Are Equestrian Injuries Inevitable?

Lindsay has been bugging me for a horse again. She's only been doing that for nine years. I knew it was coming. On the way home from our first ultrasound -- when we discovered we were having a girl -- my first thought was "oh now, now we're going to have to get a pony."

I grew up around horses and I've recently seen the sort of injuries a horse can inflict both in my ambulance and in the Emergency Department. So I was pretty interested in Dr. John Mayberry's presentation at the Northwest States Trauma Conference last week asking whether horse injuries are inevitable or preventable.

Horses used to be prey animals and as such still retain that fight or flight instinct despite a couple thousand years of domestication. Most horses are 5 - 15 times larger, 20 - 40 times stronger and three times faster than we are, Mayberry explained. They way an average of 800 pounds. Sit your little but on top of one and you head is 10 feet off the ground.

Not surprising then that according to the American Medical Equestrian Association, we see upwards of 74,000 Emergency Room visits including 14,000 children thanks to horses. You chances of getting injured riding horseback is higher -- on a per-hour basis -- than riding a motorcycle or racing a car, according to the CDC.

So does it have to be that way? Are injuries preventable?

Mayberry's review of the available research came to a couple important conclusions:

Increasing skill can decrease injuries. One study looked at the United States Pony Clubs where helmet use is required and systematic testing and skill development is practiced. Even though these riders were jumping their horses and invovled in other sporting activities, the overall injury and severity was 1 incident per 169,000 hours of horse-related activities. Of those injuries 8 percent required no treatment while 17 percent required hospitalization. Close to half the injuries happened to students at the lowest skill level with a somewhat even distribution across ages. Researchers made a point to note that skill level did not equate to experience or hours in the saddle -- even idiots can ride a horse. Dr. Doris "Bixby Hammett concluded that experience does not constitute skill," Mayberry notes. "In fact, injuries seem to decrease with increased knowledge, skill and ability rather than with age and experience."

The Pony Club study highlights two things rare in the horse-riding world - helmet use and an intensely structured training regimen. (Although advocacy organizations are increasingly pushing helmet use.)  Outside the pony club, head injuries are higher and the incidence and severity of injuries are higher.  Another study found that horse-related injuries are greater in severity than car wrecks and similar in severity to bicycle crashes.

Moreover one in five equestrians "will be seriously injured during their riding career and that approxamately 100 hours of experience are required to achieve substantial decline in the risk of injury." Novice riders are five times more likely to have a serious injury from a horse compared to a more advanced rider.

Mayberry's group asked experienced riders what they would tell those novices. Here's a sample of the advice they gave:

• Don't ride an unfamiliar horse alone
• Make sure your skill level and the horse skill level mix
• Don't buy a big horse for a little girl
• Never get on a horse you don't know
• Wear long pants and gloves
• Wear a helmet even for leading a horse
• Boots are the best safety item
• Be aware of other animals
• Watch your footing when leading a horse, if you stumble the horse will spook
• Watch out for dogs, children, goats -- all of which can spook horses
• Do not ride in a muddy field
• Be patient when training a horse
• Treat each horse as a individual
• Pay attention to the horse's body language

Mayberry also included some great quotes from the experience equestrians. Here's my favorite:

"I train BLM Mustangs, Only God Herself can protect me."