Latest from Horse & Hound in Head-injuries

How to recognise concussion in horse riders –and when it’s safe to get back in the saddle

bethany.stone@futurenet.com (Bethany Stone) — Wed, 01 Apr 2026 11:23:22 +0000

Concussion in sports is usually a topic that’s hottest in the world of contact sports. However, given the nature of horse sports, and the propensity for falling off a horse, concussion in horse riders often goes undiagnosed.

A traumatic brain injury such as concussion is an invisible injury. Because of this, it gets less attention despite potentially more severe consequences than other injuries. This, coupled with the common school of thought that you should remount your horse as quickly as possible after a fall to avoid a confidence knock, can be a recipe for disaster.

What is concussion, and how does it happen?

Concussion is a type of brain injury that can occur after a head injury or a forceful knock to the body. Even without a direct blow to the head, face or neck, concussion is still a risk when a blow is received elsewhere on the body and an impulsive force transmits through to the head.

Even the force of falling off a horse and landing on your feet can be enough to cause concussion in horse riders.

“Concussion shouldn’t be feared as it can normally be dealt with by quality and appropriate care at home,” explains sports therapist Katy Stephens, owner of Bouncing Back Injury Clinic. “What is more serious is diffuse cerebral swelling, also known as second-impact concussion.

Concussion can occur even without a direct blow to the head. (Image credit: Alamy)

“This is a second concussion that occurs minutes, days or weeks after another episode of concussion that has not yet healed. It’s particularly dangerous if the first concussion wasn’t diagnosed and key professionals aren’t aware of the initial injury.”

According to a recent interview study by mental health charity Riders Minds, concussion awareness in the equestrian community is lacking. In an example from the new concussion in horse sport research, one participant said she did not know she was concussed and carried on. Her recovery took two years and nine months.

Long-term effects of repeated episodes of concussion include memory loss, persistent headaches, brain damage, depression and Alzheimer’s. If you suspect you or someone else are suffering from concussion, seek medical attention immediately.

Symptoms of concussion

Symptoms are the effects someone might feel if suffering from concussion. These include:

drowsiness
headaches
nausea and/or vomiting
blurred vision
change in emotional responses
sensitivity to light
ringing in the ears
issues with balance

Medium to long-term effects might include changes in sleeping patterns, anxiety and/or depression and memory problems.

While these symptoms can present immediately, they can also be delayed in onset. Therefore, it is important to monitor a potential sufferer for a few days after a fall and seek medical attention if any of these symptoms start to develop.

Signs of concussion in horse riders

The signs aren’t always obvious when observing others, and according to the NHS and British Equestrian (BEF) include the following. Seek immediate medical attention if you notice any of these signs:

poor performance
a blank expression
struggling to balance
slow reactions
slurred speech
inappropriate emotional responses, such as laughing or crying without explanation
taking an unusually long time to respond to questions
acting out of character (often irritable)
confusion or inability to remember events before or after the fall

“If you are teaching a rider who has a fall and you are unsure whether they have concussion ask them some long- and short-term memory questions like ‘which pony are you riding today?’ and ‘what did we learn in our lesson last week?’” says Katy.

“Make sure you know your riders so you can identify any behaviour or personality changes which could be symptomatic of concussion.”

Awareness is especially important if you are riding with a child. Children are more susceptible and vulnerable to concussion because their brains are smaller and have more room for movement within their skull.

Annual statistics from the NHS showed that from 175,000 admissions that had a primary diagnosis of concussion, 33-50% of them were in children under the age of 15.

How equestrian sporting bodies deal with concussion

BEF has extensive guidance on monitoring and managing concussion in horse riders. The guidelines were released in March 2023.

British Showjumping (BS) brought in new concussion protocols this year that include a 21-day suspension to prevent competitors from returning to competition when they could still be vulnerable. They will also alert other British Equestrian member bodies of the suspension dates.

British Dressage (BD) told H&H it follows the same protocols as BS, including suspension date sharing.

Riders showing signs of concussion should not remount. (Image credit: Emma Herrod Photography)

How long after concussion can you ride a horse?

While remounting after suffering an innocuous fall can be a positive step to help regain confidence, if the rider is showing any signs or symptoms of concussion they should not remount, and should instead seek immediate medical attention.

“Sixty-one percent of coaches have seen a parent pressure a young person into remounting after a fall,” says Katy. “It is important to be able to recognise the symptoms of concussion and prevent riders from remounting or remove them from the saddle if you have any doubts.”

In case of concussion, BEF’s guidelines include extensive advice on returning to the saddle and outline specific stages of recovery. According to this advice, a rider who has suffered with concussion should:

Commit to complete rest for at least the first 48 hours post-injury and limit screen time
Resume sport-specific exercises with no risk of head injury, such as walking/jogging, horse grooming or practising riding position, not before seven days post-injury
Resume training drills, such as resistance training, groundwork and yard chores, not before 14 days post-injury
Return to supervised riding of a suitable horse in calm, non-competitive conditions not before 21 days post-injury
Return to regular riding following the previous stage when ability and confidence are restored

Concussion is not an easy injury to diagnose, but if you are in any doubt as to whether someone you know has suffered from it following a fall then they should not be allowed to ride a horse until they have sought medical advice.

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‘TheFox-Pitts and pologave me hope’:rider who suffered brain bleed in fall hopes to help others

Eleanor Jones — Sat, 20 May 2023 19:51:23 +0000

A rider who got “tangled in legs and reins” in a hacking fall is trying to raise awareness around head injuries and the impact they can have.

Jodie Saunders suffered a bleed on the brain when she fell from a friend’s horse in March 2019. She told H&H she is mainly recovered, and now wants to help others.

“‘What happened to me was just one of those things,” she said. “It all happened for a reason and I wouldn’t be where I am if it hadn’t happened. But I just want to hopefully help other people in the same situation.”

Jodie worked for the Fox-Pitts, then went to Hartpury University to study equine sports science, with a view of working in the industry. It was while she was studying that she took her friend’s 17.2hh five-year-old for a hack to help out.

“It’s one of those things you think will never happen,” she said. “I don’t remember it but the horse had one of those moments; leapt and bucked, and I got flung into the air, came back down and got tangled in legs and reins. If you’re going cross-country or hunting, it’s more likely but this was just a walking hack.”

Jodies said at the time of her diagnosis, she did not fully appreciate the seriousness of such head injuries.

“But for the first few months, I was at home, very much reliant on my parents,” she said. “I couldn’t really walk on my own, or stay awake. It was only when I started getting a bit better that I realised it wasn’t going to be a quick fix – I realised the lasting effects that came with it.”

Jodie, who had to deal with extreme fatigue and changed emotions among her symptoms, said the support offered by brain injury charity Headway was invaluable, as was the understanding of friends who had been through similar.

“There’s so much to it,” she said. “Horse people are very much ‘Fall off and get back on’ but I couldn’t. I couldn’t drive for 12 months so I was reliant on people; I was very lucky to have that support but it was frustrating. I tried to go back to university and they were amazing but I just couldn’t do it. It was a case of ‘Where am I going to go with my life now?’ Horses had been my life and all of a sudden, that wasn’t going to be the case.”

Jodie was referred to a specialist brain injury unit, and said occupational therapy was beneficial, but “it wasn’t till I went back to the yard that I got my confidence back, and it gave me hope again.”

Jodie wanted to go back to work, so got a bar job, but found it impossible to learn new skills in such a loud environment, so she went back to the Fox-Pitts’, where she knew what she was doing, and was supported by them to be able to do her job.

She is now working for estate agent Spencers, which is supporting the New Forest Polo Club and helping raise money for its 2023 charity Headway, culminating in the Kuseyo Cup weekend of 12-13 August.

“I’ve been very lucky,” Jodie said. “I do get tired occasionally still and a bit confused, but if I hadn’t had my hat on, I wouldn’t be here. I was extremely lucky and fortunate to receive help and support from the Fox-Pitts. My recovery has been hugely helped by the polo world and my confidence riding again has come from riding a polo pony, Orpheus; we are out competing in local low-level dressage competitions and he is very cool!

“Polo and the people in polo have helped me tremendously to get where I am today which is why I am organising the polo match on 13 August, for Headway and to help raise awareness.”

Jodie thinks recent research and Government focus on head injuries and concussion have been beneficial in helping spread the word, but the more awareness, the better.

“I look the same and am still me and people didn’t really understand it, but it happens all the time; something like every 90 seconds, someone suffers a brain injury, which is crazy,” she said. “We need more understanding.”

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(Image credit: Andrew Sydenham for Future Publishing)

Groundbreaking concussion and return to riding guidelines released

(Image credit: Andrew Sydenham for Future Publishing)

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Groundbreaking concussion and return to riding guidelines released

Lucy Elder — Thu, 02 Mar 2023 12:52:36 +0000

The first unified concussion guidelines designed specifically for riders across all equestrian disciplines are unveiled by British Equestrian (BEF) today (Thursday, 2 March).

The six-page guidelines feature easy-to-follow information about concussion in horse riders, and a “return to riding” pathway. The idea is that these give clear, up-to-date guidance, based on the latest understandings of concussion in sport, in a way that makes sense for riders and those around them, such as coaches or parents.

The launch is the first step in an awareness-raising campaign that will run throughout 2023.

BEF chief medical officer Anna-Louise Mackinnon told H&H it is “hugely important” the guidelines are aligned across the disciplines, to prevent confusion.

Dr Mackinnon added that those involved in the project have “dug deep” into the latest research and what is happening in other sports and countries to develop the guidelines.

Learnings shared at the sixth International Consensus Conference on Concussion in Sport, held in Amsterdam in 2022, played a key role in this.

“We’ve even tried to align it to the advice given out in horse racing,” she said. “Some of the educational projects we are going to be doing and developing over the next few months are completely aligned with horseracing and using much of the same material.

“From the point of view of rehabilitation and return to ride, it’s massively important [that advice is aligned across equestrian sport]. Otherwise we are just going to have riders doing all sorts of different things and everyone getting a bit confused, so it needs to be the same – and also aligned with all other sports.

“Not only have we looked at what we’ve been doing within equestrian sport, but we’ve looked at other sport – grassroots sport and the grassroots advice that will be coming out from the Government.”

The guidelines were produced in response to the Government’s concussion action plan (news, 13 January 2022). This, in turn, followed a Government inquiry that called for UK-wide protocols on dealing with head injuries and improvement in how sporting injuries are reported (news, 12 August 2022).

The overarching aim is to address concussion in sport to help reduce risks and potential long-term effects associated with head injuries.

The new BEF guidelines are aimed at participants at all levels of equestrian sport and provide detailed information on managing concussion from the time of injury to a safe return to riding.

The return to ride pathway gives specific examples of equestrian-related situations and at what stage in a person’s recovery they might be ready to return to these. For example, walking a course, grooming and yard chores. The guidelines do not replace medical advice.

BEF chief executive Jim Eyre said the member bodies have been “really engaged and are committed to the responsible management of concussions”.

“Anyone in the equestrian industry is welcome to download the guidance from our website and adopt it as their own, so we all take responsibility for our participants and their long-term wellbeing,” he added.

Ashleigh Wallace, BEF athlete health lead for the World Class Programme, is the driving force behind the project.

“Developing concussion protocols for our World Class Programme riders has

been a priority of mine, but the opportunity to use expertise, insight and knowledge – all backed up with science – to produce relevant guidance that applies to everyone is hugely gratifying,” she said.

The BEF member bodies have welcomed the news.

British Dressage sport operations manager Lou Jones told H&H: “Fortunately, serious accidents involving head injuries are comparatively rare in dressage, but we fully support this initiative and will be consulting with our organisers and officials to ensure that the guidance is followed, with appropriate measures put in place to deal with such eventualities when they do occur.”

British Eventing (BE) chief executive Helen West added that BE takes concussion “extremely seriously and fully supports the BEF” in these guidelines.

“Concussion is something we must take seriously,” she told H&H, adding that BE operates a strict medical suspension policy regarding head injuries and concussion.

“When it comes to our horses we don’t think twice about getting the right treatment and giving them time. But when it comes to ourselves we sometimes overlook this and the campaign to raise awareness of the signs and treatment of concussion can only be a positive step in the right direction.”

British Showjumping (BS) chief executive Iain Graham told H&H that BS has been involved throughout the process and is “fully supportive of the guidelines and the need to raise awareness”.

He added that it’s not just about the time people are in the competition arena, but spreading awareness of the signs, symptoms and what to do, for when people are training or riding at home.Olympic eventing team gold medallist and Badminton winner Laura Collett said this campaign is “really welcome”.

“Concussion is something we just don’t take seriously enough in equine sport. We wouldn’t think twice if it was a welfare issue with our horses, so why should we risk our own health and wellbeing?” she said. “Having experienced major brain trauma and concussion first-hand, I’d urge everyone to take the time and read the guidance, educate themselves and use the resources provided. We all have a part to play, however you enjoy horses.”

Read the BEF’s new unified concussion and return to riding guidelines [PDF]

Virtual reality headsets to be trialled in managing riding-related concussions

Lucy Elder — Thu, 22 Sep 2022 14:03:30 +0000

New virtual reality headset technology is to be trialled in British racing as a tool for managing concussion.

The technology, NeuroFlex, measures a person’s eye and head movements as they carry out simple tasks. It is the result of 30 years of research by Mimi” Galiana, NeuroFlex’s chief medical officer, and is being used in the South Australian Football League and Australian Super League. It will also be used at this year’s FIFA World Cup in Qatar.

The hope is that it can be used as an objective way of measuring jockeys’ brain health over time, which could help with decisions on returning to riding, and have benefits long after a jockey retires.

“I’ve been extremely impressed and delighted with how seriously this is being taken within the horseracing community,” NeuroFlex executive director Grenville Thynne told H&H.

As the technology works with virtual reality goggles and a laptop, it makes it portable for pitchside – or on-course – tests, which take around eight minutes.

Dr Thynne added that the key part of this technology is that it works on an individual basis and gives an objective assessment, to help those involved in recovery care make an “informed decision about whether a rider is ready to return to riding”.

“The most important part of this is the pre-season health baseline,” he said, explaining that this gives an individual-specific benchmark or “dashboard” for each person to be measured against in future.

“When we talk about humanising or personalising this process, if you have your own dashboard that means if you suffer a fall you can be monitored back to your healthy baseline, over what period of time it takes to get there, on an objective basis. And that dashboard stays with you for life.”

He said this means that for retired jockeys, should they start to feel effects from falls in future, they have that “digital dashboard” of all their previous tests to refer to.

A team from NeuroFlex’s head office in Australia is in the UK to train a select group of medical clinicians in using the technology, before baseline testing of jockeys starts this year. Training will take place at the Injured Jockeys Fund’s Oaksey House Rehabilitation and Fitness Centre.

“Given the high-risk nature of our sport, British horseracing takes concussion very seriously, with robust protocols in place to ensure the highest standards of care and attention for our jockeys, and dedicated rehabilitation support provided by the Injured Jockeys Fund,” said a British Horseracing Authority spokesman.

“It is essential that we remain at the forefront of scientific research and innovation into how concussion is managed, which includes examining the potential benefits of technological solutions, alongside ensuring engagement with colleagues from other major sports around the development of shared guidance and protocols.”

