Video analysis of head injury incidents in equestrian sports

Current helmet certification tests involve linear impacts on rigid anvils. The associated kinematics by which a jockey falls from a horse while riding are believed to be fundamentally different to those in the certification tests, i.e., they involve oblique falls (falls at an angle) to compliant surfaces. This paper provides primary data from real-world equestrian accidents to characterise such kinematics, and constitutes a basis for future helmet developments and improvements in certification tests. The purpose of this study was to use well-documented video footage of equestrian accidents to characterise associated head injuries. 1119 equestrian accidents were collected from professionally regulated horse races and eventing during an 8-year period. Head injury incidents were analysed on a frame-by-frame basis to characterise the impact event, location, and surface. A total of 73 head injury incidents afforded a set of documentary data that were analysed: these involved 69 concussions, two hematomas, two orbital fractures, a fractured zygoma, and a fractured mandible. Based on the results of this study, priorities for future helmet designs and certification tests should be informed by the present findings. Since all of the observed cases involved the head impacting compliant surfaces (turf or sand) in an oblique manner, it is recommended that the protective capacity of equestrian helmets be assessed for oblique impacts to compliant surfaces. Furthermore, since the most frequently impacted locations were the lower region of the helmet and the mid-region on the back of the helmet, it is suggested that additional protection in these areas could be beneficial.