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How SI Joint Function Is Influenced by the Hooves - An Imperative Conversation to Have With Your Farrier

The sacroiliac (SI) joint is located in the lower part of the horses back, where the sacrum passes underneath the top of the pelvis (tubera sacrale) and forms 5 fused vertebrae. The SI joint is strengthened by the ligaments; dorsal, ventral and interosseous sacroiliac ligaments and it plays an integral role in the horse's hind end movement.

Because of the complexity of the SI Joint, and it's often overlooked pathologies, I am going to be posting multiple different articles on this subject. In this post, we'll take a look at the influence of the hooves on the SI, and pathologies that create challenges for the horse which are often blamed on the hocks, stifles, or go untreated.

This information is a conglomeration of research from various Universities, from the American Farrier's Journal, from renowned Dr. John Kohnke, Dr. Kerry Ridgeway, and from expert farriers which I have compiled in order to help horse owners advocate for their horse's health, comfort and performance when addressing COMMON issues.

Knowledge is power, and by having a basic understanding of hooves and their angles and how those impact the SI joint's performance one can be empowered to make progressive changes to the horse's routine, which can ultimately result in the rehabilitation of SI injuries or osteoarthritic conditions of the SI that would interfere with a riding horse's ability to perform.

Further, many horses are suffering from SI joint pain, and their owners have simply not discovered the root cause, often addressing symptoms rather than addressing pain at the source. Horses with SI pain can be helped, and changes that horse owners make will determine that horse's ability to live without (or with) pain long-term.

HOW COMMON ARE SI ISSUES? Any horse can present signs of SI pain, with up to 50% of all equine back injuries being associated with the sacroiliac joints and ligaments. (As you can see, this is quite common!)

WHAT HAPPENS WHEN A HORSE IS EXPERIENCING SI JOINT DISFUNCTION? Lower back pain can cause changes in the horse's gait and in his behavior. You might notice a horse with SI pain has a "pointed hind end" (see image below) with muscle underdevelopment at the croup and over development toward the dock of the tail.

Horses might swish their tails or even pin their ears at gait transitions. They are often reluctant to collection and lack impulsion. Horses when palpated for SI joint pain have often immediate and extreme reactions in the gluteal-sacral region, and along the spine.


Sacroiliac joint problems in horses are influenced by a myriad of factors, a common one being poor saddle fit, but we are going to look specifically at the hoof angles and how they influence a horse's hind-end.

Horse hoof angles and SI joint pathology
Photo credit American Farrier's Journal

HOOF ANGLE INFLUENCE ON SI JOINT HEALTH. Hoof angles such as low or underrun heels and long toes cause extra loading stress to the lower back and sacroiliac region. It is important that horse owners check the hind hoof angles to prevent overloading the low-back region of the horse.

The load bearing or pressure placed on the horse's low back and joints is significantly influenced by the angle of the hooves. Therefore ideal hoof angle is imperative to an equine's overall health, soundness, and performance. The hoof angles in the hind need to support the SI area as well as the legs, joints, and tendons.

When hoof heels are too low (angle too high) underrun heels and long toes occur causing significant hoof problems such as navicular region pain/strain, bruised heels, and can potentially lead to damage further up the limbs such as knee (carpus) injuries, suspensory apparatus failure, deep digital flexor tendinitis, and you guessed it-- back and neck pain.

When hoof heels are too high (angle too low) similarly, a host of problems can occur over time. Navicular strain, tendon and ligament strain, and how the horse lands as he moves will impact his overall soundness and performance. Taking a look further up in the equine body, a higher heel can cause significant dysfunction in the 6th and 7th cervical vertebrae, and can cause SI joint dysfunction. A horse that has proper landings or footfalls will land heel first. If the heels are too long, the heel will tend to be turned under and pushed forward, which causes the sole to be pushed forward resulting in separating the capsule from the coffin bone. At first, this separation may be slight -- only 1/4 inch or less but as the condition progresses, the separation will move further up.

Saddle fit is affected by hoof angle as well! Dr. Kerry Ridgeway has an excellent, detailed article on the effects of Low Heel/High Heel Syndrome which is a comprehensive breakdown of how different hoof angles will impact the horse's stride, soundness, saddle fit, rideability and so on.

Takeaway. The equine SI joint is complex in nature, and impacts his movement and performance. SI problems are COMMON in the horse world, and often overlooked. Horse owners must understand how hoof angle impacts their horse's overall health, soundness, comfort and performance and many horses are living in pain caused by underlying issues such as SI pathology which is often linked to the hooves!

Choosing Farriers & Trimmers. It's imperative that horse owners have candid discussions with their horse trimmer or farrier regarding proper hoof angle as we must be our horse's advocates. (They cannot speak for themselves!) Unfortunately, our practitioners are only as good as their education and "practice" implies just that -- the more experience a practitioner has, the more knowledge he or she will possess. Consider vetting your horse shoer/trimmer by examining their credentials. Would you send your horse to a Veterinarian who didn't complete vet school? Would you have a surgery performed by a surgeon who had taught himself!? Your horse's hooves are no exception and require a skilled, certified practitioner who is well versed and who has studied under more experienced hoof experts. As the adage goes, "no hooves, no horse!". Consider also the cost associated with your horse's health long-term. Vet bills and rehabilitative therapies are costly! Investing in knowledgeable farriers who truly understand the hoof may cost more per trim/shoeing but will reap dividends in the long run, potentially saving your horse from loads of unnecessary pain, and ultimately saving your pocket book!

Don't cut corners on your precious equine partner's health and wellbeing.

The information herein should not be construed as Veterinary advice but has been sourced from several veterinarians and equine science program nationally (cited). If you believe your horse is presenting SI pathology or other problems, consult with a licensed veterinarian immediately.

Sources Cited:

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