Managing concussion: new ratings system for riding helmets in the pipeline

LEADING researchers into sporting concussions are on the verge of bringing a ratings system to riding helmets.

Virginia Tech doctors Steve Rowson, Stefan Duma, Mark Begonia and Barry Miller spoke at the Equestrian Symposium in Virginia, US (11-12 August), about the STAR (Summation of Tests for the Analysis of Risk) ratings system for riding helmets.

In short, the STAR value is the theoretical number of concussions someone would sustain wearing that helmet if their on-field exposure matched laboratory impact tests.

The ratings correlate with real-world injury rates; the lower the STAR value, the better the star rating, with five stars the highest helmet rating. It is designed to complement existing helmet certifications and fill in the gaps relating to concussion risks in horse riders.

“With the same impact, there can be very different biomechanical responses between helmets. We felt a responsibility that everyone should have this information,” said Dr Rowson. “Not all helmets are the same just because they meet a [pass/fail] standard. That’s true for skull damage, but not concussions.”

‘Not just a bang on the head’: mental health campaign encourages riders to ‘re-think concussion’

Becky Murray — Fri, 13 May 2022 12:03:04 +0000

Riders are being encouraged to “re-think” concussion – and the effects it can have on mental health — in a new awareness campaign.

During national Mental Health Awareness Week (9-13 May), equestrian mental health charity Riders Minds has revealed its new “Head First” campaign.

A Riders Minds spokesman said the project had been launched following the “concerning” results of a study by Charles Owen, which revealed six in 10 riders suffer from depression after a concussion. More than 1,000 riders took part in the study, carried out last year by University of Sussex MSc student Charlotte Ricca, which also found that 30% of riders who suffered from depression went on to continue to suffer from prolonged mental health problems.

As part of the campaign Riders Minds has created the “Head First checker”, a comprehensive tool to allow people to identify any signs of change, including to brain function and mental health, and the early warning signs to look out for. The tool incorporates four key areas; cognitive changes, mood/behaviour, physical signs and altered sleep pattern.

“More than 25% of riders have suffered from depression, and riders who have experienced five or more concussions are twice as likely to suffer from a mental health condition as a result. The importance of protecting our heads and monitoring signs of concussion/mental health is vital,” said Riders Minds chair Victoria Wright.

“We also know that a mental health condition following a head injury does not necessarily occur immediately afterwards, it can take six months to a year after the incident to take effect. The objective of Riders Minds has always been to support the mental health and well-being of all equestrian people and we feel extremely proud that the connection between mental health and head injury has finally been brought to light in the equestrian industry like it has in rugby, American football and other high-impact sports.”

Mental health specialist Sylvia Bruce, who is responsible for the Riders Minds’ website content, added that the campaign aims to get equestrians to “re-think” concussion in horse riders as not “just a bang on the head”.

“It’s a brain injury. And, if our brain is injured, our mind can be injured too, with potential far-reaching implications on our mental health and wellbeing,” she said.

The Head First checker and mental health support can be found at www.ridersminds.org.uk.

‘Just a bit of concussion’: calls for more awareness around minor traumatic brain injuries in children

Becky Murray — Sun, 03 Apr 2022 11:03:27 +0000

More awareness around minor traumatic brain injuries in children is needed, including the importance of rest and not dismissing the condition as “just a bit of concussion”.

A published study has suggested that persistent post-concussion syndrome (PPCS) – when concussion symptoms continue beyond the expected recovery period after the injury – is underdiagnosed in children. Parents of 205 children aged eight to 15, who attended hospital after a mild traumatic brain injury six months to three years before the research, completed a survey used to measure the severity of symptoms. It was found that 25% were suffering from PPCS, which had not been previously diagnosed. PPCS symptoms can include headaches, difficulty concentrating and irritability.

Shai Efrati of the Sagol Center for Hyperbaric Medicine and Research in Israel, who led the work, told H&H PPCS in children is often missed and symptoms can be blamed on behavioural or mental health issues.

“It means we are not looking for PPCS in children. In adults, we seek the cause for cognitive decline, but in children they are told they have a mood problem,” said Dr Efrati.

Dr Efrati said children need to be given more time to recover after concussion.

“We need more awareness that after a mild traumatic brain injury, you are more at risk of developing PPCS. I would like more screening when a child is discharged from hospital with concussion; they should be re-evaluated a month later to make sure their symptoms have resolved and if not, they should receive treatment.”

Major trauma consultant Diane Fisher, the British Equestrian Trade Association’s chief medical officer, told H&H she believes language around concussion needs to change.

“People say, ‘It’s just a bit of concussion’ and we need to remove the word ‘just’. Concussion is a traumatic brain injury – and changing the wording changes how a parent is going to view that injury,” said Dr Fisher, adding that children should rest, without screen time.

“Watching television is one of the worst things you can do – for the brain it’s like running a marathon. While recovering, you want the brain not to have to function very hard,” she said.

The Pony Club’s concussion guidance includes a flowchart and a rule that following a concussion diagnosis, a child must not ride for three weeks.

Pony Club chief executive Marcus Capel, who is part of the British Equestrian concussion (BEF) working group, told H&H there are plans for more rider concussion education in the Pony Club, and the BEF working group is producing a pocket guide – similar to those used in rugby – which will include guidance for children.

“Sometimes a parent might want the child to get back on after a fall, but we want to empower coaches to use our guidance and say, ‘In my opinion, they shouldn’t get back on and I want them to get checked by a doctor,’” said Mr Capel.

“We also want to empower riders so they learn when it’s right not to get back on, and to be able to say if they’re not feeling OK.”

In November BETA launched a rider accident reporting form to collect information, which is hoped will inform design of safety equipment. The form is available online or via a QR code and asks people to provide details of any accident that they were involved in, and, if possible, supply images or video of the helmet and/or body protector worn at the time. The form can be completed here.

“We want all injuries reported even if it’s a case of ripping a fingernail off – we want everything. Then we will have our own database across every single horse sport and we can look at what is actually happening, right now we don’t know because equestrians are not the best at going to hospital,” said Dr Fisher.

‘It felt normal – it felt good’: former Badminton winner rides again, a year after serious head injury

Eleanor Jones — Tue, 23 Nov 2021 19:56:28 +0000

Paul Tapner said getting back riding, over a year after he suffered serious head injuries in a fall, “felt normal” —and he has enjoyed it.

The 2010 Badminton winner has ridden three horses in the last week, including his advanced eventer Bonza King of Rouges.

Paul said last autumn he had no plans to ride again, eight weeks after he suffered brain bleeds and a minor stroke in a hacking fall.

“At that stage, I felt pretty wobbly, and the thought of doing pretty much anything was hard work, so the thought of riding was nowhere near my mind,” he told H&H today (23 November).

“I had physios saying they wanted me to ride as part of my rehab, but I’d seen other riders have injuries and go back not being able to ride anywhere near where they were. I didn’t want to do that, so I refused to get on a horse.”

Paul said he rode a horse simulator at Oaksey House rehabilitation centre at therapists’ request, but “it took me enough concentration to stay on and do rising trot, and I thought if I have to do that, to do what I consider very simple, I don’t ever want to ride again.”

But in the last week, Paul said, he felt physically in control enough that he could ride on a horse and it “be normal”.

“I felt I could just do it, so I did,” he said. “My wife Georgina was very supportive and helpful, although we did have an argument about which horse I’d ride, so I got on and it was good.”

Paul has so far ridden an event horse of his daughter Madison’s, a former racehorse, and King himself.

“The fight with my wife was because she wouldn’t let me ride King first!” he said. “Then she saw I was ok. She did look at me and ask if I wanted her to lead me and I said ‘I’m not a lead-rein rider, get away from the horse!

“When I was a professional rider, I didn’t like riding at home, I liked competing and winning, and I’m still like that so the fact I’ve enjoyed this riding at home surprised me; it felt normal and it felt good.”

Paul said he has “no desire to compete again”.

“I wouldn’t contemplate facing a jump at this point because I don’t feel I’ve got enough control of my body to do what I considered normal for me,” he said. “[Jumping] isn’t high on my priority list so it may or may not happen, and it’s highly likely to not happen.”

Paul said he had been discussing with someone, months ago, whether the fact he has no memory of the fall, or of some time after it, might help as he would be less likely to feel any fear, and he thinks that is the case.

And, Paul added, having checked the rules and changed qualification requirements, he realised he and King are still qualified for Badminton 2022.

“I keep joking, every time I get on, about how my preparation for Badminton is going,” he said. “I did say yesterday I was going, to scare the living daylights out of my wife, so watch this space, you never know!”

But he added: “I don’t think that will happen; I think this is one time common sense will take over from what’s in the rules.”

Rider given 1% chance of survival after fall honoured as she returns to work and the saddle

Eleanor Jones — Sun, 21 Nov 2021 20:56:32 +0000

A rider and coach who was given less than 1% chance of surviving a serious head injury sustained in a fall has been honoured for her resilience and determination as she returns to work.

Jane Cherry, is back at work at Washington Riding Centre, home of the Tyne & Wear Riding for the Disabled Association group, some three and a half years after her accident.

Jane told H&H she suffered a serious bleed on the brain stem in her fall from a four-year-old mare at a dressage show in April 2019.

“We’d done our first test, and come second, and were in the warm-up waiting for the next class,” she said. “I don’t remember any of it but from what people have told me, the mare just went down”.

Jane was put in an induced coma on the scene and taken to hospital, where her husband and family were told there was very little hope of her recovering.

But three weeks later, on the third attempt to bring her round, Jane regained consciousness.

“I remember clearly waking up, looking at my husband and saying ‘Oh, hello’!” Jane said. “I can’t remember asking about what had happened to me, it was like I knew, although no one had told me, and it was all a bit odd. I feel quite ungrateful because people have told me they came to visit me, took me out for walks and things, and I have no memory of it at all.

“I was oblivious to it all, and feel so sorry for my family because they had to cope with being told I wasn’t going to survive, then I was in hospital for four months and my husband had all the rigmarole of driving backwards and forwards every day and he never complained, bless him, although he does plenty now!”

Jane underwent physio treatment in hospital, learning to walk again — “I’d thought I was walking quite well!” she said — and was eventually sent home with a walking frame.

She is now back at work, part-time, and back in the saddle, something that happened rather sooner than her doctors had expected.

“I was back on after three months; I couldn’t remember anything that had happened so had no fear of falling, and when I saw the consultant after six months, he said ‘We’ve got to the point now where you can start thinking about riding’. I said I’d been riding for three months and he held his hands up and said ‘Don’t tell me, I don’t want to know!’”

Jane is still experiencing the effects of the injury in other ways. She has fatigue, so she has to have 10 hours of sleep every night, as well as “nanna naps” during the day. She has constant double vision, which is also tiring, and her memory is not what it was.

“People have said it can take up to five years for things to get better so I hope that improves,” she said. “But I can function, I can ride and I’m back at work. My mother’s 86 and just out of hospital so I’m looking after her, myself, the dog and my husband. I think I’m doing all right.”

Jane added that it was horses who helped get her through.

“They’ve got me back to where I am,” she said. “My horse Red, who I’ve had 15 years, has been such a sweetheart. She’s really hot and feisty but I think she knew. I’ve seen other horses who play up for able-bodied riders but with an RDA person on board, they’re so calm. I could tell Red knew — but in the last month or so, I’ve seen the feistiness come back so she must think I’m better. I’ve had the thumbs up from Red, and that makes me happy.”

Picture by Charlie Pearson (Image credit: creditUnknown)

British Horse Society (BHS) president Martin Clunes presented Jane with an award for exceptional achievement in the equine industry, at Newbury racecourse last week.

“It was a total surprise,” she said. “A girl I’d taught for years entered me for it last spring, didn’t hear anything and forgot about it. It was lovely because she then got the call on my birthday to say I’d won.

“There was a ceremony at the racecourse, Princess Anne was there, and we had a lovely meal and watched all the racing. But to be honest, I wasn’t sure I really deserved the award!

“I don’t think I’ve really done anything or been any more proactive than anyone else would have been but I’m back at work, I’m riding and doing all the things I used to do. As I was given a 1% chance of survival, I think I’ve done quite well, and the BHS agreed. It was nice for someone to say ‘You’ve done ok’.”

A BHS spokesman told H&H: “We’re delighted that Jane has won this award. Jane has shown outstanding resilience and has remained dedicated to working with horses and the Washington Riding Centre (RDA) since volunteering there as a child.

“Beating the odds, Jane has returned both to riding and her position as centre manager and is continuing her excellent work to bring structure, fun and community to the centre.”

The mare Jane was riding at the time of her fall was later diagnosed with wobblers syndrome and had to be put down.

Rider who fractured skull shares images of hat after horse landed on her

Becky Murray — Wed, 03 Nov 2021 21:03:03 +0000

A rider who sustained a hairline skull fracture in a team-chasing fall has shared images of her severely damaged riding hat and said she was “incredibly glad” she had replaced it recently — and that she was “lucky to be alive”.

Somerset-based Susannah Stanning was competing as part of Team Rideaway in the intermediate speed class at the Cotswolds team chase on Sunday (31 October) when her horse Our Kaempfer tripped, fell and landed on her head.

“I remember being pretty convinced he was going to land on me. He cartwheeled over and his hindquarters landed square on top of my head on the floor. It was about as dramatic as it can be,” Susannah told H&H.

“I was unconscious for about five minutes but I was incredibly lucky that they have such amazing medical staff there.”

Susannah, who runs a yard producing team chasers and polo ponies with her husband Roddy, was taken to hospital by ambulance and a CT scan showed she had sustained a hairline skull fracture, and she was diagnosed with concussion. Her horse was not injured in the fall.

(Image credit: creditUnknown)

“I didn’t have any damage anywhere else, I was extraordinarily lucky,” she said.

“I was kept in hospital overnight for observation but the fracture should essentially heal on its own in time. I was given advice about the concussion and there will be no riding or driving for the immediate future.”

Susannah agreed for images of her damaged riding hat to be shared online and said she had been “astounded” by the response. She is sending her hat back to Champion for the damage to be fully assessed.

“Looking at the damage to my hat I feel incredibly lucky to be alive. I have seen some video footage of the fall and it really could have been a very different story. I only bought my hat three weeks ago when I decided I probably needed a new one, and I’m incredibly glad that I did,” she said.

“I think people have been shocked by the amount of damage to my hat and thought there would have been a lot more damage to me,” she said “I’ve been very lucky in that I’ve not had a head injury before, and it goes without saying how important it is that everyone wears a riding hat with the correct safety standard, and if you have a fall it’s important it gets replaced. I hope some positives can come from this and people learn from my experience.”

Susannah’s husband Roddy, who was at the team chase, added how “brilliant” the medical team was at the Cotswold.

“We were unlucky it happened, but lucky it wasn’t worse and that this happened at a properly organised event with paramedics and a racecourse doctor. The immediate medical attention quite likely made a significant difference to her outcome,” he told H&H. “It highlighted that it’s even more important that you wear a hat at home because you’re unlikely to have any medical cover there if something happens.”

‘They don’t go to hospital unless something’s hanging off’: research shines light on equestrian-related injuries

Becky Murray — Sun, 24 Oct 2021 19:03:52 +0000

RISK of hospitalisation from equestrian-related injuries has been “severely underappreciated”, data suggests.

