Panel of experts drafts consensus statement and recommendations for female equestrian health and wellness outcomes
In 2018, Karin Pekarchik, MS, senior extension associate for distance learning, and Kimberly Tumlin, PhD, MS, MPH, assistant professor in the Department of Epidemiology, College of Public Health and the Equestrian Athlete Initiative director for research for the Sports Medicine Research Institute, cofounded the University of Kentucky Female Health and Wellness Community of Practice (CoP) to focus on equestrian health, inviting international researchers, instructors and practitioners in fields related to equestrianism to become members.
The purpose of the community of practice is to bring together equestrian researchers and industry practitioners to discuss the current status and future challenges of equestrian health and wellness and to serve as a centralized resource for communities, researchers and citizen scientists.
Collectively, that CoP drafted a consensus statement that also included proposals and recommendations. This international community of practice was an initiative of the University of Kentucky Female Equestrian Health and Wellness CoP.
The CoP’s consensus statement on female equestrian health and wellness outcomes provides six proposals and corresponding recommendations to guide researchers, organizations and equestrians.
The proposals are:
- More scholarly research is imperative to improving health and wellness outcomes of riders and to the economic prosperity of equestrian sport.
- Equestrian athletes should receive or have access to sport-specific guidelines and training to address the physical and psychological skills required within each discipline of riding in order to promote health and wellness, improve safety and prevent injury and encourage full participation throughout recreational and professional athletic pursuits and careers.
- Female equestrian health and wellness issues differ from male issues due to biological (sex) and gender (social and cultural) distinctions.
- Female equestrians should have and will benefit from access to female-sport-specific guidelines and training designed to address female sex and gender needs and expectations.
- With these sex and gender distinctions in mind, research on topics specific to female health promotion and injury prevention and educational programs designed for female well-being within equestrian sports should enable female riders to avoid unnecessary pain and to participate fully in recreational and professional pursuits.
- Athletic equipment and apparel serve to protect, preserve health and promote optimal performance. Both equipment and apparel designers and manufacturers should consider female anatomy and physiology so that their products can maximize female equestrian function and wellness.
- Clearly defined development tracks within equestrian disciplines and trades should become a priority for the industry.
- Many equestrian sports are sex-integrated, with males and females competing against one another. However, equestrian pursuits are not fully equitable, and all organizations within the equestrian industry should ensure parity of the sexes in opportunities, roles, responsibilities and compensation.
The CoP recommends an increase in grants for, commitment to and engagement in broad research and educational programs covering multiple categories related to the physical and psychological health of riders, with particular emphasis on understanding equestrian sport-related issues encountered by females, who comprise the majority of equine enthusiasts. In order for the equine industry to thrive, safety, honor and equity should be priorities throughout all levels of employment, academics, management and leadership.
The consensus statement summarizes the opinions of a panel of experts. Criteria for membership included applied experience, proficiency in research and global representation. This process led to the selection of the following panel, (listed alphabetically):
- Liz Barrett, DVM, MS, DACVS (United States)
- Alicia Benben (United States)
- Jenny Burbage, Ph.D. (Great Britain)
- Fernanda Camargo, DVM, Ph.D. (United States)
- Lorna Cameron (Great Britain)
- Sarah Jane Cullen (Ireland)
- Kate Dashper (Great Britain)
- Lucy Dumbell (Great Britain)
- Sonja Gagnon (Canada)
- Jennifer Glass, Ph.D. (United States)
- Dixie Hayes (United States)
- Morgan Hayes, Ph.D., P.E. (United States)
- Holly Heartz, Board Certified in Sports Nutrition, MS (exercise & sport science), IOC diploma in sports nutrition, PhD (c) (Canada)
- Joy Hicklin, D.P.T., D.Min, M.H.A. (United States)
- Peta Lee Hitchens (Australia)
- Hanna Hoch, Ph.D., ATC (United States)
- Victoria Lewis; Laura H. Long, PT, ATC, CSCS
- Staci McGill (United States)
- Mary Midkiff (United States)
- Glenye Oakford (United States)
- Karin Pekarchik (United States)
- Susan Pollack, MD (United States)
- Sabine Schleese, B.Sc., MBA (Canada)
- Kate E. Snyder, Ph.D. (United States)
- Natalie Stones (Great Britain)
- Kimberly Tumlin, Ph.D. (United States)
- Andrea Whittle (United States)
This paper mimics the format of “Consensus statement on improving the mental health of high-performance athletes,” published in January 2019 in the International Journal of Sport and Exercise Psychology. The University of Kentucky Female Equestrian Health Community of Practice would like to thank the authors for their inspiring work, which helped shape this paper, and for providing permission to follow their format.
