Dorsal metacarpal disease (DMD) is the most common cause of lostdays to training and racing in Thoroughbred racehorses. Colloquially termed 'bucked' or 'sore' shins, this initially painful condition commonly occurs in the first season of training and can raise welfare concerns. Clinical signs include pain with digital palpation and swelling on the dorsal, and sometimes dorso-medial, aspect of the third metacarpal (McIII). Periostitis and excessive growth of periosteal bone can be present as a response to high strain cyclic fatigue. Whilst DMD can resolve with rest or reduced exercise, it can leave bone susceptible to future catastrophic fracture at the same site, particularly saucer fractures of the lamellar bone of the diaphysis. Some trainers continue to work an animal through DMD, with the view that it will only happen once, but it can reoccur. Additionally, the animal is in discomfort and has a weakened skeletal system. In vivo studies of the effects of cyclic strain on the skeletal system of Thoroughbreds are notoriously difficult, due to the many variables involved and in vitro studies cannot mimic true training and racing conditions. Variables affecting the loading of the McIII such as exercise regimes, location, speed, direction, conformation, surfaces, farriery, and diet have all been investigated to ascertain their influence, if any, on disease predisposition and onset. In the 1990's, it was believed that certain training methods and the young age at which Thoroughbreds commenced training were the main cause of DMD. Since then, the cause of DMD has been linked to excessive bone loading stress, with bone cell absorption exceeding replacement. Other studies have reported that lengthy periods of stabling and lack of access to short bursts of high speed exercise, results in reduced bone mineral content and strength in the equine McIII, thus predisposing it to fatigue.