Demographic Predictors of Chronic Pain in American Equestrians: A Secondary Analysis
DOI:
https://doi.org/10.64292/ijes.220Keywords:
Horseback riding, body mass, risk factors, human-animal interactions, pain prevalenceAbstract
Equestrians report a high rate of chronic pain (CP), which can disrupt horse-rider movement patterns, communication, and safety. Equestrian-related risk factors (i.e., participation level) for reporting CP are well established, while demographic predictors remain underexamined in American equestrians. The purpose of this study was to examine demographic predictors of self-reported CP in American equestrians. This study was a secondary analysis of cross-sectional survey data from adult American equestrians (n = 1,968) that included self-reported CP status (no formal definition or diagnosis) and demographic variables. All variables were categorical. Chi-square tests (P < 0.25) informed forward-selection binary logistic regressions to estimate odds (ORs) of reporting CP across demographic variables, with significance set at P < 0.05. Approximately 45% of the sample reported general CP. The sample was predominantly female (96%). Participation level was a significant predictor of reporting general CP and chronic back, pelvic, and lower leg pain, with professionals having 1.71–1.95 greater odds (P < 0.05) than recreational equestrians, and 1.39–1.80 greater odds than amateur equestrians (P < 0.05). Body mass predicted general CP and chronic back pain, with riders weighing <91 kg having lower odds of reporting general and back CP (ORs = 0.45–0.60, P < 0.05). Model discrimination was modest across analyses (c-statistics: 0.58–0.63). Participation level remains significantly associated with reporting. Body mass emerged as a potential predictor, while other demographic predictors (e.g., age and sex) remain uncertain with regard to reporting CP in American equestrians. Future research should examine body mass, riding biomechanics, and joint-specific load distribution across disciplines with consideration of horse and human health.
References
Havertz A, Uebis D, Schifflers R, Hildebrand F, Weber CD. Sports injury risk assessment based on a training and functional movement analysis of young elite equestrian athletes– an exploratory cross-sectional study. BMC Sports Science, Medicine and Rehabilitation 2025;17:83. https://doi.org/10.1186/s13102-025-01138-x.
de Haan D. A review of the appropriateness of existing micro- and meso-level models of athlete development within equestrian sport. International Journal of Human Movement and Sports Sciences 2017;5:1–8. https://doi.org/10.13189/saj.2017.050101.
de Haan D, Dumbell LC. Equestrian sport at the Olympic Games from 1900 to 1948. The International Journal of the History of Sport 2016;33:648–65. https://doi.org/10.1080/09523367.2016.1195373.
de Haan D, Henry I, Sotiriadou P. Evaluating the place of equestrian sport in the Long Term Athlete Development (LTAD) and the Sport Policy factors that lead to International Sporting Success (SPLISS) models, Melbourne: 2015.
Clayton HM, MacKechnie-Guire R, Hobbs SJ. Riders' effects on horses—biomechanical principles with examples from the literature. Animals 2023;13:3854. https://doi.org/10.3390/ani13243854.
Hobbs SJ, St George L, Reed J, Stockley R, Thetford C, Sinclair J, et al. A scoping review of determinants of performance in dressage. PeerJ 2020;8:e9022. https://doi.org/10.7717/peerj.9022.
Roepstorff L, Egenvall A, Rhodin M, Byström A, Johnston C, van Weeren PR, et al. Kinetics and kinematics of the horse comparing left and right rising trot. Equine Veterinary Journal 2009;41:292–6. https://doi.org/10.2746/042516409x397127.
MacKechnie-Guire R, MacKechnie-Guire E, Fairfax V, Fisher M, Hargreaves S, Pfau T. The effect that induced rider asymmetry has on equine locomotion and the range of motion of the thoracolumbar spine when ridden in rising trot. Journal of Equine Veterinary Science 2020;88:102946. https://doi.org/10.1016/j.jevs.2020.102946.
Malchrowicz-Mośko E, Wieliński D, Adamczewska K. Perceived benefits for mental and physical health and barriers to horseback riding participation. The analysis among professional and amateur athletes. International Journal of Environmental Research and Public Health 2020;17:3736. https://doi.org/10.3390/ijerph17103736.
