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Equine Therapy, Hippotherapy, and Therapeutic Riding – What are the Differences?

Since ancient times, people have understood that horses can have therapeutic effects. For example, Hippocrates recommended that patients suffering from sciatica should be placed on a horse's back. In the 20th century, people noticed their physical and mental health was better after they had ridden horses. Building on that observation, therapists started applying horses for the treatment of psychological problems. 

We now understand that the social interaction that comes from working with horses can help us deal with depression, stress, anxiety, and other mental health issues. In nature, horses are social animals that form a very close bond with their herd. As domesticated animals, horses retain their social and empathic nature – and they are capable of reading cues and emotions of the humans they interact with. This makes working with horses an excellent therapeutic intervention.

However, there are several terms floating around that refer to different types of therapy that incorporate horses in different ways. Naturally, some confusion has arisen about what all these terms mean. The purpose of this article is to set the record straight and help you identify the type of therapy that is right for you and your horse.

Equine Therapy

“Equine Therapy” refers to therapies that can be used to improve a horse's emotional health and wellbeing. These treatments are designed to help the horse rather than its human rider. There is a range of equine therapies including equine massage, acupuncture, and chiropractic treatment.

Equine massage is a widely used method of improving a horse's emotional health and wellbeing. Massage is used to relieve pain and stress as well as improve circulation, flexibility, and range of motion. Equine massage therapists use a variety of techniques and although there is no one standard approach, there are some general guidelines for pressure and speed. It is important to note that these are guidelines only. Each horse is an individual and requires a customized approach depending on his/her needs.

Equine Acupuncture involves the insertion of very fine needles into the horse's body. When done properly, there is very little discomfort associated with this procedure. The needles are then inserted at specific points and left in place for a few minutes. It is thought that acupuncture influences the body's energy fields and that this may help stimulate the body's natural healing processes.

Equine chiropractic treatment involves the manipulation of a horse's vertebrae to relieve pressure on the spinal cord or other nerves. Practitioners believe that a horse's spine is associated with its overall health and that manipulating the spine can improve health.


Hippotherapy, the use of therapeutic horseback riding as a treatment modality for persons with disabilities. It is based on the concept that riding horses provides specific health benefits and promotes physical, cognitive, social, and emotional growth while enhancing the quality of life. 

Hippotherapy involves the client riding on the horse itself (“hippo” is the Greek word for horse). The client is in contact with the horse and experiences it in its natural environment. This allows the client to feel the horse’s motions and to communicate with the horse, making it an ideal therapy for clients who are non-verbal.

Hippotherapy is administered by a professional, certified therapist. The therapist may be a physical therapist, occupational therapist, speech therapist, or other health care professional. Hippotherapy has been used with many populations including patients with autism spectrum disorders, Down syndrome, cerebral palsy, and traumatic brain injury.

Therapeutic Riding

“Therapeutic riding” is an activity in which an individual with a disability rides a horse and uses the horse’s movement to improve his or her overall health. Therapeutic riding is generally used to help children and adults with physical, developmental, emotional, and mental disabilities. It is administered by a trained professional, but unlike hippotherapy, it does not need to be administered by a certified therapist.

Therapeutic riding can help develop communication skills, social skills, improve self-esteem and confidence, develop gross- and fine motor skills, and can help improve balance and coordination. The goals of therapeutic riding are to improve the physical, developmental, emotional, and mental health of the rider. Benefits of therapeutic riding include improved balance and coordination, increased strength and muscle tone, improved posture, and increased core strength. Therapeutic riding also helps with emotional and mental well-being, especially helping children with disabilities to feel more confident and accepted.

Whatever therapeutic method you choose, the most important thing to remember is to always be safe and to respect the horse. If you want to have a successful session, you need to establish a relationship with the horse and build trust.