University of Vermont AAHS

AMEA

November 1996, Vol. VI, Number 4

Table of Contents

Excerpts from FIT for RIDING
Aerobic Training v. Aerobics
USCT Statistics for 1990, 1991, 1993, 1995
The Stirrup Debate
1995 NEISS Figures


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Selected Excerpts from Fit for Riding: Exercises for Riders and Vaulters

Reprinted with permission from Half Halt Press

Training and Conditioning

In riding, most people see the horse as the one who must trained and fit. But only a fit rider can give maximum support to the horse and guide it to high performance levels. We practice and exercise to improve riding skills. We train to improve fitness or conditioning for riding so that we can repeat the same exercise or movement several times without tiring.

TRAINING gives us speed, strength, and endurance, increases our physical performances in those areas, and helps us attain such qualities as elasticity, speed and strength endurance. Training also increases our mechanical extension, flexibility, and coordination. Follow a regular routine, discipline yourself to build up gradually and systematically, and set goals.

CONDITIONING refers to the body's ability to be productive both physically and psychologically. The goal of general conditioning is even development of the entire body, whereas special conditioning focuses on getting fit for a particular sport.

SPEED refers to the ability to execute moves at short intervals and depends on the interaction of the brain and the muscles. If certain moves cannot be made fast enough, the. brain lacks flexibility. If the demand (stress) is very high (like riding a powerful, stubborn horse), you depend on your strength for speed in making the moves. This is what is known as speed of action. Speed of reaction means the rider reacts quickly to stimuli to eyes, ears, skin, sense of balance, or muscles. In riding, you have to make certain moves over and over again for a long period of time. Speed endurance allows you to repeat the same movements and to repeat them properly each time.

STRENGTH is the ability of the muscles to contract or to overcome resistance. Maximum strength is the greatest strength you have. Elastic strength refers to the ability of your brain to work with the muscles to allow you to move quickly. Enduring strength calls for speed endurance, but also allows your body to withstand over tiredness during long periods of exercise and training.

ENDURANCE: Aerobic endurance is when your body has enough oxygen to make the moves you want to make, a balance of oxygen intake and expenditure of energy. Riders need a high degree of aerobic endurance. The greater your aerobic endurance, the better you can develop your speed and strength endurance.

Agility is often described as joint mobility, suppleness, and flexibility. Essentially agility means flexibility - the ability of a joint to have the greatest freedom of movement that the physiology of the joint allows. A rider is agile when all joints are working freely and moving with ease. Agility can by limited by the structure of your body: the way your joints are built, the arrangement of your tendons and ligaments, the length, elasticity, and expandability of your muscles, and particularly if you are overweight. Agility is also influenced by your age, outlook, level of conditioning. degree of fatigue, outside temperature, time of day, or your method of warming up.

COORDINATION is the interplay of muscles. Riders must be highly coordinated - they need coordination to learn, to steer, and to be adaptable and flexible. In reaction to a situation, you are coordinating your eyes, ears, and skin and you are transmitting a sense of balance to your muscles. Coordination for steering includes your senses of orientation, balance and the resulting use of special muscles. If you are adaptable and flexible, you can make the right moves under various conditions and in changing situations. You will be working on five other coordination skills as well: orientation to space, sense of balance, reaction times, sense of rhythm and muscular coordination.

Orientation to space means that you can see your body in relation to the environment and time, and you can judge your moves of distance and obstacles. You need to be able to maintain your sense of balance, even when your center of gravity changes as when a horse knocks down a jump. If you have good reaction time, it means you can react to a certain event quickly and with an appropriate move, This is the ability you call on to react to a signal or when something unexpected happens. Your sense of rhythm comes into play with a change from a relaxed to tense movement such as posting to the trot. Muscular coordination allows you to impart a high degree of accuracy and finesse to your movements.

Basic Conditioning for Riders

A rider needs general aerobic endurance. The more oxygen you take in, the longer you can ride without tiring. General conditioning exercises train the rider's body as extensively as possible (see Practical Part I: General Conditioning exercises in text). These exercises can be done in circuits to achieve aerobic endurance. You need speed and strength endurance to apply the aids with your leg, back, stomach and arm muscles. You need to be agile so you can move with your horse.

