Conditions or ailments that are the cause of a problem that you see - your observation.

Your vet may diagnose

Deep Digital Flexor Tendinitis in Hoof

Synonyms: DDFT Tear Within the Hoof


The equine flexor tendons are rope-like structures located in the rear part of front and rear lower limbs. They have critical structural, shock absorbing and slinging functions in the lower limb. They are under tremendous tension as the horse bears weight.

The deep digital flexor tendon runs down the back of the cannon bone, through the back of the fetlock, down along the back of the pastern, and dives between the heel bulbs and into the hoof. Here it runs over the navicular bone and bursa, and attaches on the rear part of the coffin bone. The full weight of the horse is borne through the deep flexor tendon; it is under great strain normally.

Tendinitis is strain and tearing of the fibers of a tendon, usually from overload of the structure.

These injuries have been thought to occur from overload in deep footing or injury when a horse steps in a hole. There are likely many other reasons for injury and predisposing factors too.

Pain in the back half of the equine hoof has historically been difficult to differentiate using ultrasound and radiography. Much of it has been attributed to the navicular bone. As MRI has become more commonly performed, we have recognized a whole range of tears and injuries that occur to the deep digital flexor tendon within the hoof.

Tearing of the deep digital flexor tendon within the hoof may be part of the same process that causes degeneration of the navicular bone and inflammation within the navicular bursa. This is an important cause of lameness that is localized to the heel with nerve blocks.

Diagnosis requires lameness exam, nerve blocks, ultrasound and especially MRI. It is almost impossible to definitively diagnose this condition without MRI. Ultrasound is useful but we are limited by our ability to see the structures within the hoof.

Treatment centers on rest, but may include a variety of other treatments including regenerative therapies.

my vet's role


Guarded for return to performance. These injuries take months to a year to heal.

my role


I might observe

You might make these observations when a horse has this condition.

Very Common
Less Common
more observations

Questions To Ask Your Vet:
  • Why do you believe my horse is suffering from tendinitis, as opposed to other possible diagnoses?

Conditioning: Tendons strengthen with conditioning and gradually increasing load. Always over-condition your horse for the work asked of him. Long, slow, distance work-such as a 30- to 45-minute walk/ trot -is ideal, as this strengthens tendons and ligaments without stressing them. Ensure overall fitness exceeds work level and expectations.

Good footing. Uneven or deep footing causes tendon and ligament injury. Never ride a horse in bad footing (too deep or too thin or hard).

Hoof care: Appropriate shoeing or trimming, and prevention of hoof overgrowth is critical for minimizing stress to tendons and ligaments. Keep your horse on a regular (6-8 week) shoeing or trimming interval.

Warm-up: Plan to walk a horse under saddle a minimum of 10 to 15 minutes before you start to work.

Recognize subtle signs of lameness before they become severe. Notice swelling, heat or digital pulse in your horse's limbs by learning what constitutes normal (WHE). Observe your horse's limbs before you ride and take note of any changes you notice.

further reading & resources

Author: Doug Thal DVM Dipl. ABVP