Equestrian sports are enjoyed throughout a lifetime. Many equestrian athletes continue in their sport well beyond when many athletes have given up their high school sports. For example, the oldest U.S. Olympian that competed in the 2016 Rio Olympics was 52-year-old equestrian Phillip Dutton (Delzo, 2016). With older individuals choosing horseback riding as their hobby of choice, some equestrian sports have the reputation of being low-key, low-risk sports. As a result, potential risk and safety considerations can be overlooked. The purpose of this article is not to deter equestrians, but rather provide context for risk and potential injuries. Following is an overview of some key statistics on horse-related injuries to humans.
Relative Risk
On a total injury basis, horseback riding can be compared to other sports on an hours of participation basis (Table 1). Data on rodeo and racing injuries were collected on a competitor exposures basis making it not directly comparable to the other sports.
| Sport | Injuries per 1,000 Hours of Participation |
| American football* | 10-35 |
| Basketball | 9.1 |
| Ice hockey | 7.5 |
| Karate | 6.7 |
| Baseball** | 1.6-5.8 |
| Downhill skiing | 4.1 |
| Horse riding | 3.7 |
| Cycling | 2.0 |
| Swimming | 1.0 |
| Golf | 0.3 |
| Rodeo Event | Injuries per 1,000 Competitor Exposures |
| Bull riding*** | 141 |
| Bronc riding (bareback)*** | 72 |
| Bronc riding (saddle)*** | 63 |
| Steer wrestling*** | 50 |
| Calf roping*** | 8 |
| Ladies barrel racing*** | 6 |
| Racing Type | Injuries per 1,000 Rides |
| Jump racing**** | 10 |
| Flat racing**** | 1 |
* Data from Dvorak and Junge (2000) which is a review of epidemiological studies.
** Data from Dick, Sauers, Agel, and Keuter (2007). Injury incidence data collected through a collegiate sport surveillance program.
*** Data from Butterwick, Hagel, Nelson, LeFave, Meeuwisse (2002). Injury incidence data collected through the Canadian Professional Rodeo Sport Medicine Team.
**** Data from O’Connor, Warrington, McGoldrick, & Cullen. (2017). Injury incidence data collected from the Irish racing industry.
Compared to the American pastimes of football, basketball, and baseball, the injury rate for horse riding is relatively low. However, several studies have found that horse-related injuries presented at hospitals tend to be severe. A side-by-side comparison of horseback riding and hockey found that horseback riding-related injuries were more likely to require hospitalization. Of common childhood injuries, only being struck by a car had a higher severity score than equestrian-related injuries. Additionally, studies have found the average hospitalization for an equestrian related injury (including head injuries) is 5-6 days. Head injuries are of concern due to their severity. Approximately 10%-30% of horse-related injuries are head injuries. In fact, of all sports in the U.S., equestrian sports are the most common cause of sports-related traumatic brain injury (TBI) in adults.
Statements such as “everyone falls off” and “you aren’t a real rider until you’ve fallen off” abound in the horse industry. While these statements are often used to encourage novice riders to not give up the first time they fall, the data shows that not just falls, but injuries are likely to happen. The data agrees that injuries are likely to happen at some point in a rider’s career. A survey of riders in Oregon, Washington, and Idaho states found that 81% were injured at some point in their riding career and of that 21% were injured seriously (requiring hospitalization/surgery or causing long-term disability).
Fortunately, horse-related fatalities are relatively few. For example, horses were involved with the deaths of 43 people in New Mexico between 1993 and 2004, a span of 11 years. For comparison, 298 fatalities were due to car crashes in New Mexico during 2015 alone (University of New Mexico Geospatial and Population Studies Traffic Research Unit). Over the decades approximately 60%-70% of horse-related fatalities have been due to head injuries (Figure 1). Other factors involved in horse-related fatalities included spine injuries, crushing injuries, and the involvement of an automobile (Meredith, Ekman, & Brolin, 2018)
Figure 1. Summary of data collected in various studies on the percentage of horse-related fatalities due to head injuries. Data from [GM3][MSL4]Aronson & Tough, 1993 (Canada); Sorli, 1999 (Canada); Hammet, 1994 (North Carolina); Malavase, 1994 (New York); Koephi, 2000 (Ohio); Lathrop, 2007 (New Mexico); and Ghosh, Di Scala, Drew, Lessin, and Feins, 2000 (US).
