In our office, we see mostly (but not all!) equestrian riders and with seeing so many, we are acutely aware of how dangerous horseback riding can be for both riders and horses, although we only see riders in our office!
Horseback riding is considered to be more dangerous than riding a motorcycle, skiing, American football, and rugby. This is a dangerous sport due to the rider's head often being 9ft or more off the ground unrestrained, and they're riding a horse that can easily weigh more than half a ton, kick with the force of nearly a ton, and run 40+ mph!
This study was based out of Alberta, Canada. They looked at records for 151 riders seen at the hospital for a horseback riding accident, and surveyed 78 of them. It is worth noting that in Alberta, most riders are Western riders, and this was seen in the study.
Of the 78 riders, the average age was 47, and about 60% of them were males. The riders reported having an average of 27 years of riding experience and despite 47% of them reporting a previous injury, a minority number of the group used helmets or safety equipment. The riders generally considered their horse to be well behaved and well trained, with an average age of 7 years old. The 78 riders were typically riding in great conditions - a summer afternoon, outdoors, in a field, and in good weather.
The trauma center where the data originated does not accept trauma victims under the age of 16, an important note when looking at the statistics, considering 25% of injured equestrian riders are under the age of 16 years old.
The surveyed riders were asked about their mechanism of injury, how they were hurt...
The medical records of the 151 riders who presented to the trauma unit provided information about the riders' injuries. Then, during the survey calls with 78 of those injured riders, 38 stated they had received rehabilitation therapy services for their injuries.
In the graph above, the blue bars represent the percentage of riders (of 151) who sustained those injuries. The orange bars represent the percentage of riders, out of 38 (of the 78 who completed the survey), who reported receiving rehabilitation for their injuries.
In this study, it seemed as though if the rider had a history of a previous injury from horseback riding, they were less likely to go to rehabilitation or therapy for their current injury. This did not seem to be swayed by gender, age, or riding experience.
It is worth noting that of those who received inpatient therapy, 25% went on to also receive outpatient therapy. However, of the riders who did not receive inpatient therapy, only 12% went on to receive outpatient therapy.
Chronic physical disabilities after their accident, were quite common and impacting the lives of 55% of those surveyed. Most of their functional deficits were orthopedic related (76%) and included things like arm and hand weakness and limited use (35%) as well as chronic pain and headaches (62%). Additional disabilities included poor balance, decreased memory, and mood and personality changes. Of the riders with chronic physical disabilities, 87% were still riding, but 46% reported they had to change something about how they ride, due to their injury.
When the surveyed riders were asked about their accident, and whether or not it was preventable, 64% thought that it was and most stated they considered themselves to be the reason and cause for the accident. They included reasons like not warming their horse up properly, asking the horse to do something it was not able to do, riding on terrain that was higher risk or they should not have been on, their horse tripped, some thought their horse had a bad temperament while others stated their horse spooked at something. In our office, it seems riders have provided similar explanations for their riding accidents.
This study concluded that the risk factors for poor long-term outcomes included the rider being "advanced," as well as having injuries to their body other than to their limbs. Therapy was more likely to be received for injuries involving the spinal cord or fractures, education about the benefits of therapies and rehabilitation may help other riders to receive appropriate therapy even though their injury may not be as visible to others. Receiving and following through with proper rehabilitation would likely decrease the chances of poor long-term outcomes, improve their riding, and allow them to ride for more years.
An important note about this study - it was in Canada where they have a healthcare system which allows for patients to be seen for free or at little cost. This is not the case in the US. Our guess would be that if a US hospital was looked at, even fewer patients would have received rehabilitation due to the cost to the patient. Additionally, it may be likely that due to the fear of costs, some riders do not go to the hospital for care unless they perceive the injury to be more severe.
In our office, we encourage all patients to follow their care plan, do their exercises at home, and work on recovering from their injuries as much as possible. Our goal is to always SAFELY get our patients back in the saddle (literally and figuratively) if possible. We also advocate the use of helmets and vests to help reduce the number and severity of injuries.
In the end ... it often comes down to the choices riders make, whether that it about safety gear, seeking emergency treatment, attending rehabilitation appointments, or doing their exercises at home. Doing these things is what keeps people doing what they love, for longer, and not doing them could shorten the number of years you are in the saddle, or even result in serious injury, pain, disability, later on in life.
Ride safe!!
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