It will be easier to understand and comprehend the traditional treatment of underrun heels using egg bar shoes (with or without wedges) if we again first review the causes and pathogenesis of compromised heels. The causes of underrun heels are a genetically weak foot, individual hoof/limb conformation, breed, type of terrain on which horse is ridden, amount of daily work, amount of turnout, moisture content of feet, diseases of the feet, and, finally (and very important), the farrier practices applied to the horse along with the intervals between hoof care.

It is generally a combination of the above causes that contributes to underrun heels. For example, a horse with a genetically weak foot that is not ridden, lives in a dry terrain, and is given unlimited access to pasture will maintain a healthy heel, whereas if the same horse is exercised hard with a rider, has a high moisture content in its feet, along with limited turnout, it will ultimately develop compromised heels.

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