The Experience Miracles Podcast

Unexpected Allies in Pediatrics: Why Chiropractic and PT Need Each Other

Nov 12, 2024

Horse Therapy and Chiropractic for Complex Kids: How Hippotherapy and Neurologically-Focused Chiropractic Work Together

Episode 51 — Experience Miracles Podcast | Host: Dr. Tony Ebel, DC, CACCP — Pediatric Chiropractor & Founder of PX Docs | Published: November 12, 2024 | Duration: ~75 min

Guest: Beth Saip, DPT — Clinical Director, Dream Riders (Crystal Lake, IL)

Key Takeaways

  • Hippotherapy (therapeutic horseback riding) puts children into a neurological “ready state” by using the horse’s movement to regulate the sensory system — making the following therapy session dramatically more effective. Dream Riders currently serves 175 children per week using this approach.
  • A horse’s gait pattern mimics the human gait flipped 90 degrees: lateral horse movement produces calming rotational input for the child, while rotational horse movement produces excitatory lateral input. Matching the right horse to a child’s subluxation pattern and nervous system state is as precise as any chiropractic technique.
  • Neurologically-Focused Chiropractic Care and physical therapy are designed to work in sequence, not in parallel. Chiropractic brings the child to a regulated, parasympathetic state first — then therapy teaches motor skills that the brain can actually retain.
  • Compensatory movement patterns — where a child forces their way through development without the proper neurological foundation — create a confused, inefficient brain that shows up as sensory processing disorder, focus issues, emotional dysregulation, and in severe cases, seizures.
  • The sequence of gross motor development (rolling → sitting → crawling → walking) matters because each milestone builds neurological architecture. Skipping crawling, for example, eliminates the only developmental stage where both sides of the brain fire simultaneously and the body builds weight-bearing strength for fine motor function.
  • When a child hits a plateau in care, the first lever is communication — between parents, therapists, and chiropractors. The second lever is adjusting variables: changing the horse, switching chiropractic technique, or increasing visit frequency.

How Do Hippotherapy and Neurologically-Focused Chiropractic Work Together?

Collaborative care between pediatric physical therapists and neurologically-focused chiropractors solves a problem that neither profession can solve alone: a child whose nervous system is too dysregulated to learn and retain new movement skills. Dr. Tony Ebel, DC, CACCP, and pediatric physical therapist Beth Saip, DPT, have been working together on complex neurological cases in Crystal Lake, Illinois for nearly 20 years — building a collaborative model that most families and providers have never seen before.

The mechanism is straightforward, even if the execution is complex. Neurologically-Focused Chiropractic Care clears subluxation — the spinal dysfunction that locks a child’s nervous system into sympathetic dominance (fight-or-flight mode). A child stuck in sympathetic dominance cannot learn. As Dr. Tony puts it, citing Dr. Bruce Lipton: “You can’t be in growth and protection at the same time.” Chiropractic brings the child into a calm, regulated, parasympathetic state. Hippotherapy — physical therapy delivered with the child on a moving horse — does something parallel: the horse’s rhythmic gait pattern regulates the sensory system and primes the nervous system into what Beth Saip calls a “ready state.” Stack these two interventions before a therapy session, and the child’s brain is finally in a position to learn, retain, and build on new motor skills.

Beth’s program at Dream Riders currently serves 175 children per week. The standard protocol for children who also receive chiropractic care at PX Docs Chiropractic Wellness Center (PwC) — six minutes away — is adjustment first, then horse, then physical therapy. “You can do more in that 30 minutes than you could have done in 3 hours without the ready state,” Beth explains. The research behind this isn’t just anecdotal: it’s rooted in the neuroscience of how the brain encodes motor learning and how the autonomic nervous system gates whether learning can occur at all.

Why Provider Collaboration Changes Everything for Complex Cases [00:01:00 – 00:11:00]

Dr. Tony Ebel: Beth Saip is someone I’ve been working alongside for almost 20 years — practically since I opened my practice. She has taken care of the toughest neurological and developmental cases you’ll ever see, and when I say tough, I mean kids that came to Dream Riders as an absolute last resort, after everything else had already failed.