Hogg RC, Hodgins GA. Symbiosis or sporting tool? Competition and the horse-rider relationship in elite equestrian sports. Animals 2021;11:1352. https://doi.org/10.3390/ani11051352.
Schwarzmüller-Erber G, Stummer H, Maier M, Kundi M. Nature relatedness of recreational horseback riders and its association with mood and wellbeing. International Journal of Environmental Research and Public Health 2020;17:4136. https://doi.org/10.3390/ijerph17114136.
Bye TL, Chadwick G. Physical fitness habits and perceptions of equestrian riders. Comparative Exercise Physiology 2018;14:183–8. https://doi.org/10.3920/cep180012.
Douglas J-L, Price M, Peters DM. A systematic review of physical fitness, physiological demands and biomechanical performance in equestrian athletes. Comparative Exercise Physiology 2012;8:53–62. https://doi.org/10.3920/cep12003.
Sáez I, León-Guereño P, Malchrowicz-Mośko E, Balerdi E, Río X, Lavín B, et al. Health benefits and participation barriers of different level horseback riders age-wise. Frontiers in Psychology 2022;13:889605. https://doi.org/10.3389/fpsyg.2022.889605.
Schneider IE, Earing J, Martinson K. Revealing motivations for and conflicts associated with recreational horseback trail riding. Journal of Forestry 2013;111:282–6. https://doi.org/10.5849/jof.12-056.
Keener MM, Tumlin KI, Heebner NR. Combined driving: task-specific position impacts grip strength of equestrian athletes. European Review of Aging and Physical Activity 2022;19:2. https://doi.org/10.1186/s11556-021-00282-w.
Keener MM, Tumlin KI, Dlugonski D. Self-reported physical activity and perception of athleticism in American equestrian athletes. Journal of Physical Activity and Health 2023;20:169–79. https://doi.org/10.1123/jpah.2022-0398.
Schwarzmüller-Erber G, Maier M, Stummer H, Kundi M. Recreational horseback riding and its association with physical, mental, and social wellbeing and perceived health. Anthrozoös 2021;34:685–706. https://doi.org/10.1080/08927936.2021.1926709.
Anderson K, Karr-Lilienthal. Team members perceptions of benefits of participation on a university equestrian team. NACTA Journal 2011;55:8–13.
Fiedler JM, Ayre ML, Rosanowski S, Slater JD. Horses are worthy of care: horse sector participants' attitudes towards animal sentience, welfare, and well-being. Animal Welfare 2025;34:e6. https://doi.org/10.1017/awf.2024.69.
Fiedler JM, Ayre ML, Rosanowski S, Slater JD. Horse sector participants' attitudes towards anthropomorphism and animal welfare and wellbeing. Animals 2024;14:2482. https://doi.org/10.3390/ani14172482.
Neville EK, Hicks H, Neville CC. Epidemiology of horse trauma: a literature review. European Journal of Trauma and Emergency Surgery 2024;50:741–54. https://doi.org/10.1007/s00068-023-02436-0.
Ekberg J, Timpka T, Ramel H, Valter L. Injury rates and risk-factors associated with eventing: a total cohort study of injury events among adult Swedish eventing athletes. International Journal of Injury Control and Safety Promotion 2011;18:261–7. https://doi.org/10.1080/17457300.2010.545129.
Hobbs SJ, Baxter J, Broom L, Rossell L-A, Sinclair J, Clayton HM. Posture, flexibility and grip strength in horse riders. Journal of Human Kinetics 2014;42:113–25. https://doi.org/10.2478/hukin-2014-0066.
Kraft CN, Pennekamp PH, Becker U, Young M, Diedrich O, Lüring C, et al. Magnetic resonance imaging findings of the lumbar spine in elite horseback riders. The American Journal of Sports Medicine 2009;37:2205–13. https://doi.org/10.1177/0363546509336927.
Duarte CR, Raimundo A, Sousa JP, Fernandes O, Santos R. Prevalence of lower back pain and risk factors in equestrians: a systematic review. Sports 2024;12:355. https://doi.org/10.3390/sports12120355.
Williams J, Tabor G. Rider impacts on equitation. Applied Animal Behaviour Science 2017;190:28–42. https://doi.org/10.1016/j.applanim.2017.02.019.
