Equine Veterinary Journal ISSN 0425-1644
DOI: 10.1111/evj.12420
The foot–surface interaction and its impact on musculoskeletal
adaptation and injury risk in the horse
R. S. V. PARKES and T. H. WITTE*
Clinical Science and Services, The Royal Veterinary College, University of London, North Mymms, Hertfordshire, UK.
*Correspondence email: twitte@rvc.ac.uk; Received: 06.08.14; Accepted: 09.01.15
Summary
The equine limb has evolved for efficient locomotion and high-speed performance, with adaptations of bone, tendon and muscle. However, the system lacks
the ability seen in some species to dynamically adapt to different circumstances. The mechanical interaction of the limb and the ground is influenced by
internal and external factors including fore–hind mass distribution, lead limb, moving on a curve, shoeing and surface properties. It is unclear which of the
components of limb loading have the largest effect on injury and performance but peak load, impact and vibration all play a role. Factors related to the
foot–ground interface that limit performance are poorly understood. Peak performance varies vastly between disciplines but at high speeds such as racing
and polo, force and grip are key limits to performance.
Keywords: horse; interface; performance; lameness
Introduction
Changes to the interaction of foot and surface can have repercussions for
performance, conditioning of the musculoskeletal tissues and injury risk.
The equine limb has evolved for efficient locomotion and high-speed
performance. It can be considered mechanically constrained, lacking the
ability seen in other legged animals to adapt dynamically to different
circumstances [1,2]. Equine athletes at all levels encounter a wide range of
surfaces and are subject to a variety of interventions that alter the
hoof–surface interaction. This article aims to outline current understanding
of the environment in which the musculoskeletal system operates, the links
between surface, performance and injury and how we can have an impact
through the design of surfaces and application of shoeing strategies.
Ability of the equine limb to adapt to
changes in surface
Adaptations of the equine musculoskeletal system for efficient and
high-speed locomotion include reduced bones compared with other
species, such as a fused radius and ulna and a reduction in the distal limb
bones to allow weightbearing solely on the third metacarpal bone [3]. This
allows for minimal inertia and rapid limb protraction and a proximally
located propulsive muscle mass [4,5]. A front–hind division of function is
also evident with the muscle mass specialised for doing work concentrated
in the hindquarters [4]. During locomotion, the hindlimbs predominantly
act to propel the centre of mass forwards [6,7] or upwards during incline
running or jumping [8], while the forelimbs apply vertical impulse to the
centre of mass [6,9]. A small volume of muscle in the distal limb, with
limited fibre length and muscle shortening ability, gives less scope for gross
actuation and control [10] and instead appears to damp high-frequency
vibrations encountered during impact [11]. The exchange of kinetic and
elastic potential energy during locomotion is more evident in the long
tendons of the horse than in other species, reducing the metabolic
demand of locomotion [12,13]. The biceps brachii has a large internal
tendon running parallel to the muscle body [14], which further enhances
the energy efficient system and acts like a catapult for rapid limb
protraction [15].
Optimisation for speed and economy comes at the cost of adaptability,
with limb joints largely constrained to movement in the sagittal plane.
Metacarpophalangeal joint angle reflects force applied due to the largely
passive spring-like length change in the distal limb during loading [1].
Equine limb stiffness does not appear to change in response to alterations
in surface properties [1], speed [1,2] or gradient, in contrast to the
adaptations that have been described in human athletes [16,17]. Recent
work has suggested that an alteration in overall limb posture may be made
in response to different surfaces [18] and that the response of different
Equine Veterinary Journal 47 (2015) 519–525 © 2015 EVJ Ltd
horses to different training surfaces varies [19,20] but the mechanism of
these findings has yet to be elucidated. In addition to constrained limb
compliance, equine gaits are biologically constrained; protraction duration
[15,21] and the suspension phase of the gallop remain relatively constant
with increasing speed [22]. This specialised system appears relatively
inflexible and perhaps vulnerable to changes in the external environment.
As a result, alterations in the nature of the horse–ground interaction
directly affect loading of the musculoskeletal tissues.
Foot–ground interaction events: impact,
mid-stance and push-off
Impact force is determined by the mass and acceleration of the limb [23].