A thriving equine community requires healthy equestrians and organizational cultures. Optimal female health and wellness encompasses sport and work and influences and shapes a prosperous equine industry. This consensus statement intends to inform and inspire research, education and training focused on female equestrian health and wellness. The consensus statement also aspires to stimulate dialogue about and invite exploration into the integral relationship between female flourishing and the advancement of equestrian sports.
Well-designed empirical investigations, educational programs, training and equipment will foster holistic growth within the equine industry. Concentration on physical and psychological preparation for sport including discipline-specific biomechanics and mental skills should enhance overall equestrian health and performance outcomes. Since girls and women predominate within equestrian pursuits, scholarly and applied emphasis on issues related to the female sex (biological) and gender (social and cultural) should serve to promote comprehensive health and wellness within the equine industry.
The CoP advocates for pathways of development through apprenticeships, certifications higher education and mentoring of girls and women within (equestrian) sport and business. Achieving symmetry of male and female leadership and diversity within organizations while honoring the dignity and contribution of each individual, regardless of race, sex or gender can reap benefits for all.
The multi-faceted and multi-disciplinary equine industry involves complex interactions between horse and rider, has highly varied levels of participation and contributes to considerable economic impact. Opportunities for research abound. More scholarly research is imperative to improving health and wellness outcomes of riders and to the economic prosperity of equestrian sport.
Broad research should be conducted covering categories such as attraction to the equine industry; access; leisure, amateur and professional participation; biomechanics of horse and rider; environmental exposures; psychological aspects of equestrian sport; equipment and apparel; and local, regional, national and global economic viability and vitality.
Beyond the agricultural work and transit that the horse afforded humans for centuries, human intrigue with this majestic creature remains strong, and the equine industry ever expands to include recreational, amateur and professional handling/riding, competitive racing, dressage, three-day events, hunters and endurance disciplines as well as breed-specific showing. Equine-assisted activities including physical, occupational, and psychological treatments prove beneficial. Youth clubs, collegiate activities, discipline-specific associations and federations celebrate and regulate riding. Although engagement within the industry differs according to interest, access and abilities, all levels of equine enthusiasts have a critically important need for reliable information, systematic instruction and proper equipment to avoid harm and to foster fulfillment in human aims involving interactions with horses.
The wide range of equestrian activities and audiences influences local, regional, national and global economies. Within the United States, cities and states that profit from the effects of equine business include Louisville, Kentucky; Lexington, Kentucky; Wellington, Florida; and Tryon, North Carolina[KP1] , (and others). Nationally, the United States, the United Kingdom, France, Germany, Australia and other countries also experience significant economic gains from equestrian enterprise.
Equestrian athletes should receive or have access to sport-specific guidelines and training to address the physical and psychological skills required within each discipline of riding in order to promote health and wellness, improve safety and prevent injury and encourage full participation throughout recreational and professional athletic pursuits and careers.
Individuals, equestrian federations and other equestrian organizations should seek and benefit from resources and/or partnerships provided by credentialed professionals and scholars. Equestrian federations and organizations should model other sports’ governing bodies that have rolled out specific and comprehensive guidance specific guidance related to preparation for, participation in and excelling within each discipline.
Participating in equestrian activities requires various degrees of athleticism, ranging from novice to elite, particular to the selected discipline of riding. All disciplines of riding demand physical and psychological balance, strength, agility and stamina. Equestrians participating in each discipline of riding should have access to discipline-specific information regarding best practices of biomechanics, considering components of movement particular to the discipline and unmounted and mounted exercises designed to prepare the athlete for sport. Psychological preparation for sport must also be addressed for optimal participation and performance.
Female equestrian health and wellness issues differ from male issues due to biological (sex) and gender (social and cultural) distinctions.