Experience and Risk of Injury
Researchers report conflicting evidence as to whether experience or number of years riding reduces injury rates. A study conducted in Oregon, Washington, and Idaho found that novice riders are the most likely to be injured (Mayberry, Pearson,Wiger, Diggs, & Mullins, 2007). The same was true of a study completed in Hong Kong (Yim et al., 2007) and a study United States Pony Club members (Andres, Bushau-Sprinkle, Brier, & Seger, 2018). Additionally, recreational riders had higher rates of injury than professional equestrians in Australia (Lim et al., 2003). These findings suggest inexperienced riders are more at risk.
However, more experienced riders can take on more challenging mounts and activities which increases injury risk. The average years of riding experience for Canadian adults admitted to a trauma center for severe horse-related injuries was 27 years as determined from a 10-year study (Ball, Ball, Kirkpatrick, & Mulloy, 2007). Also, data collected in Austin, Texas, found that inexperienced dudes accounted for 38% of the livestock-injured patients, while ranchers and cowboys accounted for 43% of livestock-injured patients (Criddle, 2001). It is important to remember that accidents can happen to anyone, regardless of their level of experience.
Reducing Head Injuries
Sports and organizations that have adopted rules regarding helmet use have seen decreases in the number of head injuries and deaths. For example, the United States Pony Club, an equestrian educational organization, has documented a 60% decrease in head injuries after mandating that when mounted participants must have an ASTM (American Society for Testing and Materials (astm.org)) approved helmet with chinstrap fastened. Additionally, horse-related deaths dropped from 4.9 per year (73% due to head injuries) to only one death caused by a vehicle collision in the three years after youth organizations and the New York State Horse Council mandated the use of ASTM/SEI (Safety Equipment Institute (seinet.org)) certified helmets (Malavase, 1994). However, helmet use remains low in some parts of the country and world (Figure 2)
Figure 2. Summary of data reported on helmet usage. Data is either percentage of injured patients that were wearing a helmet at the time of injury or percentage of survey respondents that reported helmet use. Data from [GM7][MSL8]Roe et al., 2003 (Australia); Hughes, Falcone, Price, & Wickoff, 1995 (U.S.); Lim et al., 2003 (Australia); Condie, Rivara, & Bergman, 1993 (Washington); Frankel, Haskell, Digiacomo, & Rotondo., 1998 (Pennsylvania); Bond, Christoph, & Rogers, 1995 (Virginia); Ball, Ball, Kirkpatrick, & Mulloy, 2007 (Canada); Stafford, 1996 (Canada); Ueeck, Dierks, Homer, & Potter, 2004 (Oregon); Newton & Nielsen, 2005 (Colorado); Carrillo, Varnagy, Bragg, Levy & Riordan, 2007 (Florida); Yim et al., 2007 (Oregon, Washington, & Idaho); and Ikinger, Baldamus, & Spiller, 2016 (Germany).
Protective Equipment Other Than Helmets
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Figure 3. An example of one style of protective vest. An inflatable version works similar to an airbag. Photo by Sara Mastellar. |
Protective vests (Figure 3) were made mandatory for the cross-country phase of eventing in 1996 by the United States Equestrian Federation (USEF) and the United States Eventing Association (USEA) (Guyton, Houchen-Wise, Peck, & Mayberry, 2013) and have since been shown to decrease risk of injury during cross-country riding (Andres et al., 2018). They are also used in racing (harness, flat, and steeplechase) (Gibson, Thai, Saxon, & Pollock, 2008), colt starting, and rodeo. Mouth guard use, common at rodeos, may also protect against concussion through shock absorption (Butterwick et al., 2002).
In Closing
As with any sport or activity, there is some risk involved in horseback riding and related sports. Head injuries make up a significant portion of the injuries incurred by equestrians and experience may not be protective against injury. Lastly, helmets have been shown to effectively protect against head injuries. With proper precautions and awareness of injury risk, riding careers can be both long and enjoyable.
Note: This article was originally peer reviewed and published through SDSU Extension (iGrow) in 2017. It was updated for an Ohio audience in 2020.
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