Independent of horse speed, but dependent on surface, the hoof rapidly
decelerates following initial contact and reaches a standstill after 30–50 ms
[20,21,24,25]. Impact force correlates with foot velocity, which increases
with speed [26]. A 500 kg horse travelling at a gallop on a synthetic surface
and shod in a steel shoe will experience an impact force on the digit of 410
N (equivalent to approximately 42 kg). Impact force is partially mitigated by
horizontal foot slip and vertical sinking into the surface [25,27,28], which
are determined by the ratio of vertical to horizontal impact velocity. At the
gallop, the lead limb contacts the ground with a higher vertical velocity
than the nonlead limb [27] and therefore experiences a higher force at
impact, the reverse of the situation at mid-stance when the nonlead limb
experiences a higher peak vertical force [1,6,29]. Horses are more likely to
fracture the lead limb than the nonlead limb suggesting that impact force
may be a more important risk factor for injury than peak force at mid
stance [30]. While the total impact force is far lower, the rate of loading
during this period is far higher and this is likely to be important in eliciting
injury [31]. The hindlimbs have a higher horizontal velocity and a higher
overall impact velocity than the forelimbs, although the forelimbs have a
higher vertical impact velocity [23,27].
In addition to speed, a combination of external factors determine the
mechanics of impact. Farriery, shoeing and the shear and damping
properties of the surface can all be influenced directly and an improved
understanding of this initial impact interaction will help improve
performance and reduce injury.
Limb load increases rapidly after impact [24] with an associated bending
force on the third metacarpal bone [32]. Impact peaks decline dramatically
as they travel up the limb [24] and appear to be attenuated before they
reach the fetlock joint as a result of damping [24,33], particularly at the
laminar junction [34], with higher frequency vibration transmitted up the
limb during early stance. Vibration is damped by the superficial and deep
digital flexor muscles [11] and while this vibration may be important as a
stimulus for healthy musculoskeletal adaptation [11], it may also contribute
to injury [11,35,36] of subchondral bone and joints [37].
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Foot–surface interaction
Mid-stance is a period of hoof stability [28]. Vertical ground reaction
force (GRF) peaks at around 35% of stance at the walk, 45–50% of stance at
the trot [1,33] and 50% of stance at gallop and during jumping [1]. The limb
is loaded in a distal–proximal direction [38] and both bone and tendon
strain increase with increasing speed [39] in line with increasing GRF [1,29].
The suspensory ligament is an exception and appears to be subjected to
constant strains at trot and gallop [39]. Interestingly, the presence of a rider
does not significantly increase vertical limb force distribution at the canter
[6], but activities such as circling alter the direction of peak forces, with
mediolateral force making up 13–24% of resultant limb force on a circle
[40]. On a circle, limbs contact the ground at an angle [41,42], leading to an
increase in limb inclination, especially in the inside limb [41]. During stance
on a curve, the horse moves the distal limb from a position of abduction at
impact to adduction during stance [42], perhaps allowing the body mass to
move over the limb in the direction of motion [41]. The distal limb joints
also experience torsion, via axial rotation in the opposite direction to
movement [42]. During galloping the nonlead forelimb experiences a
higher peak GRF than the lead forelimb [1,6,29]. The maximum loads
experienced by tendons, ligaments and bone affect modelling and
adaptation of these tissues and injury risk.
At the end of the stance phase, the flexing moment at the distal
interphalangeal joint from force in the deep digital flexor tendon exceeds
the extending moment of the ground reaction force resulting in the heel
lifting from the ground. On a soft surface the toe rotates into the ground, or
on a hard surface eventually slips caudally, immediately prior to lift-off. This
phase of the stride is known as breakover [43] and as this occurs the centre
of pressure shifts towards the toe [44]. Properties of the foot and surface
can have an impact on force in the deep digital flexor tendon and the
timing of breakover.
External factors such as the surface properties of damping, firmness and
grip and farriery interventions interact with the phases of the equine stride
cycle to determine the overall loading environment, performance and
injury risk.
Ground-related factors
Surfaces vary in how they deform and absorb shock, their coefficient of
friction and how they return energy to the limb. Measurement of the innate
mechanical properties of surfaces remains challenging. Simple techniques
include the Clegg hammer, which primarily measures the compaction of
the surface, a biomechanical hoof tester, which measures peak load and
horizontal and vertical accelerations at impact [45], the GoingStick [46]
for depth and an agricultural penetrometer for shear properties [47]. These
allow comparisons between surfaces and different regions of the same
surface but are not able to quantify the complex interaction of the
equine foot with the surface. In vivo studies have used hoof-mounted
accelerometers to measure hoof vibration and quantify damping [48,49],
and force plates, pressure plates, instrumented horseshoes and hoof
mounted accelerometers to measure force profiles during stance (e.g.
