This article about back pain in horseback riders is adapted with permission from

Low back pain is one of the most common and most costly medical problems in industrialized countries. Over 90 percent of the U.S. population seeks help for back pain at one point or another in their lives, including horseback riders. Approximately 50 percent of working-age people in the U.S. suffer from acute low back pain every year, and it is estimated that the annual productivity loss from this condition totals between $20 and $50 billion.

Back pain affects four out of five people at some time during their lives. It is the leading cause of disability for people between the ages of 19 to 45. Back pain is second only to the common cold for causing adults under 45 to miss work. Furthermore, as we age, low back pain becomes more and more common, affecting half of the population older than 60 at any given time.

Back Pain and Horseback Riders

Though no back injury is desirable, it can be even more problematic for those who live with horses and love them. Back pain can literally rob you of the enjoyment you get from riding and working with your horses.

The rider with a healthy back will exhibit both flexibility and strength. The informed rider will also do a little bit each day to ensure continued back health.

Back strength and flexibility are not absolutes. It’s not a matter of “you either have it or you don’t.” Both flexibility and strength are measurable on a continuum. Time and circumstances can influence one or both for the better or the worse.

If you are a horseback rider experiencing back pain, you certainly should have a competent physician who is experienced at diagnosing and treating back disorders take a look at you before you begin any exercise program. Ideally, the physician you choose will be relatively experienced with horses, but this tends to unreasonably narrow the talent pool. Unfortunately, very few physicians combine a solid knowledge of the spine with an understanding of the medical aspects of riding. Don’t be surprised if you hear, “If your back hurts, don’t ride,” from well-meaning members of the medical profession. This is an attitude that I hope to change by emphasizing your responsibility and initiative for dealing with and avoiding back pain.

The Importance of Flexibility

Building flexibility and strength in your back and in related body parts is the key. In this article, I’m going to focus on flexibility.

Why do we want flexibility in our backs? The answer is simple: strength without flexibility is force produced in a limited manner, in only one direction. Flexibility enables a rider to exert a reasonable amount of force in all directions.

This is terribly important in riding, because maintaining your balance and changing your mechanics during the different gaits requires not only strength, but also coordination of that strength through a relatively broad range of motion. In order for your muscles to work efficiently and produce the strength and motion necessary for good riding, you must have some flexibility.

Age is not necessarily a contraindication of flexibility. Some elderly patients exhibit excellent range of motion.

Muscles that are flexible, and have been properly stretched, are the ones that can be trained to be the strongest. Muscles that are continuously tight, through the ligament tightening and muscle tightening, are inefficient and simply don’t provide the optimal strength and endurance possible.

Stretching Correctly

Stretching the muscles in a methodical, controlled, targeted manner is the best way to increase your range of motion. For optimum flexibility, it’s just as important to stretch your muscles after doing some sort of physical activity as it is to stretch beforehand.

The back is a somewhat difficult area to stretch at first. Learning to stretch your back effectively, safely, and for best results takes practice. Nevertheless, once you are aware of the muscles and movements involved, you can stretch your back muscles just as well as any other group of muscles in the body.

Back stretching involves stretching the hip and buttock (glute) muscles as well as the back. You can’t stretch the back very effectively without involving the hips and glutes, as well.

Back stretching exercises also stretch the muscles and ligaments in the legs at the same time. In terms of the benefit obtained, and from a muscular point of view, it’s best to stretch the back, hips and legs in concert, because you ride with them in concert.

The total time taken to do the kind of stretches I recommend is only four or five minutes, but it will pay off. It could be the best couple of minutes you’re going to spend on yourself all day, next to the actual riding time itself.

A-Frame Back Stretch 1. Stand up straight, with your feet placed shoulder-width apart and your weight balanced evenly through both legs. Raise your arms overhead. Place both hands together, one on top the other. Inhale, breathing deeply. Keep your arms straight throughout the stretch.     2. Bend at the waist and slowly stretch down and sideways, trying to touch the outside of your right foot with both hands. 3. Slowly return to a vertical position. Keep your hands together. 4. Bend at the waist and slowly stretch down and sideways, trying to touch the outside of your left foot with both hands. Keep both legs straight and stretch as far as possible. 5. Slowly return to a vertical position. Four or five repetitions of this exercise are generally sufficient.

JAMES WARSON, M.D. (ret.), founded Front Range Brain and Spine Surgery practice in Fort Collins, Colo., in 1978. He devoted the majority of his practice to spine surgery; diseases of equestrians caused or aggravated by riding were Dr. Warson’s field of expertise. In 1984, Dr. Warson established J & J Farms, where he bred, trained, exhibited, and sold multiple Grand National and World Champion Morgan horses. Today Dr. Warson is based in Fairfax, Va., where he is the Mid-Atlantic Medical Director for the Medeval Corporation and serves as Medical Director for Rider Health and Safety with the Western Dressage Association of America.

This article about back pain in horseback riders originally appeared in the November 2019 issue of Horse Illustrated magazine. Click here to subscribe!

The post Fit Rider: Stretches for Horseback Riders to Help Back Pain appeared first on Horse Illustrated Magazine.

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.

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.”

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 about horseback rider back pain originally appeared in the September 2018 issue of Horse Illustrated magazine. Click here to subscribe!

The post Fit Rider: Battling Back Pain appeared first on Horse Illustrated Magazine.