Horse riding and your knees

Riding in Qatar

Horses have a long place in Qatari life, from Arabian horse breeding and endurance riding to show jumping, racing stables and weekend riding schools. Riders range from young children having their first lessons to experienced endurance riders who spend many hours in the saddle.

The knee problems fall into two groups: overuse aches from the riding position itself, and acute injuries from falls, kicks or being crushed against a fence or stable wall.

Why the riding position can make knees ache

In the saddle, the knee is held bent, with the lower leg turned slightly outward and pressed against the horse. The inner side of the knee, where the medial collateral ligament and the inner meniscus sit, is under steady stretch, especially with a wide horse.

• Stirrups too short increase knee bending and load the kneecap.
• Stirrups too long make you reach for them, so the knee twists and the inner side strains.
• Gripping hard with the knees, often from nervousness, tires the inner thigh and irritates the knee.
• Long endurance rides keep the knee in one position for hours, which can leave it stiff when you dismount.

A riding instructor can check your stirrup length and position. Many riders also find that safety stirrups with a slight angle or flexible joints ease inner knee strain.

Falls, kicks and crush injuries

Falls are the main cause of serious riding injuries. When a foot stays caught in the stirrup as the rider falls, the knee can twist violently, damaging ligaments such as the ACL or MCL. Landing directly on a bent knee can injure the PCL or the kneecap. A kick from a horse delivers a great deal of force into a small area and can cause deep bruising or a fracture.

Good boots with a heel, safety stirrups and correct technique for an emergency dismount all reduce the risk. Body protectors protect the chest and spine but not the knee.

Riding with knee arthritis or after surgery

Many people with knee arthritis continue to ride comfortably, because riding takes body weight off the knee. Mounting and dismounting are often the hardest part. A mounting block and a controlled slide to the ground, rather than a jump, help.

After knee surgery, the timing of return depends on the operation and on control of the leg, since a fall in the early months could damage the repair. As a conventional guide, gentle hacking after arthroscopy may restart within some weeks, while after ACL reconstruction or knee replacement riding is usually delayed for several months and agreed with your surgeon. Jumping and fast work come last.

Simple steps for riders' knees

• Warm up off the horse with walking and gentle squats before riding.
• Check stirrup length regularly, especially when changing horses or saddles.
• Strengthen the thighs, hips and core, which hold your position without gripping.
• Get off and walk for a few minutes during long rides to move the knee.
• Use ice briefly after a ride if the knee aches, and rest if it swells.

When to see a knee surgeon in Doha

See a specialist promptly if you cannot bear weight after a fall, if the knee swells quickly, if it looks deformed, or if it feels unstable or locks. A kick that leaves severe pain over the bone should be X-rayed. Numbness, a cold foot or a pale leg after a major injury needs emergency care.

For persistent aching inside the knee from riding, a consultation at Aman Hospital includes an examination and, when needed, imaging. Dr. Gelber can then advise on treatment and on adjustments that let you keep riding.