[1,27,29,49,50]). More invasive studies, targeting biologically relevant
measurements such as long bone and tendon strain can be used to
investigate the effects of different surfaces on the tissues directly and limb-
mounted ultrasound can also quantify these features noninvasively [51].
Damping, firmness (hardness) and grip
Surfaces vary in their capacity to rapidly damp vibration at impact [11].
Surfaces may damp vibrations structurally by the deformation of elastic
particles or by the friction of particles sliding past one another [35]. The
damping properties of a surface are distinct from firmness, as some firm
surfaces will have good damping properties, and conversely some soft
surfaces will have poor damping properties [11]. Damping is important
because it reduces high-speed oscillations at impact and may reduce injury
[24]. Limiting the high negative acceleration associated with hoof impact
may allow a smoother transition from retardation to propulsion, improving
stride efficiency [28,52]. Ex vivo studies show dirt surfaces have a lower
damping capacity than synthetic surfaces [53] and in vivo studies confirm
that synthetic surfaces have a greater damping capacity and provide a
520
R. S. V. Parkes and T. H. Witte
Fig 1: Examples of commonly used track surfaces in racing. a) Polytrack, a synthetic
surface commonly used for training in the UK. Many other synthetic tracks are
available and are used for both training and racing in the UK and the USA. b) Shows a
turf track used widely for racing in the UK and sometimes in the USA.
lower peak impact than turf [48], dirt [54] and crushed sand [20]. Examples
of commonly used surfaces are illustrated in Figure 1.
The firmness or hardness of a surface determines how quickly the hoof
is brought to a halt and therefore helps determine the rate of deceleration
at impact and the amplitude of the impact force [45]. Stiff surfaces such as
asphalt and crushed sand lead to increased amplitude and frequency of
impact decelerations, while more compliant surfaces such as synthetic
tracks and sawdust have a significantly reduced amplitude and frequency
of vibrations at impact [28,35]. On synthetic surfaces, the braking phase
following impact is longer than that on sand, reducing the vibrations
generated by the shock of impact [20]. The effect of weather conditions on
the ‘going’ on turf cannot be overlooked, as soil with a higher moisture
content has a lower rebound rate compared with drier ground [52].
In addition to these effects at impact, surface properties can alter forces
within the limb during the remainder of the stance phase. Maximum fetlock
angle on dirt is higher than on synthetic surfaces, suggesting that peak limb
force is higher [18,48], and observations by several authors [20,24,35,55]
suggest that the distal limb is subjected to reduced mechanical stress on
all-weather tracks in comparison with sand and dirt. This is corroborated by
data on peak tendon strain derived from ultrasonographic features, with
maximal superficial digital flexor tendon force being lower on an all-weather
waxed track than on crushed sand at trot, peaking at around mid-stance
with a further peak in force corresponding with proximal interphalangeal
joint flexion occurring at 30% of stance [56]. The higher deformability of a
synthetic surface probably allows more penetration of the foot, assisting in
more gradual limb loading [56].
Grip is an important component of the horse–ground interaction both
during the impact phase as the hoof comes to a halt and during stance as
the horse exerts force on the limb to propel itself forward and, in some
circumstances, sideways or round a curve. In addition to slip on impact,
hooves may slip during foot off as they attempt to generate propulsion
[57]. Slip is often considered to be a problem contributing to injury [58] and
a risk when assessing lameness on a hard surface; however, some degree
of slip is considered essential to aid in the dissipation of impact loads
[24,59,60].
The coefficient of friction (CoF) can be used to quantify the ratio of
vertical and horizontal forces between two surfaces [61], in this case a
horse’s foot and the ground. It is measured on a scale of 0–1 unless the
animal has claws to increase grip (Wills, A.P., Myatt, J.P., Roskilly, K. and
Wilson, A.M., unpublished data) or, as is sometimes the case in horses,
studs or toe grabs. A higher CoF corresponds to a surface with increased
grip and a CoF of less than 0.6 may lead to excessive slippage. The CoF has
been measured ex vivo in several surfaces and is 0.8 on concrete and 0.61
on asphalt [62]. No measured CoF is available for dirt, synthetic surfaces or
turf, although turf has been assumed to have a CoF of around 0.6
[63],which corresponds to in vivo data for equine turning limits at the
gallop.