Since the rider needs a fine-tuned interplay of all the muscles, you have to exercise for it constantly. You have to be able to coordinate your back, legs, and arms to give aids smoothly and quietly; this kind of coordination is particularly difficult because you often will be using cross movements -- right leg, left shoulder.

General Training Principles

For speed and elasticity, exercises should be repeated up to 10 times. For speed and endurance, repeat them 20 to 30 times. To achieve general aerobic conditioning, exercises like jumping rope should be done 40 to 60 times.

We start out in different conditions so it is impossible to prescribe a certain number of exercises. You might want to start by working with a trainer at a gym who can give you a conditioning test. But if you are working on your own, the rule is this: Once you have figured out how to do the exercises in the front of the book, repeat them frequently.

To add agility and coordination to speed and strength endurance, repeat the special exercises at least 15 times each (see Practical Part II:. Additional Exercises for Riders in text). Your performance level and coordination will increase only if you have done the maximum number of repetitions frequently and regularly.

What you are seeking is a program that works you at 80% of the maximum that your current physical condition will allow you to do. If you exercise too much (90% or more), you are not going to feel very well and may do yourself some harm. When you are ready to step up your program, you want to do it at 80% of your capacity. For endurance training, you should be working at 50 to 60% of capacity.

How do you calculate your capacity? If you can do an exercise only 10 times in a row, you have to repeat it during training at least 8 times to train the specific muscle groups and you have to do it often (repetitions). If your best time for running 100 meters is 12 seconds, you have to be able to maintain a speed of 24 seconds for 100 meters (50% of maximum speed) for 20 minutes to achieve endurance.

As you ride, your energy level drops. The loss of energy requires a recovery period. It is important to maintain the right balance between work- out and recovery. If you maintain a proper training schedule over a long period of time, you will achieve greater efficiency. If you increase your training slowly, you will get maximum benefit from each session and increase your performance. But your performance will deteriorate if you exercise too much and do not rest enough afterward.

As your performance improves, your progress will slow down. At first, a little bit of exercise will create noticeable improvements in your performance and in how you feel, and the greater your training goals, the more you have to train just to maintain the conditioning you have achieved. Later in the training process, you will be working hard, but seeing only a little bit of improvement . Because your body adjusts to the stress of training, you have to check from time to time on how much training you are doing. For example, if you jog twice a week for one hour, after three or four weeks, you will have to jog farther and longer or increase the frequency or speed to experience the original amount of stress.

Training once a week does not increase performance; at best, it maintains your training level. Training every two weeks will not do anything for you. Your goal should be to train several times a week, and the frequency should be increased systematically over several years.

Everyone is different, so we need different programs to address different problems and abilities. If you have good aerobic endurance, you can concentrate on other needs - but do not lose sight of aerobic endurance. Also we each have different priorities and goals. A dressage rider needs agility and coordination in addition to good basic conditioning. An event rider needs extra endurance - general endurance and speed and strength endurance - especially for the cross-country day.

Warm Up

Warming up increases the amount of blood that supplies the muscles with the oxygen and nourishment needed for riding. Metabolic waste, which burdens muscles, is taken away, preventing muscle soreness. It also is important for the intensive blood supply of the capillaries, the fine vessels right under the skin, to get a better oxygen supply.

Warming up makes your body's temperature rise. Because the temperature in your arms, hands, legs, and feet can be lower than 98.6 degrees (especially on cold days), it is easy to see how important warming up is for those body parts because we rely on them so much in riding.

The tempo and depth of your breathing increases during your warm-up to give your muscles more oxygen and to take the carbon dioxide away. As you continue to warm up, you will soon reach a point where you are breathing rapidly but evenly. Warming up also makes your muscles more elastic and your whole body becomes more mobile. Low outside temperatures can disturb your mobility and coordination, increasing the risk of injury if you do not warm up first. With less friction and more elasticity different muscles and muscle groups coordinate better. Warming up also relaxes you, which is good for your muscles.

A general warm-up prepares large groups of muscles, not necessarily the ones you need for specific activities. The exercises have to be repeated often to get your cardiovascular system charged and they have to be increased slowly to get the body to optimum temperature (101.3 to 102.2 degrees Fahrenheit). The exercises should work different part of the body progressively rather than the same ones frequently.

from: FIT FOR RIDING: EXERCISES FOR RIDERS AND VAULTERS (1992)
written by Eckart Meyners and translated by Elke Hemrann
Half Halt Press, Inc.
PO Box 67, Boonsboro, MD 21713
800-822-9635
(Summary: Doris Bixby Hammett, MD; edited by Johanna Harris)

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Aerobic Training Versus Aerobics

When most people hear the term aerobic, the first vision that pops into their head is of svelte celebrities sweating to the oldies on video, dumbbells in hands, rhythmically stepping on and off their hot pink step hoards. However, there is a distinct difference between aerobic training and the aerobics we love to hate.

