Flexions are an integral part of the lameness exam, and may help to define the location of a problem. Following an initial assessment of lameness at the trot, where a grade is assigned to the severity of the lameness, a flexion exam is performed.
In this simple procedure, a specific region of the limb is placed under strain or compression for a given period of time (in our practice usually 60-90 seconds, depending on the location), and at the end of this time period, the horse is immediately trotted off.
The horse’s gait is then analyzed for abnormalities, and any change in degree of lameness is noted and recorded. If there is an injury or pain from within the flexed region, the presumption is that the lameness will appear worse after flexion.
Flexion exams are sometimes used to make a subtle problem more visible. Some problems are made much worse by flexion and others less so. An experienced lameness examiner understands this, and is looking for subtle variations.
Reasons to UseRelated Observations
Flexions are used after a baseline lameness score is established to add information to the study and help reach a diagnosis. Flexions can be a good general indicator of the location of a problem in the limb.
Flexion exams are nothing more than a general screening test that can narrow down a problem to a general location. They cannot define specifically the region or the condition causing lameness.
Due to the mechanics of the equine limb, multiple joints are almost always flexed together. Further diagnostics are usually needed to locate a problem with greater precision.
Different horses are more or less affected by flexion exams, further complicating the examiner's interpretation. Flexion exams without corresponding lameness must be viewed with suspicion. They may or may not indicate a problem.
From the standpoint of a pre-purchase exam (and without lameness) they may not contribute to any prediction of soundness in the future and may even be misleading.
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