Riding after a Brain Injury

[costco_muffins]

Hi guys,

In September my husband was in a horrific car accident in which he had a moderate to severe brain injury (DAI). His PT and his doctor have recommended using horses and riding to help with his recovery. He has ridden his horse twice since the accident and while I have felt it went well, he is pretty upset about it.

His balance is tough and he is having a hard time following the motion of the horse. In addition, nerve damage to his left shoulder make it painful to use. Little things, like picking his feet, are hard for DH now. He has yet to be able to successfully put on a heavyweight blanket, although he does help with feeding, filling hay bags, etc.

Luckily, he has a gem of a horse who is patient, kind, and doesn’t mind if DH accidentally kicks him as he gets on or off, doesn’t care how many tries it takes to get saddled, etc.

I want to do my best to help him and make riding more successful for him - but how?

Things I am doing so far:

• holding horse while he gets on/off
• going on low stress trail rides where we walk only
• putting his horse back in a western bridle with curb bit and gaming reins so he can neck rein with only the right hand

I just want to help him, but he said its like he has never ridden before. He is having a really hard time following the motion. And prior to this, he was comfortable riding my young hunter right after breaking him to saddle - so he was a very decent rider.

Thanks for any ideas!

[Frog_Pond]

Hi costco muffins (best username ever, longtime admirer of that!),

So, just a few non-expert thoughts. I worked & volunteered in therapeutic riding barns on and off for 30 years, which taught me a bit about hippotherapy programs. I’ve seen physical therapists have fantastic results treating kids with severe motor problems, and I know that some barns are set up to do this for adults, too. Take a look at the American Hippotherapy Association’s web page for research about how the motion of horses “rewires” people’s mind + motor skills, and here’s an inspirational adult story.

It stands to reason, given the evidence base for hippotherapy, that if your husband can tolerate the emotional distress of starting over, he might speed his recovery by simply walking around on his horse. A lot.

Also, if he can stand any yoga or pilates work, that stuff helps proprioception a LOT. Maybe a little Yoga for Equestrians is worth considering.

You’ve already addressed the nerve pain perfectly - neck reining all the way! Best of luck to both of you.

[walktrot]

I agree with Frog Pond about doing as much walking as possible. I volunteered with our barn’s therapy program for many years including working with adults with brain injuries. Another thought regarding proprioception is Centered Riding. If you have a local instructor they might be able to help him with things like mental imaging and changes in body position that would help him follow the horse’s motion more effectively. My BO has been a certified instructor for many years and works a lot of CR into lessons, including therapy lessons, even if she doesn’t say it out loud. I hope your husband doesn’t get too discouraged. Good luck to you and the horses.

[costco_muffins]

DH rode again last night - mostly walking in our arena. He set himself up for more success (removed my nosey baby horse from the area before trying to get his horse out of the paddock, leading his horse closer to the saddle to put it on, etc.) and was able to do everything himself!

I held his horse while he got on, but then he was independent after that. I rode the nosey baby horse while he was riding so he had someone around but not focusing entirely on him. We have lots of ground poles scattered around so he rode around working on balance and steering with those. Getting off, he just halted his horse by the mounting block and slowly stepped off. Have I mentioned what a gem his horse is??

And he is signing up for therapeutic yoga with an instructor who works with people with disabilities! Thanks for that suggestion!

[Frog_Pond]

Can’t believe I forgot to mention centered riding, too! Sally Swift changed my life as a crooked young teen – just a few of the simplest concepts of centered riding made a permanent difference. So, yes, that! And for sure, if he can stand them, lunge line lessons. You guys definitely sound creative and positive. Ride on

[Pennywell_Bay]

I had a TBI from a MVA, as well. Horses were actually a very large part of my rehab (my unofficial rehab, my official rehab was intense).

Honestly- I did a lot of grooming. Moving around the horses, eventually moving up to picking hooves (believe me you need balance and with a TBI proceed with caution).

I did a lot of walking on my trusted horse. I did a lot of steering exercises. I did a lot of balance. Think of the exercises you would do with a new rider. Airplane arms, reaching to the ears.

I’ll be honest- you can be surprised what muscle memory does.

Recovering isn’t easy. It can take a long time. Good luck

[AKB]

Would it help to get a quick assessment and suggestions from a physical therapist or OT from one of your local therapeutic riding centers? Some centers see a lot of adults and may be able to give him a list of things to try.

[Jim_R]

DW is going through recovering from brain injury. Has not ridden in over 3 months and previous to this riding 5 times a week. She is just starting to drive during the day, short distances. Since finding a great PT she is progressing quickly in the last month. A good PT that has experience with this might help.

[Kuegel]

Neuroplasticity

There have been a number of good (peer-reviewed) studies that show that hippotherapy improves gross motor function, balance, and gait, just to mention a few. These studies show that the movement of the horse’s back at a walk has a three dimensional movement that mimics the movements of the human pelvis while walking on the ground. By riding a horse at a walk, the rider’s pelvis is moved in a manner that sends “messages” back up the spinal cord (ascending tracts) to the motor/balance centers of the brain. The brain receives these messages and wants to interpret them. In order to do this, the brain begins to build new connections that by-pass damaged areas in the brain. It is thought that signals from these “by-passes” may travel back down the spinal cord (descending tracts) and that over time, these new connections will allow the damaged brain to order the muscles of the lower body function in a similar way that it did prior to the injury.