Annie MSOT, OTR

Hello!

I seem to be getting into a good groove with hippotherapy.  I had my third day yesterday - and it was very eventful! I did my first intake- which means I met a child for the first time and had to decide whether she needed therapy and what kind (hippo with PT, OT, SLP,) or aquatic therapy.  It was a little overwhelming at first.  But- as I observed her- I realized it’s really no different than what I do in an orthopedic setting with my clients.  Now, I didn’t break out the goniometer or anything- but I was able to take a step back, relax and figure out what I needed to look for in terms of sensory issues, and fine motor issues, etc.

I also did my first evaluation. This means one of the therapists did the intake at one point and decided this child needs OT on the horse.  I was the first therapist to get him on the horse.  I thought it was going to be a lot scarier- but it actually went extremely well!  He did awesome- and I must say I was impressed with how I handled the “new” experience! 

The only negative thing that happened to me- was that I had a tall child (on the spectrum) on top of a very tall horse.  The child got mad about me asking him to do something- and he kicked me right in the chest (maybe as hard as he could)- but I was happy with the way I handled the situation.  He was very good the rest of the session. 

One thing I should tell everybody too- which I learned in the course I took was that sometimes you will find in hippotherapy- a child may give you everything you are looking for in the first 5 minutes of the session.  Technically, after this point, the session should end and you should take the child off the horse and go do something functional.  However, the obvious problem with this is that a parent will not pay for a 5 minute ride.

I had this experience on Wednesday- I had a child on the horse- and he did awesome for the first 15 minutes.  The last 15 minutes- I lost him completely- and undid the entire session. It was disappointing- but, like I said, a parent won’t pay.

On the other end, however, sometimes it takes 15 minutes for the child to adapt to the session- and then the LAST 15 minutes – you get exactly what you needed.  This is just one of the challenges in this field.

So far though, I am really enjoying it. 

I also am loving my full-time job in orthopedics too. The nice thing with ortho- is that you get LASTING RESULTS.  The patient can eventually be discharged because 9/10 times they do very well in rehab.

Comments?

Hello all!

I completed my first day as an occupational therapist using hippotherapy! It was definitely interesting!  A little nerve racking at first- but thanks to the course I took- I felt much more comfortable than I was expecting!

For the very first time- a horse stepped on my foot! They warned us in the course that it is something that is bound to happen to everyone.  A VERY important tip to remember if you work in this setting is…If a horse steps on you- DO NOT PULL YOUR FOOT OUT!  A person told us that one of their employees lost her toe nail because of the horse’s shoes.  You have to WAIT UNTIL THE HORSE MOVES OFF THE FOOT. 

This is much easier said than done.  I was practically in tears- but I was able to give the horse a good push in the rump - which moved him off my toe.  I have some slight bruising- but it feels better today.

Anyway- as far as treating the kids- I will say that watching hippo is much different than YOU being the one who is in charge of the whole treatment session.

I am looking into taking a sensory course for pediatrics so I can better my knowledge on these topics. 

Anyway- I will update with any other exciting things.

Please ask any questions - and I will answer to the best of my knowledge!

Cheers!

I completed my Level I Equine skills, and treatment principles course this week-end.  It was 4 days.  Lots of information- but truly amazing!  I learned an unbelievable amount about horses and feel so much more prepared to start this Wednesday with the hippotherapy kids! 

Somerset Hills Handicap Riding Center (NJ) is where the course was held- and I have to say it is the CLEANEST barn I have ever been to! I had no idea a barn and stables could be that immaculate! The staff there is very knowledgeable  and very friendly!  I was super impressed and pleasantly surprised at everything they offered us throughout the course.  It was an awesome experience.  The horses there are also so well mannered :)  Which must mean they are very well taken care of

I believe this course is now a requirement for all of those who wish to participate in hippotherapy as an OT, PT or SLP.  I learned there is no such thing as a “hippotherapist”- you simply call yourself the discipline you are and hippotherapy is a modality that is used.

Although, interestingly enough - there is something called “HTCS” which is a “hippotherapy certified specialist”.  You can sit for this exam after about 1000 hours of hippotherapy and a minimum of 3 years in your profession.  Very cool!

I highly recommend it!

Cheers!

Hello!

I will be starting my new job doing hippotherapy in two weeks.  I wanted to brush up on my sensory integrative knowlege and skills.  Does anyone know of any good instructors offering courses.  I know there are a ton of them out there- but I wanted to see if anybody could recommend a real good instructor.

I am taking the course next week in Equine Skills and Treatment principles.  It is 4 days long.  I have been volunteering for the past couple of weeks at the place I will be working.  It has been really great so far.  I am learing about so many different kinds of pediatric disorders.

The OT I have been following is amazing in her knowledge and observation skills with all these kids.

Anyway- any thoughts on good courses…please send them my way

Cheers!

Once again- frustrated with how OTs are not taught how to treat the neck!  It just doesn’t make any sense to me! 

 I had to pass one of my patients off to a physical therapist - ONCE AGAIN- today due to her new cervical pain. 

I don’t get how we are allowed to treat the “upper quarter” - but our profession does not consider the neck the “upper quarter”!!! 

Does anyone else get frustrated with this?  Sometimes I run into the patient who - over the phone will set up an evaluation because “my shoulder hurts”- so they are scheduled with me.  Then- when they get here- it turns out the real problem is in their neck…ugh!  So- of course the patient and my time is waisted because I can’t treat them since they didn’t know that they had a neck problem..

They have to be rescheduled at a time when one of the physical therapists can see them…

Comments?

