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The Reins Wear Your Hands Out Slowly. The Ground Does It in One Second.
Horse riding injures hands in two unrelated ways: a slow, sustained problem from holding contact on the reins, and a sudden, serious one from coming off. Riders tend to worry about the second buuuuuut they usually get the first.
Rein-contact pain in the thumb, wrist or inner elbow usually settles in 6 to 12 weeks once you change how you hold. After a fall, plan on 8 to 12 weeks out of the saddle for a broken finger or wrist, and longer for a scaphoid.
Get the fall wrong and you lose more than a season. A missed scaphoid fracture or a torn thumb ligament that “felt like a sprain” can mean surgery months later that would have been a splint in week one.
So this page does two jobs. It sorts the slow problems from the urgent ones, and it gives you realistic dates for getting back on.
Why do my thumbs and wrists hurt after riding?
Contact means a sustained, controlled grip held for the length of a ride, with the wrist in a fixed position and the thumbs doing real work on top of the rein.
That is a static load, and static loads fatigue tissue faster than moving ones.
- Thumb pain and thumb-side wrist pain: De Quervain’s, from thumbs pressed down on the reins for hours.
- Aching forearms and hands after a long hack or a schooling session: general overuse.
- Inner elbow pain: golfer’s elbow, from sustained grip. Very common in riders who hold a strong contact or ride several horses a day.
- Numbness in the fingers on a long ride: worth reading by pattern, and often positional rather than pathological.
- Catching at the base of a finger: trigger finger, particularly in professional riders and grooms.
Grooms and yard staff get the rest: carpal tunnel from mucking out and grooming, tennis elbow from carrying water and haynets, and thumb base pain from hours of repeated grip.
Soft hands are a technique goal and a medical one. The rider with heavy hands has a horse that leans and an elbow that hurts.
How do I know which one I’ve got?
Most of these are diagnosed with hands-on tests, not scans. What a clinician checks:
- De Quervain’s: tender over the two tendons on the thumb side of the wrist, and sharp pain when you tuck the thumb into a fist and tilt the wrist toward the little finger.
- Golfer’s elbow: tender on the bony point on the inside of the elbow, worse when you bend the wrist forward against resistance or grip hard.
- Carpal tunnel: tingling in the thumb, index and middle fingers that wakes you at night. A nerve conduction test if it’s constant or the hand is getting weak.
- Trigger finger: a tender nodule in the palm at the base of the finger, and a click or catch you can feel.
- After a fall: X-rays first. A normal first X-ray does NOT rule out a scaphoid fracture. A repeat X-ray at 10 to 14 days, or an MRI or CT, settles it.
What to change in the saddle and the yard
- Thumbs on top, not pressed down hard. The rein is held, not clamped.
- Rein material and width. Rubber or webbing reins with a good grip let you hold lighter than slippery leather, which makes riders grip harder without noticing.
- Gloves that fit, with a grip surface. Same principle.
- Shorter blocks. If you ride several horses a day, put a few minutes of open hands and wrist stretches between each one.
- Carry with forearms, not fingers hooked through haynet strings and bucket handles.
- Vary the yard tasks rather than doing all the mucking out and then all the grooming.
How long does rein-contact pain take to settle?
These overuse problems run on an OPEN window. Time is on your side, as long as the load drops. A rough timeline once you change grip and calm things down:
- Weeks 0 to 2: cut the long hacks and the extra horses. Splint the thumb if it’s De Quervain’s. Pain eases first at rest, then on the reins.
- Weeks 2 to 6: start the exercises below. Short, quiet rides are usually fine if pain stays at 3 out of 10 or less and is settled by the next morning.
- Weeks 6 to 12: most De Quervain’s and early trigger fingers have settled. Build back to full riding loads, one extra horse or one longer session per week.
- 3 to 6 months: golfer’s and tennis elbow are the slow ones. Months, not weeks, is normal for an elbow tendon.
If you’re no better after 6 weeks of a proper splint and changed technique, a steroid injection becomes reasonable for De Quervain’s and trigger finger. Surgery is the late chapter, for the few that still don’t settle.
Which splint, and when do I wear it?
- De Quervain’s: a forearm-based thumb spica splint that holds the thumb and wrist still. Nights and yard work for about 4 to 6 weeks. Some riders do quiet work in a soft thumb support, but not the rigid splint, cos you can’t feel the rein through it.
- Trigger finger: a small splint holding the base knuckle straight, mostly at night, for about 6 weeks.