A study, Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA, by researchers in Texas, analysed data from the US National Trauma Data Bank from 2007 to 2016 to look at injuries recorded as horse-related with the aim of allowing the development of “targeted prevention strategies”. As part of the work, researchers compared the data against studies looking at motorcycle racing, skiing and football and said this research mirrors previous findings that the proportion of trauma centre admissions from equestrian injuries was higher, and when taken together the data suggests the dangers of equestrian activities has been “severely underappreciated”.

Of the 24,791 injuries analysed, 37.07% were in the chest region and 22.95% were head injuries. Riders aged between 50 and 59 were most likely to visit trauma centres.

One of the researchers, trauma surgeon Jeffrey Skubic, told H&H it is hoped the study will raise awareness about wearing protective equipment, especially in the US where Western riding is more common.

“A lot of these injuries can be prevented if riders wear helmets or a vest [body protector],” said Dr Skubic. “What concerns us is when we compare the data to previous studies on skiing, motorcycle riding or football, there is a higher injury rate in riding. People traditionally think of getting on a motorcycle as dangerous, but it’s a machine that you can control the majority of the time. A horse has a mind of its own and you don’t know what it’s going to do.”

“We also want to raise awareness to trauma surgeons when they are getting a patient who has fallen off a horse to know what injuries they should be looking for.”

Major trauma consultant Diane Fisher, the British Equestrian Trade Association’s chief medical officer, told H&H she welcomes the study but that it is difficult to compare like for like between the US and the UK owing to the difference in riding styles, as more US riders do not wear a safety helmet. There is a national database that collects major trauma records in the UK, but it does not specifically collect equestrian data and this is something Dr Fisher is calling for.

“There is a definite mismatch between medics’ knowledge of equestrian injuries and potential for injury, because they don’t understand the mechanism by which we hurt ourselves,” she said. “On top of this, you have a community as a whole who jump back on with fractured ribs or broken arms. They’re late presenters and don’t go to hospital unless something is hanging off, and even then it can be days later.”

Dr Fisher added the importance of wearing safety helmets when handling horses on the ground and praised Charlotte Dujardin for wearing her helmet during her Tokyo Olympic trot-up with Gio.

Rider ‘lucky to be alive’ after she was kicked in the head serves hat safety message

Lucy Elder — Fri, 20 Aug 2021 06:35:52 +0000

A rider who was seriously injured and spent six days drifting in and out of consciousness after she was kicked in the head has served a riding hat reminder to other equestrians.

Holly Williams has credited her hat and the emergency services for saving her life when she was kicked in a freak accident while turning out a horse in May.

“I’m lucky to be alive,” she said. “It was an evening after work and I went up to ride, as I normally do, and the horse Herbie – who I had on loan – was lovely.

“I had a lovely ride, a nice canter and I remember putting my saddle away. I normally put my hat in my car once I’ve ridden, but I couldn’t be bothered to take it off, so I decided to keep it on while I led him up to his field. What are the chances?

“We have to go through a gateway [on the way to the field] and I remember laughing as he grabbed some grass, then everything went completely blank.”

Holly was found face-down by the gateway by a passing walker. The damage to her hat and her other injuries led medics to the conclusion that she was probably kicked in the back of the head.

Holly spent two weeks in hospital after the accident. (Image credit: creditUnknown)

“Thank god for that walker,” she said. “She called the ambulance, with the help of my yard manager, and I was taken to hospital. I had an MRI, which showed a bleed on my brain.”

Holly spent the next six days drifting in and out of consciousness, and spent two weeks in Royal Surrey County Hospital in total. She had to re-learn how to do simple, routine tasks, such as writing, hoovering, walking down stairs and making a cup of tea.

Three months later, Holly is continuing to make good progress. She is receiving help from an occupational therapist and is “getting her life back”.

“It’s hard, but I’m glad to be alive,” said Holly. “If I hadn’t had my hat on, I would have died.”

Holly’s hat took the force in the accident, and she has credited it with saving her life. (Image credit: creditUnknown)

She has shared her story to make others think about wearing a helmet when handling horses, and to serve as a reminder for riders and yards about having emergency contact details in an easy-to-find place. She is also encouraging equestrians to read the small print on their personal accident insurance to ensure they are covered for all eventualities.

“If I can get a message out there for people to wear a helmet, and if it makes the difference to just one person, it will be worth it,” she said, adding that no matter how well you know a horse, accidents happen.

“I’d had the horse on loan for about three months and I’d grown to know him and to love him. It seemed really out of character for him,” she said.

“The ambulance and hospital teams have all been amazing – if it wasn’t for them, I wouldn’t be alive.”

‘You only get one head’: rider who broke bones and suffered concussion issues hat plea

Eleanor Jones — Wed, 18 Aug 2021 19:31:43 +0000

A rider who suffered multiple fractures and severe concussion in a fall at home wants to spread as much awareness as possible, of head injuries and the importance of wearing a correctly fitted safety helmet.

Sandra Murphy was jumping her own horse Tilly over small fences on 17 July when the mare tripped and went down. Sandra suffered a fractured shoulder, collarbone and vertebrae, as well as the head injury, but believes that had she not been wearing her helmet, recently fitted and brand new, she would not be here.

The founder of Equidiet and the BAME Equine and Rural Activities Focus Group told H&H she had just finished filming for a television programme and was jumping one last double.

“It was only 70cm, as I’m no hero!” she said. “Tilly jumped in big, and it should have been two strides but she went ‘Is it one or two?’, went to jump and just fell over it.

“It was a miscommunication; I can’t blame her, I more blame myself.”

(Image credit: creditUnknown)

Sandra hit her head on the floor, was knocked unconscious, and was taken to hospital in an air ambulance. She credits her assistant Lara Holden also for saving her life, as she came straight over with an oxygen canister after the fall; Sandra, who is in remission from cancer, also spent six weeks in hospital with Covid early this year and needs the oxygen while her lungs recover.

“She saved my life as I’d stopped breathing,” Sandra said.

Doctors at first did not realise the extent of Sandra’s injuries and sent her home but two days later, she was in agony and called her GP.

“They sent me back to hospital, where I was diagnosed with the fractures and the concussion,” she said. “I was speaking really slowly, and couldn’t form words; I said to the doctor, it felt like I had a blancmange in my head, it was awful. I had real pressure pain in my head and he said ‘That’s concussion’.”

Sandra had never suffered concussion before, and had not realised the full implications.

“The doctor explained it all, and how careful you’ve got to be,” she said. “It’s a brain injury, and you have to look after your brain. I won’t be riding for a long time as you only get one head.”

Sandra added that although she has always been a strong advocate of wearing appropriate headgear, this incident has reminded her once again just how important this is.

“Whatever you’re doing, I don’t care; wear one,” she said. “There’s no excuse not to have one on, and your brain’s so precious and so easily damaged. My Uvex helmet saved my life; I would not be here today without it.

“The thing I want to get across to people is, no matter what you’re doing, wear one. I was at home, jumping 70cm, and I trust my horse to the end of the earth; she’d never buck me off or anything but she tripped and fell, it was one of those things.”

Sandra also thanked the Lincs & Notts Air Ambulance, for which she had raised money while undergoing chemotherapy for cancer, two years ago.

“I had braids in my hair; my hair was my crowning glory and losing it was very hard but every time a braid came out, someone sponsored it and I raised £500,” she said. “That’s what got me through, and knowing I was helping other horse people.

“When you’re riding in the middle of nowhere and a road ambulance can’t get there, they will come and rescue you. I want to thank them so much.”

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Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade to access our H&H Plus online service which brings you breaking news as it happens as well as other benefits.

Calls for UK-wide protocols on concussion and head injuries in sport

Becky Murray — Mon, 09 Aug 2021 06:03:58 +0000

AN inquiry into concussion in sport is calling for UK-wide protocols on dealing with head injuries, and improvement in the reporting of sporting injuries.

The Government’s Digital, Culture, Media and Sport (DCMS) committee launched the inquiry following increasing media attention on the “growing evidence” that there is a link between taking part in sport and developing dementia later in life, and aimed to examine whether this issue needed Government intervention. Following the conclusion of the inquiry, which included evidence from health professionals, experts and sporting bodies, a report was published last month in which recommendations were made.

These include NHS England reviewing how it collates concussion data and ensuring doctors have patients’ full medical history available to better inform treatment. The report also recommends that the Government immediately mandates the Health and Safety Executive (HSE) to work with sport national governing bodies to establish a national framework by July 2022 for reporting injuries, and establishes a research fund and a specialist group to review emerging science on concussion.

Medical Equestrian Association (MEA) chair Megan Hardman told H&H the report is “very valuable”, and data collection is important, but added that in equestrian sport, a “culture change” is needed around riders returning to the saddle too soon after injury.

“At grassroots level we need riders to destigmatise head injuries so there’s not that bravado that you have to get straight back on. It’s that real ‘battling through injury’ mindset and being ‘brave’ – we see it in all equestrian sports,” she said.

“As doctors we might say to a rider ‘you need two weeks of no riding’, but once that person walks away from that event we have no control over what they do. Unless they really buy into it and believe what you tell them, we can’t force them to do it.”

Dr Hardman added that as a result of the report the MEA and British Eventing (BE) plan to produce guidance to be handed out to riders at events on what to do following a head injury.

“We already provide advice cards but it’s not explicit enough for riders in my opinion,” said Dr Hardman. “What we need is something that says ‘do this’. We also plan to have someone from the Injured Jockeys Fund to talk to us about what we should be doing with these people and why it helps them so the MEA and BE are putting out the same message.”

British Equestrian chief executive Jim Eyre told H&H the organisation and its member bodies are “committed to upholding the highest standards” of welfare for all, and takes the risk of neurological injuries and concussion “extremely seriously”.

“With the FEI, we have taken a proactive lead in this area and share their aim of reducing risk and improving management of injuries, with each member body having its own protocols to manage falls with the risk of concussion,“ he said.

“While riding helmets will help to protect riders from significant head injury trauma, we recognise they may not protect from concussion. Therefore, concussion as part of athlete welfare is regularly reviewed at all levels, from Pony Club to BEF’s world class programme. “We recognise more can always be done in terms of awareness and education, and we welcome the DCMS report and look forward to the follow-on work with UK Sport and the HSE”.

The British Horseracing Authority provided evidence to the DMCS inquiry and a spokesman told H&H the organisation “welcomes” the report.

“Discussions with the Government have already been undertaken on this subject and we look forward to continuing that work, as well as engaging with other sporting governing bodies, to understand what role British racing can play in the implementation of the report’s recommendations”.

Rider who spent six months in hospital after fall campaigns on safety equipment

Sarah Radford — Sun, 28 Mar 2021 15:21:18 +0000

A rider who spent six months in hospital recovering from a brain injury after a fall out hacking is using her experience to remind others of the importance of correct safety equipment.

Sarah Washington, 23, was riding out with her friend Gabby Andrews last June when her loan horse Teddy inexplicably spooked and bolted down a narrow track.

Sarah, who had recently started studying veterinary medicine, was dragged and knocked unconscious, and Teddy then galloped back home to the yard.

Gabby, whose 18hh four-year-old Major had stayed calm, called for an ambulance and when paramedics arrived, Sarah was placed into an induced coma and taken to the Royal Stoke hospital.

Scans revealed she had severe bleeding and bruising on her brain and a device had to be inserted to monitor the pressure inside her skull.

She remained in an induced coma in intensive care for three weeks and spent a total of six months in hospital undergoing rehabilitation, including re-learning to walk, speech therapy and help with her memory.

(Image credit: creditUnknown)

“I don’t remember much from my time in ICU and after that, although my long-term memory was OK, my short-term memory was affected and I wouldn’t know what day it was or I would forget where I was,” Sarah told H&H.

“When I first came out of intensive care, I wasn’t speaking at all — I don’t think it was because of my injury so much as I was confused and scared in a place with loads of people I didn’t know.”

Because Sarah was hospitalised during the pandemic, visits from her family were extremely limited and it was not until she moved to a rehabilitation ward at a smaller hospital, a specialist neuro rehab unit at The Hayward, that she was allowed to see her parents once a week.

“It was definitely difficult to deal with, although we got through it by regularly Facetiming,” she said.

Sarah was discharged on 15 December, and her recovery since has exceeded all expectations. Not only is she now back in the saddle but she is also using her story to campaign for hat safety.

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Trauma doctor shares simple life-saving actions all equestrians should know

Dr Diane Fisher spoke about the simple, potentially life-saving actions, people can take if a friend hits their head at

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“I set up an Instagram account to document my recovery and it ended up becoming more about spreading awareness about equestrian safety and helmets,” Sarah said.

When hat manufacturer Champion saw her posts, they asked her to send her hat back to them for analysis of the effects of the fall.

“It had really significant and visible damage,” Sarah said. “They sent back a really detailed report from their engineer. Without the hat, I would certainly have been a lot worse off.”

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade to access our H&H Plus online service which brings you breaking news as it happens as well as other benefits.

Trauma doctor shares simple life-saving actions all equestrians should know

Lucy Elder — Fri, 29 Jan 2021 11:50:15 +0000

A senior trauma doctor has urged people to send injured riders to hospital with the helmet they were wearing as part of a training clinic on potentially life-saving steps anyone can take to help someone with a head injury.

Dr Diane Fisher, who is a rider as well as a trauma consultant attached to both Royal Stoke University Hospital and the Shrewsbury and Telford Hospital NHS Trust, spoke about the simple first-aid actions people can take if a friend hits their head at the yard.

“The part that worries me is the secondary injury — I can’t do anything about the fact you’ve hurt your head, but what I can do is make sure that people know what to do with the secondary injuries,” said Dr Fisher in her “rider clinic” webinar on 28 January, held in association with Champion.

“When someone has had a head injury, their head tends to drop down and their tongue goes to the back of their throat and obstructs their airway so they are not able to get oxygen in and around their body.

“You’ve already got a piece of brain tissue that’s in pain and the last thing in the world it needs is to be starved of oxygen, so it’s really important that as soon as an injury has just happened that we work through the first aid.

“From an equestrian point of view, you do need to check it’s safe for you to get across to that casualty; if you are with people, get someone to catch the horse so he doesn’t come running back over you or the rider.”

The Rider Clinic Live: Head InjuryWow what a clinic this is!! I'll be joined by Helen from Champion Equestrain. I'll chatting about Head Injury, what to do before the paramedics arrive, when does somebody need to go to hopsital and concussion. Helen will take us through rigorous testing and research that goes intop keeping our heads safe as possible and how to choose and care for them so they last as long as possible. There is also an AMAZING GIVEAWAY of a hat from Champion Equestrian for one lucky follower!! Keep your eyes peeled for the giveaway posts!!!Posted by All_the_kings_horses_ on Thursday, January 28, 2021

She added while the advice is that people shouldn’t remove a person’s helmet if they are not trained, that has to be balanced with whether the person’s airway is obstructed and whether you are going to be able to open that with the hat on.

“If that person is not breathing, then if you need to take the hat off, you take the hat off. Without the airway, there is no question that they will die or become brain damaged from lack of oxygen as opposed to a head injury that may not be that bad,” she said.

“If they are breathing ok and the hat is on that’s fine, leave it alone and leave them where they are. However, if the airway for whatever reason is not open or they are vomiting, you’re going to have to move them to get them onto their side otherwise they are going to choke. It’s a case of dealing with what’s thrown at you.”

