Navicular Disease: The Beginning of the End?

What Is Navicular Syndrome and Disease in Horses?

Hearing the words navicular syndrome can be unsettling. For years, the diagnosis carried a reputation for being the beginning of the end of a horse’s useful life, but our understanding of the condition has changed considerably. We now know that pain in the back of the foot can involve several closely connected structures, and that horses with similar-looking X-rays may feel very different. A diagnosis gives us information; it does not, by itself, tell us what a horse’s future will be.

Some horses return to comfortable riding, some do best with lighter work, and others are happiest in retirement. What matters is identifying what is painful, improving the way the foot functions wherever possible, and paying close attention to the horse in front of you. Your veterinarian and hoof-care professional are important partners in that process.

Navicular syndrome describes pain arising from the back portion of the hoof, often called the caudal foot. The navicular bone itself is a small, flattened bone positioned behind the coffin bone and beneath the short pastern. The deep digital flexor tendon travels down the back of the leg, glides over the navicular bone and attaches to the coffin bone. Between the tendon and navicular bone sits the navicular bursa, a small fluid-filled structure that helps the tendon move smoothly as the foot loads and unloads.

The navicular bone is supported by strong ligaments and is part of a remarkably busy area of the foot. With every step, the bone, tendons, ligaments, bursa, joint surfaces and the soft tissues at the back of the hoof work together to manage force. This is why the older idea of ‘navicular disease’ as simply a diseased navicular bone is too narrow. Pain may arise from the navicular bone, the bursa, the deep digital flexor tendon, supporting ligaments, the coffin joint or a combination of these structures. You may also hear terms such as caudal heel pain or palmar foot pain, which describe the region of discomfort without assuming that one structure is responsible.

The condition is seen most commonly in the front feet and frequently affects both, although one foot may be more uncomfortable than the other. That can make the early signs surprisingly subtle.

What Causes Navicular Syndrome?

There is rarely one simple cause. Hoof conformation, repetitive loading, workload, previous injury, genetics and the condition of the tissues inside the foot can all play a part. A long toe with low or underrun heels, contracted heels, a poorly developed frog, limited sole depth or side-to-side imbalance can change the way forces travel through the hoof and increase strain on the structures at the back of the foot. Hard, rocky or demanding surfaces may add to that strain, particularly when the foot is already struggling biomechanically.

It is equally important not to reduce navicular syndrome to one trim, one shoeing cycle or one management decision. Horses with apparently good feet can still develop injury within the navicular apparatus, and hoof shape alone cannot tell us what is happening inside the foot. The useful question is not ‘Who or what caused this?’ but ‘What is contributing to this horse’s discomfort, and what can we improve from here?’

What Are the Signs of Navicular in Horses?

Navicular pain often develops gradually. Rather than seeing a dramatic limp, you may first notice that your horse feels a little less willing to go forward, shortens the stride, or stumbles more than usual. Because both front feet may be involved, some horses may protect one foot and then the other, making the lameness appear to shift.

Some horses warm out of the stiffness or seem perfectly comfortable on soft footing but noticeably different on harder ground.

Changes in attitude deserve attention too. Pinned ears during transitions, reluctance to maintain a lead, resistance to turning or simply losing enthusiasm for work can be a horse’s way of protecting a painful foot. Behaviour is information, especially when it changes suddenly.

How Is Navicular Syndrome Diagnosed?

A diagnosis should involve more than looking at the hoof or taking a single set of radiographs. Your veterinarian will usually begin with a full lameness examination, watching the horse on different surfaces and in straight lines and circles and may use hoof testers, flexion tests and diagnostic nerve blocks to help localize the pain.

Radiographs are valuable for assessing the navicular bone, coffin joint, sole depth, hoof balance and the relationship between the hoof capsule and the bones inside. They are only part of the story. Some horses have substantial radiographic changes and remain comfortable, while others are quite painful despite relatively modest changes on X-ray. Enlarged channels, changes in bone density or irregular margins can be useful diagnostic clues, but the image must be interpreted alongside the horse’s clinical signs rather than treated as the sole source of pain.

When more detail is needed, MRI can reveal injuries to the deep digital flexor tendon, navicular bursa, ligaments and other soft tissues that cannot be seen clearly on an X-ray. The more precisely we understand which structures are involved, the more thoughtfully we can support the horse.

