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Service Information

  • Lameness

    Digital radiography system in use at our Onley clinic

    We provide a modern approach to all aspects of equine lameness diagnosis. We aim to be thorough, evidence based and practical.

    In order to fully assess a lame horse it is necessary to observe movement:

    1. In a straight line
    2. After flexion of all 4 limbs
    3. Lungeing on a soft surface
    4. Lungeing on a hard surface
    5. Under saddle

    In subtle cases lameness is only detectable when the horse is ridden.

    Both our clinics are equipped with the facilities required to perform a thorough lameness examination.

    All our vets are experienced at providing an initial lameness assessment and treatment. Determining the site and cause of lameness can often be a time consuming process, usually involving the placement of ‘nerve blocks’ to sequentially eliminate each area of the limb as a potential source of the lameness.

    Lameness investigations can be performed at your yard or at either of our clinics. They can often take several hours to a full day to evaluate. Multi-limb lameness and subtle poor performance issues can take 2 or 3 days and are therefore often better suited to being admitted and performed at either of our clinics.

    Resident vets Andrew Hayes, Alice Sheldon, Steven Walsh and Becky Price have a particular interest in lameness diagnosis.

    Complex cases can or may also be referred to any one of our visiting orthopaedic specialists.


    In cases of severe and moderate lameness it is often only necessary to see a few steps of movement. In cases of subtle lameness flexion tests, observation of movement on different surfaces and under saddle are all important in reaching a diagnosis. Observing movement before and after ‘nerve and joint blocks’ are essential in determining the site of any lameness. Once the area of lameness has been established, diagnostic imaging can be focused on that particular area. This will usually allow a diagnosis and a prognosis to be made.


    An increase in lameness following a flexion test suggests that the joints surrounding soft tissue structures may be the source of pain. Flexions can be separated into upper and lower limb tests to improve specificity. The test is considered positive if the lameness is increased for more than 4 or 5 strides.

    Performing a forelimb flexion test
    Performing a hindlimb flexion test


    Frequently, lameness is more pronounced when the horse is worked in a circle, with the lameness being exaggerated when the affected leg is on the inside of the circle. Lungeing on a hard surface usually accentuates foot or lower limb lameness whereas lungeing on a soft surface usually accentuates upper limb lameness and lameness associated with soft tissues.

    lungeing on a soft surface at our Onley Clinic


    Certain lameness may be accentuated when the horse is ridden and some subtle lameness may only be observed under saddle. Clinical signs may be minor such as the horse displaying poor upward and downward transitions, a head tilt or tail swishing. Occasionally a horse may appear sound from the ground but the rider feels that the performance is impaired. In these instances it may be worth working the horse on pain relief medication (phenylbutazone) for a 7-14 day period to assess whether improvement occurs.

    lungeing on a hard surface at our Plum Park Clinic


    Local anaesthetic is placed around nerves supplying a particular part of the limb or within a joint. An improvement in the lameness by more than 50% is considered positive. Bilateral foot lameness in the forelimb is common so blocking out one foot will often lead to the lameness switching to the contralateral (opposite) foot. Bilateral conditions commonly affect the hindlimb as well particularly fetlock, distal hock joints and stifle.

    Placing a lateral plantar nerve block in hindlimb
    Placing a coffin joint block in a forelimb
    stifle radiograph
    MRI scan of equine foot

    Our portable modern digital radiography systems provide radiographs of excellent diagnostic quality greatly enhancing our ability to identify bony pathology.

    The practice possesses several portable ultrasound scanners enabling detailed examination of soft tissue structures and the identification of subtle changes on the surface of bone.

    Some cases, particularly patients with ongoing foot lameness, may require referral for MRI scans to enable a precise diagnosis and prognosis to be made. These are performed in cooperation with Oakham Veterinary Hospital or Newmarket Equine Hospital.

    Referral for scintigraphy (bone scan) may also be appropriate in the investigation of complex lameness, poor performance and some neck and back pain cases.

    If you would like to download a copy of this information, please click here.