The first thing parents need to hear from this episode is that complex cases should never be managed by a single provider working in isolation. When you’re dealing with a child who has nervous system dysregulation layered on top of developmental delays layered on top of compensatory movement patterns, one brain and two eyes simply cannot see everything. The magic isn’t in finding the best individual provider — it’s in building a team of great providers who actually talk to each other.

Beth graduated from Purdue University with a bachelor’s in health science and from Northwestern University with a doctorate in physical therapy. She’s been at Dream Riders from the beginning of her career — a nonprofit therapeutic center specializing in hippotherapy in Crystal Lake, Illinois. She’s the clinical director there now.

Beth Saip: Working at Dream Riders and at a private practice clinic simultaneously — doing early intervention, hippotherapy, and traditional PT — meant I was always seeing complex cases and always working alongside other disciplines. OT, speech, PT, all talking about the same kids. That became just what I did. It wasn’t something I planned; it’s something that happened from the environment I was in.

As a physical therapist, I was trained in school to be skeptical of chiropractic. Chiropractors are trained to be skeptical of physical therapy. Both of us were missing how much we can do together instead of thinking “I can do everything.” I cannot do everything. When we work together, it’s so much better.

Dr. Tony Ebel: Parents, take this as a direct action step: demand that your providers communicate. Voice text each other. Pop in on sessions. Ask your PX doctor and your therapy team to compare notes. The best outcome for your child isn’t the best individual practitioner — it’s a connected team. And here’s something counterintuitive: if every visit were with me specifically, that would actually be a limiting benefit. At PwC there are eight of us. With Beth, there’s her whole team. The magic is in the community.

“The power of a team — a collaborative team — we have grown together. You have made me tremendously better at the work we do chiropractically because of the conversations with you and your team.” — Dr. Tony Ebel, DC, CACCP

What Happens When a Child Gets Adjusted Before Therapy [00:11:00 – 00:18:00]

Dr. Tony Ebel: Let’s get specific. A child comes into PwC and gets adjusted. Their nervous system gets calmed, regulated, balanced. The goal of that — in the context of collaborative care — is to set the table for Beth to get more out of a 30-to-60 minute therapy session than she could otherwise. What does that look like for a child whose nervous system is in balance versus one who isn’t?

Beth Saip: The horse taught me this first. Very early in my career, I understood that the horse’s movement regulates the sensory system and primes the nervous system — so that when we teach skills in the second half of the session, children learn them faster and retain them better. They’re in a ready state. Their nervous system is calm and open and ready to learn.

When you add chiropractic on top of that, the effect multiplies. If a child gets adjusted, then comes to Dream Riders, rides a horse for 30 minutes, and then does physical therapy — it’s like magic. We’ve experimented with the timing. PwC is six minutes from our farm. The ideal sequence is adjustment → horse → therapy.

Dr. Tony Ebel: There’s a phrase on the bottom of our nervous system poster from Dr. Bruce Lipton: “You can’t be in growth and protection at the same time.” When a child goes through The Perfect Storm — prenatal stress, birth trauma, early toxin exposure — they get locked into a subluxated state, which means sympathetic dominance. The gas pedal gets stuck on fight-or-flight. They’re wound up and neurologically shut down.

Neurologically-Focused Chiropractic is designed specifically to bring that child to a neurological ready state — calm, regulated, open. That’s the state that therapy needs. A child whose nervous system is in protection mode is not going to encode what Beth is teaching. A child in a growth state will.

“You can’t be in growth and protection at the same time. Therapy needs a kiddo in a ready state — a calm, connected, open pathway state.” — Dr. Tony Ebel, DC, CACCP

How Horses Prime the Nervous System: The Science of Ready State [00:18:00 – 00:29:00]

Beth Saip: The horse’s movement mimics the human gait pattern — forward, back, side-to-side, rotation — but flipped 90 degrees. All the research focuses on the hindquarters of the horse. The horse’s pelvis is the same as a human’s pelvis, just flipped 90 degrees.

