Badminton competitor suffers traumatic brain injury in fall

The equestrian world is still in shock with the news that Emily Gilruth, an experienced British eventing rider, is in intensive care after falling from her horse at this year’s Badminton Horse Trials.

The 40 year old from Cheshire was at the third fence of the cross country course last weekend, when she fell suffering a traumatic brain injury. Badminton’s medical team were quickly on the scene and Emily was airlifted to Bristol’s Southmead Hospital where she remains under sedation.

Serious accidents like Emily’s serve to remind us all about the inherent risks associated with sports like eventing. While there are dangers in any sporting activity, some reports suggest that horse riding could potentially be up to 20 times more dangerous than motorcycling.

In fact, it’s estimated by the British Horse Society that there are more than 4,000 horse-related accidents every year in the UK. The society believes the actual figure is probably far higher as many accidents go unreported.

Sadly, fatalities do occur. In 2011, there were eight horse riding deaths on UK roads and British Eventing recorded one death in competition between 2010 and 2011. More recently, just last month, James McNeile, an amateur jockey from Devizes was competing in the Point-to-Point meet at Larkhill when he fell, hitting his head on the fence and tragically died the following day. He had sustained a traumatic brain injury.

Of course, serious injuries and death are not restricted to riding itself; accidents also occur on the ground, if for example, a rider is kicked in the head or chest.

There are significant numbers of soft tissue or muscular-skeletal injuries that could cause long-term pain and disabilities that may not require hospital treatment.  Of those that are seen at the hospital, head injuries are the most common representing about a fifth of the total.

While the majority of head injuries may not be severe, it is now widely acknowledged that even minor head injuries can have a significant impact on riders.

With any bump to the head, concussion can be a serious concern. According to the Medical Equestrian Association, concussion has been under-diagnosed in the past. While its effects can be short-lived, it’s now widely understood that symptoms can go on for much longer periods of time. Repeated concussions are an area for particular concern.

It is therefore imperative that concussion protocols are implemented when riders sustain what appears to be a concussion. The ‘Pocket concussion recognition tool’ is a useful aide to help identify concussion warning signs.

Preventative measures

At the elite level in which Emily Gilruth competes, all preventative safety measures would have been taken. Organisations such as the British Horse Society, the British Horse Racing Authority and British Eventing have good systems in place for monitoring accidents and injuries.

At a more grass roots level, risk management is equally as vital. This should be undertaken by all qualified instructors and organisations involved in the sport.  Adult riders too, need to take responsibility for their own safety. This means assessing the risks while they are horse riding – for example, whether that’s deciding not to take a particularly nervous horse out on to a busy road or deciding not to go faster than a trot on very slippery ground.

It’s also of paramount importance for riders to double-check their tack and their personal protective equipment to ensure that it is in good working order.

Protective riding hats are responsible for a significant reduction in the proportion of fatal head injuries recorded in the USA over the last 30 years. However, while riding hats can reduce the risk, they do not remove it entirely.

For eventers, British Eventing has made steps to try and ensure that horses and competitors are as safe as reasonably possible. For example, new riding hat regulations came into force in January 2017 and air jackets are increasingly being used during the cross country event. The updated regulations can be found on the British Eventing website.

These are very worrying times for Emily’s family and friends. As a talented horsewoman with more than 18 years’ experience of British event competitions, who also runs her own livery yard, horse riding and competing is a way of life and she would have been well aware of the dangers of her beloved sport.

With any traumatic brain injury, it can take some time for the extent of the injury to be known and what the future prognosis will be. It is encouraging to hear that Emily’s condition remain stable and it is hoped that she will go on to make a good recovery.