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Level 4 Diploma in  Equine Hydrotherapy 

The industry qualification to be trained as an equine hydrotherapist. A comprehensive course to set you up as a therapist within the equine hydrotherapy industry. Recognised by the Institute of Equine Hydrotherapists (IEH) and the Institute of Registered Veterinary and Animal Physiotherapists (IRVAP). Secure your career today with the skills and confidence to succeed.  



Course Starts

February 2025

Applications Open

November 2024


100 Hours




12 Months
380+ Hours

Launching in November 2024

Who is this course for?

This course is for anyone currently working in the industry. On successful completion of the course you will be a qualified Equine Hydrotherapist as recognised by the Institute of Equine Hydrotherapists (IEH). 
Throughout this course you will:

  • Take a detailed look at the musculoskeletal system of the horse
  • Consider what it means to work as part of a multidisciplinary team
  • Establish ethical and safe practice to improve equine welfare
  • Refine your record keeping and clinical reasoning skills
  • Develop your communication skills and professionalism

Clinical Hours


Theory Hours


What you will study on the level 4

The best instructors have designed the most motivating learning paths for you.

#1 Introduction to Hydrotherapy

 Candidates will cover the safe use of various hydrotherapy equipment, such as underwater treadmills and saltwater spas, by explaining their design functions, properties of water, and their application in treatment. Candidates will also examine the potential risks associated with water properties and compare the benefits, limitations, and safety features of different equipment. They will learn to identify when the use of specific equipment is indicated or contraindicated, understanding the definitions and implications of these terms, and distinguishing between precautions and contraindications. Furthermore, the course will outline recommended and discouraged practices for hydrotherapy sessions and differentiate between its use for equine rehabilitation and performance enhancement. This includes evaluating monitoring techniques and setting specific aims and objectives for both rehabilitation and performance contexts.

#2 Equine Hydrotherapy Water and Equipment Management

Candidates will learn legal and professional obligations like Health and Safety, Duty of Care, COSHH, and manual handling. They will understand professional guidelines, codes of conduct, and continual development. 

Candidates will operate and maintain essential equipment like filtration systems and chiller units, emphasising regular maintenance for safety and reliability. 
The unit includes infection control and cleaning processes, focusing on water quality and hygiene. Candidates will learn to correct unacceptable water readings with chlorine or pH adjusters. They will address common equipment problems, emergency protocols, and the importance of training for new equipment.
Finally, candidates will learn the importance of recording water and equipment management to ensure quality, functionality, and compliance, understanding the impacts of poor water management.

#3 CRA, Health Monitoring and First Aid

Candidates studying Clinical Risk Assessment (CRA) in hydrotherapy will evaluate methods like Dynamic and Leisure Risk Assessment, describe the process of Risk Rating horses, and demonstrate CRA in practice. They will cover health monitoring strategies for horses, key principles of equine first aid, and evaluate legal and ethical limitations in emergencies.

Candidates will demonstrate behaviour observations, health checks, applying a poultice, and handling medicines safely. They will understand equine emergency categories, and evaluate emergency water exit protocols.
Candidates will devise clinical procedures for emergencies, list and manage contents of an equine first aid kit, and evaluate emergency management in a clinical setting, including record keeping and conducting fire drills.

#4 Equine Functional Anatomy and Biomechanics

Candidates studying equine anatomy and biomechanics in hydrotherapy will learn about the functional roles of major peripheral nerves and the proprioceptive system. They will cover types of movement, major skeletal muscles, and their functions. The unit includes therapeutic palpation techniques for accurately locating muscles. Additionally, candidates will understand the purpose and design of the skeleton and joints, the integration of respiratory and cardiovascular systems, and equine biomechanics related to balance, movement, and gait patterns. They will also evaluate abnormal gait and lameness impacts.

#5 Equine Pain and Behaviour

Candidate studying equine pain management and behaviour will learn to explain normal and abnormal horse behaviour and discuss how pain influences behaviour. They will describe the concept of pain, how and why it is assessed, and the application of different pain scales. The course covers inflammation, groups of pain relief and their functions, and evaluates forms of medication application. Candidates will define safe practice and appropriate use of pain relief with rehabilitation equipment, explain the term 'mechanism of action,' explore indications and contraindications of pain-relieving electrotherapies, and describe the practical application of the equipment.

#6 Equine Assessment and Clinical Reasoning

Candidates will understand the components of equine assessment for clinical hydrotherapy, including referral information, history taking, observation, and hands-on examination. They will explore elements of history, observation (behavioural patterns, gait, balance, etc.), and hands-on examination (palpation, ROM, special testing). The unit involves devising and prioritising problem lists and creating SMART goals. Candidates will evaluate treatment techniques, understand clinical reasoning (critical thinking, reason pathways), and the importance of re-assessment and outcome measures (baseline assessment, regular monitoring). Effective communication strategies with both the horse and owner, including therapeutic handling and interpersonal skills, will be covered.

#7 Treatment Pathways and Common Conditions

Candidates will develop a thorough understanding of equine rehabilitation's initial goals, expectations, and the critical evaluation of progress monitoring. This includes effectively managing the expectations of owners, trainers, and riders by setting realistic goals, ensuring safety, considering financial implications, enhancing performance, and planning for long-term outcomes. They will explore how often goals should be reassessed based on regular check-ins, milestone achievements, changes in condition, feedback, and the evaluation of treatment plans.  Additionally, they will develop treatment pathways within their defined scope of practice, understanding the professional boundaries and potential implications of professional negligence, while also devising alternative strategies to address setbacks in rehabilitation scenarios.

#8 Hydrotherapy for Performance

Candidates will gain insight into the demands of various equine disciplines and sports, evaluating the fitness requirements for disciplines like eventing and racing, focusing on aspects such as jumping efforts, speed, and duration.  Additionally, they will compare injuries across different sports and discuss how equipment modifications in activities like pool and underwater treadmill training (UWTM) can advance fitness levels, while considering risks of overworking horses. They will also explore session planning through intensity, frequency, and duration adjustments, and develop protocols tailored to specific sports' fitness needs, emphasizing physiological adaptations to exercise at elite levels, signs of fatigue, and expected performance enhancements for horses and their handlers.

#9 Professionalism, Ethics and Legalities

Candidates establish the importance of having a comprehensive understanding of professional obligations, duties, and accountability as a professional working in equine hydrotherapy. Candidates will discuss and reflect on some of the moral and ethical conflicts that may be encountered in clinical practice when working as an equine healthcare professional. Candidates will know the importance of working within their scope of practice, understand their limitations, and abide by the Code of Practice of their Professional Association.

This unit empowers professionalism to include appropriate interpersonal skills and effective communication skills required from an equine healthcare professional working cohesively as part of the multidisciplinary team (MDT). 

#10 Equine Clinical Placement

During these clinical hours, candidates will receive detailed instructions and demonstrations on how to operate equipment with an opportunity for candidates to be able to do this autonomously. Skills will include water and plant management, horse handling, effective communication, risk assessments, treatment planning, and clinical reasoning. This comprehensive unit will allow the candidate to work with a range of equine hydrotherapy equipment and see both performance and rehabilitative cases.
Throughout this unit, emphasis is placed on developing practical skills through hands-on learning experiences, ensuring candidates are well-prepared to begin their careers with a solid understanding of the day-to-day responsibilities in equine care.

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