What the horse riding injury data shows, and where it comes from.

Every injury named on this page is one that needs medical care. Any suspected injury after a fall, kick or crush needs assessment by a doctor; nothing here is first aid or treatment guidance. The figures below are each study's published findings, not predictions for any rider.

Why the numbers do not add up to one picture

Each study counts a different population. A trauma registry only sees people injured badly enough to reach a trauma centre. Emergency-department surveillance sees more people, but only those who went to hospital. Coroners see deaths. None of them knows how many hours people spent riding, so true injury rates per ride are rare in this literature. The studies below should be read side by side, not added together.

United States: trauma centres and emergency departments

Mutore and colleagues (2021): trauma centre records

Writing in Trauma Surgery and Acute Care Open in 2021, K. Mutore and colleagues analysed the US National Trauma Data Bank for 2007 to 2016. The dataset held 24,791 adult patients with equestrian-related injuries, of whom 320 died. Head and neck injuries accounted for about 74.8 percent of those deaths. Chest injuries were the most common injury type, at about 37 percent, and abdominal injuries the least common, at about 13.5 percent. About 88 percent of the patients were admitted to hospital, and the largest age group was 50 to 59, at about 26.6 percent. The study was observational and limited to trauma centres that report to the data bank.

Thomas, Annest, Gilchrist and Bixby-Hammett (2006): emergency departments

This British Journal of Sports Medicine paper used national emergency-department surveillance (NEISS-AIP) for 2001 to 2003. The authors estimated that about 102,904 people a year were treated for non-fatal horse-related injuries, a rate of 35.7 per 100,000 population. The rate was higher for females (41.5 per 100,000) than for males (29.8).

• About two-thirds (66.1 percent) of those injured were mounted at the time. Being thrown or falling was the commonest mechanism when mounted, and being kicked the commonest when not mounted.
• The regions injured most often were the head and neck (23.2 percent), lower limbs (22.2 percent) and upper limbs (21.5 percent).
• Contusions and abrasions (31.4 percent) and fractures (25.2 percent) were the commonest diagnoses.
• The authors estimated about 11,502 traumatic brain injuries a year, and just over 11 percent of patients were admitted or transferred.

They described horse-related injury as a public health concern for riders and for anyone working near horses, and recommended prevention centred on helmet use and education. These are the newest US emergency-department figures in our research; we did not find a primary source for later years.

The literature reviews

Meredith, Ekman and Brolin (2018). Lauren Meredith, Robert Ekman and Karin Brolin of Chalmers University of Technology reviewed 151 articles on horse-related injury, 71 of them on overall epidemiology, mostly retrospective US hospital studies. In 60 of those 71, young women were the group most often involved. Of the studies that looked at mechanism, 97 percent named falling from the horse as the commonest cause. Every relevant study identified neurological trauma as the leading cause of death, and the authors noted evidence that helmets could perform better than they do.

Rigou and Thelot (2010). A. Rigou and B. Thelot of Sante publique France reviewed the literature from 1997 to 2009. Falls from the horse were the most common cause of injury. The published figures they collected were:

They found amateurs had more, and more severe, accidents than professionals, and noted French rules requiring helmets for children at riding centres and in some competitions.

Canada and Australia

Ball and colleagues, Calgary (2007). Chad Ball and colleagues at the University of Calgary, in a study announced for the American Journal of Surgery on 23 September 2007, reviewed 7,941 trauma patients at Calgary's Foothills Medical Centre from 1995 to 2005. They found 151 severely injured horseback riders, 45 percent of whom needed surgery. The injured riders averaged 27 years of riding experience, and only 9 percent of those interviewed had been wearing helmets. The team said chest trauma had been underappreciated. The university's release also cites earlier studies giving a hospital admission rate of 0.49 per 1,000 riding hours, against 0.14 for motorcycling; that comparison comes from those earlier studies, not from the Calgary data, and how the riding hours were estimated could not be confirmed.

Holland and colleagues, New South Wales (2001). Andrew Holland and colleagues, in the Medical Journal of Australia, studied horse-related injuries in children at two New South Wales children's hospitals from 1988 to 1999. Falls caused about 76 percent of injuries, and head and upper-limb trauma made up 73 percent. The state's Paediatric Trauma Death Registry recorded six horse-related child deaths over 12 years; five had severe head injuries, and none of the five was wearing a helmet. The authors recommended making Standards-approved helmets mandatory for children riding horses.

Chapman, Fenner and Thomas (2024 and 2025). Meredith Chapman, Kate Fenner and Matthew Thomas analysed Australian National Coronial Information System records of 50 human deaths involving horses, donkeys and mules from 2000 to 2020. The work was presented at the 19th International Society for Equitation Science conference (reported 29 November 2024) and published in Heliyon in 2025. Falls made up 56 percent of the fatal incidents, blunt force trauma caused 96 percent of fatal falls, and the horse was a causal factor in 90 percent of cases. We read the conference report, not the journal paper.

What the studies agree on

• Falls from the horse are the leading cause of injury in both reviews and in the New South Wales child study (Chalmers 2018; Sante publique France 2010; Holland 2001).
• Head and neurological injury dominate the deaths (Mutore 2021; Chalmers 2018; Holland 2001).
• Injured riders in these studies were often not wearing helmets (9 percent wearing in Calgary 2007; 9 to 20 percent across the French review).
• Injuries also happen on the ground: kicks were the commonest mechanism for people not mounted in the US emergency data.

Two other kinds of data sit outside these studies. The FEI publishes fall and injury statistics for international eventing, covered on the eventing safety page; in 2025 it reported 22 serious or fatal injuries and 22 concussions among international eventing falls. The British Horse Society publishes road incident figures, covered on the riding on roads page; over 2016 to 2025 it recorded 8 people killed and 999 injured. For what the helmet rules require, see helmet rules and history, and for how bodies handle head injury in competition, see concussion protocols.