Musculoskeletal Burden in German Equestrians: Hip-Specific Symptoms and Risk Factors

Equestrian sport is a major component of German athletics, with broad recreational participation and a strong competitive sector. In 2019, about 2.32 million people identified as active riders, and more than 60,000 competitional licences were issued in 2021, reflecting substantial competitive engagement across the Olympic disciplines and national performance levels. Hip pain is a frequent and clinically relevant complaint among athletes and can stem from structural, degenerative, or overuse-related causes. In riding, the hip joint is crucial for transmitting forces and coordinating rider-horse interaction. Fine adjustments in tension and release at the hip allow riders to follow and influence the horse's movement; pain can therefore disrupt key control mechanisms. Studies consistently show a notable burden of musculoskeletal symptoms among equestrians. Hip pain affects 8-19% of riders and is associated with impaired pelvic stability, reduced lower limb control, and performance limitations. Chronic symptoms frequently relate to previous injuries, and older riders report persistent discomfort, likely due to cumulative mechanical loading. This study aims to determine the prevalence and characteristics of hip problems in competitive German equestrians and identify relevant risk and protective factors.