Knowledge about hooves
Hufkrankheiten

Club foot – the congenital, acquired and false club foot

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What is a club foot?

Bockhuf In a club foot a flexor tendon of the horse is shortened, which makes the hoof too steep and look "boxy". Most often it is the deep flexor tendon that is too short, which permanently flexes the coffin joint. However, the superficial flexor tendon can also be shortened, in which case the constant flexion occurs in the coronet joint or fetlock joint instead. Some horse professionals call this second variant "tendon stilt foot", while others use the term synonymously with "club foot". There is no uniform definition of these two terms, just as there is none for the question of when a hoof is classified as a club foot. Some speak of a toe wall angle of 60° or more, others use the breaking of the bone axis coffin bone – short pastern bone – long pastern bone as a reference.


In principle, a club foot can occur on one or several legs and both front and hind hooves can be affected; however, a club foot occurs more often on a forelimb.

On the hind hooves, a club foot is often found together with hyperextension (i.e. a weakness of the suspensory ligament), which is then called "bear-pawed".


A club foot can occur in different degrees of severity and can extend up to floating heels, or to such severe cases that the foal cannot even bear weight on the affected limb.

True or false club foot?

A true club foot exists when the horse physically cannot extend the toe joints of the respective hoof. A false club foot, on the other hand, is a hoof that looks like a club foot but where the horse would physically be able to fully extend the toe joints. That means the tendons would be long enough, but the hoof still appears too steep (the heels are too high and the toe is overloaded).


The causes of a false club foot can be numerous:

  • uncomfortable heel area (incorrect/infrequent trimming, thrush, etc.)
  • cause higher up in the horse's body (pain in the shoulder, problems of the flexor muscles and the like)
  • husbandry problems (too little movement, ground too soft)

How can one determine whether it is a "true" or "false" club foot? For this, the veterinarian can perform a stretch test: the hoof is placed on the end of a board so that the rest of the board points towards the horse's head. This end is now slowly lifted. If the hoof remains flat on the board, the flexor tendons are stretched, showing that they could be stretched further. If, on the other hand, only the toe remains on the board and the heels (with the limb extended) "lift off", this is a sign that the flexor tendons cannot be stretched any further and that it is a true club foot.


A true club foot can also be either congenital (i.e. the foal is born with this malposition) or acquired during growth.

Consequences of a club foot

In a club foot, the toe area of the hoof is overloaded by the permanent vertical position of the coffin bone. On the one hand, this means that during break-over the toe wall is mechanically "levered away", which despite a healthy lamellar layer can lead to a widened white line. On the other hand, the toe area is excessively worn down, which sometimes leads to a thin sole. In addition, the coffin bone will slowly remodel itself due to the persistent unphysiological pressure: the bone is broken down from below at the tip and develops an addition at the lower end towards the toe wall. The coffin bone of an adult horse with a club foot can therefore ultimately look similar to the coffin bone of a laminitis horse with coffin bone rotation.


Without countermeasures, a club foot tends to get worse during a horse's life and can sometimes lead to knuckling over. The fetlock joint is then pushed forward and is no longer normally flexed in motion.

Treatment of the club foot

In the treatment options it is decisive how old the horse is. In a foal all structures are still growing and can therefore be influenced to a certain extent. Close cooperation between hoof care specialist, veterinarian and owner is important here in the first six months of life. During this period the epiphyseal plates of the lower bones are not yet closed and the greatest influence can be exerted. Afterwards the options are already limited.


Treatment options at foal age include:

  • shortening the heels
  • applying cast bandages
  • artificial lengthening of the toe by applying extended rigid Klebebeschläge or splints
  • plenty of movement on hard ground
  • administration of oxytetracycline (an antibiotic whose side effect inhibits bone growth; the exact mechanism of action with regard to the improvement of the club foot has not yet been fully clarified)

In severe cases an operation can also be performed, in which the supporting ligament of the deep flexor tendon is cut.


Once the horse is fully grown, a true club foot can hardly be completely resolved anymore. With good management, however, improvements can be achieved and the horse can lead a problem-free life (depending on the degree of severity). Management measures include:

  • very short trimming intervals (in some cases every 1-2 weeks)
  • making the heels "comfortable", i.e. ensuring a physiological development of frog and bars
  • plenty of movement
  • sufficiently hard ground in the paddock

A false club foot, on the other hand, can be completely cured again with good hoof care. Here too, very close-meshed hoof care is necessary, and possibly permanent hoof protection for a certain time is sensible in order to protect the overloaded toe from too much wear.

Causes and prevention

Bockhuf There are many circumstances that can contribute to the development of a club foot and not all are scientifically conclusively proven. The causes must also be distinguished depending on the type of club foot:


possible causes of a congenital club foot:

  • insufficient nutrient supply of the pregnant mare (especially deficiencies in calcium, phosphorus, copper and vitamin A, vitamin D3 and vitamin E)
  • faulty position of the foetus in the uterus
  • an unfavourable size ratio between covering stallion and broodmare
  • imbalance between the muscles that flex the leg and those that extend the leg
  • hereditary cause/genetic predisposition (conflicting research)

possible causes of an acquired club foot:

  • uneven growth spurts (bones grew faster than tendons)
  • intake of concentrated feed or too energy-rich and too protein-rich nutrition during growth
  • injuries (e.g. tear/rupture of the extensor tendon, which acts as the antagonist of the flexor tendons)
  • protective posture due to conditions (e.g. shoulder joint cyst, epiphysitis)
  • incorrect hoof care (including removal of the "foal beak")
  • incorrect husbandry (too little movement, husbandry only on soft surfaces)

The last points (injuries, protective posture, hoof care, husbandry) can also be causal for a false club foot. Likewise, hoof conditions (e.g. thrush) can lead to the horse no longer loading the heels normally and thus an artificial club foot developing.

Special form: joint stilt foot

In the vast majority of cases the club foot is a so-called "tendogenic stilt foot"; this means that the pathological vertical positioning of the hoof results from the shortening of the deep or superficial flexor tendons. But there is also another type of club foot, namely the "arthrogenic stilt foot"; this is also called "joint stilt foot", as the cause does not lie in shortened tendons but in conditions of the involved joints.

Author: Nathalie Kurz


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