INJURIES  AND  SAFETY  IN  RIDING  HORSES AND/OR  PONIES


INTRODUCTION

Riding accidents can happen to anyone, even experienced equestrians riding well-trained horses. Specific studies have shown that 40-60 percent of these accidents could have been prevented with education and preparation. Safe riding and horse handling practices are key to preventing accidents. It is also important to point out that many riders know the safe way to avoid injury but choose to engage in risky behavior. So knowing the right way isn't enough, we must also be mindful of our own attitudes toward riding safety and practice safe horsemanship. Proper riding instruction, selection of suitable horses for the level and type of riding, appropriate equipment and attire for both horse and rider, and planning with proper attention to detail before every ride all contribute to safe and agreeable experiences with horses. The intention of this brochure is to highlight important tips to help avoid accidents and provide valuable information should an accident occur.

A study of 679 horsemen by John Mayberry and colleagues published in 2007 showed that novices - riders with 50 hours or less riding experience - are most likely to be injured.

However, in this same study, it was recognized that the more advanced the rider, the greater the chance of serious injury - one leading to hospitalization, surgery or permanent disability. The study also showed a disturbing trend - the most experienced riders were less likely to use a helmet.



Could  this  happen  to  you?

"I was fox hunting in slippery conditions (top part of the ground had thawed - hard underneath). My horse was green and took a turn a bit too fast, leaning in on the turn as he went around the corner. His legs went out from under him and he fell on his side before I even knew what happened. Luckily, I was wearing a helmet and only had a concussion."

Always be sure of your horse's footing. Slow down in slippery conditions.



Preventing Horse-Related Injuries


What can you do to be ready when you or someone you are with is injured while handling or riding a horse? First, be prepared. Take a basic human first-aid class before you engage in riding so you will know what to do. Your local fire department and American Red Cross chapters usually provide regular classes. Know where the nearest emergency medical services (EMS) and first responders are and how to reach them. If you are in an area without phone coverage, you might not be able to reach EMS immediately, so knowing what to do is important. Keep a well-stocked first-aid kit in your horse trailer, car, barn or stable.

Education is paramount to injury prevention. Get appropriate instruction when you begin your horse experience. As you progress, continue to absorb as much knowledge as you can about horse behavior, horsemanship skills and riding safely from those more experienced than you.

A good resource for tips on safety issues is SaddleUpSAFELY.org. Armed with the number of horse-related injuries seen annually in UK Healthcare's emergency departments, a unique collaboration between the University of Kentucky and community partners was born. "Saddle Up Safely" is a five-year educational and awareness campaign to educate about horse handling safety that aims to reduce the number and severity of injuries. This site has an ever-expanding volume of first-hand tips submitted by riders.

Cost of Serious Injury

The cost of a serious injury goes beyond the actual initial medical costs and includes the cost of missed work, long-term rehabilitation, psychiatric care and counseling.

Cost data from UK Healthcare's Level I Trauma Center, where the most severely injured patients are treated, shows that the initial medical care without including rehab or psychiatric counseling averages $16,218 if the person requires hospitalization. If hospitalization is not needed, the cost of treatment is about $2,357 per person. 

Source: UK Level I Trauma Center Analysis of Patients, 2009-10


Could  this  happen  to  you?


"I was leading the horse by the cheek strap of his bridle and he reared, taking me up off the ground, and my hand was trapped in the bridle cheek strap. I swung under the horse as he leaped forward, jerking my right arm out of its socket. I fell to the ground and the horse trampled on both of my legs. Thank goodness I was wearing a helmet, as the horse's hooves hit my helmet. If I had taken the time and used proper leading equipment, I might not have been injured."

You should always lead your horse with a halter and a lead rope attached to the ring under the chin. If you have been riding and need to lead your horse, remove the reins from his neck by bringing them back over his neck and head and lead with two hands as you would with a halter and rope.



Basic Tips for Horseback Riders

Plan ahead. Whenever you ride, be prepared for emergencies. Try not to ride alone, but if you do, be aware of the risks. Keep your cell phone charged and with you. If you do go out alone, always let someone know where you will be riding and when you anticipate returning. When taking an extended trail ride into unfamiliar territory, someone in your group should carry a GPS. Wear appropriate clothing for the weather conditions, and, depending on anticipated time away, consider taking drinking water, sunscreen, rain gear, a blanket, flashlight, signaling mirror, tack repair kit, halter and 12-foot lead rope. Pack a basic first-aid kit with you.

