Horse-Related Injuries

Caring for and riding horses are popular activities in the U.S., but both can lead to injuries. Horse-related injuries can be particularly severe and often require treatment in emergency departments. From 1990 through 2017, an estimated 1.8 million individuals presented to United States emergency department with horse-related injuries. The number of concussion and closed head injury diagnoses increased by 337% from 1990 to 2009.

Horse-Related Injury Facts

  • More than 65,500 people are seen in U.S. emergency departments each year due to horse-related injuries.
  • Most (89%) of injuries occurred while mounted, 6% while not mounted, and 2% during mounting or dismounting.
  • Females accounted for 64% of horse-related injuries and had a higher injury rate than males. 
  • The median age of those injured was 29.8 years with most of the injuries occurring among patients ages 19–60 (63.2%) and 5–18 (29.6%).
  • The upper extremity (30%) and trunk (29%) were the most common body regions injured, followed by the head and neck (23%).
  • Most horse-related injuries were diagnosed as a broken bone (31%) or soft tissue injury (28%), and 11% were diagnosed as a concussion/closed head injury.
  • Among all horse-related injuries, 67% resulted from falling or being thrown, and 12% resulted from the horse bucking/rearing/spooking.
  • While falling or being thrown was the most common mechanism among those mounted (74%) or those mounting/dismounting (32%), the majority of those not mounted were injured from being kicked (42%) or stepped on/trampled/crushed (27%).
  • Most (87%) individuals with horse-related injuries were treated and released from the emergency department and 12% were admitted. Mounted injuries were more likely to lead to hospitalization than unmounted injuries. 

Horse-Related Injury Prevention Tips

  • Wear a helmet every time you ride:
    • Prevention of concussion/closed head injuries remains a critical focus for equestrian activities. Severe horse-related injuries and fatalities are often attributable to head injuries, so many medical and equestrian organizations recommend the use of a helmet in horse-related activities based on evidence that helmets reduce both the number and severity of injuries. 
    • Currently, the use of a helmet that is compliant with ASTM standard F1163 is recommended or required while riding, with evidence suggesting protective benefits of helmet use even while unmounted. 
    • Check helmet rating websites provided by independent researchers before purchasing a helmet – a more expensive helmet doesn’t always provide better protection.
    • Make sure the helmet is fitted correctly.
    • Replace your helmet every 5 years – more often if it’s stored in a hot barn.
  • Consider wearing other protective gear when you ride to prevent or lessen the severity of an injury. 
    • Riding boots should have a heel of at least 1 inch, closed toe and sole with some grip. These will help you keep your feet in the stirrups, protect you if you get stepped on, and support your leg and ankles to help you maintain good position while you ride.
    • Gloves will help you grip the reins and minimize burn.
    • A safety vest, sometimes called a crash vest or body protector, protect your chest, spine, and internal organs in case of a fall. 
  • Practice safe habits around horses and barns:
    • Educate horseback riders on horse behavior, the proper handling of horses, and safe riding practices.
    • To prevent getting stepped on or kicked, be aware of the horse’s body at all times (including while riding, grooming, leading, and performing chores), especially their legs, 
    • Ride with someone in case something happens to the horse or to the rider. 
    • Horses can be unpredictable, so environmental factors, such as the wind, rain, bad ground, and riding location, might contribute to horseback riding-related injuries.
  • Match the horse to the rider:
    • Consider the skill level of the rider and the energy and experience of the horse. Horseback riders must be physically strong and have a mastery of the skills and positioning required to be an effective horseback rider.
    • If a rider is nervous or hesitant, the horse may sense it, which could lead to injury. Similarly, if a horse is too energetic or distracted, riding that horse could be dangerous and result in an injury.

Additional Horse-Related Injury Resources: 

  • Horseback riding-related injuries treated in emergency departments: Risk factors and prevention strategies
  • Nonfatal horse-related injuries treated in emergency departments in the United States, 1990-2017