USEF Insider – by Kimberly Loushin

One of the General Rule change proposals that’s been in our system for quite a while is Tracking 065-24, which pertains to Concussions, Injuries, and Return to Sport. This rule change proposal was first introduced in 2024 and has generated a lot of robust discussion. It is in its fourth draft as proponents amended the proposal in response to comments from USEF Committees and Recognized Affiliates.

Photo – (©Devyn Trethewey/US Equestrian)

The current draft would require participants who have fallen at a competition to be examined by the competition’s Qualified Medical Personnel, a physician, physician assistant, or nurse practitioner before being allowed to remount a horse or horse-drawn vehicle. This rule does not apply to adult participants who fall and land on their feet, unless they have fallen more than once during the competition.

“The main reason for this is to try to ensure participants are not remounting after a fall with an injury that could lead to further falls or increase seriousness of injuries sustained after a fall,” Katlynn Wilbers, USEF Director of Competition Operations, said during the April USEF Virtual Listening Session. “A concussion can be a good example of this. You may feel fine, think you can jump back on the horse, adrenaline is pumping after a fall, and the qualified medical personnel evaluation just gives a moment to make sure you’re truly in the best place to be getting back on the horse.”

Expressing Concern

Though the intent is highly supported, some committees have expressed concerns over how this will affect sports such as endurance, driving, or eventing, which cover large distances and falls may occur out of sight. Other committees are concerned about how waiting to have a participant assessed may disrupt or delay the competition schedule. Another factor meriting discussion is that GR122, which defines a fall, only addresses the fall of a rider, not a driver or vaulter, and those involved in vaulting are particularly concerned because of the unique nature of the discipline, where falls and intentional dismounts are permitted.

While concussions are a common sports-related injury, returning too fast can have adverse effects and lead to a longer recovery time. Early diagnosis is imperative, as research has found that waiting until a week after the injury increases the recovery rate sixfold. Diagnostic protocol has gotten more refined with more effective physical diagnostic tools. Medical personnel use visio-vestibular exams, testing balance, special awareness and eye movement coordination, as part of the screening process. These tests are used in tandem with evaluating physical symptoms (headache, nausea/vomiting, balance problems, dizziness, vision problems, fatigue/drowsiness, and sensitivity to light or sound) and cognitive symptoms (difficulty concentrating, memory issues, cognitive fogginess and feeling slow.)

If the participant is concussed, the good news is that recovery protocol has progressed beyond the days of sitting in a dark room. Research shows two days of minimal activity and reduced screen time is the sweet spot between too much and too little exertion before returning to mild activity.

Managing Return

“We now manage return to play in a very proactive way,” Christina L. Master, MD, FAAP, CAQSM, FANSSM, a pediatrician and sports medicine specialist at Children’s Hospital of Philadelphia, said during a presentation at the US Equestrian Annual Meeting in January. “Your brain systems can be rehabilitated much the way that you rehab an ankle or back or shoulder.”

Light exercise helps brain systems recover, and gradual increases in activity as symptoms subside is part of the active rehab process. However, if symptoms worsen, it’s important to return to a lower activity level to avoid exacerbating the injury.

US Equestrian has developed a Return to Sport Concussion Strategy tailored specifically to equestrians. (You can find the RTS strategy here.) These guidelines are designed to be used alongside guidance from the athlete’s own medical provider. Timelines will vary as concussion symptoms, severity, and recovery can vary wildly based on biological factors such as age, biological sex, and pre-existing conditions such as ADHD, migraines, and mental health issues.

Learn more about concussion safety and find educational resources for coaches and parents here.

Rule change proposals are currently in the council comment period, which concludes May 31. After that, all active drafts will head to the USEF Board of Directors, who will vote on them during their Mid-Year Meeting in June.