Horse riders are more likely to be injured than motorcyclists on rural roads in Yorkshire and Lincolnshire, a BBC Inside Out investigation reveals.
House riders say they need better protective equipment
Over the past year, air ambulance crews in the region picked up 150 injured horse riders.
That is an increase of 65% compared with five years ago when only 97 riders were injured in accidents.
Spinal injury experts have said that riding a horse is 20 times more dangerous than riding a motorbike.
A leading consultant at Stoke Mandeville Hospital found that a motorcyclist would expect to have a serious accident once in every 7,500 hours they spent on a bike.
For horse riders they found there would be a serious accident once in every 350 hours.
Horse riders said they were concerned there was not enough protective equipment available and that youngsters learning to ride were not being taught properly.
Anne Pickles of the Truewell Hall Riding School, near Keighley, told the BBC's Inside Out programme that she came across children who were not even learning basic safety lessons.
Lucy Caley died after her horse stumbled and fell on top of her
She said: "We get people who've been riding for three or four years and they don't even know how to mount a horse properly, which is one of the first safety lessons that should be taught."
Sally Wilson, of Louth, in Lincolnshire, was left paralysed after a riding accident.
She said: "I was wearing a hard had and back protector, but I fell on concrete on my head."
Susan Caley's 13-year-old daughter Lucy died near her home in 2003 after her horse stumbled and fell on top of her.
Susan, of Meaux, near Beverley, said it had been a freak accident.
She said: "It wasn't the horse's fault - and Lucy had come off a thousand times in her life.
"Nothing could have been done to prevent it."