Riding has some inherent risks, as when mounted, the rider's head may be up to 4 m (13 ft) from the ground, and the horse may travel at a speed of up to 65 km/h (40 mph).[1] The injuries observed range from very minor injuries, to fatalities.
Relative risk
editA recent study in Germany reported that the relative risk of injury from riding a horse, compared to riding a bicycle, was 9 times higher for adolescents and 5.6 times higher for younger children, but that riding a horse was far less risky than riding a moped.[2]
In Victoria, Australia, a search of state records found that equestrian sports had the third highest incidence of serious injury, after motor sports and power boating.[3] In Greece, an analysis of a national registry estimated the incidence of equestrian injury to be 21 per 100,000 person-years for farming and equestrian sports combined, and 160 times higher for horse-racing personnel. Other findings were that use of spurs may contribute to ankle fractures and dislocations, and helmets likely contribute to prevention of traumatic brain injuries.[4]
In the United States each year an estimated 30 million people ride horses, resulting in 50,000 emergency room visits (1 visit per 600 riders per year).[5] A survey of 679 equestrians in Oregon, Washington, and Idaho estimated that at some time in their equestrian career one in five will be seriously injured, resulting in hospitalization, surgery, or long-term disability.[6] Among survey respondents, novice equestrians had an incidence of any injury that was three-fold over intermediates, five-fold over advanced equestrians, and nearly eight-fold over professionals. Approximately 100 hours of experience are required to achieve a substantial decline in the risk of injury. The survey authors conclude that efforts to prevent equestrian injury should focus on novice equestrians.
Mechanisms of injury
editThe most common mechanism of injury is falling from the horse, followed by being kicked, trampled, and bit. About 3 out of 4 injuries are due to falling, broadly defined. A broad definition of falling often includes being crushed and being thrown from the horse, but when reported separately each of these mechanisms may be more common than being kicked.[7][8]
Types and severity of injury
editIn Canada, a 10-year study of trauma center patients injured while riding reported that although 48% had suffered head injuries, only 9% of these riders had been wearing helmets at the time of their accident. Other injuries involved the chest (54%), abdomen (22%), and extremities (17%).[9]
A German study reported that injuries in horse riding are rare compared to other sports, but when they occur they are severe. Specifically, they found that 40% of horse riding injuries were fractures, and only 15% were sprains. Furthermore the study noted that in Germany, one quarter of all sport related fatalities are caused by horse riding.[10] Most horse related injuries are a result of falling from a horse, which is the cause of 60-80% of all such reported injuries.[11][12] Another common cause of injury is being kicked by a horse, which may cause skull fractures or severe trauma to the internal organs. Any possible additional risks caused by riding during pregnancy is a matter of some debate, and not enough evidence is available to assess any such the risks accurately.[13] Some possible injuries resulting from horseback riding, with the percent indicating the amounts in relation to all injuries as reported by a New Zealand study,[14] include:
- Arm fracture or dislocation (31%)
- Head injury (21%)
- Leg fracture or dislocation (15%)
- Chest injury (??%)
Among 36 members and employees of the Hong Kong Jockey Club who were seen in a trauma center during a period of 5 years, 24 fell from horseback and 11 were kicked by the horse. Injuries comprised: 18 torso; 11 head, face, or neck; and 11 limb.[15] The authors of this study recommend that helmets, face shields, and body protectors be worn when riding or handling horses.
In New South Wales, Australia, a study of equestrians seen at one hospital over a 6 year period found that 81% were wearing a helmet at the time of injury, and that helmet use both increased over time and was correlated with a lower rate of admission.[16] In the second half of the study period, of the equestrians seen only 14% were admitted. In contrast, a study of child equestrians seen at a hospital emergency room in Adelaide, South Australia reported that 60% were admitted.[17]
Riding astride
editThe idea that riding a horse astride could injure a woman's sex organs is an historic bugaboo.[citation needed] This includes the popular idea that riding astride can damage the hymen.[18] Evidence of injury to any female sex organs is scant.
In female high-level athletes, trauma to the perineum is rare and is associated with certain sports (see Pelvic floor#Clinical significance). The type of trauma associated with equestrian sports has been termed "horse riders' perineum".[19] A case series of 6 women, 4 mountain bike riders and 2 horse riders, found both patient-reported perineal pain and evidence of sub-clinical changes in the clitoris;[20] the relevance of these findings to horse riding is unknown.
In men, sports-related injuries are among the major causes of testicular trauma. In a small controlled but unblinded study of 52 men, varicocele was significantly more common in equestrians than in non-equestrians.[21] The difference between these two groups was small, however, compared to differences reported between extreme mountain bike riders and non-riders,[22] and also between mountain bike riders and on-road bicycle riders.[23] Horse-riding injuries to the scrotum (contusions) and testes (blunt trauma) were well known to surgeons in the 19th Century and early 20th Century.[24] Injuries from collision with the pommel of a saddle are mentioned specifically.[24]
- ^ J R Silver (June 2002). "Spinal injuries resulting from horse riding accidents". Spinal Cord. 40 (6): 264–271. doi:10.1038/sj.sc.3101280. PMID 12037707. Retrieved 2009-01-14.
