Does Equestrian Helmet Type Affect Head Injury? A Study on Equestrian Helmet Use Among Collegiate Athletes

Sara Gould; Anna E Crawford; Lauren Picken; Devon Serrano; Fernanda Gabriel; Gerald McGwin; Avinash Chandran; Kevin Schrum

doi:10.1097/JSM.0000000000001297

Does Equestrian Helmet Type Affect Head Injury? A Study on Equestrian Helmet Use Among Collegiate Athletes

Clin J Sport Med. 2024 Nov 5. doi: 10.1097/JSM.0000000000001297. Online ahead of print.

Authors

Sara Gould^{1

2}, Anna E Crawford¹, Lauren Picken^{1

2}, Devon Serrano³, Fernanda Gabriel⁴, Gerald McGwin⁵, Avinash Chandran⁶, Kevin Schrum⁴

Affiliations

¹ Department of Orthopedic Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama.
² Birmingham Veterans Administration Health Care Service (VAHCS), Birmingham, Alabama.
³ Sewanee: The University of the South, Sewanee, Tennesse.
⁴ Department of Mechanical Engineering, University of Alabama at Birmingham, Birmingham, Alabama.
⁵ Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama; and.
⁶ Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indian.

PMID: 39495084
DOI: 10.1097/JSM.0000000000001297

Abstract

Objectives: To characterize helmet use, head injury risk, and to examine rider-related factors that influence these variables.

Design: Cross-sectional study.

Setting: The University of Alabama at Birmingham Equestrian Sports Medicine Collaborative.

Patients or participants: In total, 357 equestrians competing at the collegiate level participated in this study.

Interventions or assessment of risk factors or independent variables: χ2 tests were used to evaluate potential associations between a rider's experience level, riding style, and use of helmet designed with MIPS with number of falls, past head injuries, and helmet use frequency.

Main outcome measures: Data regarding helmet use and equestrian-related injuries were collected. χ2 analysis was used to determine potential associations.

Results: More than 50% of athletes reported falling off a horse during the course of 1 year. Head injuries occurred with high frequency. Concussion was the most frequently reported type. More than 50% of athletes with self-reported concussion denied receiving medical treatment. The risk of head injury was similar across helmet brands, and between helmets with Multi-Directional Impact Protection System (MIPS) and those without. Riders with the most experience were less likely to report sustaining a head injury than those with less experience. Contrary to current safety guidelines, 78% of equestrians said that they would not replace their helmet after every fall.

Conclusions: Collegiate equestrians have a high risk of fall-related traumatic head injury. Despite this risk, they report helmet use practices that are not in line with current recommendations regarding helmet replacement. This suggests that many of the athletes are using protective equipment that does not adequately protect against head injury. Neither helmet brand nor liner type was associated with lower rate of head injury.