05/16/2026
Credit Dr Mark Caldwell
The wedge isn’t the wall
When you look at a chronic laminitic foot from the side, you see a long, often slipper-shaped toe that has grown out at the wrong angle. The new hoof wall is coming down from the coronary band at a healthier angle, and below it is the older, distorted toe.
The protocol being defended online tells you that this older, distorted toe is “the toe wall”: a structural part of the foot, a “pillar of support” that should be preserved at all costs.
It isn’t.
What’s actually sitting between the outer wall you can see and the coffin bone inside your horse’s foot is something called a lamellar wedge. It’s the pathological tissue that forms when laminitis tears apart the bond between the hoof wall and the bone. It is made of stretched, disrupted, scarred connective tissue and disorganised horn. It is not structural.
It cannot transfer load between the wall and the bone the way a healthy lamellar bond does.
It is, in plain terms, the disease, not the structure.
Think of it this way. Imagine a fingernail that has partly lifted away from the finger, and the gap between them has filled with a layer of dead, fibrous scar tissue over time. Would you call that scar tissue “the fingernail”?
Would you protect it as a structural part of the hand?
That’s what’s being preserved when the protocol tells you not to take the toe back. The outer wall is still there, but it’s no longer doing the structural job the protocol claims.
Beneath it sits a wedge of pathological tissue that grew when the lamellar bond between wall and bone failed. Wall without that bond is wall without a job. The protocol is preserving the assembly and calling it a pillar of support.
And here’s where the two things connect. By preserving that wedge, you’re keeping the effective toe long. And by keeping the toe long, you’re keeping the lever long.
Every stride, more force on the deep flexor tendon.
More force on the navicular bone.
More tension on the lamellar bond that’s trying to grow back together at the top.
The protocol denies that the toe is a lever because that’s the only way the wedge can be preserved without admitting that preserving it perpetuates the original damage.