Soundness evaluations come in many shapes and sizes. Sometimes it is just a checkup before a show and at other times the horse has a specific lameness to be addressed. There is a process not only to identifying lameness but to isolating a region in the limb responsible for that lameness. Initially a passive exam for any abnormal swellings or thickening is completed, followed by observation at the walk and trot. This may help to identify the limb or limbs of interest to which a hoof tester is then applied to ascertain if the foot is involved. Either before or after the hoof testers, flexion tests can be completed to stress different parts of the limb or limbs to further isolate the region causing a problem. Once a region on a limb or limbs has been identified, diagnostic nerve blocks may be required to further isolate the lameness. Diagnostic blocks are performed by placing a local anesthetic over the nerve(s) to desensitize a semi-specific area. Additional diagnostic tools including radiographs and/or ultrasound of the affected region and can be performed as determined between you and the veterinarian. After identifying the source of a problem, a specific treatment plan can be provided to fit the needs of the horse.