Below is a list of items that should be included in the kit:



Disposable latex or synthetic gloves (at least two pairs)

Antiseptic solution or towelettes

Saline solution

Antibiotic ointment

Adhesive dressings

Assorted sizes of gauze pads

Assorted sizes of rolled gauze

4-inch elasticized athletic wrap

Triangular bandage

Cold pack

Scissors, tweezers and pocket knife

Lighter/matches

First-aid instruction manual

CPR facemask

Drugs to treat allergic reactions: i.e. Benadryl® or EpiPen® 

if prescribed by your physician.

Adhesive tape

Be sure to check your first-aid supplies periodically and replace open packages or expired items. Check expiration dates of saline, antiseptic solutions and ointments. A more extensive first-aid kit should be available in your horse trailer, car, and bam or stable.



Extended Trail Riding Check List


Keep this checklist with you and review it before riding.

 Always let someone know where you are going and when you expect to return.

 Always carry some form of communication (cell phone) on your person - not just on your horse - because you might get separated from your horse. Do not carry a pouch in the small of your back.

 Carry a basic horse and human first-aid kit.

 Carry a jacket and/or light raincoat - especially in cold weather.

 If riding in a wooded area, carry a small emergency or pruning type saw, and make sure it has a protective cover.

 If the ride is of any length, have some means of starting a fire such as waterproof matches or cigarette lighters - especially in cold or damp weather.

 If you are riding in an area not familiar to you, someone in your group should carry a compass or a GPS device.

 It is always much safer to ride with someone than to go alone.

 Be sure your horse has solid trail experience before leaving.

 Check your tack and equipment to be sure they are in good repair before you head out.

 Find out in advance if ATVs, bicycles and hikers will be using the same trails.


What  to  carry  on  you


Mobile phone

ICE - List of "In Case of Emergency" information (personal information and emergency contacts) in a waterproof bag

Multitool (knife, wire cutters, etc.) 

Emergency whistle

Personal medications

What to carry on you:

Medical Conditions

Even if you have a medical condition, riding can

be safe if you take a few precautions. First, do not ride

alone. If you are on blood thinners such as Coumadin®,

Plavix®, or aspirin, you are at increased risk for severe

bleeding in the brain should you fall. Wear an approved

riding helmet.


Riders prone to severe allergic reactions (anaphylaxis) in which breathing could be compromised should carry Benadryl and an EpiPen. You must have a doctor's prescription for EpiPen, but in the case of severe allergies, an EpiPen can save your life. Let your riding partner(s) know of your allergies and that you have medication with you.

If you have diabetes, make sure you have your blood sugar meter with you. Keep snacks handy for quick access; carry high-sugar snacks and glucose pills or gel if needed for battling episodes of very low blood sugar. Those with insulin requirements should remember to carry insulin on the ride, especially if you plan to be gone for an extended period and/or during mealtimes.

If you have asthma, bring your inhaler.



Helmet Safety


Wearing a helmet might be the most important safety behavior you can practice. The key is to wear one all the time! The protection afforded by your helmet depends upon safety ratings, fit to correct position on your head and proper adjustment of the straps. These factors as well as the age of the helmet, wear and tear, and previous accidents all will affect how well a helmet performs. No helmet can protect you in every situation. Certain trajectories, speeds and impact can diminish the protective aspects of the helmet.

The current industry helmet standard is American Society for Testing and Materials (ASTM) F-1163-04a. Helmets are certified to that standard by the SEI (Safety Equipment Institute). Approved helmets carry a label proving they are so certified. Some helmets also carry a European safety seal. This can be written EN1384 or BS1384, and these helmets meet the same standards. The initials EN or BS simply mean the lab filed the paperwork using that particular code. There is a false belief that BS1384 helmets are different, when it simply means the paperwork was filed a particular way.




