There are many ideas surrounding how to address the back of the foot with our trim. Heels, bars, frog…some trimming techniques are more aggressive than others, recommending more or less removal of material.
I was taught a trimming technique to address distortion in the heels by Dr. Judith Shoemaker, a stellar veterinarian who practices complimentary medicine in Nottingham, PA. Heel slippering!
In trimming the heels, most methods recommend bringing the heels back to the widest part of the frog. Anytime the heels are brought back they are also lowered since the foot is a cone. In some situations, lowering the heel height is not desirable, especially if the horse is being kept barefoot and adding heel height back in is not an option with a prosthetic device. This is where heel slippering can be especially helpful!
Here is an example of a horse who benefited from using heel slippering as part of his hoof rehabilitation. He was experiencing heel pain, and also suffered from kissing spines. The owner asked if I’d help her horse become pasture sound, and through the process of rehabilitation and working with Dr. Shoemaker, he became sound and could be ridden again!
Here is his Right Front foot when I first started with him. The back of his foot at this time is quite distorted:
In applying my guidelines for hoof rehabilitation as I’ve discussed in previous blogs, I wanted to get his heels back, but couldn’t without lowering his already too low palmar P3 angle. Heel slippering gives me a way to straighten the distortion in his heels without overly lowering the height.
Here are the Right Front heels from our first trim to the third trim over a three month period of time using heel slippering as part of our trim protocol. Note the contracted under-run heels and uneven bars before, to straighter bars and wider heel and frog after those three trims:
The radiographs and photos here are during that same three month period. Note the higher palmar P3 angle and increased angle of hoof growth coming in below the coronary band after three trims. At this point he is hardly finished his rehabilitation, but off to a good start! Heel slippering helped straighten the distortion in the heels while facilitating increasing his palmar P3 angle.
Here he is being ridden after hoof rehabilitation and complimentary therapies with Dr. Shoemaker:
Heel slippering works by removing the distorted heel and bar from the ground, without lowering the height of the heels overall. The heels can be mapped to determine what material needs to be relieved to straighten the affected tubules. Dr Shoemaker observed that each curled heel seems to have a stress line, a ‘fulcrum’ that occurs on the back of the heel, at the point of folding of the heel. In heels that are quite folded, there can even be more than one fulcrum line as well.
The red arrows and the black sharpie lines mark where the fulcrum points are located on the heels of this different horse’s distorted foot. This is the first time I worked on this horse:
In mapping for slippering heels I like to mark the fulcrum points first, then I draw a line from the end of the white line of the bar, at the bar swell, to the fulcrum point. When you have multiple fulcrum points, you can use your discretion as to which fulcrum point you map based on how much of the turn of the heel you want to straighten:
The goal is to relieve the curled tubules from the ground so the new tubules will be stimulated to grow in a better direction. Similar to removing a flare so the new growth can come in straighter. The next step in mapping the heels is to draw a line from where the fulcrum point and bar line meet, down to the bottom of the collateral groove:
Everything above the slipper line needs to be SAFELY and CAREFULLY removed from the ground as marked here:
Actually trimming the heel slipper can be done with a knife, rasp or nippers. The key is to have the transition between bar and heel smooth and on a flat plane (not scooped!) so the tubules are stimulated in a straighter direction:
Here is the medial heel on this Right Front foot slippered. Notice how the bar and heel tubules are much straighter, however, the overall heel height has not been lowered.
The added benefit of this technique is when the foot fills with hoof pack, the heel support is now back at the widest part of the frog, without lowering the heel height, and therefor the palmar P3 angle.
When I have a foot that has a good bit of distortion in the heels and bars, yet a low palmar P3 angle, heel slippering is a useful tool in my toolbox to address the distortion and yet avoid overly lowering the heel height in the process. For more information on heel slippering and other ways to identify and correct hoof capsule distortion, consider attending one of our hands-on hoof clinics. See our calendar for details on clinic dates: