Horse racing is a spectacular professional sport that requires human and equine participants to perform at the very limits of their capabilities. The margin for error is tiny and the result of a misjudgement could be catastrophic for either or both athletes. Blood, sweat and tears, fractures, concussion and fatalities are not merely possibilities, they are inevitable.

Jockeys rely on race riding for their livelihood and any injury can have a major impact on the jockeys and their families. Although the majority of these injuries do not involve a lengthy period of inactivity, some jockeys do suffer career-ending injuries during the course of their professional life.

We have previously investigated the injury epidemiology of professional and amateur horse racing in Great Britain, Ireland and France.1^–3 This article will look more specifically at career-ending injuries to professional jockeys in Great Britain.

The Jockey Club (JC) has regulated British horse racing for over 250 years and has recently devolved this role to the Horseracing Regulatory Authority (HRA). Medical arrangements on all racecourses must comply with a detailed set of instructions (The Jockey Club General Instruction 11; referred to as JCGI 11). Since 1992, it has been compulsory for all injuries to jockeys to be recorded and reported to The Jockey Club Chief Medical Adviser (JC CMA).

Racing statistics

During this period, there were an average of 478 jump meetings and 706 flat meetings per annum. The average annual figures for jump racing were 30 258 rides, 1943 falls and 478 injuries and for flat racing were 49 279 rides, 220 falls and 77 injuries.

Jockeys income

Jockeys are paid a fixed fee for every ride and a fixed percentage of any prize money achieved for winning the race or being placed (around 8% of the prize money). In 2005, the riding fee was £85.79 per ride on the flat and £117.15 for every jump ride. The ability and popularity of a jockey determines how many rides s/he is offered. The average jockey would expect to get around 300 rides/yr (flat) or 200 rides/yr (jump), which is equivalent to an annual income in 2005 of £25 737 (flat) or £23 430 (jump). Jockeys are self-employed, so this is a basic wage that does not including any prize money they might be entitled to.

Professional Riders Insurance Scheme (PRIS)

The Professional Riders Insurance Scheme was created in 1974 and provides professional jockeys with financial payments in the event of temporary disablement. In those incidents where a jockey has suffered a permanent neurological disability, loss of limb or eye, or has a fatal accident, a lump sum is also payable (a “Capital Sum” payment).

When a jockey suffers an injury, the insurance scheme provides jockeys with a weekly payment comparable to what they might have been earning from race riding fees if they had not been injured. The PRIS benefits are fixed amounts, and the size of the weekly benefit depends on the grade of the jockey. The grade of the jockey is determined by the number of rides they completed in the previous 12 months (Table 1).

Jockeys who suffer career-ending injuries are entitled to a maximum of 78 weeks of benefit payments. In addition, the Capital Sum payments are: fatal accidents, £150 000 (1991) and £300 000 (2005); permanent total disablement, on a sliding percentage scale up to £500 000 (100%).

In the 15-year period (1 January 1991 to 31 December 2005) there were a total of 1328 insurance claims from professional jockeys in Great Britain. Flat jockeys submitted 354 claims for injuries, while jump jockeys submitted 974 claims.

METHODS

The relevant literature was searched through Medline. Keywords used in the searches included horse racing, sports injuries, jockeys, equestrian injuries, concussion and head injury.

The injury data was provided by The Jockey Club Medical Department and PRIS, and is based on a detailed medical evaluation of every case.

The “soft tissue” injuries that caused jockeys to retire were mainly musculoskeletal in nature. They include chronic back pain,3 injured knee ligaments2 a torn supraspinatus tendon and occlusion of the femoral artery.

RESULTS

In the 15-year period (1 January 1991 to 31 December 2005) there were 45 career-ending injuries to jockeys, including 4 fatalities (Table 2). Only 3 of the 45 jockeys were female but this is reflective of the male dominance of the professional sport in Great Britain.2 The jockeys had varying levels of experience (Table 3) and age (Table 4).

