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What is a Lame Horse? Causes, What to do & FAQs About Lameness

What is a Lame Horse? Causes, What to do & FAQs About Lameness

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Lameness is a common problem in all horses and ponies and can become serious if ignored.

Learning more about the causes, prevention, and diagnosis of lameness is the first step towards making sure your horse receives the best possible care should the problem arise.

When a horse is lame, they are compensating for musculoskeletal pain by altering their stance or gait. You might notice the horse trying to put less weight on a certain foot, but early signs of lameness are more subtle.

Lameness is usually either in the front or hind feet, but in rare cases, it can be in both. We can distinguish two types of lameness in terms of severity: weight-bearing and non-weight bearing.

Non-weight bearing lameness should be treated as an emergency as the horse cannot stand on all four feet.

In this article, we look at lameness and what you should do if your horse is lame!

How Can You Tell a Horse Is Lame?

Early detection of lameness can significantly speed up a horse’s recovery. Therefore, it’s our responsibility as horse owners and riders to learn the signs of lameness and call the vet if necessary.

The best way to tell if a horse’s lame is to perform a simple lameness exam. Ask an experienced person to watch your horse as you walk and trot him up and down a straight line on a level surface. Lunging also helps detect lameness as it magnifies any pain in the inside legs.

Lame horse walking in a grassy paddock

When looking for signs of lameness, it’s a good idea to examine your horse on both a hard and soft surface.

Hard surfaces put more pressure on bones and joints, while soft surfaces have a greater effect on tendons and ligaments. Hence, any pain in these tissues will become more obvious on one of these surfaces.

In the early stages, lameness can also manifest as a reduced willingness to work. Keep this in mind when your horse seems “lazy” or unmotivated during exercise as he might actually be in pain.

Moreover, mild lameness might only show up in trot or canter, while the horse will appear normal in walk.

In the following section, we’ll discuss the signs of forelimb and hindlimb lameness and how to assess a horse for each one.

Forelimb Lameness

The typical sign of forelimb lameness is head bobbing. When the horse has pain in one of his front feet, he will try to take the pressure off it by leaning more on the other foot. He will also lift his neck when the lame foot is on the ground as he shifts more weight onto the sound foot. This results in a visible “head bob” movement.

Check out this video of a horse head bobbing in trot. Can you guess which leg is lame?

When examining a horse for forelimb lameness, you should look at the horse both from the front and the side.

Remember that lameness might only show up in higher gaits, and don’t be afraid to ask the help of a more experienced person. The more opinions you can get, the better when it comes to detecting lameness.

Hindlimb Lameness

Hindlimb lameness is often more challenging to detect than forelimb lameness, especially in the early stages. You need to observe several things when looking for pain in the horse’s hind legs.

Start by standing behind the horse and watching the movement of the hips. A classic sign of hindlimb lameness is a hip hike, which is when one of the horse’s hips climbs higher than the other. This movement is similar to a head bob in that the horse is trying to reduce the load on the lame foot by raising his hip on the same side higher.

Here’s a video showing the hip hike of a horse with hindlimb lameness:

To further complicate matters, lameness in a hind limb can also signify pain in the diagonal forelimb. This is because the horse might compensate for lameness in the forelimb by overusing the diagonal hindlimb.

Observing the horse from the side can also provide useful insights into hindlimb lameness. Horses lame in the hindlimb often don’t track up, meaning the hoofprints of the rear legs won’t overlap those of the front legs. You might also see a flatter foot flight arc or a shorter weight-bearing phase in the horse’s gait.

Horse Lameness Grades

To determine how severe the lameness is, you can use the grading scale of the American Association of Equine Practitioners. This scale grades horses from 0 to 5 and applies to all breeds.

Grade 0

There is no sign of lameness under any circumstances. The horse is likely sound and not experiencing pain.

Grade 1

Lameness is difficult to observe and is not consistent. You might notice subtle changes in the horse’s movement but cannot link it to a specific circumstance (e.g., hard or soft surface, circling, higher gaits).

