High/Low Syndrome


This horse exhibits what is sometimes called “high/low syndrome” with one foot having high heels usually on a contracted foot (which may or may not be a clubfoot),  and the other with low and sometimes underrun heels,  flat and  lacking concavity.  The horse usually stands in a scissor stance, with the high-heeled foot back behind him and the flat foot in front of him, due to the discomfort of weighting the back of the high-heeled foot, which creates a vicious cycle of exacerbating the high heeled condition.

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Before                                      August                          September                         November

When the heels are high, the flexor/extensor tendon balance is disrupted. There is too much tension on the extensor tendon and too little in the flexor.  The excessive tension resulted in this injury of the extensor tendon leading to the swelling and convex appearance of the pastern. Withing three months’ time the heels have been lowered, the swelling has gone down and the pastern angle is not as steep. High heels are correctable with trimming, and are not prevented from doing so by a “contracted digital flexor tendon”, or from pressure in the digital flexor tendon.  The pastern angle is variable, not fixed, and rather determined by the height of the heels – as demonstrated by lowering the heels.


The other foot has begun to show some improvement in the underrun heels and shallow toe. The two feet are much more similar in terms of heel height. This better balance has beneficial effects throughout the horse’s whole body as he is able to use himself more evenly, reducing injury, soreness and incidence of arthritic conditions.