Concussions and Equestrian Canada’s Return To Play Rule

Effective as of January 1st, 2017, EC has implemented a brand new concussion-related policy, Article A101 Accidents & Return To Play to help make the sport safer for all participants.

According to Parachute (a Canadian based charitable organization that is dedicated to helping prevent predict-able and preventable head injuries), “A concussion is a common form of head and brain injury, and can be caused by a direct or indirect hit to the head or body. With a concussion, there is no visible injury to the structure of the brain, meaning that tests like MRI or CT scans usually appear normal.”

As Equestrians, we understand the inherent risk of getting on an animal weighing over 1000lbs, moving at speed, with a mind of its own. Or maybe we don’t, since we continue to swing a leg over on a regular basis anyways! Several studies have been performed in recent years high lighting contact sports and Traumatic Brain Injuries (TBIs). Horseback riding has ranked high as a cause for TBIs among sports such as football, hockey, rugby, and skiing.

As we learn more about TBIs and how post-concussive symptoms can impact our brains, bodies, and daily life – it is becoming increasingly important to minimize the risk.

Organizations such as Riders4Helmets, aim to get everyone wearing a helmet, EVERY time they get on a horse. Even “just walking” on your horse can subject you to very serious injury in the event of an accident! Wearing a helmet is the only way to protect your head from serious injury, although wearing a helmet does not completely eliminate the risk of concussion!

Immediately after a fall, you may feel completely fine, as concussion symptoms may take hours or days to appear. When you get back on to ride or compete with a concussion, you put yourself at unnecessary risk of suffering from another blow that could cause Second Impact Syndrome with devastating, life changing consequences.

In order to help limit the risk of re-injury soon after a concussion, EC has now implemented the Accidents & Return To Play rule. Here are some important excerpts from the 2017 Rule Book:

ARTICLE A101 ACCIDENTS & RETURN TO PLAY
  1. This rule is applicable to all competitors (including foreign) at EC sanctioned events and applies to falls/accidents that occur at the event location.
  2. In the event of a fall/accident where a concussion can be reasonably suspected, (not limited to a direct blow to the head or loss of consciousness), the competitor must receive medical clearance by qualified medical personnel onsite, through the EC Accident Injury Report Form before continuing. . The competitor is solely responsible for ensuring the onsite medical assessment takes place by the onsite qualified medical personnel. If the competitor refuses to be evaluated, he/she is disqualified from the event.
  3. If the qualified medical personnel suspects a concussion (regardless of symptoms displayed), or believes that the competitor may be at risk of concussion due to the nature of the fall or impact, the competitor is suspended from competition until medically released, as outlined in paragraph 6 below.
  4. Any competitor suspended from competing further at the event on the basis of any of the preceding paragraphs will be placed on a medical suspension list, man-aged by EC, until medically released as in the process described in paragraph 6.
  5. In the event a competitor is determined ineligible to compete per one of the above conditions, the competitor must submit the EC Return to Play Form to EC, completed by a licensed physician. The EC Return to Play Form will be processed by EC within two business days, at which point the competitor will be removed from the EC Medical Suspension list and may return to regular competition. If the competitor wishes to compete after being medically released by a physician but before the EC processing period of the form, the competitor must also submit a copy of the EC Return to Play Form to the show secretary. In this case the competitor is competing at their own risk and may be pursuant to fines and penalties if the form is found to be incomplete in any way.
  6. No competitor shall compete in an EC sanctioned event while on the EC Medical Suspension List. It is the responsibility of the competitor to refrain from competition and the competition organizer may refuse entry to anyone currently on the EC Medical Suspension List.

Although some riders may consider this rule to be inconvenient at times, Canada’s Equestrian governing body is doing what they feel necessary in order to limit the risk of re-injury and the devastating effects it can have on riders. In the long run, would it not be more convenient to sit out a few days of riding and/or showing, as opposed to the rest of your life?

Concussion Signs and Symptoms

Below are some common signs and symptoms of concussion. It is important to note that although symptoms of concussion usually appear immediately after the blow, it may take hours or days before they appear. When a rider has suffered a blow to the head or body in a way that could cause the head and brain to move quickly back and forth, it is important to take immediate action. Do not let the rider get back on their horse, and if they are unconscious – call 911 immediately and do not move the rider unless you are trained to do so!

Physical Symptoms
  • Dazed/stunned
  • Headache or neck pain
  • Nausea/vomiting
  • Poor coordination and/or difficulty balancing
  • Dizziness
  • Blurred or double vision
  • Sensitivity to light and noise
  • Ringing in the ears
  • Drowsiness or insomnia
  • Fatigue
  • Numbness/tingling
  • Loss of consciousness or responsiveness
  • Seizure or convulsion
Cognitive Symptoms
  • Amnesia
  • Feeling mentally foggy or slowed down
  • Difficulty concentrating or remembering recent information
  • Confusion
  • Repeats questions
  • Forgets instructions
  • Does not know the activity/class they were participating in
  • Easily distracted
Behavioural/Emotional Symptoms
  • Irritable
  • More emotional than usual
  • Nervousness or anxiety
  • Feeling sad or depressed
  • Drowsiness
  • Difficulty falling asleep
  • Sleeping more or less than usual

It is important for all riders, coaches, barn owners, and staff to be able to recognize the symptoms of concussion in order to ensure immediate attention, safety, and proper care for boarders, students, and peers. The parents/guardians of those under 18 should always be notified, as well as coaches and trainers of the riders if they were not present when the fall happened. Riders who compete in other sports should also refrain from doing so, and notify their coaches so as to avoid the risk of a second impact before the brain is able to heal itself and recover.

The Ontario Equestrian Federation (OEF) provides a page on their website dedicated to safety that includes helmet safety, concussion prevention, brain injury information, and return to play guidelines. More information at: horse.on.ca/programs/safety. Click here

The Center for Disease Control (CDC) has also developed an app called Heads Up, that will help riders learn to spot a possible concussion, and what to do if you think a concussion or brain injury has occurred. This app includes information about helmet safety and how to select the best helmet and fit for each rider! More information here.

Always remember that helmets are designed to diffuse and absorb energy in the event of a fall or blow to the head. This means that although it may show no sign of external damage, the helmet likely sustained internal damage in order to disperse the energy of the impact. This means that you MUST IMMEDIATELY replace your helmet after impact. Using a helmet that has sustained damage means that it will not be able to absorb as much energy as it was designed to in the event of a second impact!

Helmets should also be replaced every 5 years, or as recommended by the manufacturer, as sweat, heat, rain, etc can cause deterioration to the helmet overtime, and thus limit the ability of the helmet to absorb impact. Replacing your helmet every 5 years could also mean improvements in technology, safety standards, and fit that will help better protect your brain in the event of a fall/impact.

You cannot replace your brain (yet anyways), so make sure you strap on a properly fitting helmet EVERY time you get on your horse! A little bit of helmet hair is well worth the price of protecting your head!!

For more details, visit Equestrian Canada to view a digital copy of the rule book. Click here

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