What Does a Navicular Diagnosis Mean for My Horse?

Navicular syndrome is generally considered a chronic condition, and there is no single trim, medication, supplement, shoe or boot that cures every case. That does not mean there is nothing we can do. In our experience, the most productive approach is to stop focusing solely on the label and start considering the environment we are creating for the whole foot.

Medication and veterinary treatment can be very useful, particularly when a horse is painful or there is active inflammation. Depending on the structures involved, your veterinarian may recommend anti-inflammatory medication, other therapies, changes in exercise or treatment directed at a specific area. Hoof-care changes and different forms of protection may also be part of the plan.

Alongside those treatments, we believe we should pay close attention to something very basic: how comfortably the foot can function. The hoof is not a rigid container. It is a living structure that loads and unloads with every step. The frog, digital cushion, blood vessels and surrounding tissues all help support the foot and manage force, while movement plays an important role in circulation throughout the lower limb. When a horse is sore and reluctant to move, that natural cycle is affected too.

So rather than asking only, ‘How do we stop the pain?’, ask ‘What can we change so this horse can use the foot more comfortably?’ Improving balance, reducing unnecessary leverage, supporting the back of the foot, providing forgiving footing and making movement comfortable can all help create a better environment for the tissues inside the hoof. We cannot promise that every damaged structure will return to its original condition, but we can give the foot the best opportunity to function well.

Laminitis vs. Navicular

If your horse is sore on the front feet, you may wonder whether it’s navicular or laminitis. They can look alike, but they aren’t the same problem.

Navicular syndrome affects the navicular bone and the tissues around it, and it’s generally long term. Laminitis is trouble in the laminae, the connective tissue that keeps the coffin bone attached, and it often follows rich grass, too much grain, wormers or vaccinations.

Telling the two apart is a job for your veterinarian, so notice when the soreness shows up and how your horse moves, and bring that along. Our laminitis guide covers its signs, its causes and the recovery plan.

Hoof Care for Horses with Navicular Syndrome

Consistent hoof care is one of the foundations of managing navicular. The aim is usually to improve the way the hoof loads and breaks over without making abrupt changes that leave an already sore horse more uncomfortable. Excessive toe length, underrun heels, hoof-capsule distortion and imbalance may need attention, but correction should be gradual and guided by the individual foot.

Radiographs can be particularly helpful here because they allow the veterinarian and hoof-care professional to work from the internal anatomy rather than relying on the outside of the hoof alone. A painful foot rarely benefits from being dramatically reshaped in one trim. Small, thoughtful adjustments over several cycles are often kinder and more useful.

Shoes, Pads and Boots for Navicular Horses

Shoes, therapeutic shoes, pads, boots and other forms of hoof protection are all used in navicular cases. Different approaches change loading, frog engagement, heel support and breakover in different ways, and the best choice is the one that suits the horse at that stage. What we want to see is a horse becoming more comfortable: landing with confidence, moving freely, breaking over easily and using the back of the foot as well as the individual hoof allows.

Choosing Comfortable Footing

Footing can make an immediate difference. Hard, frozen, rocky or uneven ground is difficult for many horses with pain in the back of the foot, while a level, well-drained area with some give may allow them to move much more confidently. Soft does not automatically mean better, though. Deep mud and deep arena footing require considerable effort to pull the foot free and may add strain to sensitive tendons and ligaments.

Watch how your horse travels across different surfaces. A shorter stride, hesitation, stumbling or increased soreness later that day can tell you that a surface is asking too much. Where practical, access to varied but comfortable footing – dirt, suitable sand, pea gravel and well-maintained paddocks, for example – can encourage natural movement without forcing it.

Managing Movement, Circulation, and Exercise

Movement matters for circulation, joint mobility, muscle strength and general wellbeing, but a painful horse should never be made to ‘walk it off.’ Depending on the horse, your veterinarian may recommend turnout, a period of restricted activity or a controlled exercise program. When movement is appropriate, begin on footing where the horse is comfortable and increase gradually.

Straight lines are usually easier than repeated tight circles. A longer warm-up may help, while sharp turns, steep hills, deep footing and prolonged work on hard ground may need to be reduced for a time. Pay attention not only to how the horse looks during exercise but also to how they feel later that day and the following morning. Recovery tells you a great deal about whether the workload was appropriate.