Here’s the key relationship: if the horse’s movement is more lateral, the human’s resulting movement is going to be rotational. If the horse’s movement is more rotational, the human’s movement will be lateral. This matters because lateral movement is calming, and rotational movement is excitatory.

So if you have a child who is high-strung — what Dr. Tony calls a “raging bull” — you put them on a horse with a more lateral gait pattern to calm their body down. If you have a low-tone child who needs more input, you put them on a horse that creates more rotational movement to get their body engaged. We know all of our horses’ movement patterns and personalities. Matching the right horse to the right child is as intentional as any clinical decision we make.

Dr. Tony Ebel: This is where chiropractors in our audience will recognize their own language. What Beth just described — lateral subluxation pattern versus rotational subluxation pattern — is exactly the framework we use in Neurologically-Focused Chiropractic Care. A child with a counter torque (rotational) subluxation pattern is filled with tension, irritation, and agitation. That’s the raging bull. Seizures often live in this state. Those children need lateral movement for calming — and Beth knows exactly which horse provides that.

Beth Saip: We also position children differently on the horse depending on what they need. Prone over barrel inverted — lying on their tummy, slightly inverted — provides maximum vestibular input for smaller children. Prone facing rump (PFR) — lying on the tummy facing the back of the horse — delivers maximum input from the hindquarters.

Sitting upright is actually the position with the least sensory input because there’s the least body surface area in contact with the horse. So sitting isn’t a goal or a progression — it’s a care plan decision. A child who can now sit upright might actually be getting less therapeutic input than they were in prone positions. We don’t tell parents this outright because they interpret the position change as progress. But different positions serve different neurological goals.

Dr. Tony Ebel: Most practitioners — most chiropractors, most PTs — give every patient the same thing. Cookie-cutter. If a patient happens to match that technique, they get results. Others don’t. Beth taught me to use my eyes before a child ever gets on the table. Are they moving rotationally or laterally? Are they a raging bull or a drunken bull? That visual assessment changed how I practice.

The Sequence of Neuromotor Development: Why Order Matters [00:29:00 – 00:43:00]

Dr. Tony Ebel: We treat a lot of seizure patients, a lot of speech delay cases, a lot of ADHD and anxiety. Other professionals frame these as brain problems — prefrontal cortex problems, amygdala problems. Our framework is simpler: the brain works for the body and does what the body tells it to do. If the body is giving the brain bad information, the brain is going to make a bad decision.

That’s why we don’t start with the downstream brain stuff. We start with gross motor. Beth, walk us through the sequence — what does optimal neurodevelopment actually look like in order?

Beth Saip: Rolling, sitting, crawling, walking, running, jumping, climbing, then higher-level coordination and balance. Each stage builds the neurological architecture for the next one.

Crawling is one of the most important milestones. It’s the only time in life you consistently weight-bear on your hands — which is foundational for fine motor skills. It’s the only time you fully use your back muscles against gravity. And it’s the only time both hemispheres of the brain fire at the same time, consistently. So many children skip crawling entirely. If they do, we go back to it. We have kids crawl all over the house, over pillows, everywhere. The developmental benefit is that significant.

Dr. Tony Ebel: My favorite parent quote is: “My kid was so smart, they didn’t crawl — they just went right to walking.”

Beth Saip: They’re going to run in a very rotational and inefficient pattern. Their brain learned to compensate instead of building the foundation.

Dr. Tony Ebel: Compensatory patterns create confusion. When gross motor happens in an inefficient, disorganized way, you get an inefficient, disorganized brain. That shows up as sensory processing disorder, focus and concentration issues, emotional behavioral regulation challenges, cognitive delays, social-emotional imbalances. Most of our seizure patients have significant asymmetric rotational compensatory patterns.

Here’s the math: subluxation creates a stressed, wound-up nervous system. Compensation creates a confused, inefficient brain and nervous system. Both of those alone are problems. Together, in sequence, they compound significantly.

When we clear subluxation through chiropractic adjustments, the child’s body starts to compensate differently — and that’s actually a sign of progress, even if it looks strange. Sometimes a child who was getting along okay will suddenly look like they’re unsteady. Parents get scared. We get excited. The old, stuck compensatory pattern is unwinding. We’re getting to a fresh slate.

