Somber Statistics about Equine-Related Head Injuries

A rider thrown from spooked horse.
A rider thrown from spooked horse. lostinfog/Flicker

Horse riding is a dangerous activity. Few equestrians have had a career riding without suffering from injuries, some serious. Below is a summary of some medical literature on the topic.

Sports Medicine 9(1):36-47, 1009

Synopsis: The most common location of horse-related injuries is:

  • Upper extremity 24-61% (reported in different studies)
  • Lower extremity 36-40%
  • Head and face 20%

The most common type of injury is:

  • Soft tissue injury 92%
  • Fractures 57%
  • Concussion 15%

The most frequent consequence of injury is:

  • Hospitalization 5%
  • Residual impairment 2% (i.e. seizures, paralysis, cognitive impairments, etc)
  • Death 1%

JAMA, April 10, 1996, vol 275, no 14, p. 1072

Synopsis: During 1992-93 in Oklahoma, horseback riding was the leading cause of sports-related head injury, (109 of 9409 injuries or 1.2% associated with riding and 23 additional injuries attributable to horses) Of the 109, there were 3 deaths (3%). The injury statistics were:

  • Males 55, female 54
  • Age range 3 yr to 71 yrs, median 30 yrs
  • Most commonly seen in spring and summer
  • 48% occurred on Saturday or Sunday
  • 95% involved riders who struck their heads on the ground or a nearby object after falling from the horse
  • 4% were kicked or rolled on after falling from the horse
  • 1% hit head on a pole while riding and fell to the ground
  • 90% were associated with recreational activities
  • 10% were work-related
  • 107 were hospitalized with a median LOS of 2 days
  • 79% had one or more indicators of a severe brain injury, including:
    1. Loss of consciousness 63%
    2. Posttraumatic amnesia 46%
    3. Persistent neurologic sequelae 13% (seizures, cognitive/vision/speech deficits, motor impairment)

Among the 23 injuries not riding related, 21 (91%) resulted from a direct kick to the head by the horse, where 1 died immediately and 2 required CPR. 13 of these injuries occurred in children less that 13 yrs old.

Journal of Trauma 1997 July; 43(1):97-99

Synopsis: Thirty million Americans ride horses and 50,000 are treated in Emergency Departments annually. Neurologic injuries constitute the majority of severe injuries and fatalities. A prospective study of all patients admitted to the University of Kentucky Medical Center with equine-related trauma from July 1992 - January 1996 showed the following:

  • 18 of 30 (60%) patients were male
  • 11 (37%) were professional riders
  • 24 (80%) were head injuries and 9 (30%) were spinal injuries (4 with both)
  • Age ranged from 3 to 64 yrs
  • 5 patients died (17%)
  • 2 suffered permanent paralysis (7)
  • 60% were caused by "ejection or fall from horse"
  • 40% were kicked by the horse, with 4 of these sustaining crush injuries
  • 6 patients (20%) required craniotomy (i.e. brain surgery)
  • 24 patients (80%) were not wearing helmets, including all fatalities and craniotomy patients

Experience is not protective; helmets are.

EquiMed wishes to thank Emmy R. Miller, PhD, RN for providing this summary.

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EquiMed Staff

EquiMed staff writers team up to provide articles that require periodic updates based on evolving methods of equine healthcare. Compendia articles, core healthcare topics and more are written and updated as a group effort. Our review process includes an important veterinarian review, helping to assure the content is consistent with the latest understanding from a medical professional.