Keener MM, Critchley ML, Layer JS, Johnson EC, Barrett SF, Dai B. The effect of stirrup length on impact attenuation and its association with muscle strength. Journal of Strength & Conditioning Research 2021;35:3056–62. https://doi.org/10.1519/jsc.0000000000003278.
Raja SN, Carr DB, Cohen M, Finnerup NB, Flor H, Gibson S, et al. The revised International Association for the study of pain definition of pain: concepts, challenges, and compromises. Pain 2020;161:1976–82. https://doi.org/10.1097/j.pain.0000000000001939.
Cohen SP, Vase L, Hooten WM. Chronic pain: an update on burden, best practices, and new advances. The Lancet 2021;397:2082–97. https://doi.org/10.1016/s0140-6736(21)00393-7.
Smith E, Hoy DG, Cross M, Vos T, Naghavi M, Buchbinder R, et al. The global burden of other musculoskeletal disorders: estimates from the Global Burden of Disease 2010 study. Annals of the Rheumatic Diseases 2014;73:1462–9. https://doi.org/10.1136/annrheumdis-2013-204680.
Mills SEE, Nicolson KP, Smith BH. Chronic pain: a review of its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia 2019;123:e273–83. https://doi.org/10.1016/j.bja.2019.03.023.
El-Tallawy SN, Nalamasu R, Salem GI, LeQuang JAK, Pergolizzi JV, Christo PJ. Management of musculoskeletal pain: an update with emphasis on chronic musculoskeletal pain. Pain and Therapy 2021;10:181–209. https://doi.org/10.1007/s40122-021-00235-2.
Bonanni R, Cariati I, Tancredi V, Iundusi R, Gasbarra E, Tarantino U. Chronic pain in musculoskeletal diseases: do you know your enemy? Journal of Clinical Medicine 2022;11:2609. https://doi.org/10.3390/jcm11092609.
Mendonça CR, Noll M, de Carvalho Santos AS e A, Rodrigues AP dos S, Silveira EA. High prevalence of musculoskeletal pain in individuals with severe obesity: sites, intensity, and associated factors. The Korean Journal of Pain 2020;33:245–57. https://doi.org/10.3344/kjp.2020.33.3.245.
Lewis V, Kennerley R. A preliminary study to investigate the prevalence of pain in elite dressage riders during competition in the United Kingdom. Comparative Exercise Physiology 2017;13:259–64. https://doi.org/10.3920/cep170016.
Lewis V, Baldwin K. A preliminary study to investigate the prevalence of pain in international event riders during competition, in the United Kingdom. Comparative Exercise Physiology 2018;14:173–82. https://doi.org/10.3920/cep180006.
Lewis V, Dumbell L, Magnoni F. A preliminary study to investigate the prevalence of pain in competitive showjumping equestrian athletes. Journal of Physical Fitness, Medicine & Treatment in Sports 2018;4:555637. https://doi.org/10.19080/JPFMTS.2018.04.555637.
Lewis V, Nicol Z, Dumbell L, Cameron L. A study investigating prevalence of pain in horse riders over thirty-five years old. International Journal of Equine Science 2023;2:9–18. https://doi.org/10.64292/ijes.63.
Lewis V, Jones A, Dumbell L, Davies E, Cameron LJ, Williams J. The impact of yard work and stable duties on the perception of pain in United Kingdom recreational and amateur competitive horse riders. Journal of Physical Fitness, Medicine & Treatment in Sports 2025;10:555802. https://doi.org/10.19080/JPFMTS.2025.10.555802.
Kraft C, Urban N, Ilg A, Wallny T, Scharfstädt A, Jäger M, et al. [Influence of the riding discipline and riding intensity on the incidence of back pain in competitive horseback riders]. Sportverletzung · Sportschaden 2007;21:29–33. https://doi.org/10.1055/s-2007-963038.
Ball CG, Ball JE, Kirkpatrick AW, Mulloy RH. Equestrian injuries: incidence, injury patterns, and risk factors for 10 years of major traumatic injuries. The American Journal of Surgery 2007;193:636–40. https://doi.org/10.1016/j.amjsurg.2007.01.016.
Keener MM, Tumlin KI. Self-reported acute injury and chronic pain in American equestrian athletes. Comparative Exercise Physiology 2023;19:279–92. https://doi.org/10.1163/17552559-20230021.