- Carpal tunnel: a wrist splint in neutral at night, for about 6 weeks.
- Golfer’s elbow: no splint does the work. Load management and the exercises do.
Exercises for riders’ hands, wrists and elbows
Pain during these should stay at 3 out of 10 or less and settle by the next morning. If it doesn’t, drop the reps, don’t push through.
- Tendon glides: straight hand, hook fist, full fist, flat fist. 10 rounds, 3 times a day. Good for stiff, achy hands and trigger fingers.
- Wrist flexor holds (golfer’s elbow): forearm on a table, palm up, press the hand up into your other hand without moving. Hold 30 to 45 seconds, 5 times, once or twice a day.
- Slow wrist curls: once the holds are easy, a light dumbbell or a full water bottle, palm up, lower slowly over 3 seconds. 3 sets of 15, every other day.
- Thumb-side wrist lifts (De Quervain’s, after the first 2 to 3 weeks): forearm resting thumb-up, lift a light weight (start around 0.5 kg or 1 lb) by tilting the wrist up. 3 sets of 10 to 15, every other day.
- Forearm stretches: arm straight, gently pull the hand back, then down. 30 seconds each way, 3 times, after every ride.
Don’t stretch into the tuck-the-thumb-and-tilt position. That’s a test, not an exercise.
Coming off: the three injuries that get missed
Riders fall with hands out, from height, sometimes at speed. Three things get missed:
- Tenderness in the hollow at the base of the thumb, X-ray normal or not: scaphoid fracture until proven otherwise.
- A thumb forced back by a rein or a strap: UCL injury, exactly the same mechanism as a ski pole.
- A finger caught in a rein, rope or strap as the horse moves: a serious traction injury, and if a ring is involved, ring avulsion. Never wear rings when handling horses, and never wrap a lead rope around your hand.
Hollywood cowboys wrap the lead rope around their hand. Hollywood cowboys also have stunt doubles.
A crushed hand between a horse and a stable wall or door is also a crush injury, where the swelling rather than the bones decides the outcome.
The scaphoid and the thumb ligament are the two CLOSING windows on this page. A scaphoid caught in week one usually heals in a cast. One found at month three may need surgery. A completely torn thumb ligament is best repaired within the first few weeks, cos the torn end can flip out of position and can’t heal back on its own.
(Riders are famous for getting back on. Get back on, sure… and get the wrist X-rayed on the way home.)
When can I ride again after a fall?
Your surgeon or doctor’s dates win. These are typical, conservative ranges:
- Jammed or sprained finger: quiet riding within days with the finger buddy taped, usually for 2 to 4 weeks. Puffiness at the middle joint can last months. See jammed finger.
- Broken finger: 6 to 12 weeks to heal, with at least 6 to 8 weeks protected. Quiet hacking once your doctor clears it, usually around 8 weeks. Jumping and young horses later. See broken finger recovery.
- Thumb ligament (UCL), partial tear: about 4 to 6 weeks in a thumb splint, then riding in a protective splint or tape for a further few weeks. After surgical repair, plan on around 3 months.
- Broken wrist: often about 6 weeks in a cast, and around 3 months before you can hold a horse that spooks. Later for jumping. See wrist fracture recovery.
- Scaphoid fracture: 8 to 12 weeks or more to heal. No riding until healing is confirmed on imaging, which often means 3 to 4 months.
The test for getting back on isn’t “the cast is off”. It’s whether you could grip and hold a horse that bolts, with no warning.
Back to work: grooms and professional riders
- Grooms and yard staff: light duties (grooming, feeding, tack cleaning) usually come back before mucking out, carrying water and lifting haynets. Expect the heavy jobs last.
- Professional riders: one horse a day first, then add one horse per week if pain stays settled the next morning.
Go to the ER today if
- A finger was caught in a rope, rein or ring and the skin is torn, the finger is pale or cold, or the ring left a deep cut.
- A finger or wrist looks bent or deformed after a fall.
- A crushed hand is swelling fast, feels tight, and the pain is much worse than the injury looks.
Get it checked if
- Wrist pain at the base of the thumb after any fall.
- A thumb that feels unstable when pinching.
- Numbness that persists after you dismount.
- A finger that will not fully straighten.
- Elbow or wrist pain present before you tack up.
Never wrap a rope around your hand. That is the one sentence on this page that prevents amputations.
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. A thumb-side wrist that hurts after a fall deserves an X-ray this week, even if you rode home.
Part of: Hand, wrist and elbow pain by job, sport and hobby
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.