Collapsed heels are, unfortunately, a common and frequently undetected occurrence in shod horses. There are many misunderstandings about the mechanics of the condition, and likewise lots of unsuccessful treatment.

Wedge pads are often applied to horses with under-run heels, and this tends to worsen the condition because it further crushes the heels. Heel elevation makes the shod hoof look better. It is very important to know that just because the hoof looks better after shoeing, this may not mean that the horse has been helped.

Over time and multiple incorrect trimmings and shoeings, a vicious cycle develops of heel elevation and worsening backward rotation of P3 (pedal bone) with respect to the ground (creating an increasingly negative palmar angle). In a normal horse, the sole surface of the bone has a positive angle. In these horses, that gradually changes. The condition is graded on a scale of 1-4, with 4 being the worst.

Diagnosis involves veterinary lameness and hoof exams. Lateral radiographs are needed to establish the orientation of P3.

Treatment begins with a correct trim, which to begin to normalize the angle of P3 (palmar angle) based on the lateral radiographs.