[USER=38]Chip Crumbly[/USER] From post: http://farriersforum.com/threads/everyday-shoeing.84/page-2#post-1626 With a Collateral Ligament injury I have heard of two methods of shoeing. 1. Reduce leverage on the affected side. 2. Support the affected side (add leverage). What do you think and what is your theory on it?
In the cases that I have worked on with a strain or tear I have always reduced leverage and for the most part will add suport with fullness to the other side and still try to easy breakover with a 1/2 round or a PLR style shoe.
If you don't mind me asking, what is the thinking behind reducing leverage on the affected side ? I'd go with Chip's approach of adding support on the side of a joint where the ligaments are broken/injured and reducing support/leverage on the opposite side, simply to help keep the joint together and avoid/minimise subluxation or further injury on the affected side. This has worked well on the two times I had to deal with such a problem, one verified tear and one suspected, but I realise now others have different/opposite suggestions. Was it luck that these two recovered or did they recover despite the applied protocol and not because of it ?
I've reduced on the affected side also. Though I'm starting to think it makes more sense adding support so there is less pull on the affected ligament.
In reducing the tork on the joint with the easy of break over even med to lat. has made the horses that I work on heal faster along with vet care.
When I have sprained the lateral side of my ankle, closing the joint has always felt better. Opening it was painful. What that means to collateral ligaments I'm not sure.
If the foot is balanced and you relive break over med. and lat. I think in essence you keep the joint closed. the way I look at it is once the ligaments have been compromised due to tearing or strain you need to keep as much strain off the ligaments and I have had great luck with relieiving the break over.
is it the shoeing or the rest curing the injury ? i would have suspected that when the horse was moving the joint would flex and open even if only a slight amount , saying that i favour the rolled toe balanced foot approach
In my mind it depends what surface the horse is working on. If it has collateral lig damage then if the hoof is sinking on that side on soft ground then the lig will stretch and cause pain. increasing width of the shoe will increase resistance to the ground and prevent counter lateral rotation. How ever on a firm surface where a horse lands hard laterally then as the medial branch descends after the initial lateral impact then the medial ligs will stretch as the capsule levels to the firm ground (usually in conjunction with an abduction of the whole limb). The bottom line is its a fairly serious condition that needs many factors taken into consideration before jumping in. But I might be wrong. for those who arnt familiar with the complexities of the area here is a diargram.
I'm inclined to agree that a dominant factor is going to be the footing and also how the horse is going in terms of weight bearing but I'd be wanting to do something that ensured rest and am with Chris that Dr Time is then going to be the best possible cure. With this sort of injury I always say double what you think it might be to allow for the horse just putting in a silly little step and undoing what rest might have done. So 6 months to a year.
