"The grave yawns for the horseman", is the gloomy title of a study published in 1984, about equestrians sustaining severe injuries in riding accidents. While our safety equipment has evolved between the mid-80s and today, horseback riding still comes with a fair share of risks for potential injuries. Studies show that the risk of getting injured while riding horses is higher than practicing most extreme sports.

Besides getting kicked or run over by a horse, riders can sustain serious injuries from falls. From fractures to sprains and bruises - the impact of hitting the ground can cause injuries, particularly in the wrists, arms, and legs. Even more dangerous, riders can suffer from serious head injuries and concussions, if they land on their heads or collide with an object.

A study published in 2018 researched severe, horse-related injuries and their causes over several years. The authors -who are lifelong equestrians themselves- were surprised to find out that the second highest reported cause of accidents was the “error of another human”. This includes people that honk their horn or rev their engine as they drive by as well as spectators at competitions who display inappropriate behavior around horses, such as flailing of the arms, shaking loud plastic bags, opening umbrellas, running toward a horse, or even riders and new horse owners, who did not know proper show ring/trail ride riding etiquette.

This should serve as an important reminder that regardless of how advanced and skilled one is as a rider and how safe the horse usually is, you have no control over how other people behave around horses - especially if they are unfamiliar with common horse behavior and a horse’s natural flight-instinct.

How can you protect yourself? You probably already guessed the answer: by wearing a riding helmet. The most crucial safety gear for riders is undoubtedly riding helmets. The Brain Injury Alliance of Kentucky stated that in 3 out of 5 fatal equestrian accidents, brain injuries are the underlying reason. The risk of death for riders not wearing helmets is 4 times higher when injured, compared to a rider wearing a helmet.

Another study in 2018 researched numerous riding accidents and concluded that horse-related injuries are costly and disabling, which is not really news to most equestrians. However, they pointed out that from the 172 patients who were not wearing a helmet while mounted, 38% sustained head injuries that were “potentially preventable”. This should make one rethink whether it is a good choice to accept the “costly and disabling”-part of horse-related injuries, in exchange for not wearing a helmet.

Developing new safety technologies
Since back in the days, the riding helmets have evolved to provide even more protection. The latest safety technology in helmets is called MIPS, which stands for Multi-directional Impact Protection System. MIPS is an additional liner inside the riding helmet. This layer enables your head to move 10-15mm in all directions, which allows your head to move inside the helmet. The fact that your head is able to move slightly during the contact with the ground is reducing the transfer of harmful rotational forces to your brain. Those rotational forces are typically the reason for concussions or brain injuries and reducing them has been proven to reduce brain injury, particularly concussion. MIPS is also used in helmets for other high-risk sports like snowboarding, motorsports, cycling, and climbing.

Chest trauma and safety vests
Researchers looked at data from 1995 to 2005 and focused on patients who had major injuries from horseback riding (with an injury severity score of 12 or higher). They interviewed these patients using a survey with 46 questions about various factors that could contribute to the injuries, such as the rider, the horse, and the environment.

They found that out that the injuries were most commonly in the chest (54%), head (48%), abdomen (22%), and extremities (17%). This study highlighted the importance of recognizing chest trauma in horseback riding accidents, which was previously not well understood.

Safety vests have become another essential piece of equestrian safety equipment. Different types of protective vests include airbag vests, foam or gel vests. They are worn on the rider’s torso and reduce the risk of injury when falling off a horse. The vest absorbs the impact of the fall and distributes the effects of the shock. The primary purpose is to protect against rib fractures and spinal cord injuries. The risk for spinal cord injuries is elevated in eventing and jumping. Air safety vests have become typical in these high-risk disciplines. Air vests also help protect the rider’s vital organs, the abdomen, diaphragm, and lungs. Some air vests are equipped with inflatable collars that provide additional protection for the neck.

Studies examined the effectiveness of wearing safety vests in equestrian sports. Researchers compared incidents involving equestrians wearing vests with those who were not wearing them. The study analyzed data from 718 participants in the United States Pony Clubs between 2011 and 2017. The results showed that wearing protective vests did not reduce injuries when riding on flat surfaces or for show jumping. However, wearing vests during cross country activities was associated with a decrease in reported injuries and a trend towards lower severity. Wearing body protection during cross country reduced the risk of injury by 56%. The number of serious injuries did not seem to be influenced by the rider's level of experience.

While all equestrian activities carry inherent risks, there are measures that can be taken to enhance safety. By prioritizing safety, riders can minimize the risks while enjoying the pleasure of horseback riding. Wearing safety equipment like helmets and body protection, along with gaining education and experience, can help reduce the likelihood of sustaining serious injuries.

Tanja Schnuderl is the Director of International Services with The Equine Expert LLC, a multi-discipline equine expert witness and consulting firm with expert equestrians offering legal expert witness and consulting services in court cases and legal matters. Tanja is an expert on Barn Management and Horse Behavior. She was the barn manager at several boarding facilities and a private training facility of a FEI Dressage rider before taking over as Director of The South Carolina Equine Park, an established multi-discipline equine facility which hosts about 30 horse competitions each year. She has established her own equine appraisal company, Sigma Equine LLC. Tanja grew up in Germany and was a paralegal for many years.  For more information on Tanja Schnuderl email tanja@theequineexpert.com, www.theequineexpert.com

References:

Guyton, K., Houchen-Wise, E., Peck, E., & Mayberry, J. (2013). Equestrian injury is costly, disabling, and frequently preventable: The imperative for improved safety awareness. The American Surgeon
Why Wear a Safety Vest While Riding? — Equine Exchange Tack Shop (equineexchangestore.com)
Connor, T.A., Clark, J.M., Jayamohan, J. et al. Do equestrian helmets prevent concussion? A retrospective analysis of head injuries and helmet damage from real-world equestrian accidents. Sports Med - Open 5, 19 (2019). https://doi.org/10.1186/s40798-019-0193-0
Best MIPS horse riding helmets available now | Horse & Hound (horseandhound.co.uk)
Ball, C. G., Ball, J. E., Kirkpatrick, A. W., & Mulloy, R. H. (2007). Equestrian injuries: Incidence, injury patterns, and risk factors for 10 years of major traumatic injuries. The American Journal of Surgery, 193(5), 636-640. doi.org/10.1016/j.amjsurg.2007.01.016
Andres SA, Bushau-Sprinkle AM, Brier ME, et al, Effects of body protection vests and experience levels in prevention of equestrian injuries, BMJ Open Sport & Exercise Medicine 2018;4:e000426. doi: 10.1136/bmjsem-2018-000426