Better Health Through Riding

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Start a therapeutic riding program at your stable and you’ll create good will, help people with disabilities and provide a service to the community. It also makes surprisingly smart business sense.

Think we’re talking pony rides for kids in wheelchairs? Well, think again. Whether you call it therapeutic riding, adaptive riding, equine-facilitated integrated therapy training or hippotherapy, it can be as varied, fascinating and rewarding as you choose to make it and your clients need it to be.

“Most of the clients I deal with, even those with mental disabilities, come here with definite goals in mind,” says Connie Weinsoff, head instructor for Hearts Adaptive Riding Program in Santa Barbara, Calif. “If we only had pony rides, they'd get as bored as anybody.”

“Therapeutic riding improves balance, strength and muscle,” adds Weinsoff. “The horse’s movement increases the client’s blood flow, increases endorphins, gets their organs healthier and relaxes them. And in obvious and subtle ways, it increases their sense of well-being. They can go places on horseback they can’t go in wheelchairs—into an arena, down a trail, through a ravine, up a hill. Sitting on horses makes them taller than everybody. Think about it—when you spend your life in a wheelchair, you look up at everybody. All of a sudden, you’re looking down at people. We may not think much of that, but it really increases your self-esteem to be taller than someone and have control over a large animal, especially when you don’t necessarily have a lot of control over your own body.”

Who Can Benefit

Therapeutic riding is not the same as hippotherapy. The American Hippotherapy Association, a special interest section of the North American Riding for the Handicapped Association (NARHA), defines hippotherapy as a medical treatment in which horses are used to improve the balance, posture and mobility of patients with movement dysfunction due to conditions such as cerebral palsy, multiple sclerosis, spina bifida, developmental delay, traumatic brain injury, stroke, autism and learning or language disabilities. Because hippotherapy can only be practiced by specially trained and licensed physical, occupational or speech therapists, it is referable by physicians and billable to insurance at rates upwards of $100 per hour.

Therapeutic riding programs often share a similar client base as hippotherapy, in addition to clients with stroke, blindness, deafness or Alzheimer’s, and even battered women, abused children, third-strike kids, truants and at-risk teens.The big difference? Therapeutic riding is considered recreational since it is basically unregulated and its results, even from the best-run programs, are mostly anecdotal. Therapeutic riding, therefore, is neither referable (so clients are mostly acquired through word-of-mouth), billable to insurance nor as pricey as hippotherapy. Rates are generally closer to those of able-bodied recreational lessons.

Bud Newell, owner of Serenata Farms in Big Springs, Kans., is taking another tack toward professional acknowledgement. Three years ago, frustrated with the common reaction, “Oh, you’re that spot that lets crippled kids ride horses,” and realizing that “anecdotal doesn’t do it when you’re talking to a neurologist about brain trauma,” he joined with Washburn University and Kansas State University’s Department of Human Ecology to set up a long-term research project. It was designed to scientifically evaluate and produce hard data on therapeutic riding program for two reasons: “to get a client base and to be able to bill insurance.”

Into the Mainstream

The demand for therapeutic riding services is growing, and that’s where NARHA, a membership organization whose goal is to foster safe, consistent, professional, ethical therapeutic equine activities, comes in. NARHA provides its members with guidelines, standards, education, program accreditation, instructor certification, low-cost liability insurance and contacts with such organizations as the Muscular Dystrophy Association, Multiple Sclerosis Society, Special Olympics, Spina Bifida Association and United Cerebral Palsy. Today, some 600 NARHA riding centers (with around 20,000 volunteers) serve more than 30,000 individuals with disabilities.

Getting Started

“The equestrian business is a difficult business, period,” says Stan Penton, owner of Normandy Farm and Stables in Denver, Colo., and a founding member of the non-profit resident Pegasus Program, Inc., one of NARHA’s member organizations. “You have to be creative to make a go of it. The idea of starting a therapeutic riding program fit right in with our business philosophy of doing something to serve the community. It made smart business sense to have a multi-faceted program. It’s been a two-way street—Pegasus occupies boarding and office space on a consistent basis; we give them a discount on board. They frequently utilize our arena at times when it would otherwise be empty. And we get a lot of good will that enhances Normandy’s for-profit programs.”