 Annie

Hello everyone!

Well- it seems I may be starting one day per week with a hippotherapy clinic.  Does anyone do this?  I volunteered a few years ago while I was an OT student at this stable- and it was fantastic! 

For those of you who are unfamiliar with hippotherapy- it (I’m pretty sure “hippo” means horse in Greek) uses horses as a mode of treatment for children with autism, CP, or any sensory integration issues.

 It’s amazing to watch because parents will bring their kids into the stables from ages 1-21 years old with a spectrum of sensory issues due to whatever their diagnosis may be.  The therapist will put the child on the horse for a half an hour (while walking next to the horse holding the child). You can put the child on facing forward, backward, on their belly, or back, etc. whatever position they are comfortable.

Then- like magic- because of the intense sensory input the child receives from the horses gait- they can focus on what you are trying to do with them- whether it be retrieving items while they are on the horse for reaching exercises- or playing red light green light to work on their communication/cognitive skills, etc.

I have regretfully turned away some calls to this clinic because I do not work with this population in this outpatient orthopedic setting.  

I am anxious to begin. I am scheduled to start working in April- because every therapist who goes into this aspect of horses- is required to take a hippotherapy certification course.  This course is only being offered in April at this time- so I just have to get registered for it. 

I am also really psyched because I LOVE horses. 

Any comments from those of you who work with this population would be greatly appreciated.  Any questions are of course welcome and I will always answer to the best of my ability

 Cheers!

Hello!

My sincere apologies to everyone who has written to me this past year.  I had not been aware I received so many responses! 

Thank you!

To answer some questions: a

As far as good reading materials- especially those of you involved with orthopedics such as hand, wrist, shoulder, elbow injuries:  I highly recommend “Travell & Simons “Myofacial Pain and Dyfunction: The Trigger Point Manaul- Volume I - upper hapf of the Body”.  This is like a bible to me in OT in regards to treatment and symptoms of every UE muscle!

Splinting: I completely agree with all of you out there looking for good splinting course and the typical scary moments when you are actually making the splint!  I took a course with Robert Schneider - the name of the course is “An Introduction ot Hand Therapy”- he is an EXCELLENT presenter and teacher…I highly recommend this course for all OTs lookint o brush up on hand rehab and splinting.  He also provides some hand spint patterns in the back of his course book- it’s fantastic!

I am all by myself as an OT with 6 other PTs- so as far as splinting goes…it’s all me.  I have become very good friends with the books I received in school:  “intro to splinting” by Brenda Coppard and Helene Lohman as well as “Splint the hand and upper extremity” by Marylnn Jacobs and Noelle Austin.  These two books have gotten me through all the splints I have made.  In just about 2 years I have probably made 15-20 splints.  I feel much more comfortable with making them than I did when I first started.  The dynamic ones especially were scary at first.  For those- I referenced the second book I listed.

Thank you to all who have responded- and again, I apologize for taking so long to get back to some of you.  I will be away for the next week- but please post any comments or questions- and when I return- I will answer as best I can.

I wish the best of luck to all of you who are just beginning school or just getting your first jobs as OTs.  It’s really a wonderful profession. 

If you have any questions about courses you should take…please ask me!  I can tell you which ones are definitely worth it and at the same time…entertaining! (really great speakers)

Cheers! 

Hello everyone!

I hope you are having a happy and healthy start to 2009! 

 I have been an OT for just about 2 years now.  I remain adamant with attending as many continuing education courses as I can- all on the shoulder, elbow, wrist, and hand.  Even since I graduated in 2007 - there are so many new techniques to treating the upper extremity.  I am seeing immediate results with all my clients - when I use all the new and latest treatment techniques.

 I have taken courses with Lou Bigliani, Christopher Ahmad, Sandy Burkart, Kevin Wilks, John O’Halloran, and many other well known physicians and therapists. 

I welcome any questions or comments from others.

Cheers!

Hello!

I am coming into my one year mark as an OT.  It has been an awesome learning experience - going to continuing education courses, applying what I’ve learned to my patients, and getting great results!

I can’t believe it’s been one year already!  I am the only OT here right now- working with 6 other PTs.  They have been a wonderful help to me this year.

It’s amazing to think back on how nervous I used to get thinking about treating people- especially when the schedule was busy!  Now, I feel much more in a flow!

As part of my job- I also started conditioning a local high school tennis team with one other PT.  I am also going to be conducting my first senior exercise class in April in one of the local towns! 

One thing that is great about this job - is that it’s never boring!  I always am doing something new!

Annie

I am revisiting this topic once again.  I have been looking into therapy for animals and unfortuantely there are only PTs in this field.  Are there any other OTs out there who loves animals at heart (of course, enjoy working with people)- and want to apply your orthopedic knowledge to pets too?

Lets be honest…healthcare reimbursement has seen better days!  So- I would love to keep my options open and explore this other outlet where I can still use my othopedic skills!  I would not only be helping the animal - but also - the extremely worried owners of these pets.  It’t the best of both worlds!

Especially when dogs and cats develop arthritis- it would be so awesome to know how to treat them…I was reading about it on-line through the experiences PTs have had with treating animals and they say they use alot of the same modalities and manual skills on animals as they do on people!

They sell books on PT and animal rehabilitation- I was thinking of purchasing a few.  I also came across a degree I can get online as a Verternary Technician- which I think would be helpful in applying my orthopedic OT skills- as I would learn more about the animal anatomy.

Is there anyone else doing anything like this? Interested in anything like this?

 Annie