It all begins with a properly balanced body.
While a certain amount of break-down is inevitable in any super-athlete - human or animal - (and yes, I do consider Sport Horses the equivalent of super athletes), too often, we tend to lean toward treating injuries in horses rather than trying to put more focus on preventing them to begin with.
A human athlete, for example, will do whatever is necessary to keep his/her body as balanced and restriction free as possible in order to perform at their very best. Take a hurdle runner, for example, who's legs line up as evenly as possible from the hip to the feet. You would never expect them to put on a pair of uneven shoes or one shoe that has a sole that is two inches higher than the other, and run with them. It would throw their ankles, knees, hips, lower backs, etc. completely out of alignment. While he/she would probably be able to adjust, the break-down of the body on the over-loaded side would be tremendous (and performance definitely hindered).
Yet, when it comes to horses, how many times do we see jumpers in the ring with one hoof inches higher than the other? In turn throwing everything all the way up to the shoulder completely out of alignment. While most farriers will quickly dismiss this as "that's just the way he was born/is build", it is actually a quite serious problem (not to mention a problem which I have seen corrected by great farriers over and over again throughout my career - so it is fixable).
Due to this imbalance, the horse is now "loading" it's front end improperly. One of the legs is carrying a lot of added stress. As you have probably guessed by now, this, in turn, will more than likely cause injury to the overloaded leg. In addition, the horse now has to "twist" it's body in order to make up for basically stepping into a hole with one of the front legs, causing tension in muscles throughout the body, twisting of the spine, a shifting of the natural angle of the hip, in turn throwing stifles out of alignment and causing added, unnecessary stress to hocks. Not to mention stress to tendons and ligaments all over the body.
Those two inches way down in the front hooves have an absolutely detrimental effect throughout your horse's body. You'll more than likely end up with back pain, SI pain, bad stifles, and bad hocks over the course of time, in addition to front end problems, which you might treat over and over again, without ever actually addressing the CAUSE of the problem.
And this is only a very simply example. Throughout my career, I've had the wonderful opportunity to learn from some of the most compassionate horse professionals in the industry. People who truly care about the horse's well-being, educating owners, and making a difference in both the horse's and owner's/rider's life.
It began with a farrier, who demonstrated on an equine skeleton the importance of a a properly balanced hoof and showed how even the slightest shift of balance has a massive ripple effect throughout the body. Furthermore, he demonstrated what happens throughout the body when heels are contracted, angles are shifted, break-over points moved (whether to the benefit or detriment of the horse). The stress not only on muscles, bones, and joints, but also on ligaments and tendons is tremendous. It is generally only a case of WHEN they horse will get injured, rather than IF.
The hoof will also tell you a great amount about how your horse is actually "loading" each leg from the top down. The low hoof, for example, is the one he/she transfers most of the weight/impact to. Hoof walls that "roll under" are a clear sign of misalignment in other parts of the body.
While it is absolutely vital that your farrier addresses the issue in the hoof and balances and supports the horse as well as possible (instead of just leaving things the way they are), it is also necessary to address the actual cause of the problem. (No - they are NOT built that way - they are LOADING that way due to causes in other parts of the body).
Quite a few years back, I had the pleasure of meeting the absolutely wonderful Dr. Deb Marshall, a veterinarian who specializes in resolving muscle tissue injuries in horses. She patiently answered all of my endless questions and explained how tears, injuries, and "scarring" of muscle tissues causes restrictions in motion throughout the body.
Here too, this restriction - if left untreated - has a tremendous ripple effect, causing uneven loading and wear-and tear issues in not just muscles, but joints and bones, ligaments and tendons throughout the body (not just in the affected area).
In very easy terms (since most of us aren't doctors and have to find a way to understand): Muscle holds the body together. When scarring occurs, shortened or restricted mobility can easily pull joints apart or compress them, add stress to ligaments and tendons, pull bones out of alignment, even cause bones to "bend" (my own knee injury is a perfect example - I now have a bent ankle bones which developed due to years of incorrect "loading"). It might even be the cause for kissing spines.
