CARERC Pilot: Equestrian Collegiate Team Care System Access and Patient Activation in the Management of Chronic Pain and Injury

Collegiate equestrian sport has been on the rise, with over 15,000 participants, all predominantly female. 1 Equestrian is an emerging sport for division I and II women’s programs2 and, therefore, an emerging field within athletic training. Governance of competitive equestrian sport dictates care systems. Only programs sanctioned by National Collegiate Equestrian Association (NCEA), which exists in only 25 schools nationally, require attending athletic trainers and associated care systems. The remaining 1000 programs rely on athlete self-activation for post-injury care. Recently we documented that the University of Kentucky Hunt Seat Team (n=31) had 48% of suspected concussions that went unreported; 55% experienced chronic pain (CP), 29% had low back pain, and 39% had lower extremity pain. We also documented that total concussions are associated with general CP (p = 0.03) and experiencing low back CP (p = 0.01). 3 In a similar population of collegiate athletes, we identified that concussion education increased the likelihood of reporting concussion injury (p = 0.0027) regardless of the number of historical concussions experienced. 4 Post-injury care is 100% reliant on individual engagement. We propose that self-management of CP following injury may be facilitated in athletes with 1) access to regular care, 2) relationships with individuals who can provide pain management education, and 3) social support for other outcomes, such as depression and anxiety, in post-injury recovery. This pilot project will identify relationships between accessibility to a care system, physical parameters, and psychosocial outcomes. The long-term goal is designing an intervention for improving patient activation for self-management of care following an injury, which may be compounded by multiple chronic conditions, including depression, anxiety, and existing chronic pain.