Does my Doctor Know the Risks of Riding?

[TheBrownHorse]

Hi guys

I’m writing here because I’ve (pretty much) made my mind up that I’m going to start riding again, however I have some concerns and I’m just not sure my doctor is aware how physically demanding, strenuous, as well as risky horseback riding can be.

Fair warning this is long. I need some support and guidance, and so I’m here. I have an AVM (Arterial Venus Malformation, where my femoral artery and veins became one big glob) and bone tumor in my left femur. The AVM traverses the femur bone itself. The lesion is benign, and is what causes my severe, daily pain, according to the doctors. I’ve been lucky that I am studied at the BVAC (Birthmarks and Vascular Anomaly’s Clinic) at UCSF since I was 13 (now 29 going on 30), and am seen by the top Orthopedic Oncology and AVM Specialist they have to offer. I’ve had outstanding medical recourses, attention, etc. and, the good news is, over the years, according to gradual MR scans, the AVM is reducing in size. The lesion inside the femur is remaining the same, and as such, is what is likely the cause of the pain I have. That and I have pretty much no cartilage in that knee.

I live with a very swollen, enlarged leg with varicosities prominent throughout with discoloration visible to the eye. It used to cause me a lot of self-consciousness but over the years I seem to have learned to embrace it, but it still does bother me. The pain is what gets me.

I was also a competitive horseback rider, showing in the A rated jumpers with a lovely warmblood Holsteiner gelding, eventually schooling consistent coursework at 1m35

I have had a couple Bi Lateral Pulmonary Emboli, once in 2017 and once in 2019, unprovoked. I am on thinners for life. Normally, I would say that being on thinners and riding one would have to assume more caution than normal, but not out of the question. I’m not saying about going back to the level I rode at, I’m talking about walking and trotting around an arena on a very good horse. But, with a bone tumor in my femur, and an AVM, along with blood thinners, I can’t help but question myself if I’m making the right decision in getting back in the saddle. It’s what I love. It keeps me sane. It is practically all I care about. It is who I am. Horses are a part of me. There’s no denying that. I’m so sorry this is so long.

My doctor gave me the go ahead to ride, but I’m not sure if he’s TRULY aware at the dangers of horseback riding. I don’t want to exaggerate, this isn’t a dangerous horse, I’ve owned him almost his entire life, but accidents happen. I seem prone to them. However, it’s my sanity. I haven’t ridden regularly in years but it’s clearly taking a toll on me, I know I would be happier if I could ride again.

How do I tell my doctor that this is a powerful creature that’s not known to be lax in nature? He’s been dubbed a “Ferrari”, though he’s 19 now, he’s still a powerfully built, incredibly talented, get up and go kinda horse. He will take care of me I’m sure, he’s not dangerous and I know how to ride, but there is that part of me that wonders if I’m making the right choice, or if my doctor actually knows the dangers of the sport.

[SuzieQNutter]

The only thing I could think of reading all that and not really understanding it, is that there is dressage done with carriages.

You might be a lot more comfortable and also competitive doing that. It would mean adding training to your horse.

Other than that I think most doctors think of horse riding as being dangerous, especially with so many of us who end up in Hospital.
touch wood!

[TheBrownHorse]

@SuzieQNutter

The only thing I could think of reading all that and not really understanding it, is that there is dressage done with carriages.

You might be a lot more comfortable and also competitive doing that. It would mean adding training to your horse.

Other than that I think most doctors think of horse riding as being dangerous, especially with so many of us who end up in Hospital.
touch wood!

I’m sorry if it was a bit all over the place, it was cut and past from another post from a forum on Facebook, I tried to piece it together and clearly did a poor job…

[SuzieQNutter]

No worries, it is just stuff I have never heard of before. What I did pick up is that you are in pain, which is why I though sitting in a carriage might be better than sitting on a horse.

[RMJacobs]

Driving horses is considered to be more dangerous than riding. When things go bad, there is a higher chance of injury because of the complication of a carriage being involved.

OP, I think the question that your doctor needs to answer is what is the possible outcome if you fell? You can explain that it would be a fall from a height, possibly at speed if your horse bolted. I think that would help flesh out whether the doctor understands the risk.

Best of luck–I hope the answer is that you can ride.

Rebecca

[Where_sMyWhite]

Does your doctor know the risks of riding? IMO, no unless they themselves also ride. They may have some notion of the risks based on what they hear/read/see when riders are injured.

