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Hippotherapy, literally means “treatment  with the help of the horse: from the Greek word hippos meaning horse". It is often divided into Hippotherapy and therapeutic horse back riding. Specially trained physiotherapists, occupational therapists, speech therapists, and psychologists use this medical treatment for clients who are challenged.


Historically, the therapeutic benefits of the horse were recognized as early as 460 BC the field of riding for individuals who are challenged evolved throughout Europe, the US and Canada. It now occurs world wide mostly under the umbrella of Riding for the Disabled.


Hippotherapy  In classic Hippo therapy, the horse influences the client rather than the client controlling the horse. It does not teach specific skills but rather provides a foundation of improved neuromotor functions and sensory processing that can be generalized to a wide range of activities outside of treatment. The client is positioned on, and actively responds to the movement of the therapy horse. The therapist directs the movement of the horse analyzes the client's responses, and adjusts the treatment accordingly. The goal of classic Hippotherapy is to improve the client's posture, balance, mobility and function. This is the therapeutic/medical model which integrates principles of the medical and/or psychological development into various uses of the horse. The use of medical practitioners such as specially trained physiotherapists, occupational therapists, speech therapists and psychologists become an important part of the program.

Therapeutic Horseback Riding  also known as Therapeutic Riding, Equine Assisted Therapy, Equine Facilitated Therapy and Riding for the Disabled, is the use of the horse and equine oriented  activities to achieve a variety of therapeutic goals, including cognitive, physical, emotional, social, educational and behavioral goals. Where if differs from Hippotherapy is that not only does the horse influence the client but the client also influences the horse. The emphasis is on learning riding skills; these would include trail riding, driving, vaulting, and competition. An emphasis on the client’s areas of challenge and specific therapy goals are included in the riding lesson.


Many centers use an integrated approach, involving all of the above approaches, which lead to a more holistic approach to the clients benefit. The team consists of some or all of the following, riding instructors, medical professionals, volunteers, educational specialists, and behavioral specialists.


Horseback riding for the challenged is recognized as one of the more progressive forms of therapy. The horse provides sensory input through multidimensional movement, which is variable, rhythmic and repetitive. This and the variability of the horse's gait enables the therapist to grade the degree of the sensory input to the client, then use this movement in combination with other clinical treatments to achieve desired results. Clients respond enthusiastically to this enjoyable learning experience in a natural setting. By adding the ability to control a horse, once the clients body and mind are organized, inspires self confidence, responsibility and teamwork. Best of all, it is a thoroughly enjoyable experience, which creates a special relationship between rider and horse and promotes personal challenge. It can  have an affect on the following areas; physical, psychological, cognitive, behavioral and communication functions for clients of ail ages.

From the beginning, riders learn balance, coordination and self assurance while receiving therapeutic muscle and vestibular stimulation. The horse's multidimensional movement, gait changes in pace and the clients position on the horse can assist in physically challenged people.

Some of the unique aspects of contact with and the riding of therapeutic horses include,

Heat from the horse can normalize muscle tone controlling a horse helps clients to learn to control themselves riding can influence nearly every part of the human body by merely changing the clients position (sitting, kneeling, laying down supine or prone, front wards,  backwards), their placement on the horse (close to the neck, in the middle of the back, back towards the rump) and the speed of the horse (slow walk, walk, fast walk, slow trot, fast trot, canter)
Bonding with a horse may help bonding with humans
Horses give unconditional love
Horses don't talk back
Horses listen without judgment
Horses care not about what we look like, move like, past behavior of ours or what may have happened to us in the past
Horses give us the opportunity to learn about "Engine" levels, regulation strategies and modulation riding give opportunities for extremes that cannot be had elsewhere being outdoors adds a wealth of sensory experiences not found elsewhere offers the opportunity to maintain movement opportunities and modulation while working on other issues
The rider typically looks like their peers doing a natural and special activity
Can be seen as horseback riding rather than another "therapy".
One can work on multiple target areas simultaneously without the client realizing it.
Clients who have negative attitudes, expectations, ideas and experiences with therapy are less likely to have them towards Therapeutic Horse Back Riding.
The movement of the horse boosts respiration and helps to organize the body, mind and spirit.
The horse organizes the client without the client having to do much work and often without having to make a conscious effort



The horse provides its rider with a multitude of sensations and possibilities. Identifying the kinds of people or the challenges or disabilities they face that would benefit from riding a horse is complex. Four areas have been used to categorize the specific symptoms that would benefit from therapeutic horse back riding.

Physical Issues

   Muscle tone


   Strength, endurance, stamina

   Postural control

   Gravitational insecurity

   Spatial perception


   Bilaterality and laterality 



   Sensory defensiveness

   Coordination, reflexes, motor planning

   Respiration and circulation

   Appetite and digestion

   Sensation (tactile, vestibular, olfactory, vision, auditory)

   Self regulation and modulation

Psychological Issues

Self esteem
Social emotional
Autism spectrum
Sense of normality

Educational issues 

Number concepts
Motor planning
Eye hand coordination
Visual perception
Figure ground
Learning Disabilities

Social Issues

Communication (verbal and nonverbal)
Following directions
Normal peer activities

The Power of Therapeutic Horseback Riding

The use of a horse for therapy is very powerful medium. It is critical that therapeutic riding programs have appropriately trained personnel. If incorrectly implemented, it can be extremely dangerous. Since this medium involves the use of a large animal, safety issues are paramount. It is also necessary to have complete understanding of the physical and psychological nature of the horse involved and the physical, mental, and emotional needs and status of the special needs rider.

 Listed below are a few of the "power packs" that are carried by the horse when using therapeutic horseback riding with people who are challenged.

The horse's energy
The horse responds to the feeling it gets from the rider; "the real you"
Therapeutic horses are very sensitive to the riders' needs
The power of nature
Cranio sacral rhythms
The physical nature of riding a horse stimulates physical development and Sensorimotor processing
Looking after, caring for, responsibility for, and controlling a huge animal that listens to you (verbally and nonverbally).
Ability to do something most other cannot and do not do free mobility
Non verbal communication on a different level
The horse expects you to do your best and nothing more and if you are not functioning at your best for that day the horse will challenge you.


  1. Sivewright,  Molly, Thinking Riding (Book 1 a   and ). JA Allen, London

  2. British Horse Society, Manual of Horsemanship, JA Allen, London

  3. Sagar,  Ann. Vaulting   Develop Your Riding and Gymnastic Skills, BT  Batsforn  Ltd, London, 1993

  4. Swift, S, Centered Riding, 1985, St. Martins Press 

  5. Williams, MS and Shellenberger,  S, "How Does Your Engine Run?" A Leader's Guide to the Alert Program for Self Regulation. Therapy Works Inc., Albuquerque, NM

  6. Oetter, P,  Richter, E, Frick, S, MORE: Integrating the Mouth with Sensory and Postural Functions, 1993, PDP  Press, Hugo, MN

Lisa Hare OTR, Sleepy Hollow Horse Riding, Noordhoek  Beach, South Africa 6199


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