SPECIAL RISKS FOR RIDERS

Because of the height of the horse, a rider falls farther than other athletes, and the force of the potential blow from a fall increases with speed.

The potential for more serious TBIs is greater for equestrians than for participants in other sports, says Bailes. Because of the height of the horse, a rider falls farther than other athletes, and the force of the potential blow from a fall increases with the speed of the horse.

Overall, counting all injuries, people who ride horses are less likely to hurt themselves than are people who participate in other sports, including football, basketball and skiing; however, rider injuries are more likely to be severe and require hospitalization, according to data compiled by Sara Mastellar, PhD, of Ohio State ATI, in a paper published at iGrow.org. And, according to numbers from the National Trauma Data Bank, between 2003 and 2012, riders accounted for more than twice as many sportsrelated TBIs (45.2 percent) than even football players (20.2 percent).

However, it is important to understand that a rider who falls while wearing a protective helmet can still sustain a concussion. “There is no concussionproof helmet because the brain is still floating inside your skull and has the capability of moving or twisting,” Bailes says. A helmet also won’t protect you against a broken neck or other serious injuries to your body.

What a helmet can do is absorb shock and reduce the force of a direct impact on your head, such as from a kick or a fall---and that may be enough to limit the severity of a TBI and prevent complications such as skull fractures.

“The purpose of a helmet is to protect the skull from open-head injuries and protect against some of those concussive forces, but it’s not going to protect you entirely,” says Carl G. Mattacola, PhD, of the University of Kentucky. “Helmets may not be able to protect against the torsion and the torque that take place at the time of injury.”

The bottom line is that having a protective helmet on during a serious fall may make the difference between a dizzying embarrassment you can walk away from, versus a coma followed by life-long disability, if you survive at all.

According to the United States Pony Clubs (USPC), head injuries among their members decreased almost 50 percent after the organization mandated their members wear approved helmets. Few other equestrian organizations collect enough data to draw conclusions about how instituting rules for mandated helmet use has affected the rate of head injuries among their members.

“The USPC data is the only data I am aware of that has specifically tracked head injury incidence before and after implementa

tion

of a helmet policy,” says Mastellar. However, she adds, “New York state did see a drop in horse-related deaths after the state Horse Council mandated helmet use. Since most deaths were caused by head injuries, ‘deaths’ can serve as a proxy statistic for ‘head injuries.’”

Even without data, it seems safe to say that helmets save lives. We’ve all heard at least one story from someone who survived a serious fall relatively unscathed. “Helmets that are certified have to demonstrate a certain level of protection against simulated falls,” says Mastellar. “In my own experience, when I came off into the wall of an indoor arena, my helmet was punctured by a nail that was sticking out. That was damage that my head didn’t take.”

STRUCTURED FOR PROTECTION

In 1988, the American Society for Testing and Materials (ASTM, now

called ASTM International) published the first standard, titled “F1163, Specification for Protective Headgear Used in Horse Sports and Horseback Riding.” Within a year, the first helmets bearing an “ASTM/SEI-certified” label were on the market. Here’s what that means:

6HIB >ntZrnat^onal puWl^shZs very specific rules about the forces a helmet must withstand. For example, it must be able to absorb an impact and stop an object from penetrating the outer shell. It must stay on in the event of a fall. It must perform equally well in very low temperatures, very high temperatures and when saturated with water. ASTM International does not conduct any tests; the organization simply publishes the rules helmet makers must follow.

H:>! thZ Ha[Zty :fu^pmZnt Institute, is a private, nonprofit organization whose goal is to make sure manufacturers comply with the ASTM standards. Helmet makers send sample helmets to independent accredited labs for safety testing, which include dropping them onto anvils---one flat, and one with a raised edge to simulate a horseshoe---at a velocity of 6.0 meters per second. Helmets are placed on a headform, and sensors inside the headform measure the acceleration during impact testing as gravity (g) forces that would affect a rider’s head. Other procedures test the strength of the helmet straps. Then, the tests are repeated after the helmet is frozen to minus 20 degrees Fahrenheit (F), heated to 120 degrees F, and submerged in water overnight. If in any test the forces recorded by the sensors exceed 300 g, the minimum required to injure the brain, the helmet fails.

Equestrian helmets consist of a hard outer shell and an inner liner that includes a layer of polystyrene foam

as well as a sturdy harness to hold the helmet in place during an impact. In the event of a blow to the head, the foam layer is compressed, which absorbs some of the force of the impact before it reaches the skull.

“The foam liner will crush and increase the period of time over which the head accelerates,” says Bonin, who specializes in the mechanics of helmet protection. “By increasing the acceleration time, the peak head acceleration is reduced.”

The goal, of course, is to allow the helmet to take the brunt of the damage, leaving your head relatively unscathed. But that also means that the helmet can be in an accident only once: After an impact crushes the foam, it does not expand again. So even if the outer shell looks unscathed after a fall, the foam underneath may be damaged, and the helmet will not provide adequate protection should you fall again.

Protective helmets are generally designed for specific sports, based on the location and nature of the impacts the wearer is likely to sustain. Bicyclists, for example, are more likely to go forward over the handlebars in an accident, while horseback riders often fall backward or to the side, so helmets designed for each sport are reinforced in different areas. Also, bicyclists usually strike their heads only once in an accident, whereas horseback riders may sustain multiple blows from a collapsed fence or a horse’s hooves in the same fall, so a strong retention system is needed to keep the helmet in place after the first blow. That’s why it’s important to ride your horse in a helmet that is designed for that purpose ---riding your horse in a bicycle helmet is not a good idea.

A VOICE OF EXPERIENCE

Even knowing that helmets may reduce the risk of head injuries, many riders still opt not to wear one. And, yes, all adults get to make their own decisions about personal risks they are willing to take. Sometimes, however, a close call or two can be pretty convincing.

“I was one of those kids that was fearless,” says Gwen Kahler, who lives in Flagstaff, Arizona. “I grew up with horses and didn’t think twice about hopping on one and going. Helmets weren’t even a thought. Then, when I got older, I was on a trail ride with my teenage daughter and my horse tripped and I fell sideways, backward and down the hill and hit the ground.”

Kahler was hospitalized with a concussion after that incident, yet even then she still didn’t feel the need to wear a helmet when riding. But she changed her mind a few years later, after her Tennessee Walking Horse bolted and she was forced to cling to his neck to stay on. “That was the most frightening ride of my life,” she says. “After that, I said, ‘You know what? I think I need a helmet.’”

At the time of Kahler’s first concussion, almost 20 years ago, brain injuries were not as well understood as they are today. Now we know that concussive symptoms can worsen with repeated head injuries, and that the effects can last a lifetime. Kahler suffered two more concussions unrelated to horseback riding, and with each one her symptoms became more severe. Today, loud noises, bright lights and even smells can trigger “brain fog” and a headache that she describes “as if a big hand is putting pressure on my head.”

Anyone---from rank amateurs to world-class professionals---can fall off of a horse. And even the most reliable, bomb proofed campaigner can trip, fall or spook. While an ASTM/ SEI-certified helmet cannot prevent every injury, it can greatly reduce your risk of a serious concussion. And it might just save your life.