Shopping for a Helmet

Helmets come in various shapes, sizes and colors. Experiment by trying on many types. The helmet that fits your friend might not be the best for you, even if it looks like you would wear the same size. Certain helmets fit some head shapes better. Don't worry about how the helmet looks; pick one that fits. The closer the helmet fits to the side of your head, the better it will protect; ideally there will be no gap on the sides of your temples or front or rear - also the deeper the helmet fits in back down toward your neck, the better protection you have. When shopping for a helmet, wear your hair the way you will when you ride. A ponytail, clips or headband can change the way a helmet fits. Only hair or a hairnet should go under your helmet. Wear each helmet around the store. If it gives you a headache, it's too tight. On the other hand, don't buy a helmet too big thinking it will fit next year. You need one that fits well now!


Fitting a Helmet Correctly

The helmet should fit snugly all around the head without any pressure points to the front or on the sides. This may require wearing it around the store for a few minutes in order for it to adjust to the shape of your head.

When you shake your head, the helmet should not slip up and down or side to side.

You should be able to put at least one finger space between your chin and the chin strap. If you have to make it as snug as possible for it to stay on, it may not fit properly. This can be tested by being able to yawn without restriction.

If you are going to wear your hair up, be sure to put it more on the back of your head rather than on top, and compress it as flat as possible. Ideally you are better off to gather it in a hairnet at the base and sides of the helmet. Some helmets have space on the sides to allow for this.

Helmets that have V-shaped strap adjustment systems require particular care when fitting the straps. Take the time needed to make sure the straps pull the helmet straight down atop your head.

About every three months, check the fit of your helmet, as straps stretch out, padding settles and the fit changes.

Also check the fit if you cut your hair; you don't want to be going over a jump and find you cannot see because your helmet has fallen over your eyes simply because you had your hair cut.

Request to have your head measured.


Helmet Myths

Bike or skateboard helmets are fine for riding horses. Bike helmets are not appropriate for horseback riding. Equestrian helmets are specifically designed and tested to protect your head from impact in the event of falls from a horse. Equestrian helmets also cover a larger area of your head than bike helmets and have straps that, when properly adjusted, keep them in the right position while riding and if you fall.

As long as you wear a helmet, you'll never get hurt. It's not enough to wear any helmet. It must fit well, including a snug chin strap, be certified and be properly adjusted every single time you ride. Helmets will not protect you from unsafe behavior, however. You must practice other safe behaviors.

Tilting the front of your helmet up makes it easier to see, so you're safer. Tilting the front up makes the helmet unstable. The visor should be parallel to the ground and just above the crease of eyebrows.

Really good helmets are too expensive.

You can spend $500 on a helmet, but it won't make it any safer. As long as it's ASTM/SEI certified, and it's new, you're buying a certified protective helmet. Spending more might get you different padding and trendier decorations or materials, but it doesn't translate into more protection.

Helmets aren't cool.

Check out the newest designs and styles if you believe this. Newer helmets are more fashionable and comfortable than ever, and there are styles with vents and for every discipline, including Western.

If you don't have a helmet, just borrow a friend's. Your helmet needs to fit YOU - not your friend. Even if your heads look like they are a similar size, head shape can make a difference. For maximum protection the helmet must fit well. Also, you don't know if a borrowed helmet has been taken care of properly.

You can keep wearing your helmet after an accident unless you see a crack in it. You need to replace your helmet if you fall and your head hits the ground. It could have a defect that's not readily visible, and the original protection afforded might be diminished should you fall on that same part of the helmet again. Even if your helmet never takes a hit, it's a good idea to replace it at least every five years (sooner if you ride frequently). The helmet material can break down with exposure to sweat, heat, dust and rain.


If an Injury Happens

Responding to a severely injured rider

If an accident resulting in an injury occurs, do not approach the victim until you know the scene is safe. You don't want to become a victim yourself. Think clearly and pay attention to the environment. If the scene is not safe, try to create a safety zone around the victim. If possible, make sure the horse is secured. If it is not safe to approach the victim, call 911 for help immediately.

As you approach, speak to the injured person to see if he/she is able to talk or respond to you. If the person is alert and able to talk, ask them where it hurts. Determine whether you are able to help the victim yourself or call 911 for assistance if necessary.