The food you eat and the air you breath go through complex processes to create the chemical required for muscle contraction, adenosine triphosphate (ATP). The mechanical work of muscular contraction can only he performed when energy is released by the breakdown of ATP. There are three common energy producing systems that produce ATP: (a) the ATP-PC (or phosphagen) system, (b) the anaerobic glycolysis system, and (c) the aerobic system. Each system contributes to energy production according to the type of exercise being performed (short-duration, maximum-effect or long-duration submaximal-effort), as well as the athlete's state of training and diet.

The ATP-PC system is an anaerobic process that provides the most rapidly available energy and is used for brief maximal efforts, such as sprinting 100 meters. The anaerobic glycolysis system releases energy to synthesize ATP through the partial breakdown of glucose and glycogen to lactic acid, supplying energy for high intensity short-duration events, such as sprinting 400 or 800 meters. The aerobic system yields the most energy for ATP production, breaking down carbohydrates, fats, and sometimes protein. This is the primary system that fuels low-intensity long duration activities, those lasting more than 12 or 13 minutes (such as riding, cleaning stalls, or running a marathon).

During competition, a barrel racer may rely primarily on the ATP-PC system (90%) and only slightly on the anaerobic glycolysis system (10%), whereas a polo player may rely almost equally on the anaerobic glycolysis system (40%) and aerobic system (60%). The specific equestrian exercise training program you chose to follow must sufficiently stress the primary energy system(s) used during your particular equestrian event. The more the system is stressed during training, the more efficient it will become, allowing you to perform more work with less fatigue,

However physical training regimens that stress these energy producing systems may plot necessarily produce the health-related benefits associated with cardiorespiratory fitness. To realize optimal cardiorespiratory fitness benefits, the exercise program must be of sufficient type, frequency, intensity and duration. It must be rhythmic, continuous, and involve the large muscle groups of the body. In addition, the exercise program must stress the aerobic energy producing system. Appropriate activities would include jogging, swimming, hiking, rowing, biking, aerobic dancing and bench stepping aerobics. The exercise must be performed with sufficient intensity to maintain a target heart rate that is 60 to 90% of your maximum heart rate reserve and be maintained for 20 to 60 minutes, 3 to 5 days per week.

Heart Rate Reserve = Maximal Heart Rate - Resting Heart Rate Maximal Heart Rate = 220 - Your Age

With this information in mind, you can see that a physical training program that stresses the aerobic energy producing system may not necessarily produce the health-related benefits associated with cardiorespiratory fitness. A balanced equestrian physical training program must develop muscular strength and endurance, flexibility and cardiorespiratory fitness.

Johanna L Harris, MS
118 Lower Sand Branch Road
Black Mountain, NC 28711

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USCTA Statistics and Trends Years 1990, 1991, 1993 and 1995

Data collected from the technical delegate (TD) reports from horse trials including 3-Day Events were analyzed for the years 1990, 1991, 1993 and 1995. Horse trials include three phases - dressage, cross country jumping, and stadium jumping. Three- day events also include steeplechase and roads and tracks. A technical delegate is a licensed official of the American Horse Shows Association.

Several disclaimers must be included with these statistics. The TD reports vary in completeness. Some list every accident on the show grounds (including a plane crash in one example) and others list only that "several riders fell off and were okay." The follow-up of the accidents is often unknown. Serious accidents could he missed by this lack of follow-up. The TD's are not physicians and their impressions are not corroborated. It is often difficult to tell in the statistics the difference between "no injury" and "unknown." The nomenclature of the TD's is often non-specific. Reference to a "broken leg" does not differentiate between a fracture of a femur at a tibia. I made the assumption that if the TD stated "It looks like a fracture," it was a fracture, We did not look at the incidence by variables of age, sex or fall of rider versus fall of horse and rider. Statistics were not analyzed far 1994 because the national headquarters was moved from Massachusetts to Virginia during that year.

