You are a professional rider ?

let’s
talk about your health
For many centuries, riding was recommended to prevent or help cure quite a few medical conditions and
was considered a factor towards a vigorous body. But at the beginning of the XXth century, it was blamed
for its negative effects on the spine, and on certain muscles such as the adductor muscles.

Today, there is a high accident rate in the equestrian sector, whether at work, or in sports competitions.
Let’s take a look at the activity as an everyday working situation.

By Sophie BIAU - Translated from french by : Karen DUFFY - |

14.08.2016 |

Technical level :

Riding, 19th Century remedy…….

At the start of the 19th Century, the Medical science dictionary dedicated a chapter to equestrianism « A
type of exercise praised by our elders as being a highly therapeutical method ». Surgeons and authors
from the Medical society, frequently quote « the power of riding on the human body » and founded their
theory on communication of movement from the horse to man, man being described as inactive.
« Mechanical jolting, repeated shuddering resonnate throughout the body tissues, rendering organs
stronger ».
The Medical dictionary dedicates 20 pages to equestrianism. The following notes could be considered a
summary… (figure 1) :

Figure 1: Montage S. Biau from a public domain photo, provided by Ifce notes-marking-riding -as -medicine

But from the begining of the 20th century , horse-riding is blamed for its negative effects on the spine and
on muscular groups such as adductor muscles.

Multi-year occupational health and safety plan

Today, from a professional point of view, the equestrian sector is considered as a priority in the PPSST
2016-2021 (Plan pluriannuel de santé sécurité au travail = Multi-year occupational health and safety plan).
The accident rate has been calculable since the existance of compulsary declarations (1898). In 2012, the
horse sector had one of the highest rates of occupational accidents in all agricultural branches.

From a sports point if view, horse riding is identified as a dangerous activity, on a par with skiing, with
numerous fractures and a high hospitalisation rate (INVS (National health monitoring agency), 2008). The
studies mostly established from emergency ward data, describe a high risk sport with repeated injuries to
head and torso. This is detrimental to the ensuing image of the sport.

Both of these obsevations, professional and sporting, are compiled from accident rates. Another essential
aspect, would be to add to these the aches and pain linked to everyday work and competition situations.
Epidemiological study
The relationship between a professional rider’s aches and pains and his work activity, not exclusively in
competitions, were investigated by means of an epidemiological study. This study was carried out jointly
by the Ifce, and the Occupatinal health Ergonomy and Epidemiology laboratory ( Laboratoire d’Ergonomie
et d’Epidémiologie en santé au travail (LEEST) ) at Angers University.

A questionnaire was given out via social network, particularly via Facebook. The questionnaire compiled
general information, lifestyle, medical information and professional track record.

Description of the population studied

258 completed questionnaires were analysed. Much as with the other figures concerning the sector, the
sample of people in the study concerns mainly a young female population (72,5 % female, aged 32,5 +
10,5 year the average age being 30), having 23 years + 9 years riding experience, with 10 years + 9 years
professional experience, with a majority of farm-workers, with little seniority in their present employment.

The riders having answered the questionnaire were then divided into 4 groups according to the tasks
described in an open-ended question consisting in « describing the main activities or tasks inherent to the
present job. Assessing the % of work time.» :

Group predominantly engaged in teaching or administrative tasks, principally people in

charge of equestrian structures, all possessing a teaching diploma (BPJEPS, BEES1), and
statistically a little older (38 years old on average). Even when predominantly engaged
in teaching or administrative activities, some time is still dedicated to riding on a daily
basis.
Group predominantly engaged in « working out horses ». The population in this group
corresponds to the idea we have of a professional rider, and the definition given by the
professional reference document (equi-ressources, 2014). This group is mostly male
possessing few diplomas.
Group predominantly working as « stablehands or grooms ». In this group the
population is again mostly female, and works essentially in the horse’s environment,
welfare and upkeep, while retaining time to ride on a daily basis. The majority in this
category possess a diploma (BPJEPS, BEES1).
Group predominantly « working with young horses ». This group is dedicated to
breaking in young horses, and is a statistically younger male population (average age
28).

This classification reveals a certain versatility in competences and activities, but also a tendancy towards
specialisation in the search for performance. This search for specialisation, but at the same time requiring
a certain versatility is likely not linked to the horse sector, but more to the size of the structures (very
small companies, or self-employed structures).
Painful areas noted for professional riders

Figure 2: Inventory of pain felt over the course of the last 12 months (pain felt for less than 24hrs, from 1 to 7
days, from 8 to 30 days, >30 days and felt permanently)

Lower back (75%)

Cervical area (67%)
Shoulders (63,5%)
Upper back (59%)
Feet (44%)
Hands (41,5%)
Thighs (37,5%)
Forearms (34%)

The inventory of painful zones over the last 12 months preceeding the study showed a predominance of
lower back pain (lumber region), shoulder pain, neck pain, and upper back pain (dorsal area).

Theses results led to spinal pain (cervical, upper back,and lower back pain) being studied more in depth.

Backaches
Backache is a frequent disorder in the population in general. Depending on the length of the painful
episode, and the repetition, backache can have serious consequences on a person’s quality of life and his
ability to pursue professional or sports activities.

Some professional activities are more concerned by backaches, particularly activities which are physically
demanding, static postures having to be maintained, or repetitive gestures.