Eckardt F, Witte K. Horse–rider interaction: A new method based on inertial measurement units. Journal of Equine Veterinary Science 2017;55:1–8. https://doi.org/10.1016/j.jevs.2017.02.016.
Hobbs SJ, Serra Braganca FM, Rhodin M, Hernlund E, Peterson M, Clayton HM. Evaluating overall performance in high-level dressage horse–rider combinations by comparing measurements from inertial sensors with general impression scores awarded by judges. Animals 2023;13:2496. https://doi.org/10.3390/ani13152496.
Wolframm IA, Bosga J, Meulenbroek RGJ. Coordination dynamics in horse-rider dyads. Human Movement Science 2013;32:157–70. https://doi.org/10.1016/j.humov.2012.11.002.
Elmeua González M, Šarabon N. Shock attenuation and electromyographic activity of advanced and novice equestrian riders' trunk. Applied Sciences 2021;11:2304. https://doi.org/10.3390/app11052304.
Olivier A, Faugloire E, Lejeune L, Biau S, Isableu B. Head stability and head-trunk coordination in horseback riders: the contribution of visual information according to expertise. Frontiers in Human Neuroscience 2017;11:11. https://doi.org/10.3389/fnhum.2017.00011.
Domańska-Kruppa N, Wierzbicka M, Stefanik E. Advances in the clinical diagnostics to equine back pain: a review of imaging and functional modalities. Animals 2024;14:698. https://doi.org/10.3390/ani14050698.
Quinn S, Bird S. Influence of saddle type upon the incidence of lower back pain in equestrian riders. British Journal of Sports Medicine 1996;30:140–4. https://doi.org/10.1136/bjsm.30.2.140.
Ginés-Díaz A, Martínez-Romero MT, Cejudo A, Aparicio-Sarmiento A, Sainz de Baranda P. Sagittal spinal morphotype assessment in dressage and show jumping riders. Journal of Sport Rehabilitation 2019;29:533–40. https://doi.org/10.1123/jsr.2018-0247.
Keener MM, Tumlin KI. Corrigendum on: Self-reported acute injury and chronic pain in American equestrian athletes. Comparative Exercise Physiology 2024;20:97–9. https://doi.org/10.1163/17552559-2024x001.
Ferrante M, Bonetti F, Quattrini F, Mezzetti M, Demarie S. Low back pain and associated factors among Italian equestrian athletes: a cross-sectional study. Muscles, Ligaments and Tendons Journal 2021;11:344–52. https://doi.org/10.32098/mltj.02.2021.19.
Duarte C, Santos R, Fernandes O, Raimundo A. Prevalence of lower back pain in Portuguese equestrian riders. Sports 2024;12:207. https://doi.org/10.3390/sports12080207.
Puszczałowska-Lizis E, Szymański D, Pietrzak P, Wilczyński M. Incidence of back pain in people practicing amateur horse riding. Fizjoterapia Polska 2022;22:6–15. https://doi.org/10.56984/8zg1a68my.
Cejudo A, Ginés-Díaz A, Sainz de Baranda P. Asymmetry and tightness of lower limb muscles in equestrian athletes: are they predictors for back pain? Symmetry 2020;12:1679. https://doi.org/10.3390/sym12101679.
Cejudo A, Ginés-Díaz A, Rodríguez-Ferrán O, Santonja-Medina F, Sainz de Baranda P. Trunk lateral flexor endurance and body fat: predictive risk factors for low back pain in child equestrian athletes. Children 2020;7:172. https://doi.org/10.3390/children7100172.
Michaud P-C, van Soest A, Andreyeva T. Cross-Country Variation in Obesity Patterns Among Older Americans and Europeans 2007. https://doi.org/10.2139/ssrn.1003914.
Bassett DR, Pucher J, Buehler R, Thompson DL, Crouter SE. Walking, cycling, and obesity rates in Europe, North America, and Australia. Journal of Physical Activity and Health 2008;5:795–814. https://doi.org/10.1123/jpah.5.6.795.
Ohrnberger EA, Tumlin KI, Keener MM. Evaluating the relationship across physical activity domains and chronic pain in adult American equestrians: a secondary analysis. International Journal of Equine Science 2026;5:3–20. https://doi.org/10.64292/ijes.185.
Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code for Biology and Medicine 2008;3:17. https://doi.org/10.1186/1751-0473-3-17.
Greve L, Dyson S. Saddle fit and management: An investigation of the association with equine thoracolumbar asymmetries, horse and rider health. Equine Veterinary Journal 2015;47:415–21. https://doi.org/10.1111/evj.12304.
Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. Journal of Electromyography and Kinesiology 2004;14:13–23. https://doi.org/10.1016/j.jelekin.2003.09.015.
Ball JE, Ball CG, Mulloy RH, Datta I, Kirkpatrick AW. Ten years of major equestrian injury: are we addressing functional outcomes? Journal of Trauma Management & Outcomes 2009;3. https://doi.org/10.1186/1752-2897-3-2.
Teasell RW, Bombardier C. Employment-related factors in chronic pain and chronic pain disability. The Clinical Journal of Pain 2001;17:S39–45. https://doi.org/10.1097/00002508-200112001-00010.
Keener MM, Tumlin KI. The Triple-E model: advancing equestrian research with perspectives from one health. Animals 2023;13:2642. https://doi.org/10.3390/ani13162642.
Löfqvist L, Chafi MB, Osvalder AL, Bligård LO, Pinzke S. Ergonomic evaluation of long-shafted tools used in horse stables: the effects of shaft length variation and work technique on working posture. International Journal of Human Factors and Ergonomics 2012;1:298–312. https://doi.org/10.1504/ijhfe.2012.050872.
Löfqvist L, Osvalder A-L, Bligård L-O, Pinzke S. An analytical ergonomic risk evaluation of body postures during daily cleaning tasks in horse stables. WORK: A Journal of Prevention, Assessment & Rehabilitation 2015;51:667–82. https://doi.org/10.3233/wor-152022.
Tumlin K, Liu S, Park J-H. Framing future of work considerations through climate and built environment assessment of volunteer work practices in the United States equine assisted services. International Journal of Environmental Research and Public Health 2021;18:10385. https://doi.org/10.3390/ijerph181910385.
Bulens A, Sterken H, Van Beirendonck S, Van Thielen J, Driessen B. The use of different objects during a novel object test in stabled horses. Journal of Veterinary Behavior 2015;10:54–8. https://doi.org/10.1016/j.jveb.2014.09.002.
Baragli P, Vitale V, Banti L, Sighieri C. Effect of aging on behavioural and physiological responses to a stressful stimulus in horses (Equus caballus). Behaviour 2014;151:1513–33. https://doi.org/10.1163/1568539x-00003197.
Meyer H-L, Scheidgen P, Polan C, Beck P, Mester B, Kauther MD, et al. Injuries and overuse injuries in show jumping—a retrospective epidemiological cross-sectional study of show jumpers in Germany. International Journal of Environmental Research and Public Health 2022;19:2305. https://doi.org/10.3390/ijerph19042305.
Caparrós T, Alentorn-Geli E, Myer GD, Capdevila L, Samuelsson K, Hamilton B, et al. The relationship of practice exposure and injury rate on game performance and season success in professional male basketball. Journal of Sports Science & Medicine 2016;15:397–402.
Borgers J, Breedveld K, Tiessen-Raaphorst A, Thibaut E, Vandermeerschen H, Vos S, et al. A study on the frequency of participation and time spent on sport in different organisational settings. European Sport Management Quarterly 2016;16:635–54. https://doi.org/10.1080/16184742.2016.1196717.
Bruner MW, Munroe-Chandler KJ, Spink KS. Entry into elite sport: a preliminary investigation into the transition experiences of rookie athletes. Journal of Applied Sport Psychology 2008;20:236–52. https://doi.org/10.1080/10413200701867745.
Wolframm I. The science of equestrian sports: theory, practice and performance of the equestrian rider. 1st Edition. London, UK: Routledge; 2013.
Wicklund A, Foster SD, Roy AA. Getting back on the horse: sport-specific return to play in rodeo athletes after concussion injury. Journal of Athletic Training 2018;53:657–61. https://doi.org/10.4085/1062-6050-310-17.