Dr Fisher demonstrated a jaw thrust as a way of opening someone’s airway without tilting their head and moving the neck. This involves simply putting a finger each side of the jaw, below the ears, and gently pushing forwards (see tutorial video below).

Here we look at the First Element in the Trauma Assessment- Airway. No airway = imminent death learn a airway…Posted by All_the_kings_horses_ on Tuesday, December 8, 2020

She urged equestrians — especially at the moment while the NHS is dealing with the pandemic — to be sensible, lunge first if appropriate, and to be realistic about their riding ability. She added trauma teams have seen head crush injuries, which have happened at places such as gates, and stressed that for this reason it is “incredibly important” people wear hats on the ground when dealing with horses as well as when riding.

Dr Fisher also strongly recommended riders download the What3Words app and urged them to take responsibility for having a plan about what to do if things should go wrong. This includes telling someone where you are going hacking and what time you are back, and if you are hacking out with a friend, making sure you both know what to do if anything happens.

“In hospital we are really concerned with mechanism of injury and this is how my Facebook page started as I can’t tell you how many equestrians I’ve seen or know who say ‘I had a touch of concussion’ or ‘I had bit of a bang to the head’ — it’s not, it is a traumatic brain injury,” she said. “It’s not ‘just a little fall’. As equestrians we are quite hard, I think, and we have that [culture] of ‘fall, get straight back on’. I think we are moving away from that now.

“When you come into hospital, we need to know as much as possible about how the accident happened and what that person was like afterwards, so you need somebody to stay with them the whole time while others are going off and phoning for help, or catching the horse.

“If you’re the person standing with them, you need to be aware of: are they making sense; is there any big change in what their pupils look like; are they saying they feel sick or are being sick and are they sleepy. That’s because you may need to upgrade your ambulance call as it’s not unusual for someone to be a bit stunned after a head injury and then suddenly start to deteriorate. At that point, you can ring the ambulance service back and say ‘I know they were awake five minutes ago, but they’re not now’ — that would take you up from a category three to a category one, which is an immediate response.”

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She added that sending a rider’s hat with them to hospital is “particularly important” at the moment because of pandemic restrictions on visitors, and if anyone is able to jot down on a piece of paper what happened to give to the paramedics, that is a real help.

“Because of Covid there is no visiting, so nobody is coming in with [the casualty], they come in on their own,” she said. “And if their level of consciousness is low, they can’t tell me what’s happened. I need a baseline and a degree of suspicion, so when I or the radiologist is peering at your scans, if we know what happened, we have a really good idea of what we are looking for and it may change how we manage you.”

Horse & Hound magazine, out every Thursday, is packed with all the latest news and reports, as well as interviews, specials, nostalgia, vet and training advice. Find how you can enjoy the magazine delivered to your door every week, plus options to upgrade to access our H&H Plus online service which brings you breaking news as it happens as well as other benefits.

FEI looking to introduce dope testing outside competition H&H Plus

Eleanor Jones — Tue, 26 Nov 2019 17:23:10 +0000

News from the recent FEI general assembly includes the latest clean sport initiatives and wearing protective helmets when mounted to become compulsory

The FEI is looking at introducing dope testing outside competitions as well as testing from hair and saliva samples.

Veterinary director Göran Akerström updated national federations at the general assembly in Moscow (16 to 19 November) on the FEI’s clean sport work, urging delegates to have national head vets and testing programmes, as “we will not be able to protect horse welfare and ensure a level playing field and development of sustainable sport without it”.

He spoke of “lots of discussion” about contamination and stable security, adding there is a “huge need” for education of all stakeholders.

“We’ll introduce an electronic system giving us information on horses,” he added, “to enable us to start looking at out-of-competition testing, as it’s very important to ensure horses aren’t being trained on painkillers, for example.

“We’re looking into hair testing, opening up the possibility of detecting anabolic steroids for a longer time, and to deter micro-dosing of sedatives and heart rate-lowering substances on the field of play, especially in endurance, we’re looking into developing saliva testing.”

Mr Akerström also cited certain “problematic” specified substances, which have caused problems in areas including South Africa and Mexico (news, 24 October).

“Further research is important and will be carried out,” he said.

Compulsory headwear from 2021

In other news from the general assembly, federations voted in favour of a rule that all riders must wear protective headgear when mounted on showgrounds from 2021.

“Tradition is important in our sport, but it’s difficult to not follow the medical community’s advice,” said FEI dressage committee chairman Frank Kemperman. “There’s no really strong argument against the use of protective headgear in dressage.”

Riders may still be allowed to go without safety helmets in prize-givings — although in a report from FEI medical committee chairman Peter Whitehead, it was revealed that of 581 records submitted on non-eventing injuries in FEI competition, this year seven were in dressage. Two were head injuries, one sustained in a prize-giving and the other in a trot-up.

The New Zealand federation, which introduced the rule for national events three years ago, supported the change.

‘It’s what I live for’: eventer who suffered serious brain injury returns to competition

Becky Murray — Wed, 05 Jun 2019 12:55:26 +0000

An eventer who suffered a severe traumatic brain injury in a cross-country fall has praised the NHS and her family after her return to competition, a year later.

Alexa Palmer, 20, suffered a serious fall with her gelding Ogue Caviar in the intermediate class at Little Downham Horse Trials on 1 June 2018.

Alexa told H&H she did not remember much of the incident, after which she was airlifted to hospital.

“It was one of those things. It’s sometimes luck on the day – you can have a good horse who is feeling well, but these things can happen in eventing,” said Alexa.

“The doctors warned my family a couple of times in the initial stages that I might not make it. I was in and out of consciousness for about two days but then things picked up and I got stronger and stronger. I had serious post-traumatic amnesia which meant I didn’t know what was happening when I was in hospital but I’m quite fortunate whereas my poor family had to watch it all.”

Alexa spent a month in hospital where she took part in a trial of a drug trial aimed at preventing blood clots forming on the brain.

“I was very fortunate to take part. When I saw the specialists afterwards they were amazed by my progress and said they hadn’t seen anything like it,” she said.

“I was very tired in hospital and didn’t have much stamina but the nurses and the doctors were very supportive – that’s what made the difference. They were very kind and there were other patients who were nice to be around – we were all supporting each other.”

On release from hospital in July Alexa was told she faced six months out of the saddle.

“Doctors have to be quite pessimistic because they don’t want to get your hopes up too much. I was advised a second knock to the head could be fatal while I was recovering,” said Alexa.

“I evaluated everything. I knew horses gave me a lot of pleasure so I started doing a lot of teaching. I would walk my horses in-hand and lunge them to work on their strength and balance, no-one else was riding them apart from occasionally my younger sister Kitty would hop on if she had time.”

Alexa returned to the saddle in November, and to competition in January, when she rode at a British Dressage (BD) competition.

“Kitty and I went out hacking to start – I thought it might be different being back on but from the word go it’s been totally normal,” said Alexa.

“I had a winning return to competition on our homebred mare Greenhays Midnight Magic and went on to win my next two dressage competitions. It provided some nice motivation knowing I was doing something right, and when no one had been riding my horses, to get them back into work myself and get the win felt really good.”

Alexa, who has completed her second year of a BSc in business economics at Exeter University, entered a BE100 at Bovington on 13 April, with her family’s blessing to return to eventing, and came third on six-year-old Global Super Nova. She has since qualified for the BD summer regionals, and is aiming Global Super Nova for young horse British Eventing classes. Kitty has taken on the ride of Ogue Caviar, competing him in BD classes.

“I never ever doubted returning to eventing,” Alexa said. “I knew all along it’s what I wanted to do – it’s what I love and live for. I know the southwest start box team, who do all the events in the area, really well so it felt very special they were the ones starting me because they know my journey and where I’ve come from.

“My family were amazing during my recovery and once I got to the point of returning to competition they were really supportive. They’ve never doubted me, and will let me progress as far as I want to go.”

Article continued below…

(Image credit: Rosebud Designs)

Rider survives serious brain injury to raise vital funds for air ambulance

The rider spent two months in hospital and cannot remember anything from the fall

(Image credit: Rosebud Designs)

Equine therapy can help brain injury patients, study finds

The study looked into whether animal assisted therapy could help social behaviour and communication skills

(Image credit: Rosebud Designs)

Alexa has been sharing her journey with her Facebook followers.

“When I had my accident the first thing that motivated me and made me feel happy was the number of cards that came through the post from friends, family and sponsors. It was a really nice feeling. I thought ‘how can I give something back to them?’ so it’s nice for them to follow my journey; where I’ve come from, where I’m going to and the process to get there – and it’s nice for me to look back on where I’ve come from,” Alexa said.

“People have all contributed so much to my recovery in that initial stage so it’s a good way to give back to them.”

For all the latest news analysis, competition reports, interviews, features and much more, don’t miss Horse & Hound magazine, on sale every Thursday.

Rider survives serious brain injury to raise vital funds for air ambulance

Becky Murray — Wed, 07 Nov 2018 16:29:08 +0000

(Image credit: creditUnknown)

A rider who survived a serious brain injury is raising money for the air ambulance which “saved her life”.

Naomi Dobson, 47, a former joint-master of the Ludlow, fell from her eventer Lawrence while jumping at home in September 2015 and spent two weeks in a coma.

Naomi told H&H: “I don’t remember anything about the fall or the three weeks after the accident. I was told I was jumping a double, Lawrence knocked the fence and took it with him, I came off and he fell on top of me. My groom, Lou Burns, was there and thought I was dead.

“Lou called 999 and an air ambulance came. When it got there they found I had a collapsed lung. Another air ambulance with a trauma unit came and they had to put a drain into my lung and then flew me to hospital.”

Naomi was diagnosed with a diffuse axonal brain injury but said “amazingly” she didn’t suffer any broken bones.

“They tried to wake me up from the coma but couldn’t; I had a score of three [on the Glasgow Coma Scale] which is as low as it can get without being dead,” said Naomi.

“I spent a month at the Queen Elizabeth Hospital Birmingam and then another month at Central England Rehabilitation Unit in Leamington Spa. My first memory is when my dogs were brought in to see me and I remember being pushed in a wheelchair outside.”

Naomi was released from hospital in November 2015 and she started riding again in January 2016.

“I’ve always been so active and spent my life hunting and eventing. I got on my horse Henry who I’ve owned for 16 years, since he was four – he’s the most amazing horse and we’ve been through a lot together. I had to be led round and have someone on each side of me to start with,” said Naomi.

Naomi started hunting again the following Christmas but says she only jumps smaller fences due to the lasting effects of the brain injury.

“I get exhausted very quickly, and struggle with balance. Every morning I get brain fog which starts five minutes after I wake up and gets worse through the day. Three years on I’m still not back to how I was and don’t think I ever will be. Talking to people can be really tiring because of the concentration I need to get words out especially if I don’t know someone,” said Naomi.

“I would have gone berserk if I couldn’t ride – it’s my life. Because I have no recollection of the accident there is no fear factor but I am very protective of my head.”

(Image credit: Naomi Dobson)

Rider who suffered severe injuries in rotational fall raises funds for air ambulance

‘The doctors had said they weren’t sure I would walk again, let alone run‘

(Image credit: Naomi Dobson)

Marathon mission for former eventer involved in crashing fall

Natasha Al-Egaily will be running London Marathon for Yorkshire Air Ambulance

(Image credit: Naomi Dobson)

Naomi is taking part in the Saving Lives Challenge on 28 November to raise funds for the Queen Elizabeth Hospital Birmingham and Midlands Air Ambulance Charity and will cycle a bike for two hours. The challenge is a five-day fundraiser from 26 November to 30 November where participants will cycle static bikes or run on a treadmill around the clock in the main atrium at the Queen Elizabeth Hospital Birmingham.

“The hospital and air ambulance saved my life. If it hadn’t been for the air ambulance I wouldn’t have been able to get to hospital so quickly and the Queen Elizabeth staff were amazing,” said Naomi. “I thought the challenge is something I can specifically do, I can’t run or cycle a normal bike but I can ride a static bike. The hardest part of the challenge will be my energy levels; every day I need to go to bed in the afternoon for an hour and a half from exhaustion.

“The air ambulance have no funding and rely on donations. I’m determined after this I want to carry on fundraising for them – they provide such an important service and we rely on them.”

For all the latest news analysis, competition reports, interviews, features and much more, don’t miss Horse & Hound magazine, on sale every Thursday.

Four-star rider reveals her struggle with head injury

Carol Phillips — Mon, 01 Oct 2018 09:30:09 +0000

Four-star event rider Nana Dalton has revealed that she has been struggling for months with the lasting effects of a head injury that occurred in late April.

Nana shared her experience on her Nana Dalton Eventing facebook page to raise awareness of how debilitating even a ‘mild’ head injury can be and to give others an insight into her concussion after having taken solace in hearing about other people’s similar experiences.

She has stood herself down from competition for the rest of the year to give herself time to recover fully and is booked in to attend a concussion clinic in Birmingham.

“I’m not writing this to receive any form or sympathy, or any form of abuse as to how I should or shouldn’t have done things, but purely to give an insight to my experience,” she explained.

“Although not everyone will agree with what I’ve done and how I’ve done it, I have only ever tried to make the right decisions along the way and do the best I can trying to juggle everything.”

The initial injury occurred while Nana was riding a young horse in a novice section at Chilham on 29 April.

“I was warming up for the showjumping and we had a genuine misunderstanding over the approach to an oxer, resulting in an awkward jump with the horse landing on the back rail,” explained Nana. “She scooted forwards, I slipped my reins and ended up unceremoniously coming out the back door and landing on my back/shoulder blades.”

Nana instantly experienced pins and needles down her arms, and in her hands and face, but was determined not to let the seemingly innocuous fall derail her plans.

“My first thoughts were that I didn’t want it to jeopardise going to Badminton and having watched enough rugby, rationalised it as just being ‘a stinger’. Instinct took over, I jumped up, ran over to get signed ‘ok’ from the doctor and went in the ring and jumped the course of showjumps,” she said.

Signs that all was not well appeared when Nana got back to her lorry.

“Back at the lorry, my body went into shock and the realisation hit that I had indeed put our Badminton trip in jeopardy so I withdrew from the cross-country.”

Despite feeling far from her best, Nana, 39, was determined not to miss the opportunity to ride at Badminton for the second time in her career. This ambition was heightened by the fact her ride Absolut Opposition (Miley) had been suffering with soundness issues since their Badminton debut three years previously.

“With him being fit, sound, well prepared and off the waitlist, I was all the more determined to let him have his chance to shine again,” she said.

Nana successfully completed Badminton on Miley, including jumping clear across country, but once the adrenaline wore off, she felt “pretty mediocre” and so went to A&E to get checked out. Neck X-rays and a CT scan of her head came back clear, so she headed off to Chatsworth the following weekend.

“I was feeling pretty ropey and became increasingly aware that my judgement was hazy so when my number was called to go to the start box of the cross-country, I hesitated and then told them I wanted to withdraw,” she explained.

Nana described the next few months feeling like she was constantly suffering from the “worst, prolonged and most miserable hangover.” She had persistent pounding headaches, dizziness, nauseousness, was constantly tired and sensitive to light and noise.

“I’d go to bed hoping I’d just pass out so the room would stop spinning and I’d wake up feeling like I must’ve mixed all of the spirits and drunk the bar dry!” she said.

