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Discussing Palmar Foot Pain part 5

Looking at the interrelationship between the navicular bone and the rest of the foot and limb.

It is important to acknowledge the interrelationship of the distal Sesamoidean or navicular bone, the internal soft tissue architecture, and the bony structure of the limb, including its articulation within the distal interphalangeal joints and its role in reducing the symptoms of the navicular syndrome and palmar foot pain. Acknowledgement of the interrelationship of the articulation of the distal interphalangeal joint and the flexion of the deep digital flexor tendon is my ratification for including it as a major diagnosis assessment protocol in formulating every individual trim, assessing the tendon and ligament pathology to the soft tissue architecture and the bony column structure of the distal limb before starting each trimming process.  

By deploying the philosophy of biomechanical medicine, palmar hoof pain can be explained as an orthopaedic imbalance of the horse that will cause the distal sesamoid bone to sit asymmetrically to the distal phalanx, instigating stress on the collateral and impar Sesamoidean ligaments and deep digital flexor tendon, as it articulates back and forth over the distal sesamoid bone; with the extra tension triggering an inflammatory response that brings about changes to the periosteum coating, and long-term changes to the cortex of the distal sesamoid bone that, over time, becomes navicular bone disease. The statement above is my conclusion to defining the common equine complaint of navicular syndrome.

These long-term cases will also show signs of a diminishing digital cushion, misalignment of the internal and external bar structures of the foot, misalignment and structural tension in the collateral distal cartilages and the migration of the external hoof capsule according to the alignment of the internal distal phalanx, all contributing to palmar foot pain and navicular syndrome. 

Suppose the orthopaedic imbalance in the horse is left untreated. In that case, physical changes to the alignment and articulating surfaces of the distal interphalangeal joint will, over the long-term, remodel the distal and proximal surfaces of all phalanx bones, and the distal condyle surface of the longer third metacarpal, and metatarsal bones of the equine’s limb. In turn, these distal limb imbalances lead to compensation patterns that change the horse’s upper body.

Navicular pain should, therefore, be viewed as an early warning sign of unacceptable orthopaedic imbalance in the equine and, if not addressed appropriately, then long-term problems will manifest throughout the animal, as laminitis, navicular disease, musculo-skeletal alignment issues, limb conformation issues, locomotion and orientation problems, and the ever-changing balance of the hoof capsule and the horse's behavior.

I hope these blogs on understanding palmar foot pain in your horse’s will help you manage foot issues you could face with your horse, so you don’t have long-term problems with this issue, view it as an early warning sign of unacceptable orthopaedic imbalance in your horses.   

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