Injuries outside of horseracing: is it time to focus on injury prevention of jockeys outside of races?

Epidemiology of horse trauma: a literature review

PURPOSE

Horses are used for many recreational and occupational activities. They are large, strong, temperamental, and unpredictable animals and people involved with them are at risk for injuries, from minor abrasions to severe injuries that may lead to death. This review reports on horse trauma in relation to the characteristics of injured equestrians, characteristics of horse trauma, and clinical outcomes.

METHODS

A literature search was conducted from health-related electronic databases to identify studies from 2018 to 2023. The search returned 115 relevant full-text articles but after screening and assessment for eligibility, 39 were included in this review for a detailed examination of horse trauma epidemiology. Most studies were undertaken in the USA and the most used method was a retrospective review of hospital or trauma registry data.

RESULTS

There have only been very slight changes in horse trauma numbers and outcomes over the past 5 years. Most injuries often follow falls and kicks. Females in their late-20 s to mid-30 s who are recreational equestrians are the group most represented in the data. The commonest injuries include fractures, and head, thoracic, and abdominal trauma. Most individuals with horse trauma were treated in the Emergency Department and discharged. For the equestrians who were admitted to hospital, around one-third required surgery. Mortality rates are very low.

CONCLUSION

The popularity of occupational and recreational horse activities does not seem to wane and horse trauma continues to represent a significant concern for the health system. Health care workers need to be cognizant of the scope of trauma presentations as the mechanisms of injury can be complicated putting the equestrian at a high risk of associated injuries that may be life-threatening.

The psychological responses of British amateur point-to-point jockeys to personal injury

Previous research has reported significant psychological consequences of injury on rehabilitation success, performance, and wellbeing in athletes, although little is known within horse-based sports. There is a high prevalence of injury reported in point-to-point (P2P) jockeys, but despite this, comparatively little research exists examining the psychological implications resulting from physical trauma within horseracing. The aim of this study was to investigate the psychological responses to personal injury in British amateur P2P jockeys. Five amateur P2P jockeys (two male, three female, x- age 25 years old) were interviewed about their experiences post an injury sustained during racing in the preceding 12 months. Interview questions explored their pre-injury career, the rehabilitation phase, pre-return to racing phase issues and coping strategies used by jockeys. Thematic analysis revealed three higher order themes: emotional responses, coping strategies, and factors affecting recovery. Subjects universally cited negative emotional responses following injury, including grief, a sense of loss, and frustration, and all experienced denial at the onset of injury. Typical coping strategies included strong support networks of family, friends and racing staff, and goal setting. Fear of reinjury was identified by all athletes, particularly on return to the saddle, and the attitudes towards injury management, such as denial, seen in this study may provide opportunities to develop targeted education campaigns for P2P jockeys on injury services. Targeted marketing for P2P jockeys on available injury support is recommended, such as seen for professional jockeys, as well as the creation of career development resources to offer alternative routes for P2P jockeys following injury.

Physical activities of jockeys during a working week

Horse racing and training is a physically demanding sport. The aims of this study were to quantify the physical activities of jockeys during a working week and to investigate self-reported fall and injury incidence rates of jockeys at work. A daily workload diary examining workday and physical activities was emailed to all jockeys licensed to ride in a race in New Zealand in 2020. Sixty-three jockeys (25 apprentices, 33 professional and 5 amateur riders) began the diary, representing 38% of the licensed population of jockeys in New Zealand. Jockeys worked a median of 44 (interquartile range (IQR) 33-57) hours, 6-days per week. A median of 7 (IQR 6-9) horses were ridden per day, comprising 58% of work time, with 11 (IQR 7-15) hours per week spent at training pace. Elite jockeys (high performance in the premiership table) spent more time riding in races (1.1, IQR 0.7-1.2 hours per week) than non-elite jockeys (0.0, 0.0-0.4, P=0.01), with 29% (IQR 0-54%) of their weekly rides as race rides. Extra physical training was conducted by 72% of jockeys, which consisted mainly of low intensity exercise such as pleasure riding (56%) and walking (43%). Falls during morning exercise work were recorded by 87% of respondents, 40% of which had sustained an injury in the previous 12 months. Jockeys who participated in extra physical training had higher fall incidence rates per 1000 horses ridden in morning exercise work (3.5, 95% confidence interval (CI) 3.1-3.9, P=0.002) but lower fall incidence rate in race riding (2.1, 95% CI 1.5-2.8, P<0.001) than jockeys who did no extra training (2.5, 95% CI 2.0-3.0 and 5.9, 95% CI 3.8-9.0). Elite jockeys experience a level of specific race exercise which is lacking in the other jockeys.

Review of physical fitness, physiological demands and performance characteristics of jockeys

This narrative review collates data from different equestrian disciplines, both amateur and professional, to describe the physiological demands, muscle activity and synchronicity of movement involved in jockeys riding in a race and to identify limitations within our current knowledge. A literature search was conducted in Web of Science, Google Scholar, PubMed and Scopus using search terms related to jockeys, equestrian riders and their physiological demands, muscle use, movement dynamics and experience. Abstracts, theses and non-peer reviewed articles were excluded from the analysis. Jockeys work at close to their physiological capacity during a race. The quasi-isometric maintenance of the jockey position requires muscular strength and endurance, specifically from the legs and the core, both to maintain their position and adapt to the movement of the horse. Synchronous movement between horse and rider requires a coordinated activation pattern of the rider’s core muscles, resulting in less work done by the horse to carry the rider, possibly leading to a competitive advantage in race riding. Reports of chronic fatigue in jockeys demonstrate poor quantification of workload and recovery. The lack of quantitative workload metrics for jockeys’ limits calculation of a threshold required to reach race riding competency and development of sport-specific training programmes. Until the sport-specific demands of race riding are quantified, the development of evidence-based sport specific and potentially performance enhancing jockey strength and conditioning programmes cannot be realised.