As with any other type of treatment, there are some circumstances in which hippotherapy is precautioned or contraindicated.
Precautions for Dynamic Equine Movement (Hippotherapy)
Orthopedic
- Atlantoaxial instability
- Coxa arthrosis
- Cranial deficitso
- Heterotropic ossification / Myositis ossificans
- Joint subluxation/dislocation
- Osteoporosis
- Pathologic fractures
- Spinal fusion/fixationo
- Spinal instability/abnormalities
Neurologic
- Hydrocephalus / shunt
- Spina Bifida/ Hydromelia / Tethered cord
Medical
- Allergies
- Blood pressure control
- Exacerbations of medical conditions
- Heart conditions
- Hemophilia
- Medical instability
- PVD
- Respiratory compromise
- Recent surgeries
Absolute Contraindications for Dynamic Equine Movement
Orthopedic
- Unstable spine or joints including unstable internal hardware.
- Pathologic fractures without successful treatment of the underlying pathology (e.g. severe osteoporosis, osteogenesis imperfecta, bone tumor, etc.).
- Coxa arthrosis – degeneration of the hip joint; the femoral head is flattened and functions like a hinge joint versus a ball and socket joint. Sitting on the horse puts extreme stress on the joint.
- Acute herniated disc with or without nerve root compression.
- Atlantoaxial instability (AAI) – a displacement of the C1 vertebra in relation to the C2 vertebra as seen on x-ray or computed tomography of significant amount (generally agreed to be greater than 4 mm for a child) with or without neurologic signs as assessed by a qualified physician; this condition is seen with diagnoses which have ligamentous laxity such as Down syndrome or juvenile rheumatoid arthritis.
Neurologic
- Tethered cord with symptoms.
- Chiari II malformation with neurologic symptoms.
- Grand mal seizures - uncontrolled by medications.
Medical
- Open wounds over a weight-bearing surface.
- Medical conditions during acute exacerbations (rheumatoid arthritis, herniated nucleus pulposis, multiple sclerosis, diabetes, etc.).
- Indwelling urethral catheters.
- Hemophilia with a recent history of bleeding episodes.
- Active mental health disorders that would be unsafe (fire setting, suicidal, animal abuse, violent behavior, etc.)
If, after reviewing this list, you’re still not sure about whether hippotherapy is contraindicated for your child, you’re welcome to contact us.