Grade 2

Lameness is not obvious when walking or trotting in a straight line but shows up consistently in some circumstances.

Grade 3

Lameness is obvious at a trot in all scenarios (e.g., under saddle, on the lunge, different terrain and inclines, etc.)

Grade 4

The horse is consistently lame in walk.

Grade 5

Weight-bearing on the affected limb is difficult for the horse both during movement and standing. The horse might be completely unable to move.

When assessing lameness, remember to use all of your senses. As well as looking for visible signs of lameness, listen to the horse’s footfall and note any irregularities. If a hoof infection like thrush causes the lameness, you can often smell the problem.

Touch is another great asset when it comes to lameness diagnosis. Palpate your horse’s legs and feel for any unusual heat or tenderness. If one foot feels warm but not the others, there’s likely inflammation or an infection.

What Is the Most Common Cause of Lameness in Horses?

Pain is the most common cause of lameness in horses. It can originate from various conditions, such as injury, disease, infection, bad conformation, bad shoeing, or old age.

Lameness is not a disease but a symptom of a health issue within the horse. While there are many causes of lameness in horses, up to 90% of problems originate in the hoof.

The most common hoof problems that cause lameness are heel pain, abscess, poor hoof quality and conformation, navicular syndrome, and laminitis.

Heel pain results from issues with the horse structure, such as the coffin bone (equivalent to the tip of our toes), ligaments, or hoof wall.

Vet looking at a lame horse's hoof
hedgehog94 /

Meanwhile, an abscess is an infection just beneath the surface of the hoof that can cause soft tissue degeneration if left untreated.

Other causes of lameness unrelated to the hoof include:

  • Degenerative joints
  • Tendon or ligament injury
  • Neuromuscular disease
  • Genetic disorder
  • Intensive training
  • Premature training

The list is far from exhaustive, as so many horse diseases and conditions may result in lameness. However, the two most common disorders are navicular syndrome and laminitis, so let’s examine them more closely.

Navicular Syndrome

Also known as navicular bone disease, this condition usually affects the front feet. Navicular syndrome is the inflammation or decay of the navicular bone and surrounding tissues. The navicular bone is a small bone wedged between the coffin bone and the short pastern bone.

Navicular syndrome is a severe condition that may lead to permanent damage to the hoof structures. Thoroughbreds are a particularly susceptible breed for navicular syndrome.


According to the British Horse Society, laminitis affects 1 in 10 horses in the United Kingdom each year. It’s a painful hoof condition that causes the sensitive laminae between the hoof wall and the coffin bone to stretch and weaken.

Badly damaged laminae can cause the pedal bone to sink within the hoof capsule, often a point of no return for the horse.

Overweight horses are the most prone to suffering from laminitis. The condition can also be caused by spring grass due to its high sugar content.

Also read: How Much Does a Horse Weigh?

What Causes Sudden Lameness in Horses?

Sudden lameness in horses can be caused by an abscess or injury to a bone, tendon, or ligament. Since sudden lameness is more likely to be serious, you should call the vet immediately.

If your horse is suddenly showing signs of lameness, check that there is nothing wedged into the hooves that could cause pain. Sometimes, the cause may be a small pebble that has pushed too far up a crack in the hoof. Hence why it’s important to clean your horse’s hooves regularly, especially before and after you ride.

If there’s nothing in the hooves and there are no signs of injury or swelling, the cause is likely a bruise or abscess in the foot. You can determine this by palpating the limbs and feeling the digital pulse.

A foot with an abscess will be warmer than the other feet and have a pounding digital pulse.

Lame grey horse standing in a horse

Also read: 7 Most Common Horse Injuries

How Serious Is Lameness in a Horse?

Lameness in horses can range from mild to very serious, depending on the cause. Many lameness cases are treatable in horses, especially if the problem is detected early.

Unfortunately, most horses will encounter lameness at some point in their lives. The longer a lame horse goes without treatment, the worse his prognosis will be.

While some types of lameness only mildly affect performance, severe cases can be life-threatening.