If the injured person does not respond, then touch, rub or pinch the patient's skin to try to incite a response. Do not shake the patient in case a spinal injury is present. If the injured person remains unresponsive, or if he/she appears to have serious injuries, do not move him/her or allow him/her to move unless absolutely necessary (for example, if the rider is face down in water). Call 911 to get help.

If the patient is unresponsive, follow these steps:

Look, listen and feel for breathing. If the patient is breathing, do not move him/her. Look for signs of injury.

If the injured person is not breathing, ensure the airway is open. Open his/ her mouth by lifting the chin or pushing the jaw forward.

Feel for a pulse in the patient's neck or wrist. If there's no pulse, start cardiopulmonary resuscitation (CPR) if you are trained. If you are not trained, wait for emergency medical personnel.

If an injured person is bleeding, place a dressing over the wound and apply pressure to the site until the bleeding stops. If you suspect the person has a broken bone, stabilize the injured part and seek medical assistance. Keep the injured person warm, and do not allow him/her to eat or drink until he/she has been evaluated by a medical professional. It is always good to have one or more persons in your riding group trained in CPR.


Could  this  happen  to  you?

"Just last Monday I rode my horse. He is a good horse, we never had a problem. A few days ago, however, the air was crisp and we were both feeling a little frisky. We got into a trot which I wanted to sustain for a while. He obliged me, staying in perfect cadence for several runs around our equipment garage. He let out a few snorts, telling me that this was fun! Then, ever so quickly, I felt him tighten and I felt myself flying up and over his right shoulder. Usually this sort of thing happens in slow motion. Not this time! I slammed onto the ground - right on my head - and then slammed onto my back on the gravel driveway. Yes, I was wearing a helmet. As it turned out, I got a really good concussion and wrenched my arm in the fall - probably from reaching out and grabbing the saddle as I fell. My left hand was blistered and torn. My back quickly swelled. And my head ached. When three days later the ache became piercing and my attention became fuzzy, I went to the doctor. After a CT scan I was diagnosed with a concussion and contusions. As of today - a week and two days later - my arm still hurts, but my head is much better."

Lunge or walk a horse that has been inactive or is frisky. Some horses need to be able to let off some steam without a rider on their backs, some don't. Know your horse and its personality so you can approach riding safely.


Calling EMS (911)

When you call Emergency Medical Services (EMS), give the dispatcher as much information as possible about your location and the type of injuries the victim sustained. Be sure to give EMS a phone number where you can be reached if the emergency personnel have difficulty finding you. If possible, send someone to meet the EMS unit at the nearest road to escort them to your location. Request that EMS turn off sirens at that point to avoid spooking horses. Never leave the victim alone unless absolutely necessary. If EMS is arriving by helicopter, be sure to secure all horses. Let EMS know if there are loose mounts in the area. Avoid cutting fences, as EMS can usually climb fences to get to a victim, and try to avoid situations where other animals could get loose and cause problems. Unless necessary, avoid cutting and removing the victim's clothes, boots, etc. as it may cause further injury.

Minor Injuries

Minor cuts and scrapes usually do not require a trip to the emergency department. With proper care you will be able to avoid infection and other complications. Here are some guidelines for care of these minor wounds:

Stop the bleeding. Place a clean dressing or cloth over the wound and apply gentle pressure. Elevate the wounded area if possible. Keep constant pressure over the wound. Do not remove the dressing. If you notice spurting of blood or you are unable to get the bleeding to stop, seek medical attention. 

Clean the wound. Once the bleeding has stopped, rinse the wound with clean water. Remove any dirt or debris from the wound. Retained debris can lead to infection, so seek medical attention if you are unable to get the wound clean. Wash the area with soap and water or a disinfectant wipe. Apply an antibiotic cream or ointment to keep the surface moist, and cover with a clean dressing. Change the dressing at least daily until the wound heals.

Stitches. If the wound is deep, gaping or jagged, it might require stitches. If you cannot easily close the wound, see your physician as soon as possible to have the wound closed. Most wounds must be closed within six to 12 hours, if they are to be sutured.

Watch for signs of infection. If the wound is not healing or you notice increased pain, redness, drainage and/or swelling, seek medical attention. Also, if you have not had a tetanus booster shot within the past 10 years, get one as soon as possible after the injury.


