Concussion Protocols and Riding
What is a concussion?
Concussion is a brain injury caused by a knock to the head or anywhere on the body, where the force is transmitted to the head. For Equestrians, it is more often caused by a fall. Concussion involves temporary; neurological impairment. The symptoms may evolve over the hours or days following the injury. It is important to remember that all concussion is serious and should be assessed by a doctor. The growing concern is both repeat concussion and protentional long term health effects.
Concussion affects all Equestrians at all levels and disciplines, from the part time recreational rider to the full time professional. It is often not easily recognised and can evolve hours and days following the fall/ trauma and is important to remember that ~30 % of cases will have ongoing long-term symptoms.
Signs and symptoms can vary from obvious symptoms and nonspecific symptoms, so being cautious and monitoring anything out of normal is important. Some obvious signs and symptoms include:
- Loss of consciousness
- Impact seizure or tonic posturing (can be a sign of brain damage, esp. stiff leg posture, clenched fists and arms bent to hold the hands on the chest)
- Confusion, disorientation
- Memory impairment
- Dazed, blank/vacant stare or not their normal self
- Behaviour changes atypical of rider
- Balance disturbance or motor in coordination
- “feeling off or foggy”
- Rider reports significant, new, or progressive concussion symptoms.
- Should symptoms become more severe, get weakness or tingling in arms or legs, neck pain, double vision etc take IMMEDIATE medical action.
Management of concussion:
Immediate management includes not driving, remaining in the company of a responsible adult to monitor your symptoms as well as avoiding alcohol, aspirin, anti-inflammatories and sleeping medication, unless otherwise advised by a doctor. If diagnosed with concussion, Riders require immediate physical and mental rest; this allows the brain to recover. This includes time off school, work, exercise and a significant reduction in screen time (phones, laptops, TV) and reading to allow the brain proper time to rest.
It is important to note that children and adolescents under 18 years take longer to recover and is recommended a more conservative approach towards concussion management.
A gradual return to learning, work, training and sport is recommended to allow the brain to progressively load without aggravating symptoms, with regular breaks to allow time to recover. It is usually recommended 24 - 48 hours after sustaining a concussion to start a gradual return to normal activities.
The recommended stages of Return to Equestrian Activities (as found on Equestrian Australia)
Stage 1- rest = NO ACTIVITY for cognitive and physical rest. This includes no handing or interacting eg. Feeding or riding your horse
You are not recommended to progress to stage 2 until you are asymptomatic.
Stage 2- light aerobic training- walking, light mobility exercises, light yard duties eg. feeding horse, NO riding
Stage 3- Progress to equestrian specific exercise eg. Flat work, slow trail riding, Slowly increase your off horse exercise intensity
Stage 4- Gradually increase training intensity eg. Pace, duration, terrain
Stage 5- After medical clearance- return to full training
Stage 6- Return to Equestrian Competition
*If at any stage you become symptomatic you must return to stage 1 for ~24 hours before attempting to progress to the next stage.
*Request a copy of your concussion medical clearance to bring to your first event post- concussion as you will need clearance (if fall occurred at an EA event)
It is important to take concussion seriously and follow the recommended post-concussion protocols as this will increase your chances of recovery and hopefully reduce your risk of developing ongoing headaches, balance issues, light or noise sensitivities, mental health concerns and neurological conditions. Should any changes or symptoms occur seek medical advice.