A couple of wonderful dentists have taught me so much over the years about how teeth can affect the whole body. How something as simple as a small hook or bridge in the mouth can cause the neck and cheek bones to draw too close together, in turn, once again, restricting mobility. They are also often responsible for the neck and poll constantly shifting out of alignment.
And then just recently - I have become fascinated with the teachings of April Battles (http://www.holistichorseworks.com), who has introduced me to skeletal releases, skeletal alignment, osteopathy, and various other, holistic approaches to healing and aligning the body.
She has also taught me a lot about conformation vs. posture. Even after using only a few of her skeletal releases, I have seen amazing "conformation" changes in my horses. (Turns out - they're actually NOT just build that way). I've seen hips drop, backs rise, necks actually getting longer, horses loading their legs evenly when standing, etc. Not to mention the changes under saddle.
Overall, the importance of alignment cannot be stressed enough. (Our cars are perfect examples of that. The uneven tire wear, the pulling of the steering wheel, the uneven breaking, etc.). If left unaddressed, we are greatly reducing our horses' ability to perform, and are causing the body to break down at absolutely unnecessary speed. It also causes the horse to be highly uncomfortable while working, which can easily create "behavioral" issues.
Alignment needs to be considered in training also. Every time we ride a horse from the front to the back, or ask his/her body to carry itself in a way it is not properly prepared to yet, we are blocking muscles from performing the way they were meant to and are shifting balance and alignment to incorrect levels.
The neck is cranked in too soon, so the back will arch, causing the hip to shift forward and down, throwing the stifles out, sticking the hocks out behind the horse, also blocking movement in the shoulders, neck, and head. Wear and tear of joints and bones is inevitable, not only because muscles cannot perform in their natural shock-absorbancy role, but also because of uneven or incorrect loading.
Any athlete in balance and proper alignment will perform better, faster and longer without added compensatory break-down or arthritic changes. Throw that balance off in the slightest way, and you'll end up with a severe ripple effect throughout the whole body.
Even the smallest restriction will cause the horse to compensate. Restriction of muscle movement in the hind-end will cause the front end to pull harder. Restrictions in the front end will cause the hind-end to stress. Both will greatly affect the mid-section of the horse.
Even the best chiropractic work will not do much good unless you free the blockages that caused the chiropractic issue to begin with (usually, a muscle tissue issue - not necessarily in the same area, or a muscle issue caused by uneven loading anywhere in the body, and one that requires more than simple massage work).
I cannot say enough about these wonderful teachers who have finally been able to satisfy my curiosity about always getting to the cause/root of an actual problem. Their teachings, and the work they have done for the horses in my care throughout my career have made an indescribable difference. I can honestly say that they have often succeeded where modern veterinary practices left me with no further options.
I highly recommend that each owner tries to educate themselves as much as he/she can, rather than solely relying on the "experts" they are currently dealing with. To always put common sense first, rather than feeling shy about questioning the "expert". To NEVER stop asking why, until you get to the root of the problem. Sadly, in this industry, a lot of experts simply do not care to find a way to improve the horse's well-being. They might pretend that they do, but once you start asking questions, you are often confronted with a bad attitude (the "who are you to dare question me?" attitude, as I like to call it).
Always remember that those who truly, deeply care about the horse will not only love to answer any questions you might have (usually, because they are actually capable of coming up with an logical explanation and give you a reason as to WHY things are the way they are. Or - if they are not - they will actually admit that they don't know, but that they want to find out), a lot of them will actually reach out to you and try to teach you if you show the slightest interest in wanting to learn. After all, the more people know, the more lives we can change for the better.
Never, ever settle for "that's just the way he/she is built, the way things are, the way we do things". Do not EVER let an "expert" intimidate you! Experts should be TEACHERS, not high-and-mighty ultimate authorities. And even experts should always be willing, even wanting to listen and learn.
And if something doesn't make sense or isn't logical to you, keep asking until you find someone who is actually able to give you an explanation that satisfies you and helps you to understand. If there is one thing I have learned over the years it is this:
If you dig deep enough, you WILL find someone who can give you the answer and actually EXPLAIN things to you in a way that make actual sense!