Fit Rider: Battling Back Pain

Tips to get back in the saddle after a back injury.

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Rider's back
Photo: nd3000/Shutterstock

I never should have stretched those extra few inches, reaching to hang my new floor-length curtain panel. Three days later, a sharp pain in my lower back and abdomen—unlike anything I had experienced before—ushered me straight to urgent care. According to the doctor, it was just a muscle spasm. She administered a cortisone shot and stated that I would experience relief in about 30 minutes.

The shot didn’t help, and my pain intensified to the point where I wondered if I was dying. Lightheadedness seized me, and I started to sweat while my arms and fingers tingled. I was sure one or all of my internal organs had burst as I lay sprawled out on my kitchen floor with my dogs staring down at me.

I was whisked away to the emergency room via ambulance, and my alarm lessened as the cute EMT started telling me about his sister’s upcoming wedding. He didn’t seem on a mission to save my life—just to distract me from my pain.

During my eight hours in the emergency room, various painkillers were given until one ended my torment. I was discharged with a written excuse to stay home from work for a week and a prescription for steroids. That day, riding my horse was the last thing on my mind.

Types of Back Pain

Back pain among equestrians is not uncommon. The causes are diverse, ranging from arthritis and poor posture to aging and weight gain. And some are silly, preventable accidents like my muscle sprain from trying to hang a curtain alone.

Taylor Bodson slipped and fell when running in socks down hardwood stairs. Bodson, blogger at The East Coast Equestrian, sustained two closed lumbar vertebrae fractures and herniated discs during her tumble.

“Spine injuries in riders tend to be bulging intervertebral discs caused by aging and compression fractures usually due to osteoporosis or osteopenia,” says horseman and retired neurosurgeon James Warson, M.D., author of The Rider’s Pain-Free Back.

Every individual’s back pain story is unique, but the good news is that the condition causing the pain can often be addressed, or at least the pain can be managed, making a comfortable return to the saddle achievable. The most important thing is to seek medical attention at the onset of back pain to determine the cause, which will shape the plan for healing.

“The first doctor or diagnosis may not always be correct,” says Bodson. “Don’t take their word over how you actually feel.” Her first doctor missed the fractures on the X-rays, diagnosed her with muscle spasms and send her home with steroids.

Treating the Back

Warson observes that a threefold approach of stretching, especially after a ride, weight loss where appropriate, and anti-inflammatory medicines can have a positive effect on bulging discs.

According to Warson, osteopenia can be treated with bisphosphonates (a class of medicines that stop calcium loss). By combining bisphosphonates with the use of calcium citrate and vitamin D, as well as implementing a flexibility and isometric exercise program, he has witnessed that most riders can be back in the saddle for trail-type riding in about six weeks.

He has also seen success in restoring bone strength in advanced osteopenia and osteoporosis patients through the use of the Equicizer, a mechanical horse that simulates all the gaits based on a rider’s strength and ability.

Hip flexor stretch
Hip flexor stretch: Keep your shoulders back as you bend your knee up on a step; press forward and hold. Photo: Elizabeth Moyer

Stretch Yourself

Eventer and physical therapist Carlene Kelly, DPT (Doctor of Physical Therapy), finds that most equestrians have tight iliopsoas muscles from the hip flexion of riding and all the sitting most of us do in life. She recommends stretching before and after each ride and as part of a daily routine. One of her favorite stretches is the hip flexor stretch (see pg. 20).

“Make sure to keep your foot on the ground, pointed forward or slightly rotated in, and keep your shoulders upright and slightly back as you bend your knee up on a step,” she advises. “I hold for three to four seconds, back off slightly, then repeat 10 times on each leg.

“The second muscle that is a big culprit to low back and sacroiliac joint pain is the piriformis muscle,” Kelly continues. “The seated piriformis stretch is simple: Sit with one ankle crossed over the other knee, sit up tall and bend forward at the hip (chest leading) until you feel a stretch across the back of your hip on side of the crossed leg.”

Kelly is no stranger to back pain, as she has a history of sacroiliac joint injury.

“The best I have ever felt is when doing aquatic exercise and Pilates. Both of these are excellent cross-training activities for riders due to the core strengthening in lengthened positions it provides. We all need to not be restricted on our horses.”

Seated piriformis stretch
Seated piriformis stretch: Sit up tall and bend forward at the hip with one ankle crossed over the other knee. Photo: Elizabeth Moyer

Overlooked Back Pain Prevention Tips

In some cases, evaluating your mount and possibly making a change could be the key to greater comfort for riders who struggle with back pain.

“A good start to prevention is to start with the horse,” says Warson. “The harmonics of the horse and the rider are critical. [The sitting trot is] a quick way to separate horses out. A tall rider may find that an Arabian or Tennessee Walker is better for them due to the longer horizontal gait component.”

Journey to Healing

My back healed through many of hours of Netflix on the couch accompanied by steroids, ibuprofen, ice, frequent chiropractic adjustments for several weeks, and the use of a TENS machine. I incorporated stretches, a new chair with better lumbar support at work, and a new standing desk.

My doctor recommended breaking up my hour-long commute by stopping halfway to get a coffee, which allowed me to walk around and stretch. I also kept my car’s seat heater turned on. When I started riding my horse again a few weeks later, I walked him for a longer-than-usual warmup and did stretches, such as leaning over to try to touch my toe and leaning forward to reach for his poll and back toward his tail. I only cantered a few strides during my initial rides, and I rode them in a half-seat.

It has now been a year and a half since my injury and I’ve made a full return to riding and jumping, although some days my back feels a little tight. When that happens, I opt for a shorter ride. If I’m in a lesson, I will tell my trainer I need to cut it short, and do stretches afterward.

We horse owners generally baby our horses when they get hurt, and give them as much time off and TLC as they require. We need to be willing to extend that same luxury to ourselves.

“Take your time,” Bodson advises. After a three-month riding hiatus she’s back in the saddle, but learned a valuable lesson along the way.

“Despite doctor’s orders, I snuck in a few early rides and immediately regretted it. Let your body heal. Your horses will be waiting for you.”

What could be better motivation to rest and recuperate than that?


This article originally appeared in the September 2018 issue of Horse Illustrated magazine. Click here to subscribe!

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