IMO, you need to explain what your concerns are about riding that they probably don’t understand and get their opinion.

The choice to ride and what horse to ride is always yours. Even if your doctor told you ‘no riding’ would you? Sounds like for the moment your doctor has cleared you to ride. Sounds like you have a pretty good understanding of your body and its challenges and things that do make riding, for you, higher risk.

Good luck in making your decision and facing the challenges that you must face on a daily basis {{}}

[Jackie_Cochran]

I am very sorry about your physical problems. They look a lot worse than my MS, and I can understand your hesitation.

This is just a suggestion for how to get back riding with you feeling safer.

Find a lesson stable that does beginners. Ask about private lessons. Ask if there is a safe pony to ride (much less distance to fall.) If you feel it necessary ask to be led around on the safe pony until your body adjusts to the gait of the pony.

I have MS, and after many years of not riding because my horses were a bit hot I figured out that this was the way to go. I got back up on a horse (under 14.2 Arab), and over 10 years later I am still riding, on lesson horses, mostly on equines 14.2 or under.

Because of my horrific balance I am pretty much stuck in the ring BUT I am still riding! I usually feel pretty safe.

[cayuse]

This is a tough one and I feel for you. It is a difficult decision to make and probably what I have to add won’t make it any clearer. I was on a blood thinner for a year and was told I could not drive my minis until I was taken off of it and my doctor went so far as to say “no horses” at all, even ground work. I agreed to stay out of the cart but refused to stay out of the barn.
I think each doctor is individual with what risks they are comfortable with their patients taking on.

Could you show the Doc a video of you riding so he gets the full picture of what it involves?

[Fellbutbackup]

Cannot hurt to ask directly.

[Lusoluv]

Ummm…I doubt it. My new GP asked what I did for exercise and how many times/hours per week I did it. Told her I was an upper level dressage rider and an eventer. I ride 2 - 3 horses/day 6 days a week. She said, “OK, but what do you for REAL exercise”?

[cloudyandcallie]

Buy or lease a very calm lesson horse
Keep your old horse and ride him when you have someone to watch you and make sure everyone knows where to apply pressure if you need aid.

if you get in a car wreck or if you trip on stairs,etc., you can be killed by harming other vital organs. So if you give up horses you have no guarantee to live to 90.

Is there an orthotic device that can protect your thigh/leg? The orthotic experts for humans in Savannah made a long.clamshell device for one of my dogs that worked for over a decade so he could run and play as normal.

Enjoy horses but take extra care.

[pAin_t_Misbehavin]

My doctor is somewhat aware - his uncle was killed by a kick from a mule. But he feels like the overall benefits- regular exercise, social interaction, healthier lifestyle in order to keep fit for riding- vastly outweigh the risks.

[SonicWithNoRings]

I think what the Doctor means by clearing to resume riding is that you understand the risks yourself. Clearly you do understand and your Doctor is leaving the responsibility to you. You very well know what could be the complications of unfortunate events while riding. So it is really up to you. I presume your Doctor knows how important riding is to you so he can’t order to never ride again especially if physically you feel like you can. You just have to be very careful.

[Training_Cupid]

Doctors tend to be pretty conservative, overly cautious if anything. If you feel comfortable, I would go ahead with all reasonable precautions. But if you’re not comfortable, that’s understandable too.

[strangewings]

I think you have to assume no. Non-horse people think of commercial trail riding outfits when they think of “riding”. Or kids’ beginner lessons, or pony rides. They have no concept whatsoever of “sport” riding.

I saw several doctors and pa’s when I was getting set up on blood thinners recently. They all said things like “Don’t do anything dangerous like sky diving or boxing.” So I asked “What about riding?”,

Them: “Riding should be no problem”,
Me: “What about the falling risk?”,
Them: “Oh…well, only ride nice horses you won’t fall off of.”

IMO that’s a classic sign that someone doesn’t understand what riding is really like.

For improving safety, base fitness matters a lot, especially core fitness, especially if you have not been riding for a while and if your capacity to use your legs is diminished in any way.

[Scribbler]

I expect the doctor means you are cleared to resume your normal level of physical activity.

I would say doctors err about riding in both extremes.

My GP thinks riding isn’t “real exercise.”

But I once went to a walkin clinic in the horsey exurbs to get an x-ray referral after a riding fall, and got a lecture from the doctor there about how horseback riding should be banned for kids based on what he’d seen in his clinic.