- ^ Schneiders W, Rollow A, Rammelt S, Grass R, Holch M, Serra A, Richter S, Gruner EM, Schlag B, Roesner D, Zwipp H (April 2007). "Risk-inducing activities leading to injuries in a child and adolescent population of Germany". J Trauma. 62 (4): 996–1003. doi:10.1097/01.ta.0000222584.48001.a0. PMID 17426559.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Gabbe BJ, Finch CF, Cameron PA, Williamson OD (August 2005). "Incidence of serious injury and death during sport and recreation activities in Victoria, Australia". Br J Sports Med. 39 (8): 573–7. doi:10.1136/bjsm.2004.015750. PMC 1725286. PMID 16046347.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Petridou E, Kedikoglou S, Belechri M, Ntouvelis E, Dessypris N, Trichopoulos D (March 2004). "The mosaic of equestrian-related injuries in Greece". J Trauma. 56 (3): 643–7. doi:10.1097/01.ta.0000053470.38129.f4. PMID 15128138.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Carrillo EH, Varnagy D, Bragg SM, Levy J, Riordan K (2007). "Traumatic injuries associated with horseback riding". Scand J Surg. 96 (1): 79–82. doi:10.1177/145749690709600115. PMID 17461318.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Mayberry JC, Pearson TE, Wiger KJ, Diggs BS, Mullins RJ (March 2007). "Equestrian injury prevention efforts need more attention to novice riders". J Trauma. 62 (3): 735–9. doi:10.1097/ta.0b013e318031b5d4. PMID 17414356.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Loder RT (August 2008). "The demographics of equestrian-related injuries in the United States: injury patterns, orthopedic specific injuries, and avenues for injury prevention". J Trauma. 65 (2): 447–60. doi:10.1097/TA.0b013e31817dac43. PMID 18695484.
{{cite journal}}: CS1 maint: date and year (link) - ^ Clarke CN, Tsuei BJ, Butler KL (May 2008). "Equine-related injury: a retrospective analysis of outcomes over a 10-year period". Am. J. Surg. 195 (5): 702–4. doi:10.1016/j.amjsurg.2007.11.007. PMID 18424291.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Ball CG, Ball JE, Kirkpatrick AW, Mulloy RH (May 2007). "Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries". Am. J. Surg. 193 (5): 636–40. doi:10.1016/j.amjsurg.2007.01.016. PMID 17434372.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Dittmer H (1991). "The injury pattern in horseback riding". Langenbecks Archiv Fur Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft Fur Chirurgie. Kongress: 466–469. doi:10.1007/978-3-642-95662-1_203. PMID 1793946.
{{cite journal}}: Cite has empty unknown parameter:|1=(help) - ^ "Most injuries result from falls (80%)", Horse riding during pregnancy, MS Rogers.
- ^ R. G. Lloyd (March 1987). "Riding and other equestrian injuries: Considerable severity". British Journal of Sports Medicine. 21 (1): 22–24. doi:10.1136/bjsm.21.1.22. PMC 1478604. PMID 3580722.
{{cite journal}}: CS1 maint: date and year (link) - ^ "Horse riding during pregnancy", MS Rogers, retrieved 2009-01-12
- ^ Northey G (September 2003). "Equestrian injuries in New Zealand, 1993-2001: knowledge and experience". N. Z. Med. J. 116 (1182): U601. PMID 14581953.
{{cite journal}}: CS1 maint: date and year (link) - ^ Yim VW, Yeung JH, Mak PS, Graham CA, Lai PB, Rainer TH (January 2007). "Five year analysis of Jockey Club horse-related injuries presenting to a trauma centre in Hong Kong". Injury. 38 (1): 98–103. doi:10.1016/j.injury.2006.08.026. PMID 17049524.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Lim J, Puttaswamy V, Gizzi M, Christie L, Croker W, Crowe P (August 2003). "Pattern of equestrian injuries presenting to a Sydney teaching hospital". ANZ J Surg. 73 (8): 567–71. doi:10.1046/j.1445-2197.2003.02707.x. PMID 12887517.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Craven JA (August 2008). "Paediatric and adolescent horse-related injuries: does the mechanism of injury justify a trauma response?". Emerg Med Australas. 20 (4): 357–62. doi:10.1111/j.1742-6723.2008.01107.x. PMID 18782209.
{{cite journal}}: CS1 maint: date and year (link) - ^ Dhall A (1995). "Adolescence: myths and misconceptions". Health Millions. 21 (3): 35–8. PMID 12346860.
- ^ Crepin G, Biserte J, Cosson M, Duchene F (October 2006). "[The female urogenital system and high level sports]". Bull. Acad. Natl. Med. (in French). 190 (7): 1479–91, discussion 1491–3. PMID 17450681.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ "Ultrasonographic and Doppler Findings of Subclinical Clitoral Microtraumatisms in Mountain Bikers and Horseback Riders", Cesare Battaglia, Rossella Elena Nappi et al, retrieved 2009-01-12
- ^ Turgut AT, Kosar U, Kosar P, Karabulut A (July 2005). "Scrotal sonographic findings in equestrians". J Ultrasound Med. 24 (7): 911–7, quiz 919. doi:10.7863/jum.2005.24.7.911. PMID 15972705.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Frauscher F, Klauser A, Stenzl A, Helweg G, Amort B, zur Nedden D (May 2001). "US findings in the scrotum of extreme mountain bikers". Radiology. 219 (2): 427–31. doi:10.1148/radiology.219.2.r01ma42427. PMID 11323467.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ Mitterberger M, Pinggera GM, Neuwirt H, Colleselli D, Pelzer A, Bartsch G, Strasser H, Gradl J, Pallwein L, Frauscher F (January 2008). "Do mountain bikers have a higher risk of scrotal disorders than on-road cyclists?". Clin J Sport Med. 18 (1): 49–54. doi:10.1097/JSM.0b013e31815c042f. PMID 18185039.
{{cite journal}}: CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link) - ^ a b William Williams Keen, John Chalmers Da Costa, ed. (1908). Surgery, Its Principles and Practice. Vol. 4. W. B. Saunders Company.
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