Back pain in horse riders - why is it so common?

73% of horse riders, and 88% of elite riders, have significantly higher incidences of back pain compared to the general population. The riding position and forces translated to the rider from the horse’s movement are predisposing factors.

Lots of studies investigating the cause of low back pain have considered lumbar spine mobility, axial rotation, saddle type, duration and intensity of riding, leg length inequality and pelvic tilt angle; unfortunately, they found no agreement on the cause of such high rates of back pain in riders. 

My dissertation assessed many studies and highlighted muscle weakness and rider asymmetry as key contributing factors to rider LBP. This is supported by several more recent studies which have shown how differently all riders move on a horse (even between professional riders) and that this individual variation and asymmetry is the key cause of human and equine back pain.

In the presence of rider lower back pain, the ability to control the spine at every segment is lost. This causes the multifidus muscle, which also acts to stabilise the spine, to atrophy. The spine then becomes even less stable and the rider is less able to control their posture.

I commonly see this in patients who have lower back pain. They often sit or drive all day and have a very stiff thoracic spine (mid back) and stiff hips. As a result, the lower back moves more so that you can still reach forward or twist round to put your seat belt on. Unfortunately, the lumbar spine is not meant to move a lot so as a protection mechanism the lower back muscles become really tight to try and protect the hypermobile spine. The patient (or rider) experiences lower back pain and assumes that they need to have a back massage to get the tension out of the lower back muscles.

In reality, correcting the mid back and hip stiffness, as well as increasing the rider’s postural control is the best way to solve the problem. It is so important to not just rub what hurts. Like vets, farriers, dentists and riding instructors, we should all strive to understand why a particular problem has occurred rather than just fixing the immediate problem. This will provide a more holistic and thorough care of the horse and rider and prevent injuries from occurring. It is better to be proactive than reactive in the management of you and your horse’s health and wellbeing.

If you would like to read my dissertation, please do email me for a copy.