Could  this  happen  to  you?


"I was working with a trainer, helping back a 3-year-old who had some negative experiences with a previous trainer. The trainer was giving me a leg up onto the horse (bareback). After several very calm mounts and dismounts, the horse spooked at something and started spinning and bucking while I was on his back. I reached the point where I decided to let myself fall. However, he had spun so many times, I had lost my bearings in the arena and came down nearly on top of the thick steel-pipe arena fencing (it was an old roping ring). My right leg hit the top rail of the arena fence, impacting about 4 inches above my ankle. My tibia was broken in two places, and fibula in one place. Those were my only injuries. The fractures did not compound. They did require surgery and two plates and 10 screws to repair the tibia. Then, I wore a cast/boot for eight weeks, then underwent about nine months of physical therapy to really get it strong and flexible again."

Stay away from arena fencing or walls when initially backing a young horse or one with known issues. Young or untrained horses are unpredictable; never put yourselfin a situation where you might be trapped or thrown against a wall or fence.

Sprains, Strains, Extremity Fractures

Sprains, strains and fractures are common due to falls. Results of some fractures are obvious due to deformity of the injured part. Fractures are considered compound if there is a break in the skin at the site of injury, or closed if no open wound is present. Sprains, strains and fractures where there is minimal displacement of the bones are less obvious so X-rays might be necessary to determine the exact injury. Each of these injuries could be characterized by pain at the injury site, decreased ability to move the affected part, and/or swelling at the site. Bleeding might be present with open wounds. The treatment goals for these injuries are to prevent further injury, reduce pain and control any external bleeding.

Do not attempt to straighten the injured area or pull broken bones back into the skin.

Apply a dressing over any areas of broken skin and apply direct pressure over the dressing to control bleeding, if present. If bleeding is severe, continue holding pressure over the bleeding site and call 911 for help. Keep adding dressing if it becomes saturated; do not pull old dressing off, as it will tear blood clots away.

If you have to move the patient, immobilize the injury site to stabilize the injured part and prevent further injury. This can be done by making a splint long enough to immobilize the joint above and below the site of injury. You can use pieces of wood, a walking stick, sturdy tree limbs, or rolled-up newspapers or magazines as splints. Place these splints on each side of the injured limb. Wrap roll-type bandages, triangular bandages or thick tape around the splints to secure them to the affected limb.

Elevate the limb and apply an ice pack to site if possible.

Could  this  happen  to  you?

"I purchased a cheap saddle off the Internet for my youngest daughter, thinking I would upgrade in a year or so and purchase a nicer saddle, the first time I put the saddle on the horse, it didn't "feel right." The second time, I thought to myself, "This just doesn't feel safe... but it will just be for a few minutes." My daughter's arm was severely broken just above the elbow. She had to have three pins put in her elbow. She spent two days in the hospital but has healed perfectly. Slowly but surely, we are working our way back to the fearlessness of riding we had prior to the accident. It was my fault for trusting a cheap cinch strap."

Always do a safety check on your tack, regardless of the qualify. This will help to identify problem areas before they become a problem.



Head Injuries

The best treatment for head injuries is prevention. When riding, always wear an approved helmet that is in good working condition. If a rider who has sustained a fall displays any of the following, call 911 and make sure he/she receives immediate medical attention:

Severe bleeding from the head or face

Bleeding or clear fluid draining from the nose or ears

A severe headache

Vomiting

Loss of consciousness; disorientation or confusion

Bruising below his/her eyes or behind the ears

Weakness or inability to use an arm or leg

Blurring of vision

Unequal pupils

Slurred speech

Seizures

Keep the patient still and calm. Avoid moving the patient, and immobilize his/her neck if possible. Do not remove the helmet until EMS makes that decision. Control any external bleeding by applying dressings and holding gentle pressure over the site.

Watch for changes in the patient's alertness and breathing pattern. Be prepared to start CPR if breathing and heartbeat stop.


Spinal Injuries

If a rider falls and has pain in his/her neck or back, or is unconscious, suspect that a spinal injury might be present. Do not move the victim or allow him/her to move unless the patient cannot breathe. Call 911 for assistance with immobilizing the person and transporting him/her to the hospital.