“The brain works for the body and does what the body tells it to do. If the body is giving it bad information, the brain is going to make a bad decision.” — Dr. Tony Ebel, DC, CACCP

Why Children Hit Plateaus and How to Break Through Them [00:39:00 – 00:54:00]

Beth Saip: Development is not linear. Children are affected by growth spurts, teething, being sick, changes in environment, stress of any kind. When parents see progress and then plateau, the first response shouldn’t be panic — it should be communication.

I ask families: “What else is going on this week?” Usually, they know the reason. A parent always knows their child better than anyone. They just don’t know they know until they say it out loud. The worry and the stress they carry as parents creates a barrier to accessing what they actually already understand.

Once we’ve ruled out external factors — teething, illness, fever — then we look inward. On my end, I might change the horse. I might change the position. I might change what skill we’re working on, because it might be too difficult for where they are right now. If the same horse and the same position have been used for months, that input may no longer be the right stimulus.

Dr. Tony Ebel: On our end, we have similar levers. We can increase visit frequency — usually if a child is stuck, we need to go up in frequency, not maintain it. We can change chiropractic technique. Chiropractic has over 100 different techniques. Most chiropractors limit themselves to one. You need to see a PX doctor trained in multiple techniques, because every child is different — and more importantly, the whole goal of care is to change them. When you’ve made real progress, the same technique may no longer be appropriate.

Beth Saip: Parents always know. They always, always really know the reason. They just don’t know it until they say it out loud. If you ask the right question, you get them to understand.

“Parents always know. They always, always really know the reason. A parent knows their child better than anyone. They just don’t know it until they say it out loud.” — Beth Saip, DPT

Connor’s Story: Healing from Lyme Disease with Collaborative Care [00:54:00 – 01:02:00]

Beth Saip: Connor had been under chiropractic care since I was pregnant with him — not regularly, but whenever I went in, he’d get adjusted. When he was six years old, he spiked a fever out of nowhere that lasted five days. Connor is a high-energy, all-in kid — in your face, always moving. He was suddenly lethargic and just not himself.

His pediatrician referred us to an infectious disease doctor, who diagnosed him with CMV virus — similar to mono, expected to resolve in a few weeks. But it didn’t. His knee swelled up. A pediatric orthopedic doctor in Rockford was the first to suspect Lyme disease, though fluid testing came back negative. A second infectious disease doctor still attributed it to CMV. A rheumatologist was recommended next — which is when I panicked, because we have autoimmune issues in our family.

Dr. Tony Ebel: You were on your fifth doctor with no definitive answers.

Beth Saip: That’s when I called Dr. Tony. We started a care plan. He was being adjusted three times a week. We saw some improvements, but he still wasn’t himself. Nine weeks after he first got sick, the rheumatologist confirmed it wasn’t autoimmune — yet. A week later, the infectious disease doctor called back: he had Lyme disease. She prescribed 28 days of amoxicillin.

Within 24 hours of starting antibiotics, he was better. But the reason he recovered so completely and so fast was the chiropractic care that had already been running for seven weeks. The neurological soft signs — sleep improving, digestion improving, movement improving — had already been coming back. His nervous system was being supported through the whole process.

Dr. Tony Ebel: When the body gets steamrolled by Lyme and rampant inflammation, it doesn’t just go into a stress pattern — it goes into a bogged-down, exhausted pattern. The neurological adjustments during those seven weeks before diagnosis weren’t waiting for the diagnosis to matter. They were supporting his regulatory systems the entire time.

Today, Connor is on wellness care — adjusted once a week for the demands he puts on his body playing baseball. He’s a freshman in high school. He’s thriving.

How to Find the Right Therapy Team for Complex Cases [01:02:00 – 01:15:00]

Beth Saip: When looking for a physical therapist for a complex or neurological case, I’d prioritize a few things. First, look for a clinic with a team of therapists — not a solo practitioner. A team that talks to each other, challenges each other, and consults on cases has a completely different quality of clinical thinking than a solo provider. Collaboration within the clinic changes everything.

