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

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