Could  this  happen  to  you?

"I was bucked off my mare during a natural-horsemanship clinic. On the second day of the clinic, we were to ride our horses through an obstacle course. One of the tests was to grab a hula hoop off of the fence post, walk a few feet, and then throw the hulatioop around a cow head. When I reached for the hula hoop, my horse spooked to the side. I was still on her and just about to regain my balance when the lady who was running the clinic yelled for me to drop it. When I did, it bounced and hit my mare's leg, which sent her into a rodeo-style bucking spree. Needless to say, I did not last eight seconds. I was catapulted off and landed with my knee twisted to the side."

Desensitize your horse to any unusual stimuli ahead of time.



Chest and Abdominal Injuries

Many chest and abdominal injuries can be prevented, or their severity can be minimized, by wearing protective vests. The routine "old" vests helped prevent puncture wounds. The new rapidly inflatable (CO2 canister) vests provide more protection from crushing. If a patient has a wound that penetrates the chest or abdomen, he/she should be evaluated by a physician. Do not pull out the penetrating object.

Riders who have sustained blunt trauma can be more difficult to evaluate because internal bleeding might be hard to recognize. If an injured rider develops any of the symptoms below, call 911 for transport to the hospital immediately:


Shortness of breath or difficulty breathing

Pain with breathing

Severe abdominal pain

Coughing up or vomiting blood

Abdominal tenderness

Blood in the urine or from the rectum or vagina

Signs of shock, including pale skin color, weakness, loss of consciousness, faintness, thirst, anxiety, rapid heart rate and skin that's cool to the touch


Tips  from  injured  riders


Put toe stops on your stirrups.

     I always give my horses a quick check over. I touch their back, run my hands down their legs, and check their hooves and girth area to make sure there are no unseen injuries. Sitting in the saddle is not the time to find out the horse has a sore back.

      Always wear your helmet, and after a fall replace your helmet.

      If you fall or are kicked, it is wise to be safe and make sure there are no internal injuries. Often injuries to liver, spleen and other organs are not evident initially. Seek medical care immediately to be safe.

      Everything you do with your horse before you put the saddle on will result in a safe ride. Perform an equipment safety check before each ride and periodically during a lengthy one.




After the Injury Happens

If you visit a physician or a hospital emergency department for diagnosis and treatment of your injury, make sure your treatment team knows you ride horses. It is important that they tell you what your injuries are and if there are any limitations on your activity. Before you ride again, be sure you have medical clearance. Any individual with persistent post-concussion symptoms that (a) worsen, (b) do not improve over time, (c) increase in number, (d) begin to interfere with the daily activities (for example, sleep disturbances, cognitive difficulties) and/or (e) cause personality changes (often noted by family and friends) should seek further evaluation.

The Centers for Disease Control and Prevention recommends, "Referral to a specialist who cares for patients with mild traumatic brain injury (MTBI) is appropriate if symptoms do not improve within three to five days post-injury, or sooner, and if the type or severity of symptoms is of concern. An assessment by a specialist such as a neurologist, neuropsychologist or physician with training and expertise in concussion management can be particularly valuable to further evaluate the patient's situation and to help manage their condition (e.g. return to sports, school and work)." Getting help soon after the injury by trained specialists may speed recovery.


When you visit your doctor, here are some important questions to ask:

•What can I do to help my recovery from this injury?

•When is it safe to get back to my daily routine, such as school, work, or riding and doing other physical activities?

• Do I need to see a specialist?

Signs of a Concussion

The signs and symptoms of a mild traumatic brain injury (MTBI), also known as a concussion, can be subtle. Symptoms of MTBI may not appear until days or weeks following the injury or might even be missed, as people might look fine even though they could act or feel differently.


Headaches or neck pain that do not go away*

Lightheadedness, dizziness or loss of balance*

Mood changes (feeling sad or angry for no reason)*

Difficulty remembering, concentrating or making decisions*

Slowness in thinking, speaking, acting or reading

Getting lost or easily confused

Feeling tired all of the time, having no energy or motivation

Changes in sleep patterns (sleeping a lot more or having a hard time sleeping)

Urge to vomit (nausea)

Increased sensitivity to lights, sounds or distractions

Blurred vision or eyes that tire easily

Loss of sense of smell or taste

Ringing in the ears

Loss of consciousness, although this does not always occur

*most common


Rehabilitation

Rehabilitative therapy is usually the next step in the recovery process following a serious injury. Major rehabilitation hospitals provide their patients with multidisciplinary therapies based on their diagnosis through inpatient, outpatient and home health care services. Treatment plans are individualized based on the patient's diagnosis and physical ability to participate in therapy. Daily activities could include physical, occupational, speech and/or respiratory therapies, and nursing care. Most rehabilitation hospitals offer numerous types of therapy along with technology and equipment for their patients. Upon discharge from a rehab inpatient stay, patients could be referred to an outpatient or home health program. Consistency is the key component in each patient's recovery. Therapy teams need to work together to determine the best recovery path based on the diagnosis.

Therapies that could be prescribed after horse-related injuries

Physical therapy - assesses and treats the individual's mobility, strength and endurance needs.

Occupational therapy - assesses and addresses the individual's daily living activities and vocational skills and interests.

Speech therapy - treats speech problems and disorders, especially through use of exercises and audiovisual aids that develop new speech habits.

Respiratory therapy - manages acute and chronic breathing disorders.

Aquatic therapy - uses water to improve mobility.

Hippotherapy - utilizes equine movement to facilitate physical, occupational and speech-language therapeutic recovery as part of an integrated intervention program.

Therapeutic riding - (also known as equine-assisted activity or adaptive riding) improves balance, coordination, focus, independence, confidence, and motor and social skills of the patient. Therapeutic riding is beneficial to children and adults who have cognitive, physical and emotional conditions.

Resources

Kentucky Vocational Rehab - www.ovr.ky.gov

Brain Injury University at Cardinal Hill Hospital - www.cardinalnill.org

Brain Injury Alliance of Kentucky - www.biak.us

Spinal Cord Injury Association of Kentucky - www.sciak.org


Wear, tear and accidents - replacing your helmet

As a general rule, you should replace a helmet every five years. Time takes its toll on the material properties of a helmet mainly because of small dings and bumps, as well as the effects of temperature variations that occur overtime, expanding and compressing the materials over and over again. If your helmet has been subjected to a lot of hours in a hot car or has been handled and,used a lot, plan on replacing it closer to the three or even two-year mark.

Replace your helmet anytime you're in an accident, whether the impact is severe or minor. Even if you don't see any damage, the inside materia] of the helmet where impact occurred could have been compromised. NEVER use a helmet that has sustained an impact.

Another reason to regularly exchange your helmet is the ongoing improvement in helmet technology.

Most companies have low-cost replacement policies. Read the manual that comes with your helmet. It is important to register your product with the manufacturer upon purchase and/or keep your receipt to show proof of purchase date.

While most people have a tendency not to read manuals, when it comes to your helmet, reading the manual could save your life!


Psychological Consequences of Equine Injury

Equestrians who have been traumatized as a result of equine injury will often experience some psychological distress. For most injured riders it passes within a few weeks, but it's not uncommon for others to have difficulty coping with the consequences of trauma for a much longer period, and in some cases it can generate a long-lasting impact on their well-being. Some examples of the psychological consequences of trauma are intrusive thoughts, nightmares and flashbacks of the injury, avoidance of horse-related activities and other reminders of the injury, and sleep disturbances. When these last a long time, they can result in considerable social, occupational and interpersonal difficulties.

Equestrians often avoid dealing with psychological trauma. Talking about the injury without adequate help can cause additional distress. Also, equestrians may incorrectly think themselves weak or inadequate if they are unable to deal with their distress on their own. One other danger is that the fear and anxiety caused by the injury can negatively influence riding skills and communications between rider and horse and might result in repeated accidents.


To recover from equine injury:


Seek support from family and friends.

When necessary seek professional help.

Think of the injury as an opportunity to learn and grow both as a person and equestrian.

Consider working with an instructor or attending a clinic that addresses issues related to fear and recovery from equine injury.


Could  this  happen  to  you?

