Navicular Disease in Horses: Why We Now Call It Podotrochlear Syndrome
- Anushka von Oppen
- 6 days ago
- 2 min read
What Is Navicular Disease in Horses?
Navicular disease has long been used to describe chronic heel pain in horses, most commonly affecting the front feet.
However, we now understand that navicular disease is not limited to changes within the navicular bone itself. Instead, it represents a syndrome involving both the bone and surrounding soft tissue structures within the foot.
Bone and soft-tissue lesions often occur together, a connection that has become increasingly clear with the availability of advanced diagnostic imaging such as digital radiography, ultrasound, and MRI.
Today, veterinarians use the broader and more accurate term podotrochlear syndrome (‘podo’ = foot, ‘trochlea’ = grooved bone). This term refers to all the components of the podotrochlear apparatus — a group of structures that work together to absorb shock and stabilise the hoof during movement.
Understanding the Podotrochlear Apparatus
The podotrochlear apparatus includes:
The navicular bone
The deep digital flexor tendon (DDFT) as it glides over the bone
The navicular bursa acts as a cushion between the DDFT & the bone
The collateral sesamoidean ligaments that suspend and anchor the navicular bone
Together, these structures act as a shock absorber for the horse’s foot.When one or more components become inflamed or degenerate, the horse experiences pain in the heel region — what was historically called “navicular disease.”
Common Signs of Navicular Syndrome
Because navicular-related pain develops slowly, the early signs are often subtle:
Shortened stride, especially in front
Toe-first landing or reluctance to go downhill
Lameness that improves after rest but returns with work
Tripping, especially on uneven ground
Difficulty maintaining consistent contact under saddle
In many cases, both front feet are affected, making the lameness appear mild but persistent.
How We Diagnose Navicular Disease
At Core Equine Biomechanics, we use a structured, evidence-based approach to localise and identify the source of heel pain:
Comprehensive gait and lameness assessment using Sleip AI for objective analysis
Flexion and hoof tests to detect local sensitivity
Diagnostic nerve blocks (palmar digital and abaxial sesamoid) to confirm the affected region
Radiography to evaluate bone shape, cysts, or sclerosis
Ultrasonography to assess tendon and ligament involvement
MRI referral for detailed evaluation of soft-tissue structures where necessary
By combining these diagnostic layers, we can differentiate between bony, tendinous, and bursal involvement — ensuring targeted treatment rather than generalised pain management.
Treatment Options
Treatment for navicular or podotrochlear disease depends on which structures are affected and how advanced the pathology is. Management includes:
Corrective farriery is the cornerstone in management. By altering the biomechanics of the foot we can change load on the affected structures.
Controlled exercise programs to restore tendon and ligament health
Medical therapy
Ultrasound-guided regenerative treatments to support the joint and bursa. Explore our Joint Treatments & Regenerative Medicine solutions here.
Shockwave therapy to enhance soft-tissue repair
Chiropractic and biomechanical assessment to address compensatory movement patterns higher up the limb and spine
When to Call Your Vet
If your horse is showing subtle lameness, tripping, or shortening its stride, early intervention is key.With modern imaging, objective gait analysis, and regenerative therapies, many horses with navicular disease can return to long-term comfort and performance.
Book a lameness or gait assessment today to identify the cause of heel pain early.
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