A Study Investigating Prevalence of Pain in Horse Riders over Thirty-Five Years Old
Pain in UK Riders Over 35 Years Old
Keywords:
Horse riding, equestrian, injury, pain, asymmetryAbstract
Horse riding is considered to be one of the most dangerous sports, more so than skiing, motor racing, and rugby. A rider will fall, on average, once every two years, and during their career, one in five are seriously injured. Previous research has looked at pain in elite dressage, show jumping, and event riders, and how overuse injuries and lifestyle could aggravate their pain and affect performance. Persistent pain can be debilitating and determine the end of a career. This study aims to investigate the prevalence of pain in riders over the age of 35 years and the location and management of pain and self-perception of whether pain affected riding. A primarily quantitative approach was used due to the exploratory nature of the survey undertaken. 2185 participants completed a questionnaire containing 46 open and closed questions. The pain was experienced by 85.4% (n = 1866) of the participants, making the over 35-year-old riders 5.85 times (O.R.) more likely to experience pain than pain-free. Females were 1.28 times (O.R.) more likely to experience pain than male riders. Participants attributed their pain to old age, arthritis, performing stable duties, and previous injuries, with 42% (n = 784) of participants having to stop riding due to pain. The most common method to treat pain was over-the-counter medication, with female participants being 2.2 times more likely to take medication than males. Participants who had been riding for 20 years or more were 6.54 times (O.R.) more likely to have pain than not and riders who did not take part in any other physical exercise were 1.4 times (O.R.) more likely to suffer pain. The high frequency of pain in riders over 35 years, particularly lower back pain, could be due to the length of their riding career. Whilst this study reports individual perception of pain and pain management, it is individual perception that is likely to determine the impact of the pain on that individual. Further research is required regarding the perception of pain to better establish the causes of pain and determine appropriate management strategies.
References
British Equestrian Trade Association (BETA). BETA National Equestrian Survey 2019 reveals an increase in riding 2019. https://www.beta-uk.org/pages/news-amp-events/news/beta-national-equestrian-survey-2019-reveals-an-increase-in-riding.php (accessed February 17, 2023).
Dumbell LC, Rowe L, Douglas JL. Demographic profiling of British Olympic equestrian athletes in the twenty-first century. Sport in Society 2018;21:1337–50. https://doi.org/10.1080/17430437.2017.1388786.
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.
Mayberry JC, Pearson TE, Wiger KJ, Diggs BS, Mullins RJ. Equestrian injury prevention efforts need more attention to novice riders. J Trauma 2007;62:735–9. https://doi.org/10.1097/ta.0b013e318031b5d4.
Sorli JM. Equestrian injuries: a five year review of hospital admissions in British Columbia, Canada. Inj Prev 2000;6:59–61. https://doi.org/10.1136/ip.6.1.59.
Cook JL, Khan KM, Harcourt PR, Grant M, Young DA, Bonar SF. A cross sectional study of 100 athletes with jumper's knee managed conservatively and surgically. The Victorian Institute of Sport Tendon Study Group. Br J Sports Med 1997;31:332–6.
Clarsen B, Bahr R, Heymans MW, Engedahl M, Midtsundstad G, Rosenlund L, et al. The prevalence and impact of overuse injuries in five Norwegian sports: Application of a new surveillance method. Scand J Med Sci Sports 2015;25:323–30. https://doi.org/10.1111/sms.12223.
Holtslag HR, van Beeck EF, Lindeman E, Leenen LPH. Determinants of long-term functional consequences after major trauma. J Trauma 2007;62:919–27. https://doi.org/10.1097/01.ta.0000224124.47646.62.
Colantonio A, Dawson DR, McLellan BA. Head injury in young adults: long-term outcome. Archives of Physical Medicine and Rehabilitation 1998;79:550–8. https://doi.org/10.1016/S0003-9993(98)90072-7.
Dekker R, Van Der Sluis CK, Kootstra J, Groothoff JW, Eisma WH, Duis HJT. Long-term outcome of equestrian injuries in children. Disabil Rehabil 2004;26:91–6. https://doi.org/10.1080/09638280310001629688.
Schmitt H, Hansmann HJ, Brocai DR, Loew M. Long term changes of the throwing arm of former elite javelin throwers. Int J Sports Med 2001;22:275–9. https://doi.org/10.1055/s-2001-13814.
Kujala UM, Sarna S, Kaprio J. Cumulative incidence of achilles tendon rupture and tendinopathy in male former elite athletes. Clin J Sport Med 2005;15:133–5. https://doi.org/10.1097/01.jsm.0000165347.55638.23.
Kraft CN, 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]. Sportverletz Sportschaden 2007;21:29–33. https://doi.org/10.1055/s-2007-963038.
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.
Symes D, Ellis R. A preliminary study into rider asymmetry within equitation. The Veterinary Journal 2009;181:34–7. https://doi.org/10.1016/j.tvjl.2009.03.016.
Verstegen M, Williams P. Core performance: the revolutionary workout program to transform your body and your life. Rodale; 2004.