Davies E, Liddiard S, McConn-Palfreyman WJ, Parker JK, Cameron LJ, Williams JM. Anxiety and depression in British horseracing stud and stable staff following occupational injury. Animals 2023;13:3337. https://doi.org/10.3390/ani13213337.
Davies E, McConn-Palfreyman W, Williams JM, Lovell GP. A narrative review of the risk factors and psychological consequences of injury in horseracing stable staff. Comparative Exercise Physiology 2021;17:303–17. https://doi.org/10.3920/cep200073.
Davies E, McConn-Palfreyman W, Parker JK, Williams JM. "If you can walk, if you can breathe, you don't need to go to hospital": Psychological responses of British horseracing staff to occupational injury. International Journal of Equine Science 2025;4:52–71. https://doi.org/10.64292/ijes.152.
Davies E, McConn-Palfreyman W, Parker JK, Cameron LJ, Williams JM. Is injury an occupational hazard for horseracing staff? International Journal of Environmental Research and Public Health 2022;19:2054. https://doi.org/10.3390/ijerph19042054.
de Vries HJ, Brouwer S, Groothoff JW, Geertzen JH, Reneman MF. Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers' experiences. BMC Musculoskeletal Disorders 2011;12:126. https://doi.org/10.1186/1471-2474-12-126.
Azouaghe O. Determining safe rider weights for horses. Veterinary Record 2018;182:305. https://doi.org/doi.org/10.1136/vr.k1222.
Challinor CL, Randle H, Williams JM. Understanding rider:horse bodyweight ratio trends, weight management practices and rider weight perceptions within leisure and amateur riders in the UK. Comparative Exercise Physiology 2021;17:403–18. https://doi.org/10.3920/cep200082.
Christensen JW, Bathellier S, Rhodin M, Palme R, Uldahl M. Increased rider weight did not induce changes in behavior and physiological parameters in horses. Animals 2020;10:95. https://doi.org/10.3390/ani10010095.
Burke MA, Carman KG. You can be too thin (but not too tall): Social desirability bias in self-reports of weight and height. Economics & Human Biology 2017;27:198–222. https://doi.org/10.1016/j.ehb.2017.06.002.
Forino S, Cameron L, Stones N, Freeman M. Potential impacts of body image perception in female equestrians. Journal of Equine Veterinary Science 2021;107:103776. https://doi.org/10.1016/j.jevs.2021.103776.
Forino S, Cameron L, Stones N, Freeman M. Horse-rider pairing perception by dressage judges and equestrian coaches. Journal of Equine Veterinary Science 2023;128:104864. https://doi.org/10.1016/j.jevs.2023.104864.
Torres-McGehee TM, Monsma EV, Gay JL, Minton DM, Mady-Foster AN. Prevalence of eating disorder risk and body image distortion among National Collegiate Athletic Association Division I varsity equestrian athletes. Journal of Athletic Training 2011;46:431–7. https://doi.org/10.4085/1062-6050-46.4.431.
Clayton HM, Hobbs S-J. The role of biomechanical analysis of horse and rider in equitation science. Applied Animal Behaviour Science 2017;190:123–32. https://doi.org/10.1016/j.applanim.2017.02.011.
Emmerich S, Fryar C, Stierman B, Ogden C. Obesity and severe obesity prevalence in adults: United States, August 2021–August 2023. National Center for Health Statistics (U.S.); 2024. https://doi.org/10.15620/cdc/159281.
d'Errico M, Pavlova M, Spandonaro F. The economic burden of obesity in Italy: a cost-of-illness study. The European Journal of Health Economics 2022;23:177–92. https://doi.org/10.1007/s10198-021-01358-1.
Clayton HM, Dyson S, Harris P, Bondi A. Horses, saddles and riders: applying the science. Equine Veterinary Education 2015;27:447–52. https://doi.org/10.1111/eve.12407.
Dyson S, Ellis AD, Mackechnie-Guire R, Douglas J, Bondi A, Harris P. The influence of rider:horse bodyweight ratio and rider-horse-saddle fit on equine gait and behaviour: A pilot study. Equine Veterinary Education 2020;32:527–39. https://doi.org/10.1111/eve.13085.
