Contracted Tendons in Foals: Knuckling, Club Feet and Early Treatment
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By Dr Duncan Houston
A foal standing on its toes or knuckling over at the fetlocks needs an early examination. Some mild newborn deformities improve, but others interfere with standing, nursing and normal limb development.
“Contracted tendons” is a familiar term, although the problem is better described as a flexural limb deformity. It is not always a tendon that has literally shrunk.
Quick Answer
Flexural deformities prevent a limb from extending normally and may be present at birth or develop during growth. Treatment depends on the affected joint, severity, pain and age, and can include carefully planned support, farriery, medication or surgery. Call urgently if a foal cannot stand or nurse, cannot place the foot correctly, or has painful skin damage.
What is happening in the limb?
The muscles, tendons and associated structures act as a unit. If that unit is functionally too short for normal joint position, the foot or fetlock may remain excessively flexed. The MSD description of congenital limb deformities explains why tendon structure itself is not always the primary problem.
A newborn may have one or several joints involved. In an older foal, a progressively upright foot or lifted heel may indicate an acquired deformity. Long-standing cases become harder to correct because several tissues and the hoof capsule adapt to the abnormal position.
What causes acquired deformities?
Pain is important. A youngster that repeatedly unloads a painful structure may adopt a flexed posture. Physitis, osteochondrosis, foot pain or injury therefore needs consideration, alongside growth and nutrition.
The MSD owner guidance on developmental orthopaedic disease describes pain-related contracture. Simply trying to stretch the leg without finding the pain source can be counterproductive.
How urgent is it?
| Finding | Action |
|---|---|
| Mild newborn flexion, standing and nursing normally | Arrange early veterinary assessment and a monitoring plan. |
| Persistent toe-standing, increasing hoof angle or knuckling | Prompt examination; do not wait weeks for correction. |
| Unable to stand or nurse, severe pain, pressure wounds or fever | Emergency veterinary care. |
What else could look similar?
Angular limb deformities bend the limb sideways rather than mainly forwards and backwards. Tendon laxity can cause excessive extension, while weakness, nerve dysfunction or trauma can also alter stance. These require different plans.
Your vet checks whether the joints can be extended, whether weight-bearing is safe and whether the foal is systemically healthy. Radiographs assess bones, joints and alignment when needed. Do not force a rigid joint straight for a photograph.
When is this an emergency?
Call immediately if the foal cannot nurse or stand safely, or if knuckling causes skin injury. Poor milk intake and systemic illness can deteriorate quickly. A severely lame or feverish foal also needs assessment for infection, even when the limb initially looked like a developmental problem.
What treatment can help?
Selected mild cases improve with appropriate movement and observation. More significant deformities may need professionally applied splints or casts, pain relief and close skin monitoring. Support devices can create serious pressure injury if fitted or left incorrectly.
Oxytetracycline is sometimes used by veterinarians in selected newborn cases, but requires assessment of hydration and kidney risk. It is not a routine owner-administered injection. Farriery and any extensions depend on the structures involved; there is no universal instruction to lower heels or add heel extensions.
MSD’s flexural-deformity guidance describes conservative and surgical options. Surgical release of selected supporting structures may be considered when appropriate; timing and prognosis are individual.
What should you do next?
- Call your vet early and report standing, nursing and comfort.
- Keep mare and foal in safe footing while awaiting instructions.
- Photograph the limb from consistent angles without forcing a pose.
- Follow the prescribed support, farriery and activity plan exactly.
- Review growth and the complete ration, and attend scheduled rechecks.
Common mistakes
- Assuming every deformity will be outgrown.
- Forcefully stretching a painful or rigid joint.
- Applying tight homemade splints.
- Using one trimming recipe for every club foot.
- Severely restricting nutrition instead of balancing growth.
Prevention and monitoring
Provide balanced broodmare and youngster nutrition, monitor growth and inspect feet and limb alignment regularly. Investigate pain promptly. Some congenital cases cannot be prevented, and early recognition is more useful than blaming feeding alone.
Frequently asked questions
Can mild contracted tendons improve naturally?
Some can, but a vet should confirm that observation is appropriate.
Is club foot the same as knuckling?
Both can involve flexural deformity, but they affect alignment differently and may need different treatment.
Does every foal need surgery?
No. Severity, age and response to appropriate care guide the decision.
Can older horses be treated?
Sometimes, but established deformity often makes correction more challenging.
Early, precise assessment gives the best opportunity to protect comfort and developing limb function.
For help understanding your horse’s care and preparing questions for your veterinarian, visit ASK A VET™. Urgent signs need an equine veterinarian in person.