The number of competitors at USCTA sanctioned events has increased from 25,000 in 1990 to almost 30,000 in 1995. In spite of all the disclaimers, the data reveal a fairly consistent injury rate over the four years recorded. (0.36%, 0.38%, and 0.39% per competitor for 1990-91 1993, and 1995 respectively). Each entry per show is considered to be a competitor and in the case of the same individual riding four horses, for example, it would be considered four competitors.

Advanced and intermediate divisions had the highest injury rates (0.83% and 0.84% respectively) and also involve the most difficulty and the greatest number of jumping efforts. The statistics again reveal a consistent location of incidents over the four years with cross country jumping being the most frequent location (72%, 72%, and 73% respectively) and stadium jumping the second most frequent location (9%, 10%, and 10.5% respectively The injury type by location on the body showed head injuries to be the second most common location for 1990, 1991, and 1993 but the 6th most common in 1995 with 16%, 21%, 20% and 10% of the total incidents respectively. This perhaps reveals an increased use of ASTM helmets. The most common location for injury was the shoulder/clavicle area in 1990 and 1991, neck/back in 1993, and upper extremity (exclusive of shoulder and clavicle) in 1995.

Of the incidents reported, 72% resulted in non-serious injury and 28% resulted in serious injury. Thirty-nine per cent of those injured were transported. Of the non-serious injuries, other than no injuries, the most common type resulted in bruises, contusions, and/or abrasions from falling off in a jumping phase. Of the serious injuries, the most common was fracture (48%) with concussion being second (25%). The percentage of concussions dropped from 10% of the total types of injuries in 1993 to 4% in 1995. The number of unconscious riders following falls was 2% of all riders in 1993 and 1% in 1995. Fracture of the clavicle was the most frequent fracture (27%) with finger second (16%) and ankle third (14%). While most serious injuries occurred in a jumping phase, there were serious injuries in other phases, although uncommon, with a concussion in dressage, a concussion following a kick in the head during loading a horse in a trailer, and a suffocation while sleeping in a trailer using a propane heater at night (resulting in death).

In 1993 the type of fence involved in cross country incidents was analyzed. Water jumps accounted for the most incidents (19%) with 27% of those incidents being serious. Ascending oxers, vertical fences, falls between fences, and square oxers were the other most common sites of injury. Serious injuries varied from 0% for falls between fences to 50% for ascending oxers. One death occurred at a square oxer (table fence). This type of fence was previously reported to be the major cause of death in English horse trials when analyzed by cross country fence type. (USCTA NEWS October 1993.) There were 12 back injuries in 1993 and 7 in 1995. All of these occurred on cross country. In 1995 there were 3 kidney injuries and 2 punctured lungs. Protective vests were mandated in 1996. Whether there will be a decrease in these injuries with protective vests remains to be seen and further statistical tracking after the mandate should help to reveal this.

      MOST FREQUENT NON-SERIOUS INJURIES

1993 & 1995 (N=198)



1. Bruises
2. "Winded"/"Shaken Up"
3. Laceration
4. Strain / Sprain
5. Allergy / Asthma

MOST FREQUENT SERIOUS INJURIES

1993 & 1995 (N=77)


1. Fracture 48%
2. Concussion 25%
Unconscious 6%
3. Dislocation 10%
4. Heat Illness 6%
5. Pneumonthorax 2.5%
Death 2.5%

TRANSPORTED (n=lll)

1993 -33% 1995 -44%


MOST FREQUENT BODY LOCATION

YEAR 1990 1991 1993 1995

n=93 n=110 n=122 n=158
Most Freq. Shoulder/ Shoulder/ Neck/ Upper
Clavicle Clavicle Back Extremity
Second Head Head Head Lower Extremity
Third Upper Neck/ Upper Shoulder/
Extremity Back Extremity Clavicle
Fourth (tie) Face (tie) Upper Shoulder/ (tie) Neck/
Extremity Clavicle Back
Fifth (tie) Face/ Face Lower Face
Back Extremity


MOST FREQUENT AREAS FOR INCIDENTS ON X-COUNTRY

1993 (N=57)


Number % Serious
Water 11 27%
Ascending Oxer 10 50%
Vertical 9 36%
Between fences 8 0%
Square Oxer 5 40%

