Dr. Sherrie Ballentine-Talmadge on challenging common beliefs about equestrian health and safety

Horseback riding is more than just a hobby — it’s a physically demanding, mentally engaging sport that deserves the same level of medical attention and athlete care as any other high-impact discipline. Yet many equestrians still ride with outdated or harmful assumptions about injuries, prevention and recovery. Dr. Sherrie Ballantine-Talmadge of CU Sports Medicine & Performance Center is on a mission to challenge those beliefs — and help riders stay strong in the saddle for life.

Belief #1: "Riding a horse isn’t really exercise or a sport."

“Equestrians really are athletes — and we need to treat them as such,” said Dr. Ballantine-Talmadge. Horseback riding requires strength, coordination, balance and cardiovascular fitness. In fact, she added, “There’s a tremendous amount of health benefits that come from riding... very few other sports are also used as treatment for mental health and developmental conditions.”

Belief #2: “I fell off, but I’m fine. I just need to get back on.”

“If you don’t have a body to ride with, you can’t ride,” Dr. Ballantine-Talmadge emphasized. The deeply ingrained culture of pushing through pain can backfire. Riders should be mindful of their own physical and mental health — not just their horse’s.

Belief #3: “There’s nothing you can do to prevent injuries. They just happen.”

Falls are the number one cause of injury in equestrian sports, but many risk factors are modifiable. “Modernization of equestrian equipment has made a huge difference,” she explained, citing improved helmets, safety vests, and ear bonnets that reduce spook-related accidents. She also urged riders to “learn how to fall” and practice emergency dismounts.

Event preparedness is equally important. “An Emergency Action Plan is a modifiable risk factor,” she said. “A little forethought and discussion can prevent something from becoming really bad.” She encouraged barns and events to invest in certified athletic trainers, CPR training, and accessible emergency gear like AEDs and medical bags.

Belief #4: “I don’t need a medical exam to ride horses.”

Dr. Ballantine-Talmadge stressed the value of pre-participation exams (PPEs) for all equestrians — not just horses. “Even if your primary care provider doesn’t know much about riding, telling them you’re an equestrian opens the door to helpful conversations,” she said.

Belief #5: “There’s nothing you can do for a concussion, so I just kept riding.”

“Sit your riding pants down in your chair for this one,” she began. “Horseback riding is a leading cause of sports-related concussions in the U.S. — above football, ice hockey and rugby.” Many of these go unreported because they happen in private barns.

She emphasized that concussions don’t require a direct hit to the head. “It can happen with or without a helmet. A fall on your tailbone can transmit force through your spinal fluid to your brain.” Helmets reduce the severity of head injuries, not the incidence, making proper fitting and usage essential.

“Gone are the days of sitting in a dark room doing nothing. Concussion management is active and multidisciplinary,” she said. That includes riders, parents, trainers and medical professionals all working together.

Belief #6: “That fall years ago? I just dealt with it.”

Untreated injuries can lead to arthritis, chronic pain and decreased mobility. “Pain changes the way your body moves, which changes the way you ride — and what your horse feels,” said Dr. Ballantine-Talmadge. Early intervention, physical therapy, and even regenerative treatments like platelet-rich plasma (PRP) injections can prevent long-term issues.

Belief #7: “I’m scared to ride after that injury. Maybe I’m just done.”

Returning to riding after injury can be as much about mental recovery as physical. “We don’t just mourn the loss of sport — we mourn the relationship with our horse,” she said. Riders may fear being unsafe or unready, and those anxieties can alter performance. “Your horse can feel it if you're not yourself.”

Start small with low-pressure rides or groundwork, and communicate openly with your trainer and doctor about what you’re feeling. Working with a sports psychologist or physical therapist can provide tools to rebuild both strength and confidence. Support, not silence, is what helps riders truly get back in the saddle.

Belief #8: “My body just hurts because I’m an equestrian.”

Dr. Ballantine-Talmadge wants to shift that mindset. “You warm up and cool down your horse — but are you doing the same for yourself?” She recommends sport-specific strengthening, rider-focused movement assessments, and cross-training to improve biomechanics and posture.

Belief #9: “I don’t want to tell my doctor I ride horses.”

Too often, riders avoid bringing up their sport to healthcare providers out of fear they’ll be told to stop. But Dr. Ballantine-Talmadge reminded us: “If you don’t tell your doctor, you’re missing out on the chance to prevent something that might take you away from what you love.”

Reining it in

As Dr. Ballantine-Talmadge put it: “Everything we do for our soccer players, gymnasts and figure skaters — we need to do for equestrians, too.” Equestrian sports are lifelong athletic pursuits that benefit from comprehensive care, early intervention, and intentional training.

“Doctors heal bodies, but horses heal souls,” she said. Keeping both rider and horse healthy ensures that bond continues for a lifetime.

Watch the full lecture: