Q: “If a horse has contracted tendons, is it better to raise or lower the heel and use anterior or posterior extensions?”

—Virginia farrier

A: I prefer to address this question hypothetically concerning forelimb flexural deformities to this relationship of surgical or therapeutic shoeing in horses that are two or more years old.

Since heel extensions are specific to the flexor tendons, we can address the deep and superficial flexor tendons (DFT and SFT). In cases of significant DFT contracture, a surgical tenotomy is a viable option. 

Prior to the procedure, I shoe the affected limb with a heel extension. Pre-surgical support prevents the toe from tipping up. 

I usually keep them shod with heel extensions for two shoeings in a 12-week period. Some horses may need to be reset at 5-week intervals. The length of the heel extension can be reduced in sensible increments thereafter. 

The heel extension is a support method that is applied to surgical or traumatic tendon disruptions. Tendons are almost impossible to “stretch” with shoeing alone and require surgical intervention. Typically, DFT relaxation requires superior or inferior check ligament desmotomys. Depending on the site of contracture and the degree of affliction, the surgeon decides if one or both ligaments should be cut. Pre-surgical preparation includes aggressively trimming the heels and application of an anterior extension. 

If a horse is mildly contracted, surgery may not be warranted. I trim to the sole plane in order to gain a solid, functional foot. I may put a wedge…