FRACTURE LOCATION

1993 1995 TOTAL
N-16 N-21 N-37


Clavicle 38% 19% 28%
Finger 25% 10% 17%
Wrist 13% 10% 11%
Leg 0% 14% 8%
Ribs 0% 10% 5%
Nose 0% 10% 5%
Sacrum 6% 0% 3%
Lumbar 6% 0% 3%
Elbow 0% 5% 3%
Knee 0% 4% 2%
C1-C2 0% 4% 2%

MOST FREQUENT TYPE OF INJURIES
1993 1995

1. Bruises/Abrasions/ 1. Bruises/Abrasions/
Contusions (26) Contusions (27)
2. Fractures/Dislocations (2O) 2. Shaken Up/Winded (22)
3. Lacerations/Cuts/Bites (16) 3. Fractures (21)
4. Concussion (12) 4. Strains/Sprains(8)
5. Strains/Sprains (6) 5. Concussions (7)

INJURIES BY LEVEL OF RIDING
1993 1995 % Competitors
at this level

Novice 33% 32% 0.28%
Training 34% 18% 0.38%
Preliminary 23% 34% 0.63%
Intermediate 8% 11% 0.84%
Advanced 1% 5% 0.83%


INJURY RATES PER COMPETITOR

1990-91 0.36%
1993 0.38%
1995 0.39%
4 YEAR AVERAGE 0.37%


PERCENT OF INJURIES
1993 & 1995 (N-275)


Non-serious Injury 72%
Serious Injury 28%

SERIOUS INJURY OTHER THAN CROSS COUNTY
1993 & 1995


Dressage: Concussion
Stable: Suffocation in trailer
Concussion loading horse
Stadium Jumping: Two concussions

INJURIES BY LOCATION
1990-91 1993 1995

Cross Country 72% 73% 73%
Stadium Jumping 9% 10% 11%
Jump Warm-up 6% 3% 7%
Stabling 3% 4% 5%
Show Grounds 4% 9% 3%
Dressage 1% 1% 1%

David A. McLain, MD, FACP, FACR
Safety Committee Chairman, USCTA
2022 Brookwood Medical Center Drive, Suite 509
Birmingham, AL 35209

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The Stirrup Debate

ISSUE: What should Ockanickon's (a camp which serves disadvantaged children) policy be for participants who wish to horseback ride, but arrive at the barn wearing sneakers rather than the preferred heeled boots?

OPTIONS

1. Don't allow anyone wearing sneakers to ride.

Pros: avoids the controversy of "making exceptions" and eliminates liability exposure presented by sneakered riders. Encourages/represents good horsemanship.

Cons: Eliminates most "single experience" riders who do not wish to or do not have the resources to purchase special footwear.

2. Allow sneakered participants to ride, and allow them to put their feet in the regular stirrups.

Pros: Makes riding available to everyone, regardless of foot-wear. Riders are able to use the stirrups to maintain their balance, thus reducing the possibility of a fall.

Cons: More time will be spent by staff adjusting stirrups. Does not encourage/represent good horsemanship. Possibility of rider falling, getting foot entrapped in stirrup and being dragged by a frightened horse. Large liability exposure due to all written recommendations from major equine instructional agencies warn against this practice.

3. Allow sneakered participants to ride, but do not allow them to place their feet in the regular stirrups.

Pros: Makes riding available to everyone, regardless of foot-wear. No need for adjusting stirrups. Eliminates risk associated with sneakers entrapped in stirrups.

Cons: Does not allow participants to use stirrups for balance, thus increasing the possibility of a fall. Because they are unable to use their legs to relieve the pressure on their buttocks, stirrup-less riding is less comfortable for participants.

4. Purchase special safety stirrups, and allow sneakered participants to ride only if this equipment is available.

Pros: Makes riding available to everyone, regardless of foot-wear. Riders are able to use the stirrups to maintain their balance, thus reducing the possibility of a fall. Reduces risk associated with sneakers entrapped in stirrups.

Cons: Requires significant financial commitment from the Camp to supply the stirrups. Does not promote/represent good horsemanship.

Responses from Professional Equine Agencies

1. CHA: The Association for Horsemanship Safety and Education, Mr. Dan Arnold, CHA President

CHA's official stance is to recommend not allowing sneakered participants to ride unless safety stirrups are provided. The only exception is that if the rider's legs are too short to reach the stirrups, then they may ride without stirrups, at a walk, while being led by a ground person controlling the horse through a halter and leadrope. Mr. Arnold noted that a very small child cannot effectively influence a horse, thus has little or no control when mounted. Therefore even if they are provided with very short stirrups, for safety, the small riders should be kept an a leadrope. Under no circumstances, regardless of footwear, would a participant's feet be placed in stirrup leathers as this presents a great risk of foot/leg entrapment in the event 'of a fall.