The degree of slip in vivo has been used more frequently to assess the
frictional properties of surfaces. Asphalt allows a greater degree of slip
than rubber or turf [35,64]. Turf surfaces lead to a higher degree of hoof
slip than synthetic and dirt surfaces at the trot and at higher speeds the
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R. S. V. Parkes and T. H. Witte
period for which braking occurs is lower on turf and synthetic surfaces than
on dirt, implying that slip distance is longer and therefore grip is lower on
dirt than on turf and synthetic surfaces for the forelimbs [48]. This is in
agreement with a more recent study, where a greater degree of hoof slide
was seen on dirt than a synthetic surface in the hindlimbs [18]. Woodchip
has been reported by owners of dressage horses to increase slip risk [65],
in agreement with measurements of impact duration [35]. Again, as with
damping properties, the shear and frictional properties of surfaces vary
with changing moisture levels, with turf typically being more slippery
under wet conditions and dirt having a lower shear strength as moisture
levels increase [66].
Returning energy
The equine limb can be considered to consist of two springs in series; a
proximal spring, between the shoulder and the elbow and a distal spring,
between the elbow and the digit [1]. As the surface acts as the third virtual
spring in series with the proximal and distal springs in the limb [1], the
return of energy from the surface may contribute to the energetic
efficiency of gait. In human running, optimising track compliance reduces
injury, which would be ideal for equine racing and training surfaces but also
decreases race times [67]. Synthetic surfaces have a higher level of elastic
deformation and return more energy than dirt [53] but, despite this, race
times on synthetic surfaces are typically slower than those on dirt tracks
[20]. Decreased moisture content (and therefore increased firmness) of the
track is associated with a greater energy return on dirt tracks, which may in
part explain why harder tracks are ‘faster’ [66]. A more in-depth
understanding of the interactions of surface properties and performance is
required.
Surface maintenance
The impact of maintenance on training and racing surfaces is often
overlooked. The effect of harrowing on reducing surface firmness is similar
on synthetic [68] and dirt tracks [45], while the effect on shear properties
appears to vary, with dirt tracks unchanged following maintenance [69]
and synthetic surfaces showing an increase in grip [68]. Interestingly,
harrowing a synthetic track appears to increase the peak loading on the
limb [70,71] in contrast with dirt, where maintenance leads to a decrease in
peak load on the track [69]. Poorly maintained or irregular dirt and
woodchip tracks increase the variability of hoof acceleration and
deceleration, with no change in absolute forces when compared with a
well maintained track [72]. Intervals between maintenance also appear to
have an impact on surface properties. This varies between surface types,
with dirt tracks showing greater loss of elasticity with repeated loading
compared with synthetic surfaces [53]. The detrimental effects of poor
track maintenance are supported by epidemiological studies that confirm
that lower levels of track maintenance increase injury rates [73].
Limitations on maximal performance in the
sports horse
The limitations to performance in many equine disciplines and the role of
the hoof–ground interaction in these limitations are poorly understood,
perhaps as ‘performance’ and what constitutes peak performance varies
greatly between disciplines. It is important to consider the strains put on
the musculoskeletal system by different disciplines. When running freely,
horses will change gait at the most energetically efficient point [74] or
when a force limit is reached [75]. The speed at which a horse will
voluntarily change gait is lower when carrying weights [75] than when
unridden, which may be due to a limit in mechanical force acting on the
musculoskeletal system. However, when a horse is asked to perform in any
athletic pursuit, gait selection is often determined by the handler, which
may adversely affect the loading environment of the limb.
Two key limitations to maximal performance at high speed in the horse
are grip and force. During galloping on a small curve, the maximum speed
is determined by grip. This is illustrated by studies in the polo pony,
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Foot–surface interaction
showing that friction limits the turn diameter by restricting the horizontal
force that the horse can apply during turning [63]. This is, in turn, affected
by the surface in question; as noted earlier, the frictional properties or
surfaces and the interaction of foot and surface varies. Studs and toe-grabs
may be used to artificially increase grip but have consequences for
performance and injury [25].
