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Riding astride

The idea that riding a horse astride could injure a woman's sex organs is a historic, but sometimes popular even today, misunderstanding or misconception, particularly that riding astride can damage the hymen. Evidence of injury to any female sex organs is scant. In female high-level athletes, trauma to the perineum is rare and is associated with certain sports (see Pelvic floor#Clinical significance). The type of trauma associated with equestrian sports has been termed "horse riders' perineum". A case series of 4 female mountain bike riders and 2 female horse riders found both patient-reported perineal pain and evidence of sub-clinical changes in the clitoris; the relevance of these findings to horse riding is unknown.

In men, sports-related injuries are among the major causes of testicular trauma. In a small controlled but unblinded study of 52 men, varicocele was significantly more common in equestrians than in non-equestrians. The difference between these two groups was small, however, compared to differences reported between extreme mountain bike riders and non-riders, and also between mountain bike riders and on-road bicycle riders. Horse-riding injuries to the scrotum (contusions) and testes (blunt trauma) were well known to surgeons in the 19th century and early 20th century. Injuries from collision with the pommel of a saddle are mentioned specifically.