Uneven footfall or dynamic mediolateral imbalance occurs when a hoof lands on the medial or lateral wall and then tips onto the other side. This can occur as a result of axial or rotational limb deviations or hoof imbalance. Observing the horses action dynamically and trimming for level landing will help to alleviate this in mild cases. Where the uneven landing is due to a conformational deviation, it may not be possible or wise to trim for level landing.