By Allan Hamilton, MD
Unfortunately most physicians are not horseback riders or equine aficionados. If they were then their response to every new diagnosis they made would not be to automatically prohibit the patient from riding. Seems like every ailment they find always ends in advice to stop riding. Got a cold? Stop riding. Hurt your back? Stop riding. Knee bothering you? Stop riding. Got a rash? Stop riding.
Naturally, I should throw in all sorts of cautionary footnotes and medical-legal wording to ward off any suggestion of liability, but let’s be frank: horseback riding remains one of the most dangerous activities a person can undertake. I would add, almost parenthetically, it is also one of the most thrilling and satisfying. Nonetheless, we must all recognize that horseback riding is considerably more dangerous than almost any other athletic activity; this includes motorcycle riding, downhill skiing, car racing and even the more physical of contact sports such as football, rugby, and hockey. Horseback riding also is remarkable in that the average age for individuals suffering major injuries and undergoing surgery for those injuries is higher in the equestrian sports than any of the other activities I just listed. What this means is that, as older individuals, we are more likely to suffer an injury in our equestrian pursuits and those injuries may be more severe and more disabling.
Nonetheless those of us who are reaching more advanced stages of life still cling more dearly to our love of horseback riding than we do our aversion to risk. As we age, several important physical changes occur that impact our ability to ride. The first is an overall slowing down of what we call psychomotor skills. This relates to the fact that our central nervous system reacts more slowly than when we were young. Our reflexes and muscular responses deteriorate measurably as we age, especially those of us older than fifty-five. By and large, these decrements in psychomotor skills have relatively little effect in our daily lives. Where we see these age-related deficiencies emerge are, unfortunately, in those situations which stress the extremes of human physiologic performance; namely, accidents where we are in substantial danger, such as an impending car crash or, more specifically, falling off a horse. As we get older our bodies are less able to respond quickly to a sudden and unexpected mishap such as the horse spooking. Add to this the fact that our joints are less flexible, our bones are more brittle, and our muscle strength is slowly diminishing, and you have a physiological conspiracy that makes riders above the age of fifty-five more prone to serious injury from horseback riding than our younger counterparts.
I want to close with a cautionary note about healthcare providers and those of us who happen to be their patients but also avidly pursue equestrian sports. As soon as an injury occurs, most physicians will err on the side of caution. So, for example, when I suffer a back injury, almost without exception, most physicians recommend that I restrain from any equestrian activity. On the surface that makes sense. However, for those of us who love horses and horse back riding, depriving ourselves of that activity also means removing a source of tremendous enjoyment and fulfillment from our lives.I don’t want to know why I shouldn’t go riding. I want to know if I can go riding. I want to know what specific precautions I must take––if any––so I can keep riding. I want to know what limitations can be lifted in such a way as to get me back in the saddle as soon as possible. Horseback riding is not only good for the body but good for the soul. In the words of Winston Churchill: “there is nothing as good for the inside of a man than the outside of a horse.” Sometimes the prescription for what ails me is a good ride through the countryside. The only doctor I truly trust when it comes to medical advice about riding comes from a physician or healthcare professional who owns his or her own horse.
Remember: life is short so keep riding.