Under other circumstances, including galloping on a larger curve and
galloping downhill there appears to be a force limit to peak speed [63,76].
There are of course many other limiting factors to performance, such as
metabolic constraints when galloping uphill [76] which will not be
discussed here.
Surface-related factors and injury
Injury is fundamentally linked to the interaction of the horse with the
ground and surfaces have long been known to play a part in injury. Early
reports implicated harder ground for increased injury rates [77,78]. Injury
risk in general appears to be lower on softer going [73,79–82] than on
firmer ground; however, this picture is complicated for different injury
syndromes. The risk of distal limb fracture in both Thoroughbred [80,83,84]
and Standardbred [85] racehorses increases on firmer ground [83] and the
risk of tendon injuries generally increases on firm ground [86]. However,
dressage horses that regularly train on a surface that becomes deep in wet
weather, are more likely to sustain injuries than horses training on a firmer
surface [70] and softer ground is associated with a greater risk of falling
and therefore sustaining injury in both eventing [87] and the Grand
National [88]. This may be due to deeper ground increasing muscular
fatigue [89].
Specific track surfaces also lead to differing injury rates, likely due to a
combination of biomechanical properties, of which hardness is certainly a
component. Dirt tracks are almost always associated with a higher rate of
injury than turf tracks [79,80,90,91] and wood fibre tracks [92], and result in
a higher level of fatalities than synthetic tracks [93]. One study has found a
higher rate of injury on turf than dirt [94] but this study was likely
confounded. In the UK, races run on an all-weather synthetic track result in
a higher risk of fracture than races run on turf [73,82] with a higher rate of
flexor tendon/suspensory ligament injury than turf [82]. During training,
the use of a turf gallop reduces the risk of condylar fractures [84] and the
use of sand gallops may increase condylar fracture risk. In competition
horses, sand arenas appear to be linked to a higher rate of lameness
compared with waxed and rubber surfaces [87].
The location of common injuries varies depending on track type, further
supporting a hypothesis that surfaces influence the loading environment
of the equine limb. On turf, fractures of the proximal phalanx and of the
lateral condyle of the third metacarpal bone are most common, while on
all-weather and dirt surfaces proximal sesamoid fractures predominate
[80,83,95,96]. Dorsal metacarpal disease is more likely to occur on a dirt
track than on woodchip [92]. The location and severity of humeral stress
fractures also varies between track types, with distal lesions more
common on synthetic surfaces and proximocaudal lesions which tend to
be more severe and more common on dirt surfaces [97].
These differences in injury location and rate may be in part due to the
firmness of the surface, as dirt is less compliant than most comparable turf
track conditions [79] and woodchip [92]. However, given that the locations
of injuries varies between surfaces, other features of the hoof–surface
interaction such as shear and grip are also likely to play a role in force
generation throughout the limb and therefore in the propagation of injury.
Integrated studies using novel technologies such as ultrasonographic
measures of tendon strain [56] and mechanical measurements of track
properties [47] are likely to help evaluate these features more fully.
The impact of shoeing on
horse–ground interactions
The hoof represents the interface between the horse and the ground and
so by altering the shape of the hoof or the type of shoe we can influence
many features of the hoof–ground interaction.
Hoof conformation can significantly alter the forces acting on the limb. A
flatter foot contact is associated with a higher loading rate of the limb and
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Foot–surface interaction
a shorter braking period [24]. Long toes and low heels are linked to a
greater risk of injury during racing, particularly of the flexor tendons and
suspensory ligament [98–100]. By decreasing the angle of the distal
phalanx to the ground and extending the distal interphalangeal joint, a low
heel increases the peak force of the deep digital flexor tendon acting on
the navicular bone by up to 20%, which can be reversed with heel wedges
[101]. Wedges generally move the point of force toward the wedge,
mimicking hoof imbalance and calks, grabs, studs, wide webs and lateral
extensions have a similar effect depending on surface [3,102,103]. Placing
heel wedges laterally causes lateral motion of the metacarpus about the
longitudinal axis of the metacarpophalangeal joint while medial heel
wedges cause medial motion [104]. These effects can be used
therapeutically but can also be detrimental with wedges altering joint
congruence and in the case of heel wedges increasing potentially
detrimental joint pressure in the distal interphalangeal joint [105]. When
wedges are applied to the hindlimb, the effect is propagated further up the
limb and this results in an increase in fetlock and tarsal angles [106].