3A: Female equestrians should have and will benefit from access to female-sport-specific guidelines and training designed to address female sex and gender needs and expectations.
3B: With these sex and gender distinctions in mind, research on topics specific to female health promotion and injury prevention and educational programs designed for female well-being within equestrian sports should enable female riders to avoid unnecessary pain and to participate fully in recreational and professional pursuits.
An increase in grants for, commitment to and engagement in scholarly studies should advance understanding of issues encountered by female equestrians. An increase in grants for, commitment to, engagement in educational programs and training, including sport-specific guidelines, should serve to prevent harm to and enhance overall health and wellness of females, who constitute the majority of riders.
Rationale (3A and 3B)
Differences related to biological sex concern physical and physiological differences, including primary sex characteristics of the male and female reproductive systems and secondary sex characteristics such as musculoskeletal distinctions.
Reproductive system differences include hormonal influences.
Musculoskeletal differences include the shape of the pelvis as well as height and muscular strength differences.
Gender refers to social and cultural distinctions between male and female. While many similarities exist between males and females and while males and females compete with equality within equestrian sports, females and males may approach the activities with different biological, physiological and social concerns, expectations and needs. The UK Female Equestrian Health and Wellness CoP centers on female health and wellness. The CoP recognizes that diversity broadens and enriches all; and notes that the interests of men as well as all races and genders, including non-white races and LGBTQ equestrians, must also be considered.
Many under-researched subjects concerning female equestrian health beg for attention and already-studied topics have not yet been applied to female wellness within equestrian sport. Inherent dangers in equestrian and other sports have spurred ample beneficial research on impact injuries such as concussions and fractures. In contrast, chronic pain related to riding has been relatively unnoticed.
Chronic pain of the spine, hip, knee, ankle, breast or uterus may inhibit participation and prevent or limit enjoyment. The effect of chronic pain on mental health of female athletes has not been sufficiently addressed. The well-documented female athlete triad looms as a concern, especially for young women riders, but equestrian literature rarely mentions this interrelated issue. Disordered eating, amenorrhea (absence of menstruation) and osteoporosis comprise this female athlete triad, and an athlete with any of the three can be at risk. Other under-researched or well-researched but under-applied topics include osteoporosis, menstrual pain, bladder and continence issues, nutrition and the influences of apparel and equipment, such as bra fit on breast pain and saddle fit on hip and pelvic pain. On a positive note, much empirical work can be done about studying the physical and mental health benefits of participating in equestrian activities and careers throughout multiple life stages.
Athletic equipment and apparel serve to protect, preserve health and promote optimal performance. Both equipment and apparel designers and manufacturers should consider female anatomy and physiology so that their products can maximize female equestrian function and wellness.
Equipment and apparel design and development, principally saddle and undergarment evolution, influence female equestrian health, wellness and performance. More research into ideal tack and technical clothing for female equestrians should lead to greater understanding of how to improve biomechanics and the invention of products to prevent pain due to joint inflammation, skin irritation or soft tissue damage and to maximize female riders’ experience.
Most sports have embraced the positive impact of well-designed and well-crafted equipment, such as approved helmets, that reduce the likelihood of concussions, pads that cushion bones and joints and vests to protect vital organs. Investigation into the effects of ill-fitting tack on equine athletes has revealed much room to improve, and reputable companies strive to continuously offer greater comfort and ease of movement, especially at the intersection of horse and rider in the budding science of saddlery. Prior to the second World War, saddles were made with male military officers or men rounding up cattle in mind. Until recent years saddle fitting did not reflect the societal changes in the latter 20th Century that allowed greater participation of women in riding. While balance remains paramount, saddle makers must account for differences in male and female pelvis orientation and hip configuration so that female riders can comfortably accommodate the movement of their horses. Master saddler Jochen Schleese and Sabine Schleese have spurred the movement, challenging saddle makers and fitters to consider female biological and physiological distinctions from prior male-oriented saddlery. (Note: Sabine Schleese is a member of this community of practice.) Adaptations including narrower twists, extended stirrup bars, curved flaps, wider seats and Schleese’s patented crotch cutouts with padding for the symphysis pubis attend to and accommodate the female pelvis and hip and address the length ratio of the femur to the tibia.