Don’t judge progress from one especially good or bad day. Look for the pattern over several weeks: a freer stride, easier turns, more voluntary movement and greater confidence on the ground are meaningful signs.

Weight, Nutrition, and Hoof Growth

Maintaining an appropriate body weight is essential to minimize the physical strain on compromised feet.

When weight management is necessary, the transition should be steady and nutritionally balanced to ensure the horse’s sensitive digestive system remains settled. A foundation of quality forage—whether hay or long-stemmed grass—paired with essential minerals provides the fundamental building blocks for resilient hoof development. While dietary adjustments cannot single-handedly mend a compromised ligament, tendon, or bone, proper nutrition plays a vital role in managing systemic inflammation and fostering the growth of healthy new tissue.

Horses navigating metabolic challenges like PPID, Equine Metabolic Syndrome, or insulin dysregulation often require a more tailored nutritional strategy. In these instances, collaborating with your veterinarian or a qualified equine nutritionist is a proactive way to address these underlying conditions while continuing to prioritize strong, high-quality hoof growth.

Hoof Boots for Navicular Horses: Can They Help?

Hoof boots are a useful option because they protect the sole from hard or rocky ground while remaining removable. An inner pad adds cushioning and support and can be changed as the horse’s comfort and hoof shape evolve. At Cavallo, we have seen horses become noticeably more willing to move when the ground no longer hurts with every step. That improved comfort is valuable in itself and may also make appropriate, voluntary movement easier.

Fit matters. Measure for boots immediately after a fresh trim, check the fit as the hoof grows, and introduce them gradually. After use, inspect the heel bulbs, pasterns and hoof for rubbing or pressure. If boots are worn for turnout or extended periods, remove them regularly so the hoof and boot can be cleaned, dried and checked.

A hoof boot is not a cure for navicular syndrome, and it should not be presented as one. It is a tool: a way to alter the horse’s environment, provide protection and cushioning, and sometimes help a sore horse use the foot with more confidence while the larger management plan does its work.

Always start with comfort. A horse that hurts will naturally change the way they stand and move, and those compensations can place stress elsewhere. Give them footing they are willing to walk on, keep the trim cycle regular, protect a sensitive sole when needed, and make changes to hoof balance gradually rather than trying to fix everything at once.

Then observe. Is the horse landing more confidently? Is the stride beginning to open? Are turns easier? Are they choosing to walk around the paddock rather than standing in one place? Can they hold a foot up for trimming with less anxiety? These everyday details can tell you as much about progress as a single snapshot in time.

The flexibility of removable protection during rehabilitation allows us to protect the foot when the horse needs it and inspect the hoof when the protection comes off. As comfort improves, we can adjust the amount of cushioning, the surfaces the horse travels over, and the exercise program. The plan can evolve with the horse instead of forcing the horse to fit the plan.

Navicular Soundness: How Cavallo Boots Can Restore Your Horse’s Comfort & Mobility · Why Cavallo Hoof Boots are the Best for Therapy, Rehab & Turnout

Is Navicular Disease Always the Beginning of the End?

No. It is a serious diagnosis, and some horses will need lifelong management, but it does not define the horse or automatically determine the outcome. The goal is not to chase a perfect X-ray. It is to create the best possible conditions for comfortable function: thoughtful hoof care, appropriate protection, suitable footing, sensible movement and a willingness to keep adjusting as the horse tells us what is working.

We have seen horses surprise us when they are given that opportunity. We cannot promise a cure, and we should never ignore significant damage inside the foot, but we also should not assume that a horse with a navicular diagnosis has no road back to comfort. Sometimes the greatest change comes from improving the environment around the foot and allowing the horse to begin using it more normally again.

After more than two decades of helping horses stay comfortable, one thing we’ve learned is that every horse writes their own story. Our job is to listen carefully, make thoughtful choices and give them every reasonable opportunity to keep moving, enjoying life and doing what they love for as long as possible.

Have Horses Made It Through This Diagnosis and Thrived?

