Of the 500 riders selected from a national panel for the survey, 221, or 45.5 per cent, had been injured at least once due to a riding accident or handling injury, with an average of four injuries reported.
Of the 221 individuals injured, 57 per cent sought medical treatment.
A little over a third - 35.7 percent - rode alone the last time they were on a horse and only 43.8 per cent of all riders wore a helmet.
Of those injured, 23 per cent had quit riding for an extended period. Of the 221 who were injured, 66 per cent said it was due to rider error.
"Our study and a number of others have shown that many injuries can be prevented or reduced in severity by practicing safe horsemanship," says Fernanda Camargo, assistant professor and equine extension specialist at the university's College of Agriculture.
Every year, millions of Americans participate in horseback riding activities.
In 2007, 78,000 people were seen in US emergency rooms due to horse-related injuries. Nine thousand of those were admitted to the hospital for further treatment.
The most common injuries in horseback riding are fractures, bruises and abrasions, sprains and strains, internal injuries and concussions.
Injuries are most often caused by falls, but people can be kicked, stepped on or fallen on by horses.
"The most severely injured riders are seen here at University of Kentucky HealthCare's Chandler Hospital Trauma Centre," said Dr Julia Martin, associate professor in the Department of Emergency Medicine at the university's College of Medicine.
"If there was one recommended behaviour we would like to see, it would be for every equestrian, whether novice or experienced, young or old, to wear an approved, correctly fitting helmet."