Horse Riding Concussions: What I Wish I’d Known

This article is part of our “Rookies Horsing Around” series, guest authored by Emily and Sarah Harris of Sisters Horsing Around.

Getting back in the saddle isn’t always the right decision

Concussions are a type of traumatic brain injury (TBI). They are a very common, but very serious, injury that equestrians should be aware of and educate themselves about. Lots of studies and research have been done so we can help make our sport safer, know how concussions occur in our sport, and understand how we can better prevent them.

The helmet industry is always expanding, creating new technologies, and innovating safety technology. Even though wearing a helmet lessens the force of impact, it doesn’t prevent concussions.

So what do you do besides wear a helmet? First, you need to be aware of the signs and symptoms of concussion. This is important because if you, someone you know, or even someone you are watching falls and hits her head, quick action is critical.

Earlier this year, I sustained two concussions within a two week period. I knew about concussions in general, but I wish that I (and those around me) were more aware of the symptoms. We certainly would have done some things differently!

March 11th: My First Concussion

My sister Sarah and I were at our trainer’s facility where we are working students. We had been riding two inexperienced drafty horses that were brothers. I rode Chip and Sarah rode Charlie. Charlie was a sweet boy that could be headstrong at times.

Chip was anxious, mistrusting, and a whole LOT greener than I was initially told.

The barn team saw that Chip liked me and that we were making quick progress, so Sarah and I went on a trail ride. Charlie did well, and Chip wasn’t too bad…but he had his issues. He was very cautious and nervous, and I noticed he did not like going down hills.

Close to the end of our ride, we were heading downhill when Chip stepped on a leaf. The crackling sound spooked him, and he bucked. (Yes, all it took was a little leaf!) It threw me out of the saddle and I landed on his neck, slid down the side, then landed on some rocks by his feet.

Chip could have stepped on me, but thankfully he didn’t. Instead, he took off up the hill, ran into Sarah and Charlie, then beelined towards some horses we had passed on the trail.

I got up to go catch Chip while Sarah called the barn staff to let them know what happened. Once he was caught, I took Chip to a round pen so he could let off some steam. He had worked himself up to a frenzy, and he wouldn’t stand still long enough for me to remount (luckily).

By this time the barn staff and one of our trainer’s had come over to see if I was okay. When Chip settled down a little, my trainer held him while I mounted up and rode back to the schooling barn. I untacked him and turned him back out like usual.

And how did I feel? In a word, I felt terrible.

I was sore and a bit slow, but I was still sharp minded thanks to adrenaline. Plus, I had a head splitting headache. When I got home, I laid down for 4 hours and slept off my headache. When I got up, I noticed my body had slowed down significantly, but it wasn’t enough to be noticeable by anyone except myself and Sarah.

March 23rd: My Second Concussion

Two weeks later, I felt pretty good. My neck still hurt because of the rocks I had fallen on, but I was ready to ride. (Or, so I thought.) My trainer told us that we would be schooling cross country and that Chip and Charlie had enough progress to go in the cross country field.

I was excited. I didn’t foresee that ride would take a turn for the worse.

It took some time to persuade Chip to go down to the field, but we made it. He did fairly well. After warming up we started jumping. There was Sarah, myself, and another girl training either green or difficult horses. My turn had come up for a little log jump, and Chip and I trotted to it. He ran-out the jump, then turned sharply to the left which sent me flying in the opposite direction.

The force was enough to twist me backwards, and I slammed into the ground. My back and head took the brunt of the impact.

I felt completely jarred and confused. I couldn’t figure out how I had gotten turned around. What was only seconds felt like minutes.

I went through a quick mental check of my body and decided I was okay.

I got up to catch Chip, who was waiting patiently for me a short distance away as though nothing had happened. My trainer reached him first, and we started talking about the fall as I walked over. I had just shifted my weight left when I felt my leg shaking. Seeing my leg shaking seemed very odd to me, but I kept on listening to what my trainer was saying.

I then prepared myself to mount up and decided to test my left leg first. As soon as I had put weight on it, my eyes rolled up, and I fainted.

I quickly regained consciousness, but was totally confused and scared to tears. I RARELY cry when I am hurt and I NEVER cry when I am scared. I tried to laugh it off, but the tears kept coming. My trainer’s back was to me when I fainted, so she missed it. When she saw me on the ground, she asked what I was doing. “I don’t know.”

