The Importance of Equine Lameness Exams

If you follow any equine-related accounts or groups on social media, you likely have seen the post about how flexions during lameness exams are causing pain and injury to your horse. The typical accompanying image on that post compares flexing a horse’s front limb to a person’s arm being twisted behind their back. This is an inaccurate comparison because during a flexion test you are flexing the horse’s limb in its normal alignment, while twisting someone’s arm behind their back is bending it in an abnormal alignment. Posts like this make us realize how little some people understand the “why” behind comprehensive lameness exams. Since we are passionate about equine sports medicine and are committed to performing high quality lameness exams and therapies, it’s important to us that equine owners understand what we are doing.

Janelle spent a large part of her vet tech career working on the top performance horses in Colorado and beyond during her time at Countryside Veterinary Hospital in Colorado. Thanks to Janelle’s connections, Dr. Kolar was able to do lameness training with Dr. Shoemaker at Countryside as well and hone her skills. At South Peak Veterinary Services, we perform a full lameness exam every time we are seeing a new patient for lameness or a new issue.

A thorough lameness exam consists of the following:

• Gathering a thorough medical history on the horse

• Evaluation of the horse at rest and in motion. We evaluate the horse at a walk, trot, and lunging in a circle in both directions. If conditions allow, we also prefer to evaluate the horse moving on firm and soft ground for comparison. This gives us a baseline to compare our flexions to.

• Thorough hands-on exam. We palpate along the entire spine, each limb, and major muscle groups to identify areas of sensitivity and any abnormalities

• Hoof testers. Hoof testers are applied to every foot to look for sensitivity

• Flexions. We generally flex the carpus and fetlock on both front limbs, and the stifle, hock, and fetlock on both hind limbs. There are additional flexions we can perform if we feel they are necessary, but they aren’t part of our routine flexions. The purpose of flexions is to place mild strain on specific areas of the limb to try to identify the source of the horse’s pain. The limb is held in a flexed position for a recommended length of time, then the horse is jogged off in a straight line. If the horse appears lame in the first few steps but then is sound, we would not call that a positive response. We expect the horse to take a couple bad steps as they readjust, just as if a person held their leg flexed at the knee for a period of time and then tried to jog. However, if the horse appears lame the entire length of the trot then we would call that a positive response. During flexions, we are not bending the horse’s leg in a way that is abnormal to them, so it is not comparable to twisting someone’s arm behind their back. We are placing mild strain on a specific area of the limb, but not enough to cause injury.

After a thorough lameness exam, depending on results, a patient can either receive treatment or may require additional diagnostics to isolate the cause of the lameness.

Lameness exams are a vital component of any performance horse’s care. Providing a thorough exam every time is critical to ensure that horse is receiving the best care and can return to work. Since equine lameness is a favorite topic of ours, we plan to put out more educational content! Keep an eye out for more information on our social media and in our future newsletters!

The article “The Importance of Equine Lameness Exams” first appeared in our Spring 2023 Newsletter.