Long Toe Low Heel Syndrome

6 November 2021

A Solution to Long Toe Low Heel Syndrome

Ross Smith Center of Balance Horseshoeing

The Long Toe Low Heel Syndrome (LTLH) is a very common problem with horses. What it means is that the toe of the hoof has grown longer than it should and the heels have been pulled forward with it. Due to this problem the hoof has different stressors placed on it. This configuration of the hoof does not cause all horses to be lame but it will affect the skeleton and muscles of the body, the internal structures of the hoof and the leg above. This will lead to a horse being more susceptible to chronic joint issues, tendon injuries, fetlock and knee issues, quarter cracks, navicular disease just to name afew. All this stress on the foot can lead to changes that cannot be remedied.

Why does LTLH occur so regularly? Part of the issue is breeding. The other part is trimming or shoeing a foot a little long that is already prone to LTLH. If each time the hoof is trimmed the toe is left long the foot will then change to that particular configuration. The horse’s balance will be affected and the heels will begin to receive more pressure than they should. This will then create circulation problems in the hoof which in turn will restrict growth in the heel which can collapse while the toe grows longer.

Until now to help a horse with the LTLH syndrome there were only so many ways to try and minimize the damage that had occurred. The Ross Smith Center of Balance Horseshoeing and the Center of Balance Indicating Tool are a solution to this condition. Using the COBIT allows one to find the center of balance on the horse’s foot which in turn finds the correct breakover. Having the correct breakover then allows the horse to stand with its leg under it, to balance properly with its weight in the right area of the foot. Once this is accomplished the horse will begin to feel better. The changes due to finding the center of balance will affect the whole body – skeletal, muscles and the hoof will begin to change and grow in the correct way. The weight bearing area of the hoof is now in the right area, the foot grows to the weight bearing surface, circulation in the hoof will increase which will bring the nutrients back into it. This is not a problem that will be fixed immediately and could take a long time but there should be a difference in the horse within 2 to 3 trims/shoeing. It is important that a consistent and regular schedule of trimming/shoeing with the COBIT be applied. You will continue to see the effects of the application of the Center of Balance Horseshoeing and the COBIT for a long time.

When researching the application of the Center of Balance Horseshoeing and being guided by the COBIT, this solution for LTLH was discovered. All horses trimmed/shod by Ross are part of his success story and there have been horses with LTLH syndrome. Using the COBIT and applying his techniques led to this revelation. How exciting that was! The benefits of Center of Balance Horseshoeing are powerful and we are sure there are more to discover.


Hill, Cherry, and Kilmesh, Richard. "Horse Hoof Care." Storey Publishing LLC., Jan. 1, 2009. pp 109-110.

Loving, Nancy, DVM. "Long Toe-Low Heel Horse Hoof Conformation." Oct, 29, 2020, Accessed Oct. 28, 2021.