Sole Bruising

A bruised sole can happen as quickly and simply as a horse stepping on a rock or working on a hard surface. It can occur as the result of excessive hoof trimming, or be associated with laminitis. Sole bruising can be an uncomplicated condition that responds to simple treatments, or be part of an underlying disease process that requires careful veterinary management. For sure, it is one of the most common causes of forelimb lameness.

Sole bruises are a contusion (bruising) of the solar cushion and corium (the soft tissues between the sole of the hoof and coffin bone). This bruising causes rupturing of the small vessels in the area, explains Daniel J. Burba, DVM, Dipl. ACVS, Associate Professor Equine Surgery at Louisiana State University. "This results in formation of a hematoma or blood pocket, leading to an acute inflammatory reaction and pain."

The most obvious clinical sign is mild or severe sudden lameness localized to the foot. A closer examination of the affected foot might reveal increased foot warmth or increased digital pulses through the digital arteries, notes Jan F. Hawkins, DVM, Dipl. ACVS, Assistant Professor of Large Animal Surgery, Purdue University.

Sole bruises are caused by direct trauma to the undersurface of the hoof. Says Philip J. Johnson, BVSc (Hons), DVM, MS, Dipl. ACVIM, MRCVS, Associate Professor of Equine Medicine and Surgery, University of Missouri, "The most common type of trauma is that associated with work under saddle, especially on hard or rocky ground. Other important causes include the effect of a small rock caught in the sulci (grooves) of the frog; aggressive trimming (removal of too much protective horn tissue); and badly fitted or old, worn-out shoes that impinge onto the sole area, which can result in bruising and even abscessation. Sole bruising might be associated with pathologies such as abscess development that can occur from a nail penetration to the undersurface of the hoof or in association with laminitis ('founder')."

Adds Burba, "The amount of force placed on a foot is an influencing factor on the development of sole bruising, i.e., running at high speed."

Any horse is susceptible to sole bruising, but some conditions and breeds might be at higher risk. "Horses with 'thin soles' are certainly predisposed to the problem," says Hawkins. "Also, horses with soft soles secondary to housing in wet areas may also be at risk."

Johnson notes that the larger, heavier working breeds are more likely to be affected than miniatures. He is of the personal opinion that horses which spend a lot of time on concrete also are at increased risk. "A hard, unyielding surface tests and stresses the flexibility of the hoof capsule, leading to soft tissues being inflamed. And there is a possible role for chemicals that leach out of some types of concrete," he theorizes. "But these are both unsubstantiated theories."


Burba says diagnosis of a sole bruise begins with the veterinarian observing clinical signs and inquiring about any history of fast work, work on hard or rocky surfaces, or recent farrier work. The veterinarian also will seek to demonstrate that the lameness is clearly attributable to hoof pain; besides increased hoof warmth, increased digital arterial pulse, or visible evidence of a penetrating wound or foreign body. Other indicators are sensitivity to pressure when hoof testers are applied to the foot (particularly along the quarter and/or toe) or the relief of pain if the affected foot is anesthetized.

"It is always necessary to scrupulously clean the undersurface of the hoof and to carefully pare away the superficial layers of the sole to inspect for the presence of a bruise or an abscess," Johnson says. "It is often necessary to remove a shoe, if present, to fully inspect the solar surface of the affected hoof." This might show a red or purple area within the corium of the sole, indicating a hemorrhage.

"In some cases, the specific location of a bruise within the hoof can be predicted based on the manner in which the horse places weight on the affected hoof," states Johnson. "The weight may be preferentially placed on the inside or the outside of the hoof wall while the horse is walked as the horse attempts to protect the painful part."

Although not always done, taking radiographs is a good idea so that you can be sure of what you are dealing with.


As soon as lameness is evident, the horse should be rested. While sole bruising generally is not an emergency condition, prompt veterinary attention and diagnosis still should be sought.

Treatment might be undemanding. "A simple bruise should gradually resolve (disappearance of pain and lameness) with a few days of rest if underlying causative factors such as an entrapped rock, work on rocky ground, old displaced shoe, etc., are eliminated," Johnson says. "Stall rest or small paddock rest, along with a reduction in diet according to decreased needs during the rest phase, are often sufficient."

In some cases, additional therapy might be suggested. "I sometimes recommend daily foot soaks with warm water and Epsom salts as an antiphlogistic (anti-inflammatory)," says Burba. He also might prescribe maintaining the foot in an ichthammol wrap (an ointment that is used as a "drawing agent" to relieve soreness) for three to five days and a round of phenylbutazone (Bute) to reduce inflammation and pain.

"Once there is no evidence that a subsolar abscess is forming, then I recommend the foot be shod with a regular shoe with a neoprene pad; it is important that a pad is used to protect the sole from further trauma," continues Johnson. "The regular shoe can be substituted with a wide-web aluminum shoe." A common way to use this shoe is when the farrier bevels the inside edge so there is no contact between the sole and the shoe. Too much contact can cause more bruising.

Hawkins adds that a treatment plate can be screwed to the shoe to protect the sole. The farrier's goal is to relieve pressure on the affected area of the sole, she says.

As a prevention, some veterinarians and farriers advocate that pads be worn to protect the horse against the effects of local ground trauma. "It should be noted that pads, when applied in-correctly, may in-crease the risk for bruising," warns Johnson. "Pads bring the sole into direct concussive contact with the ground surface."

The veterinarian also might administer a tetanus booster, Johnson says. "Horses as a species are very prone to tetanus. A bruise can sometimes turn into an abscess (an infection in the hoof) associated with soil-borne bacteria that can lead to tetanus."

Although many horse owners believe applying a poultice will help, Johnson reports the medical effectiveness of this procedure is highly questionable. He also advises against using antibiotics unless a deep penetration has occurred.

Draining a simple bruise is not suggested. "In general, I recommend against draining of the bruised area," Hawkins states. "Draining will usually result in a subsolar abscess because bacteria are introduced to the damaged areas of the sole. However, if the bruising advances into a subsolar abscess, then the abscess will need to be drained by traditional methods."

While a non-penetrating bruise will resolve with rest, Johnson points out that what might appear to be a simple bruise could actually be an early, hitherto undiagnosed abscess, or that the simple bruise can become an abscess.

Be especially concerned if sole bruising occurs on a chronic basis. "In my experience, many horses with recurrent sole bruising problems actually have underlying laminitis (or some other problem)" warns Johnson. "Bruising is a common recurrent cause of lameness in foundered horses."

Along those same lines, should sole bruising become chronic, it is more likely that a subsolar abscess can develop, indicates Burba. "The infection may progress to the coffin bone, resulting in osteomyelitis. Pedal osteitis is another problem that might develop. This is a chronic inflammatory condition of the coffin bone that results in bone resorption and weakening of the bone. A pathologic fracture of the coffin bone could result."

However, for a simple sole bruise, the prognosis is excellent. "Depending on how sore the horse is," states Hawkins, "a withdrawal from exercise of five to seven days is generally all that is needed."

About the Author

Marcia King

Marcia King is an award-winning freelance writer based in Ohio who specializes in equine, canine, and feline veterinary topics. She's schooled in hunt seat, dressage, and Western pleasure.

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