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;13:259–63. https://doi.org/10.3920/CEP170016.
Lewis V, Dumbell L, Magnoni F. A Preliminary Study to Investigate the Prevalence of Pain in Competitive Showjumping Equestrian Athletes. JPFMTS 2018;4. https://doi.org/10.19080/JPFMTS.2018.04.555637.
Diem KG. A step-by-step guide to developing effective questionnaires and survey procedures for program evaluation and research. 2002.
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;14:173–81. https://doi.org/10.3920/CEP180006.
Brace I. Questionnaire design: How to plan, structure and write survey material for effective market research 2018.
Melzack R. The short-form McGill Pain Questionnaire. Pain 1987;30:191–7. https://doi.org/10.1016/0304-3959(87)91074-8.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976) 2000;25:2940–52; discussion 2952. https://doi.org/10.1097/00007632-200011150-00017.
Fowler FJ. Survey Research Methods. 3rd Edition. Thousand Oaks: Sage; 2002.
Ploner M, Lee MC, Wiech K, Bingel U, Tracey I. Prestimulus functional connectivity determines pain perception in humans. Proceedings of the National Academy of Sciences 2010;107:355–60. https://doi.org/10.1073/pnas.0906186106.
Loeser JD, Melzack R. Pain: an overview. The Lancet 1999;353:1607–9. https://doi.org/10.1016/S0140-6736(99)01311-2.
Haslam DR. Age and the perception of pain. Psychonomic Science 1969;15:86–7.
Melzack R, Wall PD. Pain mechanisms: a new theory. Science 1965;150:971–9. https://doi.org/10.1126/science.150.3699.971.
Webb R, Brammah T, Lunt M, Urwin M, Allison T, Symmons D. Prevalence and predictors of intense, chronic, and disabling neck and back pain in the UK general population. Spine (Phila Pa 1976) 2003;28:1195–202. https://doi.org/10.1097/01.BRS.0000067430.49169.01.
Dick RW. Is there a gender difference in concussion incidence and outcomes? Br J Sports Med 2009;43 Suppl 1:i46-50. https://doi.org/10.1136/bjsm.2009.058172.
Womble MN, Collins MW. Concussions in American Football. Am J Orthop (Belle Mead NJ) 2016;45:352–6.
Scher M. Men in hiding: A challenge for the counselor. Personnel & Guidance Journal 1981;60:199–202. https://doi.org/10.1002/j.2164-4918.1981.tb00281.x.
Young K, White P, McTeer W. Body Talk: Male Athletes Reflect on Sport, Injury, and Pain. Sociology of Sport Journal 1994;11:175–94. https://doi.org/10.1123/ssj.11.2.175.
Jordan JL, Holden MA, Mason EE, Foster NE. Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev 2010;2010:CD005956. https://doi.org/10.1002/14651858.CD005956.pub2.
Manchikanti L, Manchikanti KN, Cash KA, Singh V, Giordano J. Age-related prevalence of facet-joint involvement in chronic neck and low back pain. Pain Physician 2008;11:67–75.
Warson J. The Rider's Pain-Free Back: Overcome Chronic Soreness, Injury, and Aging, and Stay in the Saddle for Years to Come. Trafalgar Square Books; 2007.
DePalma MJ, Ketchum JM, Saullo T. What Is the Source of Chronic Low Back Pain and Does Age Play a Role? Pain Medicine 2011;12:224–33. https://doi.org/10.1111/j.1526-4637.2010.01045.x.
O'Brien D. Look Before You Leap: What Are the Obstacles to Risk Calculation in the Equestrian Sport of Eventing? Animals 2016;6:13. https://doi.org/10.3390/ani6020013.
Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The Lancet 2012;379:482–91. https://doi.org/10.1016/S0140-6736(11)60610-7.
Andersson HI, Ejlertsson G, Leden I, Rosenberg C. Chronic pain in a geographically defined general population: studies of differences in age, gender, social class, and pain localization. Clin J Pain 1993;9:174–82. https://doi.org/10.1097/00002508-199309000-00004.
Van Dillen LR, Bloom NJ, Gombatto SP, Susco TM. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Physical Therapy in Sport 2008;9:72–81. https://doi.org/10.1016/j.ptsp.2008.01.002.
Gombatto SP, Collins DR, Sahrmann SA, Engsberg JR, Van Dillen LR. Gender differences in pattern of hip and lumbopelvic rotation in people with low back pain. Clin Biomech (Bristol, Avon) 2006;21:263–71. https://doi.org/10.1016/j.clinbiomech.2005.11.002.
Mason C, Greig M. Lumbar Spine Loading During Dressage Riding. J Sport Rehabil 2020;29:315–9. https://doi.org/10.1123/jsr.2019-0266.
Scholtes SA, Gombatto SP, Van Dillen LR. Differences in lumbopelvic motion between people with and people without low back pain during two lower limb movement tests. Clin Biomech (Bristol, Avon) 2009;24:7–12. https://doi.org/10.1016/j.clinbiomech.2008.09.008.