Over time, horse owners have sent their success stories to us –detailing what they have done to help their horses with a Navicular Disease or Syndrome diagnosis. Here are some stories from real horse owners to help provide hope:

“The Boots Are Life-Changing…”

Rider Kelly Barbato reports, “The boots are life-changing. My mare was diagnosed with pretty bad Navicular on her front right. With big diet changes, awesome trimming, and finding these boots, this makes it possible to keep riding. We do long trail riding on weekends; we camp with our horses. Lady was diagnosed with navicular a year and a half ago, and your boots have kept her on the trail! Over 30 miles on our last trip! So, thank you for what you’ve given us! Lady is a Paint and is 22 years young, ridden by my mom, 71, who just started riding 4 years ago. She loves long trail rides. Fifteen miles is her favourite distance.”

“Walked Like He Was on Stilts…”

Linda Thielen Tatro wrote, “My navicular boy walked like he was on stilts and was very ouchie on rocks. I bought him Cavallo Trek boots and put your pads in them and he walks out stretching out in total comfort and he loves them. Best investment I ever made. I’ll get many more years of riding with him. Thank you.”

“He Painfully Limps on Pavement…”

Mary Sutherland sent in a photo of her horses riding in a parade. “On the far end is my son in his first parade with our 26-year-old gelding,” she says. “The horse has long toes and short heels, coffin joint arthritis, and early Navicular changes, and painfully limps on concrete— but today, he stepped right out the whole way in his ELBs with pads! Thank you so much!”

“She Was Prancing Home Like a Machine!”

Christine Kasowski Cernetisch says, “I want to share my day—because no doubt, without my Cavallos, I’d not have gone more than a mile or two. I’m in South Dakota, and we had massive snow and ice, but now it’s mud and slop, and the fields are so drifted it’s either muddy or rocky. Oh, and the mare is also diagnosed with Navicular. But 10 miles later, she was prancing home like a machine! I love our boots with ice tips! Mud, muck, slop, and drifts, and they didn’t budge!”

“110% Sound for Almost Two Years Now!”

Finally, Lena Hylton shares, “Cavallo helped my extremely sole-sensitive 20-year-old Paint gelding who also had a touch of Navicular. He has been barefoot and 110 percent sound for almost two years now! I love my Cavallo Boots and they have travelled hundreds of miles on trails with him. He loves them, too. He lifts up his hooves to have them put on! Thank you, Cavallo!”

Cavallo Hoof Boots for Navicular: Life-Changing for a 30-Year-Old Horse

“Awesome! I really appreciate all your time and help! You guys give the best customer service on TOP of already having the best hoof boots ever. My horse and I have been able to ride even though he is 30 and was “diagnosed” w navicular when he was 8. Going barefoot and using your boots was the best thing I ever did for the two of us! Here’s a pic of us out riding today!

Thank you again so much,

– Jenn (and Roger)

Cavallo Hoof Boots Give Comfort to an Older, Navicular Rescue

“Back in 2009 I rescued an Appaloosa gelding, I had big plans for him and I!! Well the more flat work I asked of him the more evident it became that something was very wrong. After xrays, it determined the severity of his navicular. My vet said clinically this horse should not be above ground. I then realized why he was sent through two slaughter sales and was given up on. However I didn’t give up on him. I tried many shoes, many drugs and to no avail was devastated at the outcome. Being a practicing herbalist it dawned on me why not the horses?!?!

So I did my research on holistically addressing his navicular and other compensatory injuries. I searched for certified barefoot trimmers and formulated a very good herbal formula which has maintained him since. My farrier suggested boots for him and I found the Cavallos that was his icing on the cake!! He did well without them when the ground was soft but he did exceptional when it was hard, dry, icy. The cavallo boots have allowed him to give him the support he needs without putting a nail in an already compromised hoof. He loves his Cavallos even the off colors that don’t sell so well!! He was sporting his pink sneakers very proudly and happily.

Eddie has long since been retired at the age of 29 now soon to be 30 in the spring of 2021. As long as he’s comfortable being a pasture ornament that’s fine with me. I am so grateful for the Cavallo boots you literally were part of his rescue.
Thank you”

– Laurie Allen

Know Your Horse, Know Your Mind

With proper care and management, most horses with navicular disease can live a full and active life. Understanding the implications of the personal choice you make in the treatment of any diagnosis is your responsibility as a horse owner. You also can choose to accept or reject a prognosis, seek another opinion, and do your own research. The important thing is the quality of life your horse enjoys. Soundness is living a pain-free life.

Wishing you many happy trails,

-Carole Herder