Other psychsocial factors at work are also quoted in relevant litterature, such as factors relating to work
demand and control over work (autonomy, responsibility, monotonous tasks etc.), and factors relating to
social support (colleague or hierarchcal support) , symptoms of stress….
Figure 3: Location of backaches on a professional rider’s back © A. Laurioux

Prevalence
The prevalence of backaches noted in this study is high compared to that in the general population (see
figure 2). Contrary to data from litterature, backaches among professional riders from our study are linked
neither to age, sex, size nor body mass index (BMI). In addition, there was no link found to the type of job,
the volume of weekly work nor to seniority in the company.

What the study does reveal however, is a link to the type of activity : it is the group principally engaged in
caring for horses and maintenance of infrastructures which is the most affected (figure 3).

The type of backache noted for these groups are cervical pains, and backaches in the dorsal region,
whereas pain in the lumbar region, which is much more common in the general population, affects all
groups.

Medical check-ups
In parallel to these high figures, the questionnaire revealed two things : a high number of professional
riders pays regular visits to osteopaths and physiotherapists, and has a positive opinion of their health
despite the pains expressed.

« I’ve got backache, but I find ways of carrying on with my activities... »

Riders tend to have regular medical check-ups, at an identical frequency to the general population. But
there is also, as noted in this study, a high % of regular visits to physiotherapists (61%) , to osteopaths
(81%), and to chiropodists (26%). When pain becomes chronic, riders tend to drop the osteopath and
reinforce physiotherapy sessions. These practices enable them to carry on with their activities despite the
pain felt. When the situation allows, reorganisation of the daily tasks is considered, usually meaning a
decrease in working time.

« I’ve got backache, but I’m fine…. »

In answer to the question « Do you think your health is bad, mediocre, good, very good, excellent ? », 84
of the people suffering from cervical pain, or backache in the dorsal region expressed a positive opinion of
their health !

Studies have shown that people in manual jobs have a lower tendancy to declare their pain than people in
office jobs. But for professional riders, the way they perceive their health seems to depend on the manner
in which it contributes to acheiving their professional goals. From this point of view, health is synonomous
with acheiving a professional project. If health problems get in the way of this acheivement, then the
direction taken will consist in finding the necessary physical and socio-economic resources.

Horse-riding as a means of physiotherapy ?

Physiotherapy for backache in the lower back has evolved. It is now commonly admitted that it is better to
favour exercise over immobilisation. Studies have demonstrated the need to carry on exercising despite
episodes of lumbago.

Horse riding can be considered a physical exercise contributing to physiotherapy. Riding helps work out
the paraspinal muscles. These muscles are precisely those that physiotherapy exercises aim to strengthen
(torso flexor and extensor muscles, and local spinal stabilising muscles) during sessions with patients
suffering from lumbago. Continuing exercises which are compatible with the pain felt, seems to be
desirable. Exercise is an efficient way to prevent pain in the lower back, but the intensity of the exercise
for riders when in a work situation, is as yet unknown, unmeasured and not assessed.

Riding could actually be one of the ways to treat lower back pains for riders, this seems to be confirmed br
the disappearance of pain when riding. Some authors even describe horse riding as beneficial for the back,
due to sensory effects transmitted through the rider’s seat, all the while retaining an « upright position »
so as to respect the natural spinal curves which can then act as shock absorbers. The balance between
abdominal and dorsal muscles, and the endurance of spinal extensor muscles, are essential factors in
protecting the spine.

Warming-up, and complementary physical activity

Muscular exercise when riding can be supplemented with another complementary form of physical activity.
But only 38 % of professional riders in this study do another sport, mainly running and swimming, and on
an irregular basis for the main part.
© A. Laurioux

As with any sport, prior warming up and stretching is essential. But only 13 % of riders warm up before
riding, and 30 % while riding. It can be noted that of the riders warming up prior to mounting, 69 % had
not felt any pain over the last 12 months preceeding the study…. It is the riders who are mainly engaged
in working out horses and breaking in youngsters who warm up the least, sometimes not at all.
Professional riders do not appear to consider themselves sportsmen...

Consequences of backache on working out horses

The repercussions of health on work activities is probably under-estimated. Even if pain seems to
disappear on horseback, the repercussions of a bout of lumbago on the body and the risk of an impact on
performance on horseback, should not be ignored. Coordinated activity of paraspinal, abdominal and
interspinal muscles is essential for stability of the spine. In people subject to lumbago, this coordination is
altered, and spinal stability no longer ensured, which can in turn lead to spinal structural deterioration. In
addition, this leads to longer muscular response time in the pelvic and lumbo-sacral areas, and reduced
neuromuscular control due to tiredness. A rider suffering from lumbago tires more easily, and is less
reactive...

Conclusion
The prevalence of chronic backaches in professional riders is high. Horse riding itself does not seem to be
the cause of these backaches. The pain appears to concern more specifically those professionals whose
main tasks consist in caring for the horses, and maintenance of the stables. This group of professionals is
largely feminine, and is a reflection of the entire horse sector. Reorganisation of the tasks when possible,
and a serious medical monitoring programme, will enable the professional rider to carry on with his/her
activity, at least in the short term.

Limiting pain is conceivable by looking into working conditions, and particularly into the hazardous
situations that are the tasks associated with horse care and maintenance of the infrastructures.
Know more about our authors

Sophie BIAU Ingénieur de recherche physiologie du sport

Translated from french by : Karen DUFFY Translator

To find this document:

www.equipedia.ifce.fr/en
Editing date: 12 02 2024