Al-Eisa E, Egan D, Deluzio K, Wassersug R. Effects of pelvic asymmetry and low back pain on trunk kinematics during sitting: a comparison with standing. Spine (Phila Pa 1976) 2006;31:E135-143. https://doi.org/10.1097/01.brs.0000201325.89493.5f.
Nankervis K, Dumbell L, Herbert L, Winfield J, Guire R, Launder E. A comparison of the position of elite and non-elite riders during competitive show jumping. Comparative Exercise Physiology 2015;11:119–26. https://doi.org/10.3920/cep150004.
Legg K, Cochrane D, Gee E, Macdermid P, Rogers C. Physiological demands and muscle activity of jockeys in trial and race riding. Animals 2022;12:2351. https://doi.org/10.3390/ani12182351.
American Horse Council Foundation. Economic impact study of the us horse industry 2017. https://www.cabidigitallibrary.org/doi/pdf/10.5555/20193333566.
Stanfill AG, Wynja K, Cao X, Prescott D, Shore S, Baughman B, et al. Helmet use in equestrian athletes: opportunities for intervention. Concussion 2021;6. https://doi.org/10.2217/cnc-2020-0019.
Overstreet DS, Strath LJ, Jordan M, Jordan IA, Hobson JM, Owens MA, et al. A brief overview: Sex differences in prevalent chronic musculoskeletal conditions. International Journal of Environmental Research and Public Health 2023;20:4521. https://doi.org/10.3390/ijerph20054521.
Mundal I, Gråwe RW, Bjørngaard JH, Linaker OM, Fors EA. Psychosocial factors and risk of chronic widespread pain: an 11-year follow-up study—the HUNT study. Pain 2014;155:1555–61. https://doi.org/10.1016/j.pain.2014.04.033.
Konieczny MR, Senyurt H, Krauspe R. Epidemiology of adolescent idiopathic scoliosis. Journal of Children's Orthopaedics 2013;7:3–9. https://doi.org/10.1007/s11832-012-0457-4.
Fernandez M, Colodro-Conde L, Hartvigsen J, Ferreira ML, Refshauge KM, Pinheiro MB, et al. Chronic low back pain and the risk of depression or anxiety symptoms: insights from a longitudinal twin study. The Spine Journal 2017;17:905–12. https://doi.org/10.1016/j.spinee.2017.02.009.
Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A hypothesis of gender differences in self-reporting symptom of depression: implications to solve under-diagnosis and under-treatment of depression in males. Frontiers in Psychiatry 2021;12:589687. https://doi.org/10.3389/fpsyt.2021.589687.
McLean CP, Asnaani A, Litz BT, Hofmann SG. Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness. Journal of Psychiatric Research 2011;45:1027–35. https://doi.org/10.1016/j.jpsychires.2011.03.006.
Musalek C, Kirchengast S. Grip strength as an indicator of health-related quality of life in old age—a pilot study. International Journal of Environmental Research and Public Health 2017;14:1447. https://doi.org/10.3390/ijerph14121447.
Hong YS, Kim H. Hand grip strength and health-related quality of life in postmenopausal women: a national population-based study. Menopause 2021;28:1330–9. https://doi.org/10.1097/gme.0000000000001863.
Gopinath B, Kifley A, Liew G, Mitchell P. Handgrip strength and its association with functional independence, depressive symptoms and quality of life in older adults. Maturitas 2017;106:92–4. https://doi.org/10.1016/j.maturitas.2017.09.009.
Deckers I, De Bruyne C, Roussel NA, Truijen S, Minguet P, Lewis V, et al. Assessing the sport-specific and functional characteristics of back pain in horse riders. Comparative Exercise Physiology 2021;17:7–16. https://doi.org/10.3920/cep190075.
American Horse Council Foundation. 2023 economic impact study of the US Horse industry. American Horse Council Foundation McLean (VA); 2024. https://horsecouncil.org/economic-impact-study.
Downloads
Published
Data Availability Statement
The datasets analyzed during the current study are not publicly available due to institutional review board restrictions, but are available from the corresponding author upon reasonable request.
Issue
Section
License
Copyright (c) 2026 Elisabeth A. Ohrnberger, Kimberly I. Tumlin, Michaela M. Keener
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors retain the copyright of their manuscripts, and all Open Access articles are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided that the original work is properly cited.
How to Cite
