Poor Performance Examination

At Pool House Equine Clinic, lame horses are commonly seen, diagnosed and treated

At Pool House Equine Clinic, lame horses and ponies are commonly seen, diagnosed and treated at our Poor Performance examinations. Cases of lameness can occur in both pleasure and competition horses. Whilst in some horses the cause of the lameness may be easily determined, in others, a more detailed lameness work up is required. There are many different reasons why a horse may present with lameness, from foot balance issues, laminitis to tendon and ligament damage. It is also not infrequently caused by damage to joints. This may be damage to the cartilage, which lines the joint, to the fibrous capsule that surrounds a joint (the synovium) or may include a chip fracture of the underlying bone.

When a horse is first presented with a lameness issue, their history is important. For example, what are the presenting signs, how long has the horse been lame, is it persistent or intermittent lameness, when do you notice the lameness, does the horse warm up and improve? All of these factors will aid us when trying to figure out the cause.


An examination of the horse is then necessary both visually and with manual palpation. This is to identify any abnormalities such as asymmetry or limb swelling which could suggest a potential cause.

Most patients will then require walking and/or trotting in a straight line, ideally on a hard, level surface. This will help to identify which limb (or limbs) the horse or pony is suffering pain in. The gait of the horse and their behaviour is also assessed as these can be important indicators. Our digital lameness locator system can also be used confirm the area of lameness.

Flexion tests are commonly performed next, which involve holding the limb (or a section of the limb) up before trotting the horse away. Flexion tests increase pressure on joints and surrounding structures and may exacerbate lameness associated with the area that has been stressed. The response (or lack of a response) will all add information when determining the site and causation of lameness.


Lunging the horse on both a hard and soft surface is also extremely beneficial. A horse may present, or change, the lameness pattern on different surfaces and different reins. If the horses’ behaviour and comfort levels allow, a ridden assessment (either by the owner, or a professional rider) can be of great assistance to the investigation.

Nerve blocks (or ‘diagnostic regional analgesia’) use local anaesthetic to ‘numb’ different specific areas. If the painful area is blocked and the lameness improves – then it can be reasonably assumed that the pain is originating from this location.

A joint block is performed under sterile, aseptic conditions. The area is cleaned and the joint or synovial structure is infiltrated with local anaesthetic. The lameness is then re-assessed.

When the origin of pain has been identified, x-ray imaging and/or an ultrasonographic examination can be performed, hopefully leading to a diagnosis.  Occasionally, more detailed imaging is required, in the form of an MRI (magnetic resonance imaging). MRI is useful for investigating foot pain as it produces 600-900 highly detailed images of the complicated soft tissue and bony structures of this area.

Once the cause of the lameness has been established, we can advise you on appropriate treatments and management strategies. This can include, but is not limited to, box rest and a change of management at home, shockwave therapy, surgeries (i.e neurectomy and fasciotomy procedures), oral pain relief, steroid injections or remedial shoeing. We are extremely lucky to have a remedial world champion farrier, Grant Moon FWCF, regularly attend the hospital for shoeing.

If you have any further queries, or wish to book an appointment with one of our vets for a lameness issue, please do not hesitate to contact our reception team on 01283 799700.

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