A doctor that clears you for regular exercise is not necessarily clearing you for accidents associated with the activity. If they say you can go back to jogging or hiking or even brisk walking they aren’t factoring in you tripping on a curb or slipping on a wet stream bank or getting hit by a car.

So I would ask about risks associated with falling and then decide how likely I am to fall. That will depend on how sticky your seat is, how calm your horse is, and where your fitness level currently is.

If you haven’t ridden regularly for years I would start with getting lessons. I’d suggest finding a coach that has worked with para riders and has some ideas about working with different physical limitations

[TheBrownHorse]

@Scribbler

I expect the doctor means you are cleared to resume your normal level of physical activity.

I would say doctors err about riding in both extremes.

My GP thinks riding isn’t “real exercise.”

But I once went to a walkin clinic in the horsey exurbs to get an x-ray referral after a riding fall, and got a lecture from the doctor there about how horseback riding should be banned for kids based on what he’d seen in his clinic.

A doctor that clears you for regular exercise is not necessarily clearing you for accidents associated with the activity. If they say you can go back to jogging or hiking or even brisk walking they aren’t factoring in you tripping on a curb or slipping on a wet stream bank or getting hit by a car.

So I would ask about risks associated with falling and then decide how likely I am to fall. That will depend on how sticky your seat is, how calm your horse is, and where your fitness level currently is.

If you haven’t ridden regularly for years I would start with getting lessons. I’d suggest finding a coach that has worked with para riders and has some ideas about working with different physical limitations

This has by far been the most helpful to me (everyone’s responses have been helpful btw) but putting it in perspective in that, doctors clear people to walk, but not necessarily trip up curbs etc. has really helped so thank you for that.

I am going to see about investing in some lessons. I have started a (non horsey) fitness routine to get back in as much saddle shape as I can pre-saddle time, and am going to take it from there. I’m also going to contact with my doctors to talk about the associated risks of riding with these issues.

[ReSomething]

I applied to the para riding program after a lengthy hospitalization in which I became extremely weak because my regular trainer just didn’t have quiet enough horses. I’d have had a side walker as I gained balance. That program needed a release from my doctor, she sent me to my cardiologist who approved me with the comments I was frail and used a cane and she refused to sign off. I worked out for a month and unfortunately for me I went boating several times and skated down a slimy boat ramp during that time and sliced up my knee. She had to take out the stitches and absolutely refused to sign off after that. Obviously I could fall, you see.

Although your doctor may have cleared you to ride he may not be willing to sign a release for a para program.

[Scribbler]

@ReSomething

I applied to the para riding program after a lengthy hospitalization in which I became extremely weak because my regular trainer just didn’t have quiet enough horses. I’d have had a side walker as I gained balance. That program needed a release from my doctor, she sent me to my cardiologist who approved me with the comments I was frail and used a cane and she refused to sign off. I worked out for a month and unfortunately for me I went boating several times and skated down a slimy boat ramp during that time and sliced up my knee. She had to take out the stitches and absolutely refused to sign off after that. Obviously I could fall, you see.

Although your doctor may have cleared you to ride he may not be willing to sign a release for a para program.

Oh very very interesting!

You can’t get into a para program without a doctor’s
note, but if you are too shakey they won’t sign the note, leaving you in regular horse world. That is certainly a Catch 22 situation!

There are however coaches with para experience who don’t work entirely within a para program. I know an ammie who took regular dressage lessons from someone who also coached or had coached a Paralympian. They wouldn’t have a full program but might be a good resource on modifications. I believe that locally our riding therapy programs will offer advice or lesson sessions to riders with physical issues without them being in a program. Another friend with a bad knee was going to pursue this

[GoodTimes]

At the end of the day it’s up to you.

If it would make you more comfortable ask about the risks of falling. Ask if they would be comfortable with you biking, skiing, snowboarding, etc. These activities are similar in risk, but your doc may be more familiar with them.

Look up “Taylor Campbell” on YouTube. She’s a physiotherapist who works with the Canadian para Equestrian athletes (she used to ride as well).
She’s currently working on a 10 week program to help all equestrians with strength, symmetry, and flexibility.

I did my undergrad with her and she knows her stuff. I’ll be following along myself as I know I’m crooked, and have various posture problems and weaknesses from being a runner and sitting so much at work. https://youtu.be/Eu29_oAT2Is