Undergarments are another key area of interest for female equestrians. Recent studies on bra fit suggest that female equestrians often suffer from breast pain possibly related to significant vertical displacement of the breasts while riding and from improperly designed and/or poorly fitting bras. This breast pain may be short-term due to issues such as underwire pressure, tight shoulder straps, rubbing and chafing or suffering may become chronic due to irreversible damage to fatty tissue. Female riders often require padded underwear to prevent friction between the saddle and skin causing saddle sores.
Clearly defined career development tracks within equestrian disciplines and trades should become a priority for the industry.
All employees, especially entry level employees, should be respected and mentored. The industry and all employers should ensure efficacy of their workforce, focus on the benefits of work within nature and the value of engaging with animals and people, model successful certification practices, emphasize apprenticeships and increase grant scholarships to enhance the equine industry.
Although equestrian ventures can contribute in a significant way economically, high turnover of entry-level employees within organizations occurs due to dissatisfaction with pay, insufficient instruction, safety concerns, unavailability of role models and demanding physical work. Supportive personnel within the equine industry may feel unappreciated and be undertrained. Employee education, skills training, recognition, rewards, clearly defined pathways of ascent and apprenticeships may help retain the workers who buttress the equestrian industry. Imbuing prestige into the work of handling and grooming may encourage these dedicated individuals.
Some equestrian disciplines and trades in multiple nations, including Great Britain, Germany, Canada and within the United States offer riding instructor, judging, farrier, saddlery and veterinary technician certifications. These certifications do not require education beyond secondary level. Attaining these certifications offer students of the horse meaningful alternatives to higher education. Regarding employee dedication and aptitude with appropriate scholarships for certifications may prove to be a worthy investment.
Higher education options including bachelor’s, master’s and doctoral degrees offer opportunities to those who desire academic achievement in equine science, equine studies and business. Scholarships for diligent individuals who demonstrate passion and perseverance could augment empirical investigations and advancements within equestrian sport.
Many equestrian sports are sex-integrated, with males and females competing directly against one another. However, equestrian pursuits are not fully equitable, and all organizations within the equestrian industry should ensure parity of the sexes in opportunities, roles, responsibilities and compensation.
Females and males should have equal representation in paid and unpaid positions, including as volunteers, employees, on boards, etc. Pathways should be developed so that women achieve parity with male counterparts. Dedicated support, development and mentoring networks could encourage girls and women onward through transitions in levels of competition and in business. Organizations should seek justice and act impartially. Education about bias and discrimination may address unacknowledged assumptions and unfortunate practices. Where women lack equal representation, organizations may consider quotas. Workplaces must be fair and safe, free of physical or mental dangers, such as sexual harassment.
Studies demonstrate that girls and women participate in equestrian activities over their lifespan more than boys and men. Since the majority of equine enthusiasts are females, many women have much to offer others from their decades of experience. Yet a greater percentage of men occupy leadership and ownership positions. This difference between the sexes may be multifactorial, and women, for various reasons, related to differing roles and responsibilities over the female lifespan, may choose to decline higher offices for which they are capable. However, the contrast between the greater number of women involved in equestrian activities and the smaller number of women in key management, leadership and ownership titles calls for thoughtful contemplation and fair action.
The University of Kentucky Female Health and Wellness Community of Practice (CoP) provided this information.
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Equestrian health and wellness links
Leeds Beckett University
North American Racing Academy
University Centre Hartpury, Equine
University Centre Sparsholt, Equine Studies
University of Kentucky Active Women’s Health Initiative
University of Kentucky Equestrian Athlete Initiative
University of Kentucky Female Equestrian Health and Wellness Community of Practice https://www.uky.edu/equestrians/members
University of Kentucky Indoor Arena Survey Results
University of Kentucky Horse Industry Safety Summit
University of Melbourne
University of Portsmouth Research Group in Breast Health
Waterford Institute of Technology
Schleese, Saddlefit 4 Life
Glenye Cain, The Home Run Horse
Joy Hicklin, Sleepy Ponies
Mary Midkiff, Fitness, Performance, and the Female Equestrian
Holly Heartz, registered dietitian and board-certified sports nutritionist