Analysis of Helmet Damage and Associated Head Injuries Arising from Real-World Equestrian Fall Accidents

There is significant difference between the loading conditions used to certify equestrian helmets and the environment in which they are commonly used. This may affect their ability to provide adequate protection against head injury during a riding accident. The efficacy of helmet performance under real-world riding conditions can be judged by examining physical damage to the helmet during an impact, along with details of any head injury that may have been sustained by the rider. The present study considered the influence of different impact events on helmet damage sustained during real-world equestrian racing and eventing accidents. Video analysis of the accidents and assessment of the corresponding helmets allowed helmet damage to be matched to impacts. From a total of 1,119 accident videos and 218 inspected helmets, there was a total of 18 cases for which both the helmet and unobstructed video views of the accident sequence were available, along with details of any injuries sustained by the rider. All 18 cases involved the riders falling from their horses and impacting their heads against the turf. For 7 of the 18 cases, head impacts occurred in which a rider's head was also either kicked, crushed, or stomped on by a horse: those subsequent impacts led to significant helmet damage, suggesting that the helmets provided protection for the riders during those secondary and tertiary impacts. Surprisingly, 11 of the 18 cases involved only a fall for which none of the helmets had any evident damage, despite 6 of those cases involving diagnosed concussions and 1 hematoma. This indicates that traumatic brain injury can occur in equestrian sports even while the rider wears a helmet, which suggests that there is scope to further improve the ability of equestrian helmets to protect against concussion when riders fall and impact their head against turf.