Racing, sport horse bodies put heads together on concussion education

The horse racing industry is keen to share its work with the sport horse world in how it manages riders with concussions.

The British racing industry, with more than 20 years of awareness of the implications of concussion following racing injuries, is the most advanced of the equestrian sports with very specific guidelines around identifying concussions, baseline testing and recovery procedures before a participant can return to the saddle.

Information was shared with more than 100 attendees from across the equestrian disciplines in the UK at last week’s inaugural Cross-Industry Concussion Symposium 2023 at Cheltenham Racecourse, hosted jointly by the Injured Jockeys Fund (IJF) and British Equestrian (BEF).

The conference was compered by racing and equestrian presenter Alice Plunkett, and the key speakers were Dr Jerry Hill, Chief Medical Adviser for the British Horseracing Authority (BHA), Dr Anna-Louise Mackinnon, Lead Medical Adviser at the IJF and Chief Medical Officer for British Equestrian and Rosy Hyman, Racing Industry Concussion Practitioner.

It looked at the history, development and government guidelines around concussion and discuss best practices, and shared learnings for a more collaborative approach moving forwards. Jockeys, past and present, adding input via video into the conference, included Tom Scudamore, Martin Dwyer, Tabitha Worsley, Kevin Brogan, and Harry Bannister. They all shared their experiences of concussion, notably that in some incidents, you do not realise you have it and in some, you want to ‘cover it up’, ‘beat the Doctor’ and not lose rides.

But they all acknowledged that riding with a concussion is not only dangerous but will not have you performing at your best, and so as times move forwards, all jockeys and staff at yards are going to have to change attitudes and use the help at hand, especially at the IJF’s three centres. Concussion procedure will therefore start to become the norm.

IJF Chairman William Norris, KC, said he believed the IJF was well placed to help others in equestrian sport to develop and follow good practice for participants, “and for the benefit of those who have some social and legal responsibility to those participants be they trainers, owners, or organisers.

“Everyone needs to understand and follow good practice, partly because it’s the right thing to do and partly because that is the way in which they can discharge their legal duty of care. It won’t be an overnight fix; it is a question of developing ways of educating and sharing our experiences across equestrian sport generally.”

IJF CEO Lisa Hancock said the conference was encouraging as those taking part were keen to work together using education and communication to improve things for the 1.8 million people who ride, regardless of skill, age, or discipline.

“Racing is fortunate in that we have over 20 years of awareness as to the implications of concussion and we are very keen to share those learnings and best practice with other equestrian disciplines,” Hancock said.

Dr Jerry Hill from the BHA said it was important to promote the concept of collective responsibility with concussion. “You can’t have medical staff being the only people concerned, you need the support of other colleagues across the equestrian spectre, particularly decision makers and funders as some of the changes we need are structural. If you are the doctor, or first aider, you need the support of the organisation behind you.”

Dr Anna-Lousie Mackinnon, the BEF’s Chief Medical Officer, noted that a key issue was that concussion is largely invisible, and it is often not treated in the same way as a broken limb. “And yet correct diagnosis and recovery are vital to the rider being able to return to safely continue participating in their sport in whatever they do and at whatever level.” As part of an education campaign earlier this year, the BEF introduced general concussion guidance for equestrians.

Racing Industry Concussion Practitioner Rosy Hyman said the key focus must be “what we call the four R’s – Recognise (the signs and symptoms). Remove (the injured person from all horse-related activities). Recover (until all symptoms have been resolved). Return (to ridden activity through gradual, stepwise process).”

“We know that if you return too quickly, you are at a much higher risk of another injury.”

The conference also included workshops that looked at issues such as financial and logistical restrictions, especially at grassroots level, the difficulties of having the ‘same rules for everyone’ plus the challenges of changing attitudes across all disciplines to this often ‘invisible’ condition. It was agreed that one cost-effective solution, especially targeted at the younger generation, could be across discipline social media campaigns — simple to execute and far-reaching in their scope.

In closing, Alice Plunkett summed up: “It’s such a complex issue with no easy fix, and it is therefore essential that all disciplines work together and take on multiple levels of responsibility. What has been so encouraging today is that so many in this room have the desire to do that and to make our wonderful sport as safe as it can be for the participants in the future.”