Mediolateral hoof balance — the lateral-to-medial symmetry of the hoof — is a critical but often overlooked welfare determinant for coffin joint and digital health.
Mediolateral hoof balance is a welfare dimension that receives less attention than dorsopalmar balance (toe-heel) despite significant consequences for coffin joint health. Chronically imbalanced hooves create asymmetric joint loading that causes progressive articular cartilage wear — a source of chronic pain that develops gradually and may not be clinically obvious until significant damage has occurred. Farriery assessment and correction of mediolateral balance is a preventive welfare intervention that protects joint health across a horse's working life. Radiographic assessment of coffin joint congruence provides objective evidence of balance adequacy — an investment justified for performance horses whose joint health is critical for their welfare and working life duration.