Although the association acknowledges that a sturdy hard-soled leather shoe with a half inch heel is the preferred foot attire, the association directors also understand that requiring this attire may not be feasible in all instruction/recreational situations. Also, with the recent proliferation of "riding sneakers" (specially designed with a heel and arch support), banning sneakers from the barn has become more complex.

2. AMEA: American Medical Equestrian Association, Doris Bixby Hammett, MD. . AMEA recommendation is not to allow anyone wearing sneakers into the barn. However if this is not feasible, then the AMEA directors too recommend not allowing sneakered participants to ride unless safety stirrups are provided. Dr. Hammett is not aware of reports of any injuries as a result of getting a foot entrapped in either the peacock or foot- free safety stirrups. She noted that the United States Pony Clubs with 1300 members use the peacock stirrup extensively and has not reported any resultant injuries. Dr. Hammett stressed that there has not been any extensive surveys or trials done on safety stirrups so evidence in support of them is anecdotal.

3. United States Pony Clubs, Drusilla Malavase, Safety Committee.

USPC's stance on short- legged riders is a little more complex than CHA's. Ms. Malavase recommended that anyone under age five not ride in instructional programs. If faced with short-legged riders, instructors can either provide stirrup leathers that have been cut short to accommodate short legs, or the participants may ride without stirrups at a walk if there is a ground person controlling the horse through a halter and leadrope, and ground persons spotting an both sides of the horse. Ms. Malavase emphasized that a participant's feet should never be placed in stirrup leathers as this presents a big risk of foot/leg entrapment in the event of a fall.

Conclusions

After reviewing the pros and cons of each option, and analyzing the suggestions from the organizations consulted, I recommend that Ockanickon Camp take the following steps to manage riders who do not have proper footwear:

1. Purchase 5-10 pairs of safety stirrups and make it a policy that any sneakered rider must be mounted on a horse tacked in this equipment. Peacock stirrups manufactured in Taiwan should be avoided as there have been reports of bent foot supports due to the use of inferior metals. There is need for various stirrup widths. A 1/2-inch clearance around the rider's foot allows for a stirrup that does not grip the shoe like a vise, but also is not dangerously large. Just as with helmets, staff must be vigilant about monitoring and assuring that the stirrup sizes are appropriate for the riders. The peacock stirrup offers four different sizes, and the Foot Free offers two sizes.

2. For very small riders (perhaps set up a "Measuring Guide" similar to those found in amusement parks) permit them to ride only at a walk while being led by a ground person. If extra leathers are available, the Camp can provide the short stirrups suggested, but it will be tedious to frequently alternate the various lengths of leathers.

3. Since riding in sneakers does not encourage/represent good horsemanship individuals enrolled in the extended lesson programs should be required to wear proper footwear. If this presents a financial burden to clients, then a 'boot box" of donated/left and found footwear can be established. Lesson programs should teach and emphasize excellent horsemanship habits. Therefore, allowing improper footwear would be a disservice to the students.

Teresa Kpachavi
15 Cranberry Court
Marlton, NJ 08053

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1995 NEISS Figures

The figures used are from a compilation of information derived from horse associated injuries treated in hospital emergency rooms participating in the National Electronic Injury Surveillance System (NEISS) of the U.S. Consumer Product Safety Commission. The NEISS estimates are calculated from a sample of hospitals which are statistically representative of institutions with emergency treatment departments located within the United States and its territories. NEISS warns small figures in their statistics have a high margin of error and may net have significance. (See AMEA NEWS NEISS Nov. 1992, May 1993, Feb. 1994, Nov. 1995.) This will report the figures for 1995.

                  TOTAL RECORDED
1990 74349 1992 73685 1994 71248
1991 71490 1993 68517 1995 65702

The year 1995 had the fewest number of horse related injuries going to hospital emergency rooms. We feel that this figure reflects a greater level of safety in the horse community and that the number in the horse community are increasing, Since we have no national census of the horse community, it might be possible that the number of persons involved with horses is decreasing resulting in the decrease of the number injured.