In the 15-year period, PRIS paid out a total sum of £2 569 477 for the 45 career-ending injuries. £682 000 was paid out for the four fatalities. The other 41 jockeys received weekly income benefits totalling £1 260 477, a further 6 of whom also receiving lump sum payments totalling £627 000 due to permanent disability.

Of the 41 jockeys who received weekly income benefit, the smallest amount (£7461) was received by a Grade 1 jockey, while the largest amount (£97 759) was received by a Grade 9 jockey. On average, PRIS paid out £30 743 each to the 41 jockeys receiving weekly income benefits.

One jockey (ID 107) who suffered a fractured tibia returned to race riding 2 years after the injury. None of the other jockeys returned to race riding.

Injury categories

The different types of injuries suffered by the jockeys are listed in table 5. Fractures are the most common injury.

The injury subcategory “neurological pathology” mainly encompasses injuries to the head and spinal cord. Probably due to the nature of the sport, head injuries are seen much more frequently in jump jockeys than in flat jockeys.2 3 Even though the wearing of protective helmets has been compulsory for over 25 years, serious injuries to the head are not uncommon.

Figure 1 displays the anatomical distribution of the 45 career-ending injuries. For the most part, the injuries are evenly distributed across the major regions of the body.

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Figure 1 Anatomical distribution of injuries (figure adapted from Waller et al).4

Apart from injuries to the head (see below), the most common site of injury was to the back and shoulder. Most of the back injuries were fractures of the vertebral column. Most of the shoulder injuries were fractures, dislocations or both, all of which were experienced by jump jockeys. The other shoulder injury was a ruptured supraspinatus tendon in a flat jockey.

Fatalities

In the 15-year period of the study, there were four fatalities to professional jockeys in Great Britain. The four jockeys suffered different types of injuries. Two of the jockeys suffered injuries to their torso that resulted in intra-thoracic and intra-abdominal haemorrhage. The other two jockeys died as a result of head injuries in association with multiple trauma.

Head injuries

Of the 45 career-ending injuries, 9 were head injuries. These included a spectrum of pathology including subdural haematoma, extradural haematoma, intra-cranial haemorrhage, chronic traumatic encephalopathy and post concussion syndrome. Eight of the nine head injuries occurred in jump jockeys.

DISCUSSION

This study investigates career-ending injuries suffered by professional jockeys in Great Britain. Fractures are the most common type of injury, followed by neurological pathology (Table 5). Previous injury epidemiology studies have found that fractures are indeed the most common injury type suffered by jockeys.1^–4 The majority of injuries in this study occurred to the head, shoulder or torso (Table 6). This is despite the fact that the use of helmets and body protectors has been mandatory throughout this period. The only variation has been the introduction of specified European Standards for protective equipment. The European Standard EN 1384 for helmets became compulsory in 1996 and EN 13158 for body protectors became compulsory in 1999. Prior to these dates, helmets used when race riding were required to meet BS 4472 and body protectors had to meet the BETA (British Equestrian Trade Association) Level 3 Standard.

There is limited literature on injury epidemiology in professional horse racing.1^–6 and a similar paucity of published articles relating to recreational equestrian and paediatric equestrian injuries.7^–13

A number of reports have looked at serious injuries that are a result of horse riding.9 11 14^–17 All the studies agree with our findings that head injuries are the major cause of serious injury to jockeys. Two of the studies indicate that head injuries account for 60% of all fatalities.11 17 A number of the more recent studies claim that the use of protective head gear has resulted in the reduction in the number of head injuries seen in riders.6 8 10 18 19 This study includes insufficient data to evaluate the improvement in protection provided by the new helmet design in 1996 and the new body protector design in 1999.

CONCLUSION

Horse racing is a very dangerous sport and the injuries that jockeys suffer can cost them their livelihood or their life. Injuries to the head are the most common career-ending injuries, and the mandated wearing of protective helmets does not prevent these injuries from occurring. The investigation of improvements in helmet design should be a priority for all involved in this professional sport.