Second, look for a therapist who is willing to work with your entire care team — not just other PTs, but your chiropractor, your pediatrician, your OT, your speech therapist. If a provider isn’t willing to communicate across disciplines, that’s a limitation for your child.

Third, you don’t have to stay with the first therapist you find. It’s okay to want someone who meshes better with your family’s personality and goals.

As for hippotherapy specifically — yes, the horse is unique and I believe it’s tremendously powerful. But there are excellent therapists working in traditional clinic settings. The key is the collaboration and the team, wherever they’re working.

Dr. Tony Ebel: The worst thing to find is a provider who does 17 things. If your chiropractor is adjusting, doing nutritional counseling, working on primitive reflexes, running laser therapy, and managing dietary protocols — they’re probably not exceptional at any of them. When you get genuinely good at one thing, you don’t have bandwidth for much else. Stay in your lane and build your team.

The call to action from this episode is threefold:

First: Look at your current therapy team. Do you have the right practitioners — ones who are experienced with complex cases and willing to collaborate with each other?

Second: Do you have a Neurologically-Focused Chiropractor on your team? For most families navigating developmental and neurological challenges, this is the missing piece — the one that unlocks better responses from every other therapy their child is already receiving. Find a PX Docs office at pxdocs.com/directory.

Third: If your providers don’t know each other, you be the connector. Send this episode to your therapy team. Host a meetup. Text your PT and your PX doctor in the same message. The collaboration that changes a child’s trajectory doesn’t have to start from the provider side — it can start from you.

“The power of what we can do individually is great, but what we can do together is so much more impactful.” — Beth Saip, DPT

Frequently Asked Questions

What is hippotherapy and how does it help kids with developmental challenges?

Hippotherapy is physical therapy delivered with the child positioned on a moving horse. The horse’s gait pattern mimics the human gait, delivering rhythmic sensory input that regulates the autonomic nervous system and primes the brain for learning — a state Beth Saip, DPT calls “ready state.” Dream Riders in Crystal Lake, Illinois, where Beth is clinical director, currently serves 175 children per week using this approach.

Why does chiropractic care help kids get more out of physical therapy?

A child stuck in sympathetic dominance — the fight-or-flight state caused by subluxation — cannot encode new motor skills effectively. Neurologically-Focused Chiropractic Care brings the nervous system into a calm, regulated state before therapy begins. Dr. Tony Ebel describes the goal as moving the child from “protection mode” to “growth mode.” Research on motor learning supports this: the autonomic state of the nervous system directly gates whether the brain can retain what it’s being taught.

Why does gross motor development have to come before speech or academic skills?

The brain works for the body and responds to the information the body sends it. If a child’s motor system is disorganized — full of compensatory patterns from skipping developmental milestones like crawling — the brain is operating with a confused, inefficient signal. That shows up downstream as sensory processing problems, focus issues, speech delays, and behavioral dysregulation. Beth Saip and Dr. Tony Ebel both emphasize fixing the foundation first: gross motor must come before fine motor, fine motor before speech, speech before higher cognitive skills.

What should I do if my child has hit a plateau in therapy or chiropractic care?

Plateaus are normal and expected — development is not linear. The first step is communication: tell your providers everything that’s going on, including illness, stress, environmental changes, and schedule disruptions. Parents almost always already know the reason; they just haven’t said it out loud. On the therapy side, changing the horse, position, or skill being practiced can break a plateau. On the chiropractic side, increasing visit frequency or adjusting technique may be needed. The key is that all providers are talking to each other.

How do I find a physical therapist who works well with complex neurological cases?

Beth Saip recommends looking for a clinic with multiple therapists who collaborate internally, across disciplines, and who are willing to communicate with your child’s full care team — including their chiropractor. Avoid providers who operate in isolation or who try to do everything themselves. Experience with complex cases specifically matters; look for a practice where complex neurological and developmental kids are the norm, not the exception.

How do I find a Neurologically-Focused Chiropractor for my child?

The PX Docs directory lists trained pediatric chiropractors who practice Neurologically-Focused Chiropractic Care across the country. Use the directory to find an office near you: pxdocs.com/directory.

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