Dressage rider recovers from 'hangman's fracture'

October 26, 2010

A British dressage rider who suffered a 'hangman's fracture' injury to her neck while schooling a horse is back in the saddle following a new method of rehabilitation.

Research physiotherapist Don Gatherer has developed new methods of assessing injuries and rehabilitation.

Second cervical vertebra, or epistropheus, from above.

Horse breeder and rider Thea Maxfield, 26, sustained the injury in December 2009 at her Castle Grange Stud in Oxfordshire. She was bucked 20 feet into the air, and she told Britain's Daily Express newspaper that when she was trying to get up, she had to support her head in her hands to avoid damaging her spinal cord after her vertebrae shattered. "I had to literally pick my head up and carry it in my hands. I didn't have much hope of a recovery." With the help of a unique electronic method of assessing injuries and rehabilitation, invented by research physiotherapist Don Gatherer, she is back in the saddle and training towards Prix St Georges level.

A Hangman's fracture is the colloquial name given to a fracture of both pedicles or pars interarticularis of the axis vertebra (C2).

Traditionally, such a fracture occurred during judicial hanging. When the subject was dropped, the head would be forced into hyperextension by the full weight of the body, a sufficient force to cause the fracture. The mechanism of injury - a sudden forceful hyperextension centered just under the chin - occurs mainly with deceleration injuries in which the victim's face or chin strike an unyielding object with the neck in extension.

Maxfield received treatment to repair her vertebrae and then became one of the first patients to be fitted with a special head brace connected to a computer.

Tiny sensors were used to assess the strength and weakness of her neck, and this provided Don Gatherer with the infotmation to create an exercise routine for Maxfield.

The Daily Express said the £6000 TGP Analysis device is normally used in Formula One motor racing, and monitors steering wheel, suspension and air-flow factors.

Using loadcells (force measurement electronics) to measure muscle force, Gatherer attaches a leather harness to the patient, evenly applying weight loads to the damaged area. This new objective form of physiotherapy provides a detailed and accurate assessment of the patient's condition, and enables him to accurately advise his patients when they have recovered sufficiently to ride again.

Maxfield began her treatment in February 2010, three months after her accident. Using a saddle horse set up at her yard, the patented harness and a regime designed by Gatherer, she has not only recovered from her injury but also built up her core strength and improved her posture and stability.

The young rider, who is trained by Sandy Phillips, Adam Murdin, and Emile Faurie, told British Dressage, "I feel that Don's pioneering method of analysis and rehabilitation has been instrumental in getting me back in the saddle just seven months after my accident."

She suggests that a rider may focus considerably on the horse and not think enough about their own fitness and conditioning.

"We treat the horses as athletes but not the riders. This unique form of physio has helped to counter the left or right handedness of my horses also,' she said.

"Even without an injury, the necessity to be physically strong is key to being a better rider. This analysis would also be beneficial for anyone wanting to ensure that every muscle is strong for peak performance."

Maxfield was shortlisted for the British Dressage Young Professionals Award but had to withdraw because of the injury.

She runs the Castle Grange Stud along with her mother, Diane.