Shoes have an effect on grip, hoof expansion on impact and the inertia
of the distal limb [3]. As a result, shod horses experience a higher peak
vertical force [107,108] compared with unshod horses and a higher landing
velocity of the foot [108] results in greater force at the moment of impact.
Small changes in weighting on the distal limb can change kinematics; stride
duration and swing angle of the limb are increased and the arc of foot flight
is lower [107,109]. The changes in distal limb weight required to alter gait
are relatively small with a 700 g weight [109] or simply shoeing the horse
with normal shoes weighing between 400 and 500 g [107] leading to these
changes. However, the point of force acting on the limb during stance is
not altered in a regular shoe compared with the unshod hoof [103].
Shoeing does not appear to ‘improve’ gait [107] compared with unshod
horses, although measures of gait quality are inherently subjective.
Variation in shoeing has the potential to vastly change the interaction
between the horse and the ground and therefore alter the way of going
and impact upon injury risk. The use of different shoe materials changes
the slip distance seen at impact and may have an impact on jarring during
foot deceleration. For example, plastic shoes significantly reduce the
decelerative force experienced compared with both rubber and steel
shoes on concrete [59], although differences in interactions with other
surfaces have not been investigated. In competition horses, studs are
often used to improve grip and decrease slip distance significantly [25].
While this is likely to be beneficial in reducing grip limits to turning
performance by reducing the risk of slipping, there is probably a trade-off
between increased grip and the risk of injury due to increased impact
vibrations and increased impact force caused by more sudden braking.
The shape of a shoe is an important determinant of forces within the
limb. Similar to the effect of heel wedges, eggbar shoes shift the centre of
pressure caudally and result in a lower mean pressure across the foot
[106]. Rolled toe, square toe and rocker toe shoes do not affect breakover
duration on a hard surface [58,110], although breakover may be smoother
with rolled toe shoes [110]. Natural Balancea and quarter-clip shoes do not
affect distal interphalangeal joint moment or force on the navicular bone
during breakover [111]. On the other hand, toe grabs often increase
breakover time [112], although kinematic changes vary from horse to
horse. The rates of injury seen in racehorses shod with toe grabs appear to
be higher than with regular shoes [94,99,100], which have been linked to
increased strain on the distal limb, potentially by increasing the moment
around the hoof and increasing strain on the flexor tendons.
The impact of these intentional shoeing interventions illustrate the
importance of proper hoof balance in maintaining normal forces and
kinematics throughout the limb during locomotion and in mediating and
preventing injury. This is critically important when we take into the account
the horse’s limited ability to adapt gait to different circumstances.
Conclusion
This article has outlined how the interaction of hoof and surface play an
important part in determining the loading environment of the equine limb,
which in turn influences injury and performance. While the horse has a
limited ability to alter its own limb compliance and gait in response to the
external environment, as veterinarians we can have a significant impact on
the interaction by changing surface properties and shoeing strategies.
522
R. S. V. Parkes and T. H. Witte
The provision of appropriate foot care, surfaces and training are crucial
to the maintenance of the equine athlete. Further research should focus on
the precise sport-specific mechanisms of hoof–ground interactions of
sports horses and racehorses. More work is required on the effect of novel
shoe types and the effects of trimming techniques on gait in healthy and
diseased horses.
Authors’ declaration of interests
No competing interests have been declared.
Ethical animal research
Not applicable for review article.
Sources of funding
R.P. is funded by a Horserace Betting Levy Board-funded doctoral
scholarship.
Authorship
R. Parkes and T. Witte contributed to study design and preparation of the
manuscript and gave their final approval of the manuscript.
Manufacturers’ address
a
Malaysian Horseshoe Company, Selangor Darul Ehsan, Malaysia.
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Contains more than 500 carefully crafted illustrations, with contributions from around 50 leading
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Willem Back, DVM, PhD, Diplomate, ECVS, Diplomate, RNVA, Assistant Professor in Equine Surgery,
Department of Equine Sciences, Utrecht University, The Netherlands
Hilary M. Clayton, BVSc, PhD, MRCVS, McPhail Dressage Chair in Equine Sports Science, Department of Large
Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA,
McPhail Dressage Chair in Equine Sports Science

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