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.

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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 con­cus­sion- proof 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.

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