Philosophies and good will aside, there are practical considerations in starting a program. You’ll need mounting blocks or wheelchair ramps to help riders mount and dismount. You may need boots, clothing, braces and protective headgear, as well. And you’ll definitely need tack, including saddles, surcingles, bridles, reins, lead ropes and longe lines.

Insurance requirements don’t differ materially from those for a regular recreational riding program. If you adhere to NARHA’s member requirements, you’ll be sure to cover yourself, your instructors, riders and volunteers with:

1. A $1 million (per occurrence) general liability policy;

2. An Excess Accident and Medical Policy that includes at least $10,000 per accident and at least $15,000 for accidental death and dismemberment;

3. A recommended $3 million aggregate limit;

4. Additionally, if you hire a physical therapist, you need proof of his or her professional liability coverage and medical malpractice insurance to cover yourself;

5. Finally, be sure to have an attorney practicing in your state review all your insurance, organizational, information and release documents.

Let Your Imagination Be Your Guide

Therapeutic riding programs are anything but set in stone. You can have one or two horses; you can have a barn-full. You can operate part-time, seasonally or year-round. You can have trained therapists focus on specific disabilities, or you can lean toward recreational (but beneficial) activities and skills such as games, trail rides, driving, vaulting, longeing, long-lining, competition and even stable management. None of these programs can exist without volunteers. They’re needed for everything from leading to sidewalking, grooming, tacking up, cooling out, cleaning tack and tending to the endless administrative duties.

The following are some variations on the theme:

• Don’t stop with horses! Explore the mental-health and interactive benefits of gardening (and where better to use all that manure), and keeping a small menagerie of guinea pigs, rabbits, burros, goats, miniature horses, pot-bellied pigs, cats, dogs and chickens. “Youngsters who can’t tell you where they are on a trail ride,” says Bud Newell, “know if one of the goats is missing from its pen. And even autistic children want to earn the right to feed the guinea pig or check the water in the rabbit’s pen.”

• Shhhh...whisper. Your horses (and clients) will listen. Incorporate the gentling, desensitizing and training techniques of such handlers as Monty Roberts (who actively encourages therapeutic riding instructors to participate in his seminars), John Lyons, Pat Parelli and Frank Bell. “The horses will work better for you because they feel you're on their side,” says Connie Weinsoff, adding, “teaching your clients how to read horses’ signals and body language is very effective, because the disabled often find it easier to understand nonverbal communication than verbal communication.” Bud Newell agrees: “It’s very important for troubled kids who’ve never learned things like verbal communication, trust and setting boundaries.”

• Build it and they will come. If you have room for pastures but no room for or access to trails, build the pastures with 16-foot wide lanes between, and you’ll have a safe but roomy trail system suitable for riding and driving. And remember to make your wash racks, grooming areas, bathrooms and, yes, even your stalls, wheelchair-accessible. Even the wheelchair-bound, says Bud Newell, should have the right to wheel into stalls, lead their horses out, and after their rides, pick out a few meadow muffins from the bedding.

• Encourage therapists, teachers and caregivers to get involved. “A child’s speech or physical therapist will come up to me and say, ‘I wondered what you were doing because he was making such improvement and I knew it wasn’t because of me,’” says Connie Weinsoff. “That’s gratifying, but think how much more we could accomplish if we worked closely together.”

• Find and keep those volunteers. If local high school students are required to log a certain number of volunteer hours before graduating, make presentations at their assemblies. Put ads in the local college and university newspapers. Recruit parents and caregivers (as long as you don’t have them work with their own children, cautions Bud Newell), and don’t overlook retirement home residents, as long as they’re strong and fit enough. Then reward the volunteers with free lessons and trail rides after a certain number of hours. Most will jump at the opportunity since they’re usually there because they love being around horses.