"I was trampled by another person's horse. My horse threw me while I was riding with five of my friends, I was just fine, got up to catch my horse, and the inexperienced rider in front of me pulled back on her reins and her horse knocked me back down in the narrow trail and trampled me. She then turned the horse around on top of me. I was stepped on at least 15 times, four on my head. My helmet saved my life. So it does not have to be damage from your own horse. I also had four broken ribs, multiple fractures, and hoof-shaped bruising on my legs, arms, face, chest and abdomen; but my head was protected. I would not be here today if it weren't for that helmet."


Wearing a properly fitted approved helmet all the time is good advice.



RESOURCES

Available Booklets



Horseback Riding Safety

This booklet reviews some of the facts about horseback riding injuries and reviews many basic safety tips for equestrians to use.


Horse Transmitted Diseases

While not common, it is possible to acquire some diseases from a horse. Some of the more common diseases are discussed and suggestions for prevention are offered.

If you would like more copies of Horseback Riding Safety, Horse Transmitted Diseases, or this booklet Horse-Related Injury, please call 859-257-1000 or 1-800-333-8874 (toll free).

SaddleUpSAFELY.org

The Saddle Up SAFELY website is always expanding, with new information constantly being added by our experts and visitors, especially those who have been injured. To read tips from other riders and notes from our review team of certified horseman safety experts, go to SaddleUpSAFELY.org and click on Tips from our website visitors. You may also share your injury or leave a tip on the site, as well as read Dr. Fernanda Camargo's horseback riding safety blog and columns from our safety experts.


Could  this  happen  to  you?

"I was kicked in the hip by my horse while he was in cross-ties. It was a very cold day when I went to ride. I put my horse in cross-ties in his stall, removed his winter blankets and stuffed them into the grates of his wall hay-rack, which was located toward the rear of the stall. Then I proceeded to groom him. As I was brushing his flank, loin and hindquarters, unbeknownst to me, the blankets were coming loose from the hay-rack, slipping out of the grates. They have a nylon cover and upon coming loose entirely and falling to the ground they made a loud rustling sound. Immediately, my horse cow-kicked at the sound and hit me in the hip. This all happened so fast, had no idea what had just happened. I was on the ground in pain, so I rolled over and crawled out of the stall. Even though I was wearing heavy winter jodhpurs, the blow had torn the fabric and I was bleeding. The story all came together for me as I was lying in the aisleway, looking back into the stall. Hence, my first and hopefully last ambulance trip."

Stalls need to be safe for horses. Take blankets and other horse equipment out of the stall and store them in the tack room.


Further Reading

The best way to learn horseback riding and horse handling safety is from an experienced instructor. But horseback riding safety books are another option to supplement your learning. Many of the books can be found in libraries and all can be purchased inexpensively as used books in used book stores or online. Some examples of good reading include:

Early publications

Kauffman 's Manual of Riding Safety, Sandra Kauffman, 1978

Walter Farley's How to Stay Out ofTrouble with Your Horse, Walter Farley, 1981 .

Riding and Stable Safety, Ann Brock, 1983

More recent publications

Safe Horse Safe Rider, Jessie Haas, 1994

The Horse, Safety and the Law, Vanessa Britton, 1994

Happy Trails, Les Sellnow, 2004

101 Trail Riding Tips, Dan Aadland, 2005

Equine Emergency Bible, Karen Combe, 2007

Horsemanship Composite Manual, Certified Horsemanship Association, 2008

For children

Safety, Tom Webber, 2004

Horse Safety, Elizabeth Moyer, 2008


Be sure to check out the resources below for more in-depth information about horse-related injuries and how to prevent them from occurring.

Other Equestrian Safety-Related Resources

American Riding Instructors Association

Promotes safe, knowledgeable riding instruction and certifies training for teaching. www.riding-instructor.com

Centers for Disease Control & Prevention

Offers fact sheets, videos and podcasts on adult and child safety for horseback

riding and horse handling.

www.cdc.gov

Equestrian Medical Safety Association

Provides education, research and resources to protect riders and improve safety

within equestrian sports.

www.emsaonline.net

Pegasus Helmets

Offers videos on fitting a helmet and a toll-free number for advice. www.pegasushelmets.com

Troxel Safety Center

This helmet manufacturer's site contains useful tips from professionals in the field. www.troxelhelmets.com/safety

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