced in proper barefoot trimming.

Rasping the hoof wall in a barefoot trim on a horse


Support is available for you as you transition to barefoot. If you aren’t finding support locally, know that there are many online barefoot communities where you can connect with knowledgeable barefoot advocates, including our community here at Scoot Boot. 


Have questions about how to transition your horse to barefoot or about how Scoot Boots can help? Reach out to our team here.

Riding horses wearing Scoot Boots through water

 

Other Resources for Barefoot as a Treatment for Navicular


http://www.hoofrehab.com/NavicularSyndrome.html


https://www.herefordequestrian.co.uk/2011/10/27/going-barefoot-a-new-approach-to-healing/


http://www.hoofrehabstore.com/care-and-rehab-of-the-equine-foot/


Auburn University Navicular Studies - http://www.hoofrehab.com/NavStudy.html


2014 Auburn University study - https://www.sciencedirect.com/science/article/pii/S0737080613006370

 

Bibliography 

All-Natural-Horse-Care.com, 2006. Side View Of The Hoof Capsule. [image] Available at: <http://www.all-natural-horse-care.com/barefoot-hoof-diagrams.html> [Accessed 14 May 2020].

 

Cornell University, College of Veterinary Medicine, n.d. Palmar Digital Neurecotomy. [image] Available at: <https://courses.cit.cornell.edu/vet644/legPDNerve.html> [Accessed 15 May 2020].

 

Dr. J Rooney, 1998. The Lame Horse, Paperback - June 1, 1998. [image] Available at: <https://www.amazon.com/Lame-Horse-James-R-Rooney/dp/0929346556> [Accessed 14 May 2020].

 

Henderson, C., 2015. Treating Navicular Disease With Farriery. [image] Available at: <https://www.horsejournals.com/horse-care/hoof-care/lameness/treating-navicular-disease-farriery> [Accessed 14 May 2020].

 

Horsetalk.co.nz, 2015. Nerving: (Posterior Digital Neurectomy) A Farrier’S Point Of View. [image] Available at: <https://www.horsetalk.co.nz/2015/07/19/nerving-posterior-digital-neurectomy-farriers-view/> [Accessed 14 May 2020].

 

Kauffmann, S., 2006. New Thoughts On Navicular Syndrome. [image] Available at: <http://www.hoofrehab.com/ArticlesPDF/Navicular_story.pdf> [Accessed 14 May 2020].

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