Over this period Nana sought advice and treatment from top healthcare professionals, including weekly visits to a sports concussion doctor, physio sessions including vestibular work to help with the whiplash, more MRI and CT scans, various medications and even a nerve block injection into her head with varying results.

While she knew that rest was key, it was difficult to achieve while being a single mum to her five-year-old son and running a business that relied on her riding and competing horses.

“Three months of doing nothing was very alien to me,” she explained. “Physically it wasn’t great, but mentally it was even harder – it’s easier said than done trying to rest the brain.”

While the healthcare professionals warned her that head injuries can take a very long time to recover from, they were happy for Nana to “use her common sense” as to how she felt best to proceed.

“I started at home, just riding one horse a day and then building up,” said Nana. “I did a handful of one-day events, again just starting off with just one horse a day and then did a couple in the day. My confidence was totally intact and I completely trusted my ability and instincts… and that of the horses I was riding.”

Feeling like she needed a focus in order to move on, Nana decided to enter two horses for Burghley.

“Sat at home filling in the entry form was the easy bit… but would I ever be well enough or fit enough to do the horses, the owners or myself justice? Only time would tell, but I felt I really needed a direction,” she said.

Burghley came around and while Nana described herself as feeling “emotionally very vulnerable” she felt she was feeling and functioning much better physically.

“I felt like I did the horses, their owners and myself justice and Miley had another great placing,” she explained.

But after showjumping, her emotions threatened to get the better of her once more, and she was shocked by how much the event had drained her.

“The following week, some of the original symptoms came flooding back with the booming throb of the blood pumping in my head reaching antisocial levels again and cantering making me feel very sick,” she said.

Nana headed off to Blenheim, but withdrew before the cross-country as she was “still not feeling great” and has now called time on trying to do any more competing this year.

Continued below…

(Image credit: www.sarahfarnsworth.co.uk)

Meet our Badminton Horse Trials’ first-timer: Nana Dalton

Meet our first-timer, who juggles being a mum to her two-year-old son with running a yard and will be riding

(Image credit: www.sarahfarnsworth.co.uk)

Nana Dalton’s Burghley blog: We’re back!

Nana is back, only this time she will be updating us on her journey to the prestigious Burghley Horse Trials

(Image credit: www.sarahfarnsworth.co.uk)

Nana Dalton’s Burghley blog: all change, meet ‘super sub’ Bug

Find out why Miley has been ruled out of Burghley giving his stable mate the chance to make his four-star

She knows that the period since the injury has been particularly challenging for everyone around her, and wishes to thank everyone for their support.

“The ramifications on those closest to me have been huge, especially dealing with the complexity of a head injury, even a relatively mild one like mine,” she said. “My family and friends have been exceptional. I have been so reliant on them and they have been unconditional in their love, help and support. I have been overwhelmed by the level of compassion, understanding and support shown.”

For all the latest news analysis, competition reports, interviews, features and much more, don’t miss Horse & Hound magazine, on sale every Thursday

‘He looked after me when I needed him’: how horses helped Jo Barry come back from major brain injury

Polly Bryan — Mon, 02 Jul 2018 07:25:05 +0000

One day in December 2014, leading Scottish dressage rider Jo Barry was schooling her small tour horse Corchapin (Colin) at home, on a high after a successful month of training with her former employer Carl Hester. Ten days later she woke up in hospital, having been found unconscious after Colin apparently tripped and fell. Having suffered a devastating brain injury, Jo was faced with the monumental struggle of learning to walk, talk and ride again.

After winning her first national title since the accident in April this year (pictured on Goofy La Perle), she explains how instrumental horses and dressage have been in her recovery.

“Horses and riding has been the best possible physio,” she says. “Simple things like tacking up — the first time I tried to put on a bridle and my hands just started to take over and do it — it was so familiar. Even mucking out has helped so much with hand-eye coordination — just being able to get the droppings in the bucket.

“Riding has done so much for my coordination too. I wasn’t as quick with my aids — it was like a delayed response. The first time I tried to do tempi changes I just couldn’t, and it’s taken time and patience from Colin to accept that I’m not quite right.”

As well as physically helping Jo recover, the desire to get her dressage career back on track kept her going through the most difficult times.

“Being back on a proper dressage horse felt like I’d come home,” she remembers. “Doing my first change was lovely, and my first half-pass.

“It took a long time before I let myself go down to train with Carl though. I wouldn’t go until I felt ready to not waste his time, and to not embarrass myself. That first lesson with him I was in tears because I couldn’t do it how I wanted. But on the second day there were glimmers of how it used to feel, and that’s what I held on to.”

The bond with her horses, especially Colin, whom she describes as “like an old pair of slippers” made the impossible possible.

“Colin had qualified for regionals the year after the accident. I had the entry for them sitting underneath my sitting room table for God knows how long, but everyone told me I was stupid. I posted it off on the very last day I could. It was my first competition back — and Colin looked after me. I’d looked after him throughout his career and then he turned around and looked after me when I needed him.”

Jo quickly realised that in the time she had been out of the sport, dressage had moved on, and meant she had to up her game even further if she wanted to get back on top.

“I’m such a perfectionist,” she admits. “I’d say I still have 10% to go before I get back to where I used to be, but I need to be better than the old Jo because dressage has moved up from three years ago. It was hard enough before but the training, the horsepower has all improved and now you need to be scoring at least in the mid-70s to win a championship. So really I have 20% still to go.”

Article continues below…

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(Image credit: creditUnknown)

‘The best bunch of horses we’ve ever had’: go behind the scenes at Carl and Charlotte’s yard

Find out what daily life is like on the yard of dressage supremos Carl Hester and Charlotte Dujardin.

And it’s not just the horses and the competing — Jo credits the horsey community for being instrumental in her recovery.

“I’ve been so lucky to have such a circle of support, from my friends to my sponsors and British Dressage, and Carl has been there through thick and thin. You don’t realise who you have around you until you have to rely on them, and it’s amazing who will step up, sometimes people you don’t expect. With the amount of flowers I received after the accident I could have opened a florist!”

To read the full interview with Jo Barry, don’t miss the current issue of Horse & Hound magazine, which is out until 4 July

Equine head injuries — what’s the prognosis? H&H VIP

Horse & Hound — Mon, 28 Aug 2017 07:55:42 +0000

“I thought he was dead,” recalls Kate Cook of the day she found her gelding Max lying motionless in the field. The eight- year-old had collided with a tree in a freak accident (see case study, below).

“Apparently, he had cantered headlong into an overhanging branch that flipped him over backwards,” Kate explains. “He had a wound between his eyes and blood was pouring from his nose. I touched him and he tried to stand, eventually getting to his feet.”

A bewildered Max was then coaxed to his stable and treated with painkillers and antibiotics. He was unco-ordinated and appeared blind, walking in circles and grinding his teeth. But within two weeks, he had regained his eyesight and enough strength to go back out in the field.

Six weeks later, Max was taken to Bell Equine in Kent for a CT (computed tomography) examination of his skull. The findings stunned the team.

A CT scan of Max’s head enabled complete evaluation of his injuries. the cranium (the bony shell around the brain) should be a complete circle. However, it is irregular in shape and there are fragments of bone protruding down into the grey tissue of the brain (Image credit: creditUnknown)

“The scan identified that some of the bony shell of Max’s skull had fractured during the collision, leaving fragments embedded in his brain,” said David Sinclair MRCVS. “His recovery is nothing short of astonishing.”

Kicks and collisions

“Blunt” trauma, from a collision or kick, is a typical cause of facial injury in adult horses. Foals are also at risk of being kicked or trodden on by the mare.

The most commonly injured bones include the nasal, frontal and maxillary bones, and the zygomatic process. Fortunately, horses have a large sinus arcade and extensive nasal passages that can normally tolerate a significant amount of damage without life- threatening consequences.

As is seen in Max’s case, however, injury can result in trauma to the brain and eyes. It is usually the damage to the nasal passages and paranasal sinuses that results in severe haemorrhage — although horses have a huge circulating blood volume and can survive large blood loss.

Depression fractures to the frontal and maxillary sinuses typically occur upon impact, causing a profuse but short-term nosebleed. This may lead to intermittent bleeding that can last more than a month in some cases.

If the trauma has resulted in damage to the skin, facial fractures are usually obvious. And occasionally, the offending item — such as a fence post or polo stick — may still be in place, or the fracture may be sizable with a significant skin defect. Otherwise, it is not uncommon to diagnose a fracture many weeks after the event while investigating a small but persistent nosebleed.

An unstable fragment may move when the horse breathes and if the defect is large, then it can even be possible to literally see into the horse’s head. This kind of severe trauma, with extensive bleeding, is usually not nearly as bad as it looks so try not to panic, but seek immediate veterinary attention.

When facial fractures are less obvious, diagnosis may be made by examination. Air can escape under intact skin to cause emphysema, which feels like a piece of bubble wrap popping as you run your hand over the area. And it may be possible to feel crepitus (fracture fragments) moving beneath your fingers.

Radiographs (X-rays) of the skull are often required to reveal the extent of the fracture and endoscopy (scoping) is useful for evaluating the nasal cavities, especially when a nosebleed is the presenting complaint. However, a CT scan presents a “slice by slice” picture that enables complete evaluation of the head and detailed pre-operative planning for any fracture repair.

It is also wise to examine the eyes and perform a neurological assessment to detect any further or more severe damage.

Fracture repair

Initial treatment should be aimed at stabilising the horse.

Supportive care ranges from basic wound management to antibiotic therapy and analgesia (pain relief ), usually in the form of phenylbutazone (bute). In most cases, there is no need to repair the fracture immediately — a delay is often useful to allow any wounds to heal and swelling to dissipate. Further treatment will be aimed at reconstructing the bone and mending the fracture. Displaced fractures can rarely be left to heal on their own, as this typically leads to sinus infections.

Sinuses that have been traumatised and are full of blood or contamination may need lavage (flushing out) to prevent any residual infection occurring. Reduction (alignment) can then be achieved in most cases by lifting the fracture fragments and wedging them back into place like a tight-fitting jigsaw puzzle.

More often than not, the soft tissue attachments will provide adequate blood supply and the means for stabilising the fragments, but a more complicated fracture may require further treatment. If the fragments do not reduce snugly, they can be held in place by cerclage (looped) wire sutures.

A complicated fracture may also warrant the use of reconstruction plates and screws, but this increases the risk of infection and makes closure of the facial skin more difficult.

Prognosis for a full return to work is usually good, and factors that might have long-lasting effects — such as damage to the eyes, the nasolacrimal duct (tear duct), salivary duct and the brain — are normally realised before any repair is attempted.

A good cosmetic outcome is usually possible. The best prognosis is with the simplest, least invasive repair. Carbon fibre implants can be used to reshape the face where a depression in the bone has remained, but this is rarely necessary.

If wire sutures or plates, or both, have been used, the skin can remain thickened and bony swellings called nasofrontal suture exotoses can develop. These may be self-resolving or permanent and little can be done to prevent them, other than adhering to the “less is more” mantra when repairing skull fractures. evaluation of the head and detailed pre-operative planning for any fracture repair.

Case study — a survival against all odds

Three months after his accident, Max shows almost no signs of neurological problems, other than some very subtle changes to his facial expression. Surgery to remove the bone fragments is not an option, however, due to difficulties with sedation and aftercare, so his future looks uncertain.

A return to work may be possible for Max, who has started some light lungeing (Image credit: creditUnknown)

“The literature on equine cranial trauma does not document a single case of a horse surviving such damage to the skull and brain,” explains David Sinclair, “although similar cases of canine skull injury have done very well. Seizures are possible, indeed probable, and also infection of the brain (meningitis and encephalitis) owing to the fact that Max’s cranium (brain cavity) was open to the elements for a while, but we have seen neither of these.

Max bears the scars, but is currently progressing well (Image credit: creditUnknown)

“While collapse, seizures and abnormal neurological behaviour in a dog would probably not put its owner at risk, half a ton of horse with these problems is a different matter. We cannot rule out problems, but we can mitigate risks by advising any attempt to try to return Max to some sort of working life is done very slowly, and that any activities are introduced unridden.”

Kate adds: “Max was my daughter Molly’s showjumping horse and such a talented animal, but I wouldn’t put her on him again. His previous owner wants to give him a chance, however,

so he has started some light lungeing and is progressing well.”

Ref: Horse & Hound; 24 August 2017

Racing to improve concussion care for jockeys

Lucy Elder — Thu, 21 Jul 2016 16:39:53 +0000

Repeat tests and active rehabilitation are among the new concussion protocols to be introduced by the British Horseracing Authority (BHA).

The enhancements to the BHA’s rules will come into force on 1 August.

The aim is to ensure riders are better protected and prevented from riding while they have a concussive injury.

Dr Jerry Hill, the BHA’s chief medical adviser, said it is “essential” that a sport should not be complacent about the management of such a serious issue as concussion.

“For some time British racing has been recognised as pioneers when it comes to concussion management, as you would expect from a sport which carries an above average risk of concussion injury,” he said.

“It is my intention that in British racing we provide our jockey athletes with the appropriate guidance, treatment and care.

“This is why I am personally putting a renewed focus on the support these athletes receive in injury management as well as wellbeing, nutrition and mental health.”

This follows a review of the existing concussion management protocols led by Dr Hill, in consultation with relevant stakeholders such as the Professional Jockeys Association.

The updated protocols include an extension of the course-side screening test to ensure all riders involved in a fall are assessed with symptom scores, balance and short and long-term memory tests — previously only memory was tested.

Doctors will also be allowed to test riders involved in heavy falls a second time, around 25-30 minutes after the initial test, even if the rider passed the initial screening. This is to help detect late-onset concussions.

As well as this, the BHA is involving other members of racecourse teams to encourage potentially concussed jockeys to attend testing and retesting with the on-site medics.

Further research and development of an active rehabilitation programme and enhancing baseline testing are also part of the updates.

The Injured Jockeys Fund’s almoners will be included in the baseline testing process to help make it more convenient for riders.

“The enhancements to our concussion management protocols will help reduce the risk of jockeys continuing to ride while suffering from a concussion,” added Dr Hill.

“It will also aid their safe return to riding following a concussion injury.”

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More improvements planned for the “near future” include a rewrite of head injury guidelines given to jockeys plus enhancements to the helmet bounty system.

The BHA is also working on an education programme for anyone working within racing on how to diagnose concussion and the risks of riding with a head injury.

Suffered a head injury? 7 things you need to know before you start driving again

Lucy Elder — Tue, 14 Jun 2016 11:52:35 +0000

Driving is something we all take for granted — and is often critical to our livelihoods. But after a serious head injury, it is important to know where you stand before you get behind the wheel again

“For a survivor of brain injury, returning to driving can be an important step towards regaining a lost sense of independence,” says Luke Griggs from brain injury charity Headway.

“It’s a life skill that many of us take for granted and it’s sometimes easy to forget that driving is a very complex activity.

“Driving requires a number of cognitive and physical skills, as well as the ability to co-ordinate them. As all these skills can be significantly impaired by brain injury, it is vital that people do not get back behind the wheel until they have been medically assessed and passed fit to do so.

“By law, when a person has a significant neurological injury, they are required to inform the DVLA and their insurance company of any changes to health that may affect their fitness to drive. We also recommend people seek advice from their GP in the first instance.”

