Mediolateral hoof balance, the alignment of the hoof capsule from side to side, significantly influences joint loading patterns and long-term welfare of horses in work.
Mediolateral hoof balance is a subtle but welfare-relevant variable that operates below the threshold of obvious lameness in many horses. Chronic uneven loading creates progressive joint stress that eventually results in degenerative changes and pain. By the time these changes cause detectable lameness, significant irreversible pathology may already be present. Proactive farriery focused on achieving optimal radiographic hoof balance prevents this progression. The welfare case for routine radiographic assessment in working horses is compelling, as it enables interventions before clinical signs appear. The integration of veterinary and farriery expertise for hoof balance management represents best practice.