Hold on to your horses! Share by Harry Brownlow, October 2017 Equestrianism is a dangerous sport! Falling from a horse, even when stationary, can lead to nasty injuries. But being thrown from the saddle when jumping or at speed adds dramatically to the energy of the crash landing and can lead to serious trouble. The commonest injury I encounter from riding falls are clavicle (collarbone) fractures (breaks). These cause pain and a lump. It is usually pretty obvious if you have broken your collarbone and a simple xray will confirm the diagnosis. If you have a fracture then you may wish to discuss whether or not to have an operation or to let it heal in a sling. There is no absolute right or wrong decision and the individual circumstances need to be considered. However the key points are that the surgical route gets you out of a sling within a couple of days (rather than 6 weeks) which means a much quicker return to work and sport and also a nice straight collarbone. But at the expense of a scar and with a small risk of infection or other complications. Many people choose the operation in order to return to normal life as quickly as possible. However most professional jockeys don’t even bother getting an xray but will take some painkillers and carry on regardless! There is no right or wrong decision Other common injuries include shoulder dislocation, acromioclavicular(ACJ) dislocation, shoulder fractures, and rotator cuff tears. These can be serious injuries which merit early attention. If you have sustained a fall from a horse you should seek urgent medical attention if you have severe pain, or sustained tingling or numbness, or an obvious deformity. If you have persistent pain despite a normal xray then you should see a shoulder specialist soon to rule out a rotator cuff tear which doesn’t show on an xray and which needs addressing quickly. This is best done by ultrasound or MRI.