1. After a “serious head injury”, you must tell the DVLA. If you don’t, you could be fined £1,000 and prosecuted in the event of an accident.

2. By law, it is also a requirement to contact your insurer. Your insurance could also be invalid if you do not.

3. There are forms on the government website where you can report your injury confidentially. There is a separate form for car licences to lorry licences

4. If you are unsure whether your injury consistutes being “serious”, the government recommends you see a doctor

5. Depending on the severity of your injury, you may need to take a driving test before you are given your licence back

6. It is possible for the DVLA to return part of your licence to you, but withhold extra categories. For example, you may be allowed to drive a car again, but the rules surrounding group two (HGV) licences are stricter

7. Each case is considered individually by the DVLA. However, medical guidelines state people who have sustained a serious traumatic brain injury should not drive for six months to a year

For more information, Headway has put together an e-booklet or visit the DVLA website

Advances in concussion testing

Lucy Elder — Sat, 20 Feb 2016 11:55:12 +0000

A test that could help detect the severity of a concussion is a step closer after researchers found a specific protein present in patients with a certain type of head injury.

Scientists have discovered that some “mild” concussions can cause cognitive impairment that lasts for several months or longer.

Researchers at the University of Pennsylvania and the University of Glasgow have found a biomarker that is present in concussions with this brain damage.

They have narrowed it down to a specific protein, which rises in the blood following this type of concussion.

Scientists hope this could be used to diagnose specific brain injuries and predict cognitive impairment in patients.

“We’re starting to believe that ‘mild traumatic brain injury’ is an oxymoron,” said author Dr Douglas Smith. “For some people there’s nothing mild about it.”

A concussion test similar to the standard blood test used to detect cardiac damage from a heart attack may be available in the future.

“The brain protein specifically indicates the presence of nerve fibre damage that we call diffuse axonal injury,” said Dr Smith.

“Our findings confirm that even relatively mild, concussion-type brain impacts can cause permanent damage of this kind.”

Dr Jerry Hill, chief medical advisor at the British Horseracing Authority (BHA), said the development of biomarkers as pitchside or near-patient tests has been the subject of research from groups around the world.

“If these chemicals could be measured on breath or finger-prick blood tests that gave instant results and were accurate, reliable and cost-effective, then such tests have the potential to revolutionise the management of concussion,” he told H&H.

“Research is ongoing and the BHA will monitor developments to assess when and if such testing can be incorporated into our current protocols.

“Racing has, for many years, been recognised as being ahead of the curve when it comes to concussion management, however we cannot be complacent.”

He added that the BHA is currently reviewing its concussion protocols.

The BHA rules currently require all professional jockeys to undergo yearly baseline neuropsychological screening.

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Following a concussion diagnosis, a rider is immediately stood down for a minimum of six days.

They then undergo one or more repeat neuropsychological tests that are compared to their baseline, an assessment by a separate consultant neurologist and, in some cases, a brain scan.

Only when the results of these tests return to normal is the jockey allowed to return to race-riding.

Ref: H&H 18 February, 2016

Money off new helmets for concussed riders

Lucy Elder — Wed, 27 Jan 2016 14:00:32 +0000

A £100 hat voucher will be given to riders who sustain a head injury while competing at a British Eventing (BE) competition.

The British Equestrian Trade Association (BETA) has teamed up with BE to develop the new BETA “helmet bounty scheme”.

Any rider who is concussed during the cross-country phase at a BE-affiliated event will receive a voucher to be put towards the cost of a replacement jockey skull.

“Improving rider safety is an integral part of our work and we are tremendously pleased that the scheme — effectively a hat amnesty — will help to drive home the message that hats should always be replaced when they have been involved in an incident,” said Claire Williams from BETA.

To receive the voucher, riders must be diagnosed with concussion by an event’s medical officer.

They must then agree to give the hat they were wearing at the time of the fall to BETA and to BE, passing on details of their injury.

The voucher will be valid with BETA-participating retailers.

“We are delighted to be working with BETA on this extremely important initiative,” added BE’s Chris Farr.

“[It] will not only help riders to replace their hats, but those collected will be used by the trade association to conduct further research into improving riding hat standards.”

The scheme will be introduced ready for the beginning of the 2016 eventing season, which kicks off at Isleham on 5 March.

The British Horseracing Authority (BHA) already runs a similar scheme, whereby jockeys who suffer a concussion while racing under Rules are given an £80 voucher for a new helmet.

Jockeys are also required to surrender their old helmet before they are given a voucher for a new one.

Plans are also in the pipeline for BETA to work with the BHA on updating its existing scheme.

Volunteers rescue seriously injured rider lost in dense forest

Ellie Hughes — Thu, 07 Jan 2016 11:07:39 +0000

A rider has credited a volunteer search and rescue team with saving her from potentially life-changing injuries after she fell from her horse during a 10-mile pleasure ride in Northern Ireland.

Charmaine Halliday (pictured above her daughter Megan before the accident) was taking part in a ride organised by the Irish Long Distance Riding Association (ILDRA) in the Tollymore Forest, near Newcastle, on 3 January.

“There was around two miles left and I was cantering along when I lost my stirrup. I slid off the side because my saddle was so wet in the rain,” Charmaine told H&H.

“According to my daughter, Megan, who was riding behind me, I fell down the bank and hit some rocks and trees, but as I was knocked unconscious I don’t remember anything.”

The Mourne Forest Mountain Rescue team, which comprises around 35 volunteers from around the Mourne area, was called to the forest at around 1.30pm after emergency services were unable to locate Charmaine, who had become unshipped in a particularly dense area of forest.

The team co-ordinated a rescue effort that involved more than 20 people from the Northern Ireland Ambulance Service, the police and coastguard and forest service staff.

After she was found by the team, Charmaine was airlifted to Daisy Hill Hospital in Newry, where she was treated for head, neck and back injuries and kept in hospital overnight for observation.

Charmaine is a member of the ILDRA and regularly takes part in rides with her seven-year-old mare, Ethel.

“It’s lucky she’s as quiet as she is,” she added. “Apparently she put her head straight down to eat the grass and stayed there even when the helicopter started buzzing overhead.”

Charmaine is now planning a sponsored ride to raise money for the Mourne Mountain Rescue team, which relies on donations to maintain the service.

“I’ve suffered concussion, a large hematoma on the left side of my head, whiplash and my left hand is cut to bits. But without the rescue team’s efforts it could have been far worse,” she said.

The ILDRA also thanked the rescue team via Facebook: “The professionalism and efficiency shown from all involved, professional and voluntary, was a credit to the system, as was the co-operation between services and agencies, north and south.”

‘Where did I go?’ eventer pens book about recovery from brain injury

Lucy Elder — Sat, 12 Dec 2015 16:55:37 +0000

A former four-star event rider who suffered a traumatic brain injury has written a book about her recovery.

Polly Williamson had a serious fall from a young horse in December 2011.

She was riding at home on her yard in Malmesbury, Wilts, when the horse slipped, fell and panicked when he couldn’t get up.

One of his hooves caught Polly on her head and she also broke three vertebrae.

She spent a month in hospital and three months in a rehabilitation unit at Frenchay Hospital in Bristol.

The book — titled Where Did I Go? — follows how she relearnt to walk and think following the accident.

Polly revealed the news about her new book on social media on Thursday (10 December).

“Two years ago Alison Booth turned to me and said ‘you should write a book’,” Polly said.

“We were talking briefly about my accident so I went home and started to write.”

(Image credit: creditUnknown)

After finishing a first draft, she shelved the idea while she began her return to teaching.

This summer, Polly sent the manuscript to three publishing houses.

The former junior and young rider European eventing champion has now signed a deal with publishers Crumps Brown Studio, who will be releasing it as an eBook in March and in paperback in April.

Polly will also be speaking at charity Headway — the Brain Injury Association’s conference in March.

“Thank you all for your generous comments,” she said.

She added that writing came easily, but talking about it will be much harder.

During her competitive career, Polly won a total of six gold medals at junior and young rider European level.

She was ninth in her first Badminton in 1989 at the age of 20 and was also on the British squad that competed at the European Eventing Championships at Burghley that year.

Polly continues to train riders from Pony Club up to international level.

Simple reading test could help detect concussion

Lucy Elder — Mon, 09 Nov 2015 07:25:27 +0000

A simple reading test could help establish whether a rider has concussion, according to researchers.

A timed vision test — known as the King- Devick Test — involves athletes with a suspected head injury reading numbers as quickly as they can off a series of three cards, while being timed with a stopwatch.

This is then compared to their result from a pre-season baseline test.

It took concussed athletes an average of 4.8 seconds longer than their baseline score to complete the test, whereas non-concussed athletes improved by an average of 1.9 seconds.

The study, which was published on 10 September in the journal Concussion, was carried out by researchers at the NYU Langone Medical Center in America.

“There is no diagnostic substitute for a medical professional when it comes to evaluating an athlete for concussion, but physicians are not always on the sidelines when an injury might occur,” said senior study author Prof Laura Balcher.

Researchers reviewed 15 studies where a rapid number-naming test had been used.

In total, the study involved 1,419 athletes from sports including hockey, football, boxing, lacrosse and rugby, of which 112 had sustained a concussion.

The test detected 96 out of the 112 concussions, which were then confirmed by clinical diagnosis.

Co-author Dr Steven Galetta said that when used as part of a “battery of tests” assessing cognition and balance, the vision test can “raise a flag” for those athletes that need to see a medical professional.

This is one of several recent studies that have thrown up questions about how concussion is measured (news, 17 September).

According to Sport England, 15.5m people aged 16 years and over play sport weekly — including 279,300 riders.

“This research is very interesting and could benefit riders to ensure that anyone with concussion is identified and provided with the correct medical treatment,” said Sarah Phillips from the British Horse Society.

“It will be interesting to see how the practical application of this procedure can be adapted for equestrian sport.”

Ref: H&H 5 November, 2015

UPDATE: William Fox-Pitt ‘stable’ in hospital after serious fall

Amy Mathieson — Mon, 19 Oct 2015 19:50:56 +0000

William Fox-Pitt remains in hospital in France with a head trauma following a serious fall on Saturday (17 October).

The Olympic eventer fell at fence 20, an owl hole, on the cross-country at Le Lion d’Angers with Reinstated.

The pair were competing in the seven-year-old CCI2* class at the FEI/WBFSH world championships for young eventing horses.

The horse, whom William first competed in May 2014 at Chatsworth, was not injured in the fall.

The course was held for more than an hour while William received medical assistance before being transferred to Angers hospital.

“William has suffered a head trauma, but is otherwise fine. He is comfortable and stable under sedation and will be under constant observation,” read a statement on Saturday.

This morning (Monday, 19 October) a spokesman for British Eventing told H&H there was “no change” in William’s condition and that he remains “under observation”.

“William had a good night and remained stable and under sedation; he will undergo further tests later today,” the spokesman added.

“On behalf of the Fox-Pitt family and their support team at home, William’s wife Alice Fox-Pitt would like to express her thanks to everyone for their support and well wishes, it means a tremendous amount to them all that everyone is thinking of William.”

Alice has travelled to France to be with him.

Willliam, who currently stands at number three in the world eventing rankings, had already completed the course successfully on his first ride, The Soapdodger.

His last win was at the CIC3* at Hartpury in August with Bay My Hero.

Top dressage rider returns to competition after serious head injury

Amy Mathieson — Tue, 22 Sep 2015 13:55:00 +0000

Italy’s top dressage rider Valentina Truppa is back competing after a serious fall in June.

Valentina suffered a serious head injury when she fell from her horse at Arrezzo CDI on 7 June.

At the end of July she was given the all clear by doctors, who confirmed she had recovered well. However, they told her she wouldn’t be allowed to ride until September.

This led to her withdrawing from the Italian team for the FEI European Dressage Championships (12-19 August). She had already been selected for the team, prior to her hospital appointment on 29 July.

And now she’s back in action and will be at the Italian Championship in Arezzo (2-4 October), where she will compete with Fixdesign Eremo Del Castegno.

“I start again in the Italian Championship in Arezzo after a fall. But after a fall, which can happen to anyone who like me has dedicated her life to horses, it is most important to stand up again more determined than before,” she said.

“I will be more focused than ever and any show or placing will be a victory for me.

“Thanks to all my fans who were so close to me during this period.”

Valentina most recently represented her country at the World Equestrian Games in Normandy last year, riding Fixdesign Eremo Del Castegno — the horse on whom she was selected for this summer’s Europeans.

She also represented her country at the 2012 Olympic Games in London, where she qualified for the freestyle and finished 15th individually.

The rider, who was wearing a crash hat at the time of the fall in June (not pictured), was aboard the seven-year-old HotPoint di Fonteabeti, a Hotline x Royal Diamond gelding, in a national intermediate I class at the show.

Her father and trainer Vincenzo (Enzo) Truppa told H&H at the time: “She was riding a young horse who was scared by some workers still in the competition arena when the horse was supposed to enter for his test.

“The horse reacted by spinning round and falling over, and Valentina fell off. Fortunately the helmet protected the base of the head, but the counter movement caused a blow to her head.”

The 29-year-old was taken to the local San Donato hospital and was later transferred to a specialist hospital in Siena. She remained in hospital for two weeks.

Last month she thanked the medical support she received.

“It is thanks to this top medical assistance that I will be back riding in less than three months from my accident,” she said.

Injured jockey with 3% chance of survival returns to racing

Amy Mathieson — Mon, 08 Jun 2015 16:25:58 +0000

Two years after a life-threatening fall, jump jockey Brian Toomey has regained his jockeys licence.

Brian suffered serious head injuries in a fall on 4 July 2013 at Perth racecourse.

Last month Brian told H&H he was determined to race-ride again (feature, Bouncing Back, 28 May), and today (8 June) the British Horseracing Authority (BHA) confirmed that he been relicensed.

(Image credit: creditUnknown)

After the fall the rider was placed in an induced coma for two weeks and had part of his skull removed in an operation. He remained in hospital for 157 days.

“It’s been a long road back but the one thing that has driven me throughout my recovery, and the main thing that has kept me going, was a desire to be a jockey again, and I am delighted that I’ve been cleared to ride by Dr Hill.

“Following the accident, the paramedics said that I was dead for six seconds, but they managed to resuscitate me. Then when I made it to the hospital they thought that I only had a 3% chance of survival.

“Now here I am, two years on, ready to race ride again.

“I know there will be people who will say I’m mad to want to come back but it’s been my dream since I was a boy to be a jockey and it’s a job and life I love, and I was absolutely determined that, if I couldn’t make it back, it wouldn’t be through a lack of effort on my part.

Brian had to pass tests and assessments with neurosurgeons to determine fitness to ride, ability to control a horse safely and the risk of further injury if he were to fall.

Dr Jerry Hill, chief medical adviser for the BHA, said: “The safety of our competitors is paramount in British horseracing and we have a duty as far as is possible to ensure any returning jockey is fit to safely control his horse and that he and his family understands the risks that he or she may be taking in race riding. Brian has shown through his medical assessments and physical tests that he is fit to ride again.

“The fact that Brian is still alive is a testament to the first class medical care which exists on British racecourses. It is very likely that the team of doctors at Perth, with their rapid and decisive response, saved Brian’s life. To now be returning to ride again in Britain two years on, and having met all of the demanding criteria required of him to do so, is a quite remarkable story and an illustration of his determination and bravery.”

Brian added: “Just in surviving and overcoming all that I have been through I feel I have won the biggest and most important race of my life, and anything else is a bonus. I’m going to take my time and work on my fitness before taking my first ride. That’s the next target to aim for and I’ll give it my all to get there.

“I hope what I’ve been through can serve as an inspiration for others who injure themselves and are told that they might never return to doing what they love. Work hard and never give up and you just never know what could happen.”

Rider returns to the saddle 100 days after sustaining a serious head injury

Amy Mathieson — Mon, 06 Apr 2015 15:49:19 +0000

Scottish dressage rider Jo Hamilton has been back on a horse, 100 days after sustaining a serious head injury.

Jo was riding at her yard near Edinburgh on 21 December when she fell from her horse Corchapin.

She was in hospital for around nine weeks, but was discharged in March and is making good progress at home. She has been helping out with the horses, and last week (1 April) was back in the saddle for the first time since the accident.

Jo rode again in a “safe situation” at a riding school and described it as feeling like “going home”.

“It is lovely to be riding again — and at the school I learned to ride at many years ago,” she told H&H today (Monday 6 April).

“I’m taking it slowly as my strength and fitness improve, but I’m glad to report that balance and feel are still there.

“My body felt like a beginner again but it’s a start and the desire is still there.”

Jo was on her own when she fell, so no one is clear exactly what happened, but she was found shortly after the accident unconscious in the school. She had been wearing a crash hat.

“She was due to teach someone after she’d worked her horse, and she was found unconscious on the ground. The horse had sand on his knees and on his saddle so we assume he must have fallen,” her mother Flora told H&H at the time.

“It all happened really quickly. Jo always wears a helmet, thank goodness, as it could have been so much worse without that hat.

“It’s a huge road to recovery but her mobility is getting better every day.”

Although based in Scotland, Jo continued to train with her former employer, Gloucestershire rider Carl Hester before her accident. Her horses are currently being ridden by Kate Cowell, another of Carl’s pupils.

Stud reducing numbers after owner’s son kicked in the head

Caroline Bankes — Tue, 30 Sep 2014 07:55:31 +0000

The Alvescot Stud in Oxfordshire is reducing its stock of youngsters after the family’s son, Duncan Hobbs, suffered a serious head injury earlier this month (1 September).

Duncan, 37, was lungeing a three-year old in the stud’s indoor school before he was found unconscious.

“We couldn’t get an air ambulance because of the low cloud, but a doctor came from RAF Brize Norton and Duncan was taken to the John Radcliffe hospital,” said his father, Stephen.

After 10 days in intensive care, Duncan was moved to the hospital’s neuroscience ward, where he will remain until he recovers.

The last scans indicate he was kicked in the head.

“He’s never been kicked seriously before and is always very careful how he backs them. He’s coming back slowly but it will take a while,” said his father.

The Hobbs family set-up the Alvescot Stud in 1981 and have 120 horses at the Burford-based farm.

The stud’s main stallion Flashpoint was champion at the Warmblood Breeders-UK stallion grading in 2012 and has been used several times by dressage rider Dan Greenwood.

“The three- and four-year-olds sold very quickly and we’re now going to try and sell the two-year-olds and yearlings before the winter,” added Stephen.

For more details visit www.alvescotstud.co.uk

Rider in intensive care after eventing fall

Sophia Heath — Wed, 24 Sep 2014 15:19:02 +0000

An event rider is in intensive care after a serious fall at Allerton Horse Trials on Saturday (20 September).

Katy Hurst, who competes up to three-star, had a horse fall with Ted Dexter in the intermediate novice. The combination had won a novice section at Richmond last month (29 August)

The 32-year-old is understood to be in intensive care at Leeds Hospital having sustained head and pelvic injuries.

“Kate has spent 12hrs in theatre today undergoing several procedures,” her father said on social media in the early hours of this morning (24 September).

“The surgeon advised that all went well. She is now back in intensive care resting.”

Local press have reported that Katy is being kept in an induced coma in order to help her recovery.

Support has flooded in for the rider, who is based near Market Rasen, on her Facebook page.

“Wishing Katy well and sending thoughts and prayers to you all, she will bounce back and will be riding again before you know it,” wrote one well-wisher. “Katy is very strong and if anyone can come back from such an awful accident it’s Katy. Thinking of you all.”

“So sorry to hear about your accident, thinking of you and wishing you all the best for a speedy recovery,” added another.

Top polo club takes the lead on hat safety

Horse & Hound — Mon, 22 Sep 2014 07:55:14 +0000

Guards Polo Club is set to introduce a rule on polo hats for next season after one of its players has been left in a coma following a serious fall earlier this summer.

From 2015 the club will enforce warnings and fines on any players who fail to wear protective headgear. However, the specific regulations are yet to be confirmed, according to Guards’ chief executive, Neil Hobday.

“We are working to adopt the minimum standard of safety required,” Mr Hobday told H&H. “Collectively as a sport we must take it [hat safety] very seriously indeed. There does not seem to be any pushback from the playing community about it. We wanted to get the process going.”

After the accident involving Brazilian four-goal player Juracy Santos at Guards, H&H polo reporter Aurora Eastwood started a campaign for the sport’s governing body — the Hurlingham Polo Association (HPA) — to bring in a blanket ruling. An online petition to change the rule for the 2015 season has received hundreds of signatures.

A safety hat regulation would bring the HPA in line with other equestrian bodies. Safety hats are compulsory for all British Showjumping competitors; British Dressage, except for advanced and above; and for British Eventing, except for dressage and prize-giving at novice and above. Safety hats are already compulsory for polo in the Pony Club.

Last month all four members of the British dressage team competed in crash helmets at the World Equestrian Games.

At present, the HPA enforces the wearing of “protective headgear with the chinstrap or harness correctly fastened” but many players choose to play in “low profile”, single-strap helmets.

The HPA told H&H that the issue of safer headgear is due to be discussed and a decision taken at the stewards meeting in October.

HPA chief executive David Woodd said; “The HPA is surprised to see Guards proposing to follow its own line. The HPA is considering what action it should be taking, bearing in mind its rule will apply to all players in this country and in all countries affiliated to the HPA.

“It’s a big issue: will it also apply to grooms and those umpiring? A decision is needed but it needs to be a very clear decision that makes sense to players.”

➤ To sign the polo safety hat petition visit: http://www.change.org/p/the-hurlingham-polo-association-change-rule-3c-to-insist-upon-safe-helmets-for-the-2015-season

This news story was first published in H&H magazine on 18 September 2014

What are the most common causes of equine-related injury? [H&H VIP]

Horse & Hound — Sat, 20 Sep 2014 08:55:44 +0000

Horse riders are considered by insurers to be 20 times more likely to be injured than motorcyclists.

Doctors in Kentucky, USA, recently published a study looking at the pattern of injury

of patients admitted to state hospitals with horse-related trauma.

Kentucky has a large equine population and a considerable human workforce and pleasure group involved with horses.

The doctors wondered if there was a pattern of injury in riders compared with those handling horses on the ground.

They analysed the hospital records of 284 patients admitted for horse-related trauma. The two most common causes of injury were a fall from a horse while riding or a kick while handling one on the ground.

Serious head injuries were equally common in mounted and unmounted people, although in riders the head injuries were sustained by impact from falling whereas handlers were more typically kicked in the head.

More than a third of all admissions were for a fracture — most likely a leg, for riders, and facial for handlers. Analysis of injuries to bodily regions revealed that riders were more likely to suffer chest or leg injuries, while handlers were more at risk from serious injury to face or abdomen.

More people were killed by a kick to the head than from a fall from the horse, although these numbers were very small. The doctors concluded that horses are indeed dangerous — and asked why so few interacting with them wear safety equipment such as helmets.

This article was first published in Horse & Hound magazine (18 September 2014)

How to fall off a horse safely [VIDEO]

Jockey defies odds to plan racing comeback

Caroline Bankes — Sun, 14 Sep 2014 11:57:15 +0000

Jockey Brian Toomey — who had a life-threatening fall at Perth racecourse last year — is intending to reapply for his jockey’s licence.

Brian, 25, was in an induced coma for 18 days after falling from Solway Dandy three from home on 4 July last year.

After five months in hospital, he went to Oaksey House in Lambourn, the Injured Jockeys Fund rehabilitation centre.

(Image credit: creditUnknown)

“I had a 3% chance of survival on the day of the accident. My family were told I wouldn’t get through the next 24 hours,” Toomey (pictured above and right) told H&H.

“It’s been a long haul. My surgeon told me one in 60 people come out of this injury alive.”

The jockey started riding out again two months ago at trainer Brian Ellison’s Malton yard and is now waiting for one last report from his neurologist.

“I have researched loads of professional sportsmen and women who’ve come back after a similar injury,” added Brian.

But he admitted: “There are no guarantees I will get my licence back.”

Dr Jerry Hill who recently took over as the chief medical adviser at the British Horseracing Authority (BHA) is responsible for jockey’s recovery from injury and will approve or deny a licence.

Fatal head injuries as likely to happen on the ground as while riding [H&H VIP]

Sophia Heath — Thu, 05 Jun 2014 08:00:12 +0000

A new study has thrown a spotlight on the question of head protection when handling horses on the ground.

Hospital patients admitted as a result of horse accidents during a 5 year period at the University of Kentucky Trauma Registry have revealed that there were equal rates of head injury for both riders and handlers.

All 3 of the deaths recorded were handlers on the ground rather than riders. One was caused by a kick to the head, another a kick to the chest and the third after a fall from a trailer when loading a horse.

As a result of the survey, researchers have concluded the “findings reinforce the need for protective equipment usage at all times around horses”.

Accidents closer to home

The topic was highlighted last week closer to home (28 May) when Irish vet Gerard Long was killed after being kicked in the head while treating a mare in Co Tipperary.

The Irish Health and Safety Authority told H&H that it is investigating the death but a conclusion is expected to take “a number of months”.

There have been several other fatalities from injuries incurred on the ground in Britain in the past couple of years.

In 2011, 16-year-old Lauren Bryant from Scotland died after being found with serious head injuries having gone to catch her horse from its field.

The following October a bank manager suffered fatal head injuries while trying to calm a horse in the back of a lorry.

Olympic gold medallist Ben Maher was also in the news in 2012 after he was kicked in the head when a horse he was leading in at his yard in Essex slipped and fell on him.

The most dangerous times on the ground are considered to be lungeing, leading, loading and turning out. But, despite the horror stories, many riders are still reluctant to wear a hat when dismounted.

“I accept that having and handling horses comes with a level of risk,” said H&H reader Lucinda Waldron. “I’m unlikely to wear my hat all the time on the ground, but I am aware that it’s not always the sensible option.”

“While I always ride with my hat on, I definitely don’t always wear one while working on the ground with my horses,” added another reader.

Rules and regulations

Approved safety hats when mounted are compulsory for British Showjumping competitors, for British Eventing except for dressage and prize-giving at intermediate and above, and at British Dressage except for advanced and above. But there are no regulations referring to handlers on the ground.

In racing it is compulsory for all stalls handlers to wear safety headgear, but not for anyone else helping on the ground.

There are no specific guidelines for registered farriers or vets about hats.

The Pony Club teaches that wearing a hat when entering a stable, turning out, loading and lungeing is “best practice”, but does not have a blanket policy.

Nor is wearing a hat when not mounted a requirement for many insurance policies for livery yards and riding schools.

“Our insurance has no requirement saying that hard hats must be worn while handling horses or on the ground around horses,” said Kathryn Herring from South Essex Insurance Brokers (SEIB). “We do however encourage the wearing of hard hats.

“We would also advise clients to carry out risk assessments to include where they feel it necessary to make people wear hard hats on the ground.”

Too hard to enforce?

A spokesman from the Pony Club told H&H that there is no “over arching rule” because “given the scale of the membership it would be un-enforceable”.

Ms Herring told H&H that some of her clients suggest that it would not be safe to make employees wear hard hats all day in the summer because of the risk of fainting.

But despite the concerns raised, some in the equestrian industry say they would be happy to wear their hats more often.

“I wouldn’t have a problem if an employer asked me to wear my hat when on the ground,” said H&H reader Jessica Fardoe. “I think it’s just a good safety precaution -— especially if you’re on a yard with fit and often unpredictable competition horses.”

Instructor Danielle Dawson said: “I make all the Pony Club kids wear them at all times doing horse care. I don’t think that it is health and safety gone mad.”

What do you think about wearing head protection on the ground? Write to us at hhletters@ipcmedia.com

First published in Horse & Hound magazine (5 June 2014 issue)

Riding school death ruled accidental

Amy Mathieson — Thu, 16 Aug 2012 16:43:44 +0000

The death of a 72-year-old grandfather, who died from head injuries sustained when falling from a horse, has been ruled accidental.

Anthony Golding died on 15 December, two days after falling from a riding school horse.

The 72-year-old was out with staff from Fern Bank Riding School, near Cromer, when he fell and suffered a brain haemorrhage.

Norfolk coroner William Armstrong recorded a verdict of accidental death, saying the riding school’s lack of a licence had no bearing on the death, but called for examination of how riding schools are licensed.

Riding schools must be licensed by their local authority.

The school’s licence, issued by North Norfolk District Council expired in July 2011 and was not renewed until February 2012.

Mr Armstrong said it was “not satisfactory” that it had been unlicensed for so long while paperwork was being processed.

Rosemary Fabb from Fern Bank said they had applied for their licence, but receiving it had been a long process.

“We are very sorry for Mr Golding’s family. The whole issue has caused them and us a lot of stress, and the council has been unsympathetic,” she told H&H.

Chris Cawley from North Norfolk District Council said: “The coroner intends to raise a few issues with us. Licensing at riding establishments is more with regard to animal welfare than public safety, but we will look at what we can and can’t do.”

Julian Marczak of the Association of British Riding Schools said he was surprised by the council’s comment.

“In our experience, both welfare and public safety are looked at, though there is a lack of uniformity among local authorities.”

This news story was first published in the current issue of Horse & Hound (16 August 2012)

Amateur jockey Jessica Westwood to focus on training

Amy Mathieson — Thu, 10 May 2012 15:59:29 +0000

Amateur jockey Jessica Westwood will be focusing on training horses after being told she will not race-ride again.

Jessica, who is 21, is currently at a neuro rehabilitation clinic in Germany, where she will be for two to three weeks.

In March Jessica suffered her second serious head injury in five years, at the Quantock Staghounds point-to-point meeting at Cothelstone (17 March).

When she was 15, she suffered swelling to the brain after falling off then being kicked in the head.

She will be unable to get a jockey’s license on medical grounds, but hopes to get a training permit.

“The doctors said I wasn’t going to get my license back,” she told H&H. “I’d had two serious head injuries and they wouldn’t risk it. But I enjoy training and have four horses currently at home so I’m hoping to be good at that.

“I’m getting a lot better, the left side of my body is a lot slower though. I won’t be allowed to race ride but there’s no way I wouldn’t ride at home, I couldn’t not.”

Her star horse, Monkerty Tunkerty was her first winner as a trainer in December 2010. And she enjoyed a double when Rockon Xmoor also won on the same day.