Prevention is Key

Being proactive with hoof care is essential in ensuring your horse lives a long and happy life. As a horse owner or handler, there’s much that you can do to minimize the chances of your horse going lame.

We have previously mentioned the importance of regular hoof care. This includes picking your horse’s hooves out daily, keeping up with farrier visits, and making sure your horse’s living conditions are up to standard.

Extremely dry or wet weather can deteriorate your horse’s hooves. The hoof must keep its moisture balance within the limits to stay healthy and cannot gain or lose too much water. In extreme weather conditions, consult your farrier for advice.

Besides hoof care, other factors affect lameness in horses. Regular exercise is key to keeping your horse’s body systems healthy, and it should start with a warm-up and end with a cool-down.

Lameness can also have nutritional causes, and consulting your vet for a feeding plan is the best practice.

When it comes to lameness, early recognition is vital. Make sure you know what’s normal for your horse and learn how to perform a basic lameness exam.

Vet checking a horse's hoof for stones and other objects
ValenPh /

It’s also good to brush up on your knowledge of equine anatomy and conditions that affect your horse’s breed. You can start by taking our horse anatomy quiz or reading our horse skeleton facts guide.

How Long Does It Take for a Lame Horse to Heal?

The time it takes for a lame horse to heal depends on the severity of the lameness. However, the average timeframe ranges from a few weeks to a few months.

Treating lameness, unfortunately, is a long-term game. Even mild cases can take weeks to heal, but more serious lameness will take months or even years to go away completely.

The earlier lameness is recognized and treated, the quicker the horse will recover.

When Should I Call the Vet for a Lame Horse?

You should call the vet if your horse has a sudden onset of severe lameness or has been lame for a few days. Sometimes, stiffness from standing in a stall can make a horse appear lame. However, this usually goes away within a few hours or days.

If lameness is suspected in a horse, the vet’s priority will be finding the cause and treating the root issue. He will first examine the horse’s medical history and look for clues that might point toward the cause of the lameness.

Next, the vet will perform a lameness exam and palpate the limbs and the hoof. He will then do a complete physical examination, including an inspection of the back and neck, to try and identify where the lameness is coming from. The vet might also do a nerve or joint block in the suspected limb to see if lameness improves.

Diagnostic imaging often comes into play during a lameness diagnosis. Radiographs provide useful information about internal structures and are frequently the last step before the vet makes a diagnosis. However, an ultrasound or MRI scanner may also be used in more complex cases.

Treatment for lameness varies greatly depending on the cause. The vet may prescribe painkillers or anti-inflammatories and recommend box rest or cold hosing of the affected area.

Hooves with an abscess will often require bandaging and regular disinfection. On the other hand, severe lameness cases may only be resolved by surgery.

How Much Does a Lameness Exam Cost?

The cost of a lameness exam can run into hundreds of dollars, depending on how many tests are necessary to make the diagnosis. The most expensive diagnostic test is the MRI scan, which costs around $2,000-$2,500.

Vet stretching out a horse's leg
Brastock /

As mentioned above, a lameness exam is a multi-layered veterinary exam that consists of several steps. The treatment plan will draw from the results of each step and will often change depending on the horse’s response.

When there’s a lameness issue, owning a horse can quickly become expensive. These unexpected problems are why it’s helpful to have an excellent equine insurance plan that will cover the expenses of diagnosing and treating lameness.

How Common Is Lameness in Horses?

Lameness is one of the most common health issues in horses, alongside colic. It costs the equine industry hundreds of millions of dollars to deal with cases of lameness that arise each year.

Lameness is also the most common reason a horse has to stop working temporarily or permanently. In 2019, the American Farriers Journal conducted a survey to estimate how many horses suffer from lameness issues in the United States. They asked farriers to enter the percentage of lame horses they encounter in a year.

From 173 responses, the study concluded that nearly a quarter (24%) of horses farriers treat each year are lame.

The paper also mentioned that around a third of horses in the United Kingdom have lameness issues. This evidence supports that lameness is a universal issue in all horses.