                  BODY PART INJURED
Body Part 1987-94 Percent 1995 Percent

Lower Trunk 64764 13.0% 9773 14.9%
Head 53740 10.8% 8341 12.7%
Upper Trunk 44425 10.0% 6979 10.6%
Wrist 38307 7.7% 4869 7.4%
Ankle 28263 5.7% 3388 5.2%
Lower Arm 25929 5.2% 2982 4.5%
Shoulder 35909 7.2% 5298 8.1%
Face 29098 5.8% 3291 5.0%
Finger 21065 4.2% 2623 4.0%
Knee 21193 4.2% 2919 4.4%

The top 10 body locations are listed. Of considerable concern are the figures that indicate a percent increase in the head injuries. This is occurring although the horse community should be aware of the safety factors of ASTM standard SEI certified fitted secured headgrear which should be worn at all times when mounted on the horse. There must he an increased concern of rule making bodies in the organized activities to require protective headgear.

Type Injury        1987-94  Percent   1995    Percent
Contusion/Abrasion 200310 31.4% 18850 28.7%
Fracture 182830 28.6% 19133 29.1%
Strain/Sprain 106795 16.7% 10872 16.5%
Laceration 55705 8.7% 5584 8.5%
Concussion 22556 3.5% 2829 4.3%
Internal Injury 16489 2.6% 2550 3.9%
Dislocation 10577 1.7% 1252 1.9%
All other types were less than 1%.

These figures show little change in 1995 but again of concern is the increase in concussions. This figure reinforces the information that the increasing percent of head injuries are resulting in an increase of the percent of concussion injuries in the emergency rooms.

    FRACTURES BODY PART   1995     PERCENT OF FX
Upper Trunk 3376 17.6%
Wrist 3142 16.4%
Lower Arm 2302 12.0%
Shoulder 1645 8.6%
Ankle 1197 6.3%
Elbow 1054 5.5%
Finger 957 5.0%
Lower Trunk 937 4.9%
Face 822 4.3%
Lower Leg 757 4.0%
Upper Arm 646 3.4%
Foot 472 2.5%
Hand 390 2.0%
All others are less than 2%

Fractures are the most frequent serious injury. The upper trunk includes the clavicle. The horse community needs to conduct studies involving the vest in reducing upper trunk injuries. The arm, including the shoulder, are the most common location of fractures. These fractures can be reduced by practice in the emergency dismount, learning the movements of gymnastics and vaulting, cross training, and conditioning.

                 AGE OF THE INJURED
Age 1987-1994 Percent 1995 Percent

0-4 9793 2.0% 1424 2.2%
5-14 104640 21.0% 11523 17.5%
15-24 115232 23.1% 14415 21.9%
25-44 202258 40.5% 24994 38.0%
45-64 58566 11.7% 11613 17.7%
65+ 8701 1.7% 1728 2.6%
TOTAL 499388 65695

These figures show continuation of the trend that the younger riders are decreasing their percentage of injuries, even going into the age group of riders 25-44 years with the greatest increase in the riders over 44 pears of age. These are frequently the riders who are determined that they do not need protective headgear,

     LOCATION QF THE ACCIDENT CAUSING INJURY
Location 1987-94 Percent 1995 % of Known

Home 161905 38.5% 14895 40.5%
Sports 122132 29.0% 12129 33.0%
Farm 77576 18.5% 3417 9.3%
Public 40889 9.7% 5699 15.5%
Street 9462 2.3% 243 0.7%
School 2987 0.7% 363 1.0%
Industrial 5505 1.3% 0 0.0%
Unknown 245994 28950
TOTAL 666451 65696
KNOWN TOTAL 420457 36746

Injuries at home and in "public" indicates recreational riding injuries percent continues to increase. However disturbing is the percent increase during sports, i.e. organited events. The governing bodies may be negligent in their education for safety and in increasing use of protective headgear which is known to decrease all horse-related accidents.

The percent of males to female injuries continue to show that more females are injured than males, but as females participate in the sport in greater numbers than males it is not known if these figures have changed.

NEISS figures do not give reasons and are only estimates, but the horse community can use them to make judgements concerning their sport.

NEISS, US Consumer Product Safety Commission
National Injury Information Clearing House
Washington, DC 20207
Reported by Doris Bixby Hammet, MD

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