• Use your therapy horses for recreational lessons or even leases to able-bodied riders. You’ll help the horses’ mental and physical soundness. “Even they get burned out,” says Connie Weinsoff. If you’re a non-profit, you can apply the lesson and/or lease fees to the therapeutic program. And talk about outreach!

“We’ve sent some of our mustangs to three-day events,” says Stan Penton. “It’s great publicity when they do well and the announcer gives them, the Bureau of Land Management and therapeutic riding a plug.”

“This is the easiest job for me as a teacher,” says Weinsoff. “For everybody who comes here, this is pretty much the highlight of their week. I don’t have discipline or behavior problems. It’s fun, they’re motivated, they all want to be here and they’re improving.”

For the Handicapped—Which Horses Work Best

There’s no one formula for finding the right horse for therapeutic riding, but age, size, temperament, soundness and training all play a part. Three professionals share their impressions and handling tests.

Connie Weinsoff relies on donations and leases from the community. “I personally love quarter horses,” she says. “They’re generally less high-strung than thoroughbreds and Arabians, and they seem to be more tolerant, flexible and malleable. I wheel wheelchairs around them, I throw balls at them, I have little rubber rings I put on their ears—I do a lot of different things to them that you wouldn’t ordinarily do, and they usually stand there and look at me like, ‘What are you doin’?’ That’s the kind of mentality I want.” At the same time, adds Connie, she doesn’t want a dead plug horse either. “I need a horse that has a brain, that’s willing to go with the program even if it’s a little boring in the beginning, but will move and walk out when I need him to.” Connie also likes her horses to be between 12 and 18. “You definitely have health problems with the older horses,” she says, “But all the experience they’ve had trailering, punching cows, going to shows and listening to loudspeakers just seems to make them more accepting.”

Bud Newell prefers to rely on Arabian brood mares and youngsters he’s raised and worked into his program. “It’s in the Arabian horse’s heritage to be ‘people-ized.’ They enjoy being around people and they just seem to react better to people than other breeds.” When it comes to age, he prefers horses in the 6-, 7- or 8-year-old range. “Once these horses put their lives in our hands and we get our clients to be honest with them, we don’t have many age-related problems.”

Going younger still, Stan Penton relies on the Pegasus Program’s Horses Healing Humans Times Three, an arrangement where Pegasus adopts mustangs from the Bureau of Land Management. They are “gentled” by Colorado Department of Corrections inmates under the supervision of handler, Frank Bell. Once the mustangs have basic riding and handling skills, at-risk youth work along with Frank Bell and Pegasus Director Robin Bowman to prepare the horses specifically for hippotherapy and therapeutic riding. Penton is sold on mustangs. “They have strong feet. They don’t usually need shoes. Once gentled, they are mentally very sound. They’re survivors with good common sense and a real good laid-back temperament. Their average height is 14hh or 15hh—good for working with patients. And they're young, which means you don’t have health issues and a constant infusion of expensive veterinary care."

For training, “Each horse learns to stand and withstand an autistic child screaming,” says Penton. “He learns about sidewalkers and carrying a child laying over his back with a physical therapist. He goes up to a wheelchair ramp and loads. We even have one horse that’s being trained right now to compensate for a rider who has very poor balance and leans heavily to one side.” Pegasus is now placing their “overflow” Mustangs with other NARHA centers around the country. —KG

FOR MORE INFORMATION

Call NARHA at (800) 368-RIDE, email them at narha@narha.org or visit their Website at www.narha.org. To learn more about Normandy Farm and the Pegasus Program, visit www.normandyfarmandstables.com and www.horseshealinghumans.com. And to find out more about, or sign on for, Bud Newell's outcome studies, email him at mbnewell@att.net or visit his website at www.serenata.ksmo.net.