Event medics forced to ‘save riders from themselves’ *H&H VIP*

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  • Riders are risking serious injuries by not being honest about their physical condition, according to health professionals.

    The issue was brought to the attention of the Medical Equestrian Association at its annual conference (21 November, 2015).

    Andy Thomas, physiotherapist, has worked in close collaboration with Team GBR in all disciplines over the past 10 years.

    “High-level riders learn to hide injuries, and they hide them well,” he said.

    “I’ve been fortunate to see many different riders, but I’ve also seen a lot of lying and the panic as soon as the rider knows you are onto them. I’ve had riders coming into my treatment area with a whole range of injuries, from mild lower back pain to fractured pelvises.

    “I recognised very early on that I was very vulnerable to these riders wanting to come in and be taped up so they could carry on competing. The risk factor of somebody competing even with a minor pain is quite large, never mind a fracture.”

    Mr Thomas said the problem is exacerbated by riders competing on a second horse following a fall from another at the same event.

    “I’ve had riders with all sorts of problems — rib injuries, coughing up blood, not being able to move shoulders — then going out and riding their next mount.”

    Strict fall rules

    FEI rules state if a rider falls at a competition they are not allowed to continue without a medical assessment, even if they do not have an obvious injury. It adds that “frustrated athletes who fall and then refuse medical attention create an issue for the host medical service providers.”

    Any rider who leaves a venue after a fall without being assessed is automatically issued with a yellow card.

    The British Horseracing Authority (BHA) safeguards jockeys by keeping a database of all jockeys’ injuries that is accessible to all racecourse doctors. The organisation monitors the progress of injured jockeys to ensure that they only return to race-riding once it is safe for them to do so.

    Similarly in eventing, British Eventing (BE) rules stipulate that competitors who are suspended for medical reasons may not resume competition until written confirmation of fitness to compete has been supplied to the BE office.

    Point-to-Point Authority medical advisor Dr Linsey Whitley told H&H it is a doctor’s responsibility to “save riders from themselves”.

    “In point-to-point racing every unseated jockey must be assessed by the designated doctor prior to any subsequent rides. This enables the doctor to assess the rider for any injury.

    “Some injuries, such as concussion, discrete fractures and types of slow abdominal bleeds, present as normal or are concealed from the doctor or paramedic on the racecourse, but when some time has elapsed and adrenalin drops, these are clearly problematic.

    “These can at best be mismanaged, and at worst are potentially life-threatening and require immediate care.”

    Dr Whitley said the reasons behind concealing an injury can be multiple.

    “Jockeys put a huge amount of time, effort, money and heart into their riding and horses. It takes a very determined character to do what they do, with statistically one out of seven rides at point-to-points resulting in a fall,” she said.

    “Understandably they are very reluctant to be dissuaded from their goal. There is also external pressure on the riders, intended or not, from owners, trainers, family and colleagues. Reputation and pride are held very highly too.

    “Our main aim is for our jockeys to know that we want to get them riding, but riding safely, not at the detriment of others or their long-term health.”

    Point-to-point jockey Richard Smith suffered a broken shoulder in a fall at Sheriff Hutton last January, but has since made a full recovery.

    “We just want to be back on as soon as we can,” he told H&H. “The season is short enough without having setbacks. It’s frustrating when you injure yourself, but it’s part and parcel of what we do.”

    ‘We are extremely fortunate’

    Four-star event rider Coral Keen praised the level of care given to riders.

    “At events, medics are on duty as standard and if you have an accident they can be with you in minutes,” she told H&H.

    “I don’t think that can ever be underestimated, and I think we are extremely fortunate that we have such good medical cover at events.”

    She added that riders shouldn’t be “too dismissive” as it’s “very easy to be gung-ho if you’re young and fearless”.

    “With hindsight I am always grateful for a medic’s attention, even if at the time I am itching to jump back on and get going again,” she said.

    Fellow British eventer Lauren Shannon added that it’s important for riders to consider the image of the sport.

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    “It would be irresponsible to get back on after a serious fall,” she said. “We tend to think if you fall off you get back on and carry on, and that’s a pretty good mentality, but you won’t ride very well if you have concussion or a break.

    “You have got to think about what’s in the best interest for the horse you’re riding and what you want to achieve.”

    Andy Thomas added that by developing a relationship of trust with medics, athletes are less likely to obscure their injuries.

    “The riders who I dealt with on a regular basis — my team riders and development riders — began to trust me because I would explain that if they are riding round with a fracture it’s quite likely that something seriously nasty could happen,” he said.

    “Pain is not performance enhancing — it never has been and never will be.”

    Ref: H&H 9/2/16