Concussion in the Equestrian Athlete: A Review of the Literature

Background and/or Objectives: In the United States there are an estimated 30 million athletes who participate in equestrian sports, ranging from professional riders to amateurs. Traumatic brain injuries (TBI), primarily concussions, are one of the most common injuries among the equestrian population. A systematic review of the current literature was performed to synthesize the data on concussions effecting the equestrian population.

Design: Systematic review using PubMed database. Combination of words including equestrian sport injuries, equestrian concussion, concussion, concussion recovery, equestrian, equestrian sport were used. Studies available for review included surveys, systemic and complete reviews.

Setting: Eight studies were deemed appropriate for review during search of PubMed database.

Participants: Studies included athletes participating in equestrian activities at time of injury.

Interventions: Not applicable

Main Outcome Measures: Outcome measures include quantitative concussion reporting, return to play knowledge and reporting of preventative measures.

Results: Prevalence of concussion in the equestrian community varied amongst studies, with the average number being 20% for athletes. Most studies relied on self-reporting by athletes, which introduced bias. One survey showed that only 43.8% of athletes were aware of any concussion guidelines, although knowledge of concussion symptoms was high. Responses varied widely on when a person should return to working with horses following concussion. Knowledge of helmet function is low with only 13% reporting that helmets do not prevent concussion.

Conclusions: Equestrian athletes make up a large portion of the active population. Concussion in equestrian athletes is a common injury and they would benefit from a more robust education including the facts and treatment plans surrounding concussions. Studies pertaining to equestrian injuries are limited and the field would benefit from more qualitative studies. Many athletes do not participate in a proper return to play protocol due to the training principles and lack of education. While helmet use does not prevent concussion, it limits the severity of injury with falls.