The same steep hoof form is also responsible for a deficiency of blood flow and chronic overload of the dorsal part of the laminae, which sets the stage for acute laminitis. A 12-year study of more than 200 coffin bones from slaughtered horses shows that rarely does one find a coffin bone not deformed and damaged by improper hoof shape. The palmar processes of a healthy coffin bone form an opening parabolic shape, while in contracted hooves it shows an elliptic arch. The length of a healthy coffin bone equals its width; the commonly deformed coffin bone is narrower than it is long.The horse's weight, with each step, is equally distributed onto the laminae. (In a calculation, this results in about 8kg per sqcm of laminae, at a canter.) Horses live with this for 30-40 years even in rocky areas.
Studies of wild horses show the coffin bone of a natural foot parallel to the ground and the frog/ bulbs actually touching the ground.

Domestic horses, however, are largely forced to live with high heels, and no frog contact. A change in the distribution of pressure results; the steeper the coffin bone, the more weight moves to the tip of the coffin bone and the more the laminae there are overloaded. Soft ground is less harmful under these conditions than hard ground.

The overloading of the laminae can be borne for some time if there is optimal circulation and good horn quality (unshod hoof). If anything like a metabolic disorder occurs, such as an excess in protein, the overloaded area becomes inflamed. Horses show pain and shift their weight rearward, onto parts of the hoof where the laminae is still intact.

With wild horses, actue laminitis heals quickly, since the animal has to migrate with the herd, and circulation resolves the laminitis within a few days. The rearward shift also shortens the overlong heels.Veterinary treatment, however, focuses mainly on the inflammation, or the already occurred rotation of the coffin bone. However, seen from a pathophysiological point of view, inflammation is a functional measure for repair: through increased bloodflow, metabolism (the exchange of waste products for nutrients and oxygen) is intensified. Basically, an inflammation is a natural repair mechanism; it causes pain, but has a function, and suppressing it (as with anti-inflammatories) prevents this natural healing mechanism from working.