Back in the Saddle: Injuries in the Equestrian Athlete

Whether you are mounted or unmounted, injuries from riding horses can range from mild to life threatening. Serious injuries can occur when a rider is thrown, trampled, kicked, or dragged and any time a rider experiences a serious injury, he or she should seek medical care immediately.

Injury Prevention Tips

Before getting on a horse, there are multiple ways to decrease the chance of injury.

Helmets protect the head and decrease the chance of skull fractures from falls, being thrown, or kicked.

Boots should be worn at all times in the barn and while riding. Most riding boots have reinforced toeboxes and heels to protect the feet from being injured when stepped on. Boots also have heels that help the rider stay in the stirrups.

Safety stirrup irons help prevent a rider from having their foot trapped in a fall and being dragged.

Supervision and pairings by a riding instructor, or lead for trail rides, should ensure a safe riding environment, educate riders on correct technique and safety information. Riders should be paired to a horse that is appropriate for their skill level.

Danger areas, especially directly behind a horse (kicking zone) and directly in front of it (biting/trample zone), are risky places. Riders should be instructed on how to approach and handle the horse without putting themselves in danger of serious injury.

Risks for Injury

Even when taking all precautions to prevent injuries, there are still risk factors that increase the likelihood of becoming injured:

• Riding English or sport saddle
• Riding more hours per month
• Being an inexperienced rider

Riding puts pressure on shoulders, low back and hips, knees, and ankles, especially when trying to compete with correct form. Shoulder injuries occur when the rider becomes fatigued, uses poor form, or the horse forcefully pulls on the reins. 

Poor riding form can lead to a slouched forward position which can contribute to shoulder pain and back problems. These are common in riding due to the increased forces placed on the spine in the saddle and from repetitive, overuse motions, such as shoveling out a stall.

Injuries in the back can range from muscle strains to stress fractures spondylolysis and any child with back pain lasting longer than 2-3 weeks, should see a sport medicine specialist. Hip and knee injuries are commonly seen in riders due to prolonged sitting in a “squatting position” and can include snapping hip syndrome and patella femoral pain. These injuries are due to muscle imbalances (one group of muscles being weak from being on a constant stretch and another being too tight from being in a shortened position). 

Ankle injuries can occur when the ankle becomes caught in the stirrup and twisted, being stepped on by the horse, or stepping on an uneven surface when putting the horse in a stall. Another common source of injury to the low back, hips knees and ankles happens in English or sport-style of riding. In this form, the rider ‘posts’, lifting themselves from the saddle in time with the stride and impact of the horses hooves. Done properly, this smooths out the ride, but if timing is off, the rider impacts the saddle repetitively causing compressive forces in the low back.

While all injuries have different timelines for a return to activity, following physician clearance riders should continue to perform a home exercise program on a regular basis as instructed by an athletic trainer. Regularly performing exercises will help decrease chance of re-injury.

For more information on Nationwide Children’s Hospital Sports Medicine services, click here.