University of Bath

Equestrian spinal injuries

This research aims to analyse the mechanisms of equestrian injury, and to identify viable routes for the design of interventions to minimise injury occurrence.

A field of horses and jockeys during a race
Equestrian spinal injuries can have life-changing consequences, but little is known about the mechanisms of how they occur

There are an estimated 1.3 million people in the UK who regularly ride horses, and despite riding being a healthy activity that people of all ages can enjoy, it carries a high risk of injury. One area that requires better understanding is significant spinal injuries, which are rare but have a life-changing impact. In the last 30 years patterns of injuries in professional and amateur riders have been studied using pictures or video footage. However, little is known about the mechanisms related to spinal injuries in riding and this limits the ability to improve safety.

To understand the complexity of how spinal injuries occur, the research team for this project will combine information from a variety of sources to create computer simulations. Once a computer simulation is done, they will look at what happens in terms of injury outcome if they change a variable such as the way someone falls, anatomical spine features, and whether they are wearing protective equipment.

To create the computer simulation model, the research team will collect information about injuries that occur and look at this alongside video footage of the incident. They'll carry out experiments where professional riders are filmed during “falls training” on a simulator to ensure the validity and applicability of the computer model.

Researchers will start by collecting this information in horse racing, as they know that they can access the information needed in this setting. Once they have developed a valid and reliable model in this setting they will be able to apply this to other riding disciplines. This programme of work is a key step and will help all stakeholders in riding to develop injury prevention approaches to reduce the number of serious injuries that occur, making an activity that so many people enjoy safer.

Research team

Project objectives

  • To categorise and quantitatively describe injuries from the analysis of video footage
  • To analyse the effect of protective garments on trunk and head movement during a simulated fall
  • To accurately measure and analyse the biomechanical load and body motion during simulated falls
  • To identify the injury mechanisms related to different injurious events via musculoskeletal models and computer simulations
  • To devise the application of the injury analysis framework on other riding disciplines

Expected outcomes

  • Identification and high-level description of the environmental, behavioural, and biomechanical features related to equestrian spinal injuries
  • Accurate measurement of whole body, trunk, and head motion and biomechanical load during staged falls, as well as quantitative analysis on the effect of protective garments on spinal injury risk
  • Estimation of the internal load experienced by jockeys and identification of the safest falling technique used
  • An optimised version of the simulation and analysis framework to investigate the injury mechanisms from a selected database of non-racing events

Phase 1: Characterisation of spinal injury events in horse racing

Although not representative of all equestrian settings, the availability of high quality footage of falls during horse racing makes this a sensible starting point for this research. Current research funded by the British Medical Association (BMA) at the University of Bath will be linking different databases to identify video footage of equestrian spinal injuries along with injury diagnoses and description of inciting event.

Video footage will be categorised according to the type of injury and the event will be described to determine whether there are any patterns in which types of fall lead to serious injury. A quantitative biomechanical analysis will then be carried out on the selected group of spinal injuries from the BMA analysis to extract the gross biomechanical variables describing the whole body and trunk kinematics, and estimating the impact force.

Phase 2: Analysis of the effect of protective garments on spinal injury risk during staged falls

Whole-body movements and biomechanical loads will be measured via inertial measurement units (Xsens, The Netherlands) and an optoelectronic system (Qualisys, Sweden) during staged falls. This is possible thanks to the jockeys’ training facilities, which include a horse simulator and dedicated area equipped with specific padding where jockeys are trained to fall to the ground. Jockeys will repeat the same protocol wearing a variety of protective garments, and the trunk and head motion and impact accelerations will be compared against garment-free trials.

The analysis of jockey’s body motion, trunk, and head accelerations will highlight whether protective garments have the potential of decreasing spinal injury risk or have a negative effect such as constraining the spine leading to risk of a neck injury rather than a lower spine injury.

Phase 3: Internal loading analysis during falls

Information from phase 2 will be used as input for a multibody simulation software for impact loading (MADYMO, The Netherlands), which will provide an accurate estimate of the contact forces during impact in a fall. This further analysis is key to linking what we measure externally (body motion and external forces) to how the force is transmitted within the body towards the spine and the head. This way the different falling techniques embraced by jockeys will be linked with the estimated internal load with the final aim to highlight the safest one.

Phase 4: Simulation of injurious event and exploration of ‘what if’ scenarios

The research team will replicate the injurious events analysed in phase 1 of the project in a computer simulation. A subject-specific musculoskeletal model will be created using a full body MRI scan of a jockey, and a computer simulation and modelling software (OpenSim, Stanford University) will be employed to run biomechanical simulations. These simulations will include both the exact replication of the injuries identified in phase 1, and the exploration of ‘what if’ scenarios in which characteristics of the falling technique or spinal muscles activation will be simulated.

The injury replication simulations will demonstrate the validity of the model created whilst the exploratory simulations will allow evaluation of the influence of technique and jockeys’ neuromuscular status on injury risk. This way the researchers will be able to both highlight the injury mechanisms related to specific spinal injuries and inform coaching by drawing attention to the safest techniques and physical preparation level required. This is a key step for the application of the framework to the analysis of the injury mechanisms related to non-racing injurious event.

Phase 5: Optimisation of simulation framework for the analysis of injuries during wider riding events

Phase 3 and 4 will provide a validated and reliable simulation and analysis framework for the analysis of real-world or theoretical injurious scenarios. However, the proposed framework requires a specific quality and format of the inputs (such as video footage quality, diagnoses, and qualitative description of the injury) which might not be achievable in other riding events. The aim of this framework is to evaluate the minimum level of information and the lowest video quality level for exploring the injury mechanisms related to injuries in other riding disciplines.