“Most people don’t know that equestrians are more likely than combat veterans to have a traumatic brain injury,” said Ansley Grimes Stanfill, PhD, RN, associate professor and associate dean of research in the College of Nursing at the University of Tennessee Health Science Center in Memphis.

“Helmets are really the most important piece of equipment a rider can have,” she continued. “We (medical professionals) can pin your bones back together, and we can sew up your lacerations. But your brain is hard to fix, so you really need to be sure you’re protecting it correctly.”

A nurse scientist and a lifelong equestrian, Stanfill noticed riders didn’t always wear helmets or wore them incorrectly. “I saw people with chin straps flapping or with the helmet tilted way back or too far forward or people dropping them and then putting them back on,” she said, adding these issues can greatly reduce the helmet’s protective effects during a fall.

One-Fourth of Online Survey Participants Ride Helmetless

Curious about her real-world observations, Stanfill and her fellow researchers carried out an online survey over social media about helmet use. Active for 30 days, the survey resulted in 2,598 complete, anonymous responses from adult riders across the globe.

Three-fourths of the respondents stated they always wore a helmet while riding, Stanfill said. However, she added, it’s likely the actual percentage of helmetless riders is higher in the general population. The survey probably attracted people who are interested in helmets because of the topic and also because participants could qualify for a drawing to win a new helmet upon completing the survey. Even so, 25% of respondents said they didn’t always wear a helmet, with 57% saying it’s because they’re not necessary and 49% saying they don’t fit well.

Better-fitting helmets could help encourage people to wear them more often, Stanfill said, especially as technology makes that increasingly possible.

Meanwhile, better communication and education about the importance of helmets could lead to more frequent use. Professional riders could also encourage helmet use by always wearing them, she added.

Old, Dropped, Overheated, or Worn During a Fall? That’s a Risky Helmet.

Among survey participants who stated they always wore helmets, many described unsafe use, said Stanfill.

All helmets sold in the U.S. must comply with standards set by the American Society for Testing and Materials (ASTM) and the Safety Equipment Institute (SEI), she explained. So when used and fitted properly, they should provide good head and brain protection.

In practice, however, riders’ helmets are often too old, well exceeding their manufacturer-stated expiration dates, said Stanfill. Helmets should be replaced every five years, she said—and that’s not just a marketing scheme. The outer shell might look pristine, but the inner shock absorbers break down over time, even though we can’t see the wear.

“It’s like those rubber gaskets around door jambs in older cars; they start to flake and crack over time,” said Stanfill, who writes her purchase dates inside her helmets to keep track of their age. “The same thing happens inside helmets.”

For the same reason, always replace a dropped helmet immediately, as the internal shock absorbers might have been damaged, she said. That’s also true for any helmet involved in a fall. “You often can’t tell just by looking at the helmet whether or not that system has broken,” she said.

Many manufacturers offer a replacement warranty, she added, so riders should check the paperwork when they buy a helmet and keep it where they can find it later. “A lot of times if you fill out the warranty card when you buy the helmet, they’ll send you a free replacement,” said Stanfill.

Finally, riders need to be careful about helmet maintenance, she said. Extreme temperatures and humidity—such as from sweat, uncontrolled tack rooms, and hot car trunks—can lead to faster break down. People should keep their helmets clean and dry, use cleaning products meant for them, and store them at appropriate temperatures.

“Your helmet is a part of your equipment,” Stanfill said. “You clean your tack; you inspect your tack to make sure the buckles are not wearing down; you make sure that your stitching is good on your bridle; you replace them when needed … You’ve got to do the same for your helmet. It might be one of your smaller pieces of equipment, but you’ve got to treat it well because it’s protecting the most valuable piece of yourself.”

The study, “Helmet use in equestrian athletes: opportunities for intervention,”  was published in the Dec. 14, 2020, edition of Concussion.

Stanfill AG, Wynja K, Cao X, et al. Concussion. 2020;6(1):CNC85. Published 2020 Dec 14. doi:10.2217/cnc-2020-0019