Page 15 - Summer 2020

STOP SPORTS INJURIES
Staying Safe in the Saddle

BY KAREN SUTTON, MD
& LAUREN WESSEL, MD

Approximately 30 million people ride of skull fractures have decreased with
horses annually in the United States. the increased trend in helmet use, and
While popular, equestrian sports carry a all riders should be aware of this safety
high risk of injury with a reported rate of precaution. When selecting a helmet, look
1 for every 350 to 1000 hours spent riding. for SEI (Safety Equipment Institute) and
The risk of injury in riding may be ASTM (American Society of Testing and
attributable to the position of the rider, Materials) approved gear. Horseback riding is a popular sport;
fall from height, and speed of travel however, it comes with a high
during sport. The range of orthopaedic Footwear risk of injury. The combination of
injuries include spine and pelvis injuries, Proper footwear and appropriate riding height and speed of travel during
upper and lower extremity long bone position can help mitigate risk and fall from a horse contribute to the
fractures, and joint dislocations. afford riders with the greatest control severity of associated injuries,
Given the severity of trauma associated while mounted. Appropriately heeled which include a high incidence of
with equestrian sport, efforts should be boots aid riders in maintenance of ankle head and neck injuries as well as
taken to prevent undue injuries. Falling dorsiflexion while mounted. Additionally, extremity fractures. We advocate
off the horse is the most common cause stronger riding boots may decrease for the use of helmets as well as
of injury and efforts should be taken to the risk of ankle injuries secondary to protective equipment for the upper
ensure the greatest ability for riders to rotational loads. and lower limbs in order to stay
maintain balance. A few specific cautions safe in the saddle.
should be heeded by those embarking Additional Protective Equipment
on equestrian sport. Upper extremity fractures account for >50
percent of riding related fractures. While
Helmets upper extremity protective equipment
Prior literature demonstrates rates has been noted to reduce fracture rate in 1 in
of use of protective equipment range activities such as rollerblading, benefits
from 6 to 66.7 percent. This variation in have not been formally evaluated in 350 hours
use persists despite literature that has riding. The shoulder, elbow, and wrist are
shown that use of helmets decreases prone to high injury rates, and protective horseback riding injury rate
hospitalization secondary to injury up to equipment may prove beneficial in
5-fold. Both the incidence and severity reducing injury occurrence.

Summer 2020, Issue 3 | sportsmed.org 13 