Sarah had seen the whole thing, and she told them what happened. Then came the usual questions you ask a person when they are not acting normal. I was asked multiple questions, by three different people, and I answered correctly—but slower than usual.

I got up, and they pointed out a jump for me to sit on. In my confusion I turned and went the opposite direction. They redirected me, and I rested for a while to get my bearings and talk through what happened.

But if you thought that I was done for the day, I am sorry to say I was not.

I ended up getting back on Chip and riding him for another 30 minutes—through more trails, crossing a creek, riding around the cross country field, and finishing in the arena.

Nope, I didn’t stop there either.

I went and did evening chores at the main barn, which has ten horses, all by myself. Once my work was done, I drove Sarah and myself home.

The Aftermath:

The next day, I woke up not feeling the greatest—it wasn’t enough to keep me home. My parents were very concerned, but I reassured them I was fine.

I drove Sarah back to the barn, and we did morning chores. One of the barn managers asked if I was okay, and I nodded and said “I’m here.” That was all I could muster.

After I finished at the barn, I couldn’t do anything else. I felt dizzy, lightheaded whenever I bent over, extremely slow, and  couldn’t lift as much as usual.

I felt nauseous and like I could vomit, but I didn’t have anything in my stomach to throw up.

I was extremely sore, and I had a killer headache. I went and laid down to sleep off the headache, but it didn’t work.

Sarah told the others that I was done for the day and called our parents. They picked us up and took me to an immediate care doctor. Because of COVID restrictions, I had to go in by myself and explain the situation.

Thankfully, my fall and faint were videotaped so the doctor could see exactly what happened. She immediately transferred me to the emergency room where they issued a level 2 trauma alert.

I was rushed to a critical care room on a stretcher with a neck brace around my neck.

The room quickly filled with nurses and a new doctor, like you see in the movies. I had x-rays, a CT scan, and an IV. I was in the emergency hospital wing for hours! 

The tests showed that I didn’t have any broken bones, fractures, or hemorrhaging. But I was diagnosed with a concussion.

I was finally discharged with a referral to see a concussion specialist doctor within a week. At my appointment, I had to take an Impact Test that measured my motor skills, memory, and speed. My balance and strength was checked as well.

The results of my concussion tests were sobering.

Out of 100, my ability to remember words and animals was at 60, shapes and patterns were at 40, and my speed and balance was at 4 and 1. As for strength, my left side was significantly slower and weaker than my right side.

I also learned that when I had fainted in the cross country field, that was considered a THIRD fall.

Two weeks earlier, I hit my head when Chip spooked at the leaf. Then, I hit my head again when I fell at the log jump. When I fainted, it was yet another fall and blow to my head. I hadn’t thought about it like that before that moment.

The specialist said I would need 8 weeks of recovery and 6 weeks of physical therapy. I was not allowed to ride until I had completed therapy.

I couldn’t work with my horses, muck out stalls, or even be near excitable horses. The risk of having another fall and head injury were simply too high.

I was allowed to use a smartphone and computer, since that is necessary for the work I do. But I had to drastically limit my screen time.

Here’s a video I posted on Facebook about my experience.

What You NEED to Know

Here’s the thing about concussions: you don’t have to be on a horse to get one and you don’t have to fall off to get one either.

A concussion is any blow, bump, or jolt to the head that causes it to either move back and forth or twist. Concussions can also cause permanent nerve damage to your brain, which could affect the rest of your body and mental and emotional health.

Here’s a helpful video overview of concussions:

Knowing how to spot concussion symptoms is so important!

It’s also a good idea to educate your non-riding friends and family so they can help if you hit your head. You can’t rely on your own decision-making skills, as my story clearly shows.

According to the CDC, there are two types of signs and symptoms:

• Typical concussion symptoms
• Dangerous concussion symptoms

Knowing both sets is crucial because it will give you an idea of what is going on and help you relay information to your doctor. Concussion symptoms can also play tricks on you. They might not show up right away and can take hours or days to become apparent.

Thinking back, I displayed almost every sign and symptom (from both categories) the day I fell off at the jump through the day I went to the ER.

That is why it’s so important to STOP riding after any impact to your head.