Keogh E, Herdenfeldt M. Gender, coping and the perception of pain. Pain 2002;97:195–201. https://doi.org/10.1016/S0304-3959(01)00427-4.
Montastruc J-L, Bondon-Guitton E, Abadie D, Lacroix I, Berreni A, Pugnet G, et al. Pharmacovigilance, risks and adverse effects of self-medication. Therapies 2016;71:257–62. https://doi.org/10.1016/j.therap.2016.02.012.
Feucht CL, Patel DR. Analgesics and anti-inflammatory medications in sports: use and abuse. Pediatr Clin North Am 2010;57:751–74. https://doi.org/10.1016/j.pcl.2010.02.004.
Rosser BA, McCracken LM, Velleman SC, Boichat C, Eccleston C. Concerns about medication and medication adherence in patients with chronic pain recruited from general practice. Pain 2011;152:1201–5. https://doi.org/10.1016/j.pain.2011.01.053.
Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochemical Pharmacology 2020;180:114147. https://doi.org/10.1016/j.bcp.2020.114147.
Riordan M, Rylance G, Berry K. Poisoning in children 2: Painkillers. Archives of Disease in Childhood 2002;87:397–9. https://doi.org/10.1136/adc.87.5.397.
Jeukendrup A, VanDiemen A. Heart rate monitoring during training and competition in cyclists. J Sports Sci 1998;16 Suppl:S91-99. https://doi.org/10.1080/026404198366722.
Wadman M. How does a painkiller harm the heart? Nature 2006;441:262–262. https://doi.org/10.1038/441262a.
Bennin F, Rother H-A. "But it's just paracetamol": Caregivers' ability to administer over-the-counter painkillers to children with the information provided. Patient Education and Counseling 2015;98:331–7. https://doi.org/10.1016/j.pec.2014.11.025.
Hamson-Utley JJ, Martin S, Walters J. Athletic Trainers' and Physical Therapists' Perceptions of the Effectiveness of Psychological Skills Within Sport Injury Rehabilitation Programs. J Athl Train 2008;43:258–64.
Cherkin DC, Deyo RA, Battié M, Street J, Barlow W. A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain. N Engl J Med 1998;339:1021–9. https://doi.org/10.1056/NEJM199810083391502.
Hernandez-reif M, Field T, Krasnegor J, Theakston H. Lower Back Pain is Reduced and Range of Motion Increased After Massage Therapy. International Journal of Neuroscience 2001;106:131–45. https://doi.org/10.3109/00207450109149744.
Baird CL, Sands L. A pilot study of the effectiveness of guided imagery with progressive muscle relaxation to reduce chronic pain and mobility difficulties of osteoarthritis. Pain Management Nursing 2004;5:97–104. https://doi.org/10.1016/j.pmn.2004.01.003.
Nicholas MK, Blyth FM. Are self-management strategies effective in chronic pain treatment? Pain Management 2016;6:75–88. https://doi.org/10.2217/pmt.15.57.
Morone NE, Greco CM, Moore CG, Rollman BL, Lane B, Morrow LA, et al. A Mind-Body Program for Older Adults With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA Intern Med 2016;176:329–37. https://doi.org/10.1001/jamainternmed.2015.8033.
Cruz-Ferreira A, Fernandes J, Gomes D, Bernardo LM, Kirkcaldy BD, Barbosa TM, et al. Effects of Pilates-Based Exercise on Life Satisfaction, Physical Self-Concept and Health Status in Adult Women. Women & Health 2011;51:240–55. https://doi.org/10.1080/03630242.2011.563417.
Kofotolis N, Kellis E, Vlachopoulos SP, Gouitas I, Theodorakis Y. Effects of Pilates and trunk strengthening exercises on health-related quality of life in women with chronic low back pain. J Back Musculoskelet Rehabil 2016;29:649–59. https://doi.org/10.3233/BMR-160665.
Mokhtari M, Nezakatalhossaini M, Esfarjani F. The Effect of 12-Week Pilates Exercises on Depression and Balance Associated with Falling in the Elderly. Procedia - Social and Behavioral Sciences 2013;70:1714–23. https://doi.org/10.1016/j.sbspro.2013.01.246.
International Society for Equitation Science. 10 ISES Training Principles 2023.
Lovett T, Hodson-Tole E, Nankervis K. A preliminary investigation of rider position during walk, trot and canter. Equine and Comparative Exercise Physiology 2005;2:71–6. https://doi.org/10.1079/ECP200444.
Münz A, Eckardt F, Witte K. Horse–rider interaction in dressage riding. Human Movement Science 2014;33:227–37. https://doi.org/10.1016/j.humov.2013.09.003.
König v. Borstel U, Visser EK, Hall C. Indicators of stress in equitation. Applied Animal Behaviour Science 2017;190:43–56. https://doi.org/10.1016/j.applanim.2017.02.018.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Victoria Lewis, Zoe Nicol, Lucy Dumbell, Lorna Cameron
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.