Case study with radiographs - Willow - a 6 year old warmblood with NPLA and compensatory posture

Beccy Smith
Jul 15
4 min read

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Willow is regularly trimmed by a professional hoof care provider however the question of poor hoof balance was raised by a body worker; vet physio and trauma informed therapist Yasmin Stuart. Yasmin was concerned Willows posture was negatively impacted by suspected negative plantar angles (NPLA), meaning her hind hoof coffin bones were potentially sitting lower at the back than at the front, causing a compensated, pathological posture.

Willows' owner already suspected something wasn't quite right and had purposefully not backed her. Instead she chose a proactive and preventative approach to preventing lameness and committed herself to learning how to optimise her posture and hoof health, with an integrative equine podiatry initial consult.

Here you will learn via objective evidence, the impact of the implementation of a hoof care plan and reductive intervention from 11th July 2025, aimed at improving Willow's posture, development, hoof balance and comfort.

Radiographic assessment and findings

Dorso-palmar and latero-medial radiographs were taken the day before the consult.

There was minimal medio-lateral imbalance however the concern about lack of ideal phalangeal alignment was confirmed, with lower than ideal palmar (front hoof) and plantar (hind hoof) P3 angles.

The radiographs provided evidence of:

a lack of ideal sole depth (industry ideal = minimum of 14-15mm of total sole depth under the tip of P3)
less than ideal vertical position of the inner foot relative to the capsule as denoted by the distal displacement measured at the coronet-extensor process distance (CE distance)
less than ideal phalangeal alignment, denoted by the disparity between P1 and P2 and especially between P2 and P3 angles.
the palmar and plantar P3 angles are all less than the ideal industry standard of positive 5-8 degree
The left fore and both hinds were negative, meaning there is an associated increased risk of pathology and lameness in the digit, limb and body of the horse

The vet did not comment on dorso-palmar balance and referred the owner to me for comment instead. A lameness examination was not performed.

Integrative equine podiatry assessment and findings

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