It’s 100% okay not to get back on, even if you were bucked off, thrown, or fell while jumping.

As equestrians, we are trained to think that we need to get back on so that your horse doesn’t think it has gotten away with unacceptable behavior. But making sure that you are safe is more important than getting back into the saddle.

Your horse can wait another day, and you can always fix what went wrong later.

Your brain cannot wait.

Ignoring and pushing through your symptoms will only make things worse. Healing takes time, and the longer you wait to get things checked out the longer your recovery time will be.

You are also much more likely to have another concussion while the brain is still healing. Repeat concussions, like mine, can increase the time it takes to recover.

After you (or others) have identified the symptoms, stop whatever you’re doing and go see a physician!

Once you have visited your doctor and have a prognosis, recovery begins. This will look different for everyone. Some brains recover quickly, and others recover slowly.

Recovery time is based on the severity of the concussion—the more severe it is, the longer it will take to heal.

My doctor told me that I had a pretty bad concussion, so I did all that I could to recover properly. Luckily, I was able to be ‘released’ two weeks earlier than my original prognosis.

Also, my concussion specialist told me that the way I had hit my head would have been much worse if I was an “ordinary” person. Because I was very active—an athlete and an equestrian—my balance starting off was better than the average person. (Go “Team Equestrian!”).

That meant that my concussion affected me a bit less than it would have affected a non-athletic person.

Once you have recovered and are released to ride, do not jump back into your old routine right away.

Make sure that you ease yourself back into work. You don’t want your body to have a negative reaction to the sudden change.

Another thing that you will need to be aware of is Post Concussion Syndrome (PCS). This is where you experience concussion-like symptoms weeks or even months after your initial concussion. If you suspect that you are dealing with PCS, contact your doctor immediately.

Mind Your Melon

I even don’t want to think about what could have happened if I hadn’t been wearing my helmet during all three falls. In hindsight, though, I should have replaced my helmet after the first fall. (Even if you don’t have an accident, helmets should be replaced every five years.)

Any time your helmet is involved in a fall or impact-related incident, it must be replaced.

Preventing another concussion is absolutely critical, and your helmet may have internal damage you can’t see from the outside.

Investing in a high-quality helmet is huge. Even when you’ve fully recovered, your brain has been compromised and is more susceptible to another concussion.

Frequently Asked Questions

Can I ride a horse with a concussion?

Never get back on a horse after you hit your head without consulting a doctor. If you’ve sustained a concussion (or other injury), your ability to make good decisions is severely impacted. You may think you’re able to ride, but your balance, memory, and other functions may be impaired. 

When in doubt, sit it out!

Does horse riding cause brain injury?

Falls are some of the most common riding-related injuries, and any head impact sustained in a fall can be serious. Even if you’re wearing a helmet, you can still get a concussion. 

Does a helmet prevent concussions?

According to the CDC, helmets are not designed to prevent concussions. But they DO help prevent skull fractures and other serious brain injuries. All equestrians should wear helmets while riding—and it’s never a bad idea to wear a helmet on the ground around horses either!

Parting Thoughts

I am pretty sure you have noticed some huge red flags from my own experience. You might have also wondered why I waited so long after having such a major fall to get checked out by a doctor.

It’s okay, I have had to answer that question multiple times.

As equestrians we have been taught to “get back on the horse.” We also are a very tough group of people. If we get hurt, we try to tough it out.

Even though the word “concussion” was mentioned to me several times during my experience, I still didn’t think I had one. For the most part, I felt okay enough to continue as normal.

That’s the thing with a concussion: because it is a brain injury, your ability to make good judgement calls is SIGNIFICANTLY reduced.

For some, their concussion might not be that bad and they recover quickly. Then there will be some who recover fine, but the after-effects are not so good, and there will still be those that don’t recover quickly and experience a lot of difficulties.

As of now, I am doing pretty well and should improve more as time goes on. I have been working on training myself to get back to where I used to be both physically and mentally. It just takes time.

If you have had a concussion before, there are many others who know what you are dealing with. Join an online concussion group or develop a relationship with someone you know who has had a concussion before. They can be a big help in advising, supporting, and encouraging you.

You only have one brain. Educate yourself, be mindful, and stay safe!

P.S. Enjoy this article? Trot on over to:

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