Monkerty Tunkerty, whom she owns and trains was due to run in the Christie’s Foxhunter before being ruled out due to a bruised foot.

He is now being aimed at the John Corbet Cup at Stratford (1 June). He will be ridden by Josh Guerriero.

“Monkerty Tunkerty was bought for me and it will be difficult to watch someone else ride, but he’d be wasted otherwise,” said Jessica.

This news story was first published in the current issue of H&H (10 May)

Injured rider in line for compensation after six-year fight

Charlotte White — Fri, 11 Nov 2011 15:12:12 +0000

A rider who suffered a serious head injury and brain damage when her horse was in collision with a motorbike has won a six-year fight for compensation.

Michaela Devereux was riding in the New Forest with her husband on 29 October 2006 when they were approached by a Honda motorbike with a pillion passenger.

Mrs Devereux claimed that the defendant lost control of his bike, which slid into her horse. Her horse bolted and she was thrown.

The motorcyclist, Peter Hayward, denied his bike hit her horse. He claimed the horse took fright at his approach and the rider fell.

But a judge at the High Court, Winchester District Registry, decided the evidence pointed to a collision. On 28 October he ruled that the accident had been caused by Mr Hayward travelling at excess speed.

This means Mrs Devereux can now recover full compensation for her injuries.

This news story was first published in the current issue of Horse and Hound (10 November, 2011)

For all your insurance needs, contact KBIS

Should British Showjumping have concussion rules?

Amy Mathieson — Fri, 15 Jul 2011 15:31:10 +0000

An accident at a show in which a rider was kicked in the head has highlighted the lack of rules surrounding head injuries in showjumping and dressage.

On 2 July showjumper Charlotte Arnold, from Co Durham, was taking part in a competition at Waterford Equestrian, when she was kicked and taken to hospital.

But there was no rule to say she should not compete after such an injury and the next day she went on to win a class.

Charlotte told H&H she was putting studs on the back shoes of her horse Gibside Queen Bee when a horsefly landed on the mare and she lashed out.

“She walloped me full on the head,” said Charlotte. “I went flying — I turned three somersaults in the air.”

She was assessed in hospital and had six staples to her head. The next day she competed in the last Scope qualifier of The Blue Riband Classic and won.

Though she chose to compete, she thinks there should be stricter rules.

“I squeezed my hat over the bandage and felt OK,” she said. “I wasn’t concussed, but if you are, I think you should be stood down.”

Unlike racing and eventing, where post-concussion suspension is mandatory, a spokesman for BS said there were no rules regarding head injuries and it was up to the rider’s discretion.

H&H columnist Graham Fletcher said: “We’re turning into a country of wusses, so I applaud her carrying on. But with concussion there should be a rule — it’s very serious.”

British Dressage also has no formal rules regarding concussion.

On 9 July 16-year-old Emma Littlewood was kicked in a fall during a BYRDS competition at Keysoe and taken to hospital, only to compete the next day.

She said she was “determined” to continue as she “didn’t want to let the team down”.

Dr Suzannah Hoult from the Medical Equestrian Association said it depends how serious the injury is but added: “I feel the bodies should look at rules regarding assessment of riders after a head injury and hand out a suspension as appropriate.”

This news story was first published in the current issue of Horse & Hound (14 July, 2011)

Courtney King Dye suffers serious head injuries in fall from horse

Horse & Hound — Fri, 05 Mar 2010 16:28:39 +0000

American international dressage rider Courtney King-Dye suffered serious head injuries in a fall from a horse on Wednesday (3 March).

Courtney, who is currently heavily sedated in the intensive care unit of St Mary’s Hospital, Florida, was injured while schooling a client’s horse in Loxhatchee, near Wellington.

The horse slipped and fell, knocking her unconscious. She was airlifted to hospital with a skull fracture.

“We think one hind foot stepped on the other — the horse semi sat down and tipped over sideways,” Lendon Gray, long time trainer and mentor, told local papers. “She was basically under him, and her head obviously hit the ground.”

Overnight the pressure in her brain went down, but neurologists are still unsure as to when Courtney will wake up.

Courtney, who has had to have two of her top horses put down in the last six months, was disqualified from the 2008 Olympics when her mount, Mythilus, tested positive in a dope test.

This February she was awarded the Carol Lavell Advanced Dressage Prize by the Dressage Foundation, accompanied with a cheque for $25,000, designed to help riders excel at international levels.

“Courtney’s accident reminds us all how vulnerable we are around horses,” Heather Blitz, Grand Prix dressage rider, said in a press release.

“Our heartfelt sympathies go out to Courtney and her family as she faces this medical challenge, and we wish her a full and speedy recovery.”

Man in hospital after horse kick

Charlotte White — Thu, 26 Nov 2009 15:04:01 +0000

A man was taken to hospital with head injuries when he was kicked by a horse in Newmarket this morning (26 November).

An ambulance was called to stables off the B1506 at around 8.46am.

A spokesman for the East of England Ambulance Service said a man in his 30s was taken to Addenbrooke’s Hospital in Cambridge.

The severity of his injuries was not known

Dealing with head injuries in horses

Horse & Hound — Thu, 05 Apr 2007 17:13:14 +0000

The majority of head injuries have external skin or skull bone trauma but less than half will actually involve the brain or exhibit signs of damage to the central nervous system (CNS).

Signs of a head injury vary from a minor wound or bleeding from the nose or ears to alarming staggering (ataxia), recumbency, paralysis, blindness, fits, coma and death. An undetected head injury is often the true cause of sudden death, frequently with surprisingly few signs of obvious external injury.

Skull fractures

Horses that suffer a skull fracture often have a history of rearing and flipping over, striking their head on the ground, or hitting it on an overhead structure such as a trailer or stable ceiling.

When a horse rears over backwards it is likely to sustain serious injuries, which can include a catastrophic fracture at the base of the skull. The brain inside is likely to be damaged too. Since there is minimal space inside the skull for it to swell, complications rapidly arise.

In contrast, a horse that collides head on with an obstacle may have much more obvious ugly injuries, but is slightly less likely to sustain brain damage. This depends on the impact.

At the front of the head, horses have large cavities or sinuses that are normally air-filled and act as a protective cushion against any impact. Although a bump on the front of the head might look awful, and there may even be a large gaping hole into the sinuses, it may not be quite as bad as feared.

A broken jaw

The jawbone is the most commonly fractured bone in the equine head. This usually happens if the head becomes trapped as a horse pulls back suddenly. A kick from another horse is also a common cause.

Although such injuries are a safe distance from the brain, they can be problematic, because they are painful and prevent the horse from eating. Fortunately, there are various surgical techniques with which the loose fragments of jaw can be wired back together and the majority heal very well.

Time is a great healer

The good news with head injuries is that wounds heal quickly because there is a good blood supply. The bad news is that, for the very same reason, even a relatively minor head wound will bleed profusely.

The worst-case scenario is a horse that is unable to stand after a severe blow to its head. Ideally, it should be allowed 24hr to regain its feet. Many horses with head injuries will stagger for some time after they stand, usually due to damage to the balance centres within the brain.

In the same way human head injuries can require a lengthy convalescence, it can take almost a year before a horse has recovered as much as it is going to from serious head trauma, so be patient. Time and mother nature can be extremely effective healers.

This veterinary feature was first published in Horse & Hound.

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‘TheFox-Pitts and pologave me hope’:rider who suffered brain bleed in fall hopes to help others

“‘What happened to me was just one of those things,” she said. “It all happened for a reason and I wouldn’t be where I am if it hadn’t happened. But I just want to hopefully help other people in the same situation.”

Jodies said at the time of her diagnosis, she did not fully appreciate the seriousness of such head injuries.

Jodie, who had to deal with extreme fatigue and changed emotions among her symptoms, said the support offered by brain injury charity Headway was invaluable, as was the understanding of friends who had been through similar.

Jodie was referred to a specialist brain injury unit, and said occupational therapy was beneficial, but “it wasn’t till I went back to the yard that I got my confidence back, and it gave me hope again.”

Jodie wanted to go back to work, so got a bar job, but found it impossible to learn new skills in such a loud environment, so she went back to the Fox-Pitts’, where she knew what she was doing, and was supported by them to be able to do her job.

She is now working for estate agent Spencers, which is supporting the New Forest Polo Club and helping raise money for its 2023 charity Headway, culminating in the Kuseyo Cup weekend of 12-13 August.

“Polo and the people in polo have helped me tremendously to get where I am today which is why I am organising the polo match on 13 August, for Headway and to help raise awareness.”

“I look the same and am still me and people didn’t really understand it, but it happens all the time; something like every 90 seconds, someone suffers a brain injury, which is crazy,” she said. “We need more understanding.”

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Managing concussion: new ratings system for riding helmets in the pipeline

LEADING researchers into sporting concussions are on the verge of bringing a ratings system to riding helmets.

Virginia Tech doctors Steve Rowson, Stefan Duma, Mark Begonia and Barry Miller spoke at the Equestrian Symposium in Virginia, US (11-12 August), about the STAR (Summation of Tests for the Analysis of Risk) ratings system for riding helmets.

In short, the STAR value is the theoretical number of concussions someone would sustain wearing that helmet if their on-field exposure matched laboratory impact tests.

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‘Not just a bang on the head’: mental health campaign encourages riders to ‘re-think concussion’

“It’s a brain injury. And, if our brain is injured, our mind can be injured too, with potential far-reaching implications on our mental health and wellbeing,” she said.

The Head First checker and mental health support can be found at www.ridersminds.org.uk.

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‘Just a bit of concussion’: calls for more awareness around minor traumatic brain injuries in children

Shai Efrati of the Sagol Center for Hyperbaric Medicine and Research in Israel, who led the work, told H&H PPCS in children is often missed and symptoms can be blamed on behavioural or mental health issues.

“It means we are not looking for PPCS in children. In adults, we seek the cause for cognitive decline, but in children they are told they have a mood problem,” said Dr Efrati.

Dr Efrati said children need to be given more time to recover after concussion.

“People say, ‘It’s just a bit of concussion’ and we need to remove the word ‘just’. Concussion is a traumatic brain injury – and changing the wording changes how a parent is going to view that injury,” said Dr Fisher, adding that children should rest, without screen time.

“Watching television is one of the worst things you can do – for the brain it’s like running a marathon. While recovering, you want the brain not to have to function very hard,” she said.

“Sometimes a parent might want the child to get back on after a fall, but we want to empower coaches to use our guidance and say, ‘In my opinion, they shouldn’t get back on and I want them to get checked by a doctor,’” said Mr Capel.

“We also want to empower riders so they learn when it’s right not to get back on, and to be able to say if they’re not feeling OK.”

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‘It felt normal – it felt good’: former Badminton winner rides again, a year after serious head injury

“At that stage, I felt pretty wobbly, and the thought of doing pretty much anything was hard work, so the thought of riding was nowhere near my mind,” he told H&H today (23 November).

“I had physios saying they wanted me to ride as part of my rehab, but I’d seen other riders have injuries and go back not being able to ride anywhere near where they were. I didn’t want to do that, so I refused to get on a horse.”

But in the last week, Paul said, he felt physically in control enough that he could ride on a horse and it “be normal”.

“I felt I could just do it, so I did,” he said. “My wife Georgina was very supportive and helpful, although we did have an argument about which horse I’d ride, so I got on and it was good.”

Paul has so far ridden an event horse of his daughter Madison’s, a former racehorse, and King himself.

“The fight with my wife was because she wouldn’t let me ride King first!” he said. “Then she saw I was ok. She did look at me and ask if I wanted her to lead me and I said ‘I’m not a lead-rein rider, get away from the horse!

Paul said he has “no desire to compete again”.

“I wouldn’t contemplate facing a jump at this point because I don’t feel I’ve got enough control of my body to do what I considered normal for me,” he said. “[Jumping] isn’t high on my priority list so it may or may not happen, and it’s highly likely to not happen.”

Paul said he had been discussing with someone, months ago, whether the fact he has no memory of the fall, or of some time after it, might help as he would be less likely to feel any fear, and he thinks that is the case.

“I’ve never felt any sort of fear,” he said. “That might be a slight blessing but my wife remembers all the hassle, so this has been more difficult for her than for me, she’s been brave. So there was some advantage — but I don’t recommend it!”

And, Paul added, having checked the rules and changed qualification requirements, he realised he and King are still qualified for Badminton 2022.

“I keep joking, every time I get on, about how my preparation for Badminton is going,” he said. “I did say yesterday I was going, to scare the living daylights out of my wife, so watch this space, you never know!”

But he added: “I don’t think that will happen; I think this is one time common sense will take over from what’s in the rules.”

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Rider given 1% chance of survival after fall honoured as she returns to work and the saddle

“It was a total surprise,” she said. “A girl I’d taught for years entered me for it last spring, didn’t hear anything and forgot about it. It was lovely because she then got the call on my birthday to say I’d won.

A BHS spokesman told H&H: “We’re delighted that Jane has won this award. Jane has shown outstanding resilience and has remained dedicated to working with horses and the Washington Riding Centre (RDA) since volunteering there as a child.

“Beating the odds, Jane has returned both to riding and her position as centre manager and is continuing her excellent work to bring structure, fun and community to the centre.”

The mare Jane was riding at the time of her fall was later diagnosed with wobblers syndrome and had to be put down.

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Rider who fractured skull shares images of hat after horse landed on her

“I remember being pretty convinced he was going to land on me. He cartwheeled over and his hindquarters landed square on top of my head on the floor. It was about as dramatic as it can be,” Susannah told H&H.

“I was unconscious for about five minutes but I was incredibly lucky that they have such amazing medical staff there.”

Susannah, who runs a yard producing team chasers and polo ponies with her husband Roddy, was taken to hospital by ambulance and a CT scan showed she had sustained a hairline skull fracture, and she was diagnosed with concussion. Her horse was not injured in the fall.

“I didn’t have any damage anywhere else, I was extraordinarily lucky,” she said.

“I was kept in hospital overnight for observation but the fracture should essentially heal on its own in time. I was given advice about the concussion and there will be no riding or driving for the immediate future.”

Susannah agreed for images of her damaged riding hat to be shared online and said she had been “astounded” by the response. She is sending her hat back to Champion for the damage to be fully assessed.

Susannah’s husband Roddy, who was at the team chase, added how “brilliant” the medical team was at the Cotswold.

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‘They don’t go to hospital unless something’s hanging off’: research shines light on equestrian-related injuries

One of the researchers, trauma surgeon Jeffrey Skubic, told H&H it is hoped the study will raise awareness about wearing protective equipment, especially in the US where Western riding is more common.

“We also want to raise awareness to trauma surgeons when they are getting a patient who has fallen off a horse to know what injuries they should be looking for.”

“Many of the really serious injuries happen on the ground because people don’t tend to wear a hat taking their horse to the field, or when loading. I think this is the area we really need to concentrate on going forward.”

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Rider ‘lucky to be alive’ after she was kicked in the head serves hat safety message

“If I can get a message out there for people to wear a helmet, and if it makes the difference to just one person, it will be worth it,” she said, adding that no matter how well you know a horse, accidents happen.

“I’d had the horse on loan for about three months and I’d grown to know him and to love him. It seemed really out of character for him,” she said.

“The ambulance and hospital teams have all been amazing – if it wasn’t for them, I wouldn’t be alive.”

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