Certain legends become self perpetuating, and back pain in equestrians is among them. As a spine care specialist and neurosurgeon, I literally built a career getting riders back in the saddle after being told by their physician that back pain meant that they should cease riding. A look at this issue reveals that, while there is a correlation between riding and back pain, it is no greater than many other activities. There are reasonable ways to prevent and treat back pain in riders. The book titled The Rider’s Pain Free Back goes into extensive detail, but here are some of the highlights.

Let’s look at history to see if there is a correlation. No place is more historic than Pompei, Italy. This was an entertainment center for Rome, and was frequented by politicians and the military, the two classes of equestrians of the era. Riding in stirrup-less saddles would inspire these people to frequent the taverns of Pompei. All of these had a marble step in front of their bar, the early equivalent of the brass rail. As the
patrons flexed a hip to place a foot on the step, it would alleviate their sciatica, thus inspiring them to stay longer and drink more, possibly producing further relief. The addition of stirrups lessened seat contact, but rider populations increased and back pain became entrenched in their ranks.

Both horse and rider play an equal part in preventing and treating back pain. First the horse. There are two gait groups of horses as far as back pain is concerned. The horizontally gaited ones, of which Arabians, Tennessee Walkers, and Paso Finos are examples, have a gait where force is directed horizontally. This means less upward impact on the base of the rider’s spine. Vertically gaited horses , such as some Morgans and Hackneys, are more animated in their movements and have a measurable increase in upward impact against the rider’s spine. These are generalizations, and there are notable exceptions within all breeds. Add the rider, and you add what I call harmonics. Harmonics are the natural movements of the particular rider’s spine and how they blend with those of a particular horse. The smaller rider may be capable of more rapid spine flexibility movements, much like the guards in basketball. The tall thin rider will generally have a more willowy natural spine movement capability. My advice is, no matter how good that black horse looks, you need to try him out first. My experience has suggested that the sitting trot is the quickest way to find out if harmonics are present. If the sitting trot is comfortable, you’ve got something.

Let’s now look at who are today’s riders. If you look at American riders as a pie chart, the biggest piece is a middle aged woman who recreationally rides what is most likely a Quarter horse. These baby boomer women are an economic force that spends millions on horses now that their children have grown and they have time and money to pursue their girlhood dreams. Unfortunately they are starting to suffer from natural processes of aging, which made them fill my office seeking relief and the chance to continue riding. For the majority of them, the answers were in proper horse and tack choices, improved
flexibility and strengthening, and appropriate medications. Having discussed horse choices, let’s move to exercises to improve flexibility and strengthening. Flexibility comes first, because tight muscles and ligaments won’t strengthen properly. The internet is full of stretching exercises, or you can consult the
above mentioned book for rider specific ones. What is important is to not only stretch before riding, but after the ride. Riding doesn’t transfer to any other human activity, so stretching afterward allows your muscles to “reset” for the next activity. Without this reset, your next activity won’t be effective, and back pain will result. Strengthening should always be done in an isometric mode. Multiple repetition exercises don’t work for riders’ strengthening. Don’t do a lot of reps. Do an exercise where you hold a position for a longer time, just like in riding. If it bores you, just increase the weight resistance.
Medications deserve special attention. These should be used under your personal physician’s direction in concert with any other medications used. Antiinflammatory medications used appropriately are a savior to many riding careers. Some of them can reduce blood clotting capability. Riding is a contact sport, and sometimes involves unscheduled decelerations. The normal bleeding and bruising that may occur can be
significantly increased in the presence of certain anti-inflammatory medications. Properly utilized, not only do anti-inflammatory medications lessen the discomfort of aging muscles, joints, and ligaments, but they also significantly decrease dementias such as Alzheimer’s, so that we can enjoy our horses more. Keep riding. JSW

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