Waller AE, Daniels JL, Weaver NL, Robinson P. Jockey Injuries in the United States. JAMA. 2000;283(10):1326-1328. doi:10.1001/jama.283.10.1326
Author Affiliations: Department of Emergency Medicine, School of Medicine (Dr Waller), Injury Prevention Research Center (Drs Waller and Daniels), Department of Epidemiology, School of Public Health (Dr Daniels), and the Department of Exercise and Sport Science (Ms Weaver and Dr Robinson), University of North Carolina at Chapel Hill.
Context In the sport of horse racing, the position of the jockey and speed of
the horse predispose the jockey to risk of injury.
Objective To estimate rates of medically treated injuries among professional jockeys
and identify patterns of injury events.
Design Cross-sectional survey from data compiled by an insurance broker. Information
on the cause of injury, location on the track, and body part injured was evaluated.
Setting Official races at US professional racing facilities (n = 114) from January
1, 1993, through December 31, 1996.
Participants A licensed jockey population of approximately 2700 persons.
Main Outcome Measures Annual injury incidence rates per 1000 jockey-years, as well as injury
type, cause, and location on the track.
Results A total of 6545 injury events occurred during official races between
1993 and 1996 (606 per 1000 jockey-years). Nearly 1 in 5 injuries (18.8%)
was to the jockey's head or neck. Other frequent sites included the leg (15.5%),
foot/ankle (10.7%), back (10.7%), arm/hand (11.0%), and shoulder (9.6%). The
most frequent location where injuries occurred was entering, within, or leaving
the starting gate (35.1%), including 29.5% of head injuries, 39.8% of arm/hand
injuries, and 52.0% of injuries to the leg/foot. Most head injuries resulted
from being thrown from the horse (41.8%) or struck by the horse's head (23.2%).
Being thrown from the horse was the cause of 55.1% of back and 49.6% of chest
Conclusions Our data suggest that jockeys have a high injury rate. Efforts are needed
to reduce the number of potential injury events on the track and to improve
protective equipment so events do not lead to injury.
Thoroughbred horse racing is a competitive sport enjoyed around the
world. As the largest spectator sport in the United States, its paid attendance
exceeds that of all other major professional and collegiate sports.1 Unlike most major sports, which have adopted new safety
practices and protective equipment, thoroughbred racing has changed little
during the past century.
In thoroughbred racing, a jockey weighing approximately 50 kg rides
a horse weighing approximately 500 kg around a dirt or grass track at more
than 65 km/h.2 The primary protective equipment
used by the jockey is a helmet and flak jacket to protect the head and chest.
The positioning of the jockey on the horse approximately 3 m above the ground
in a forward stance creates a situation of dynamic imbalance and ballistic
opportunity, predisposing the jockey to a forward roll in response to any
sudden change in the horse's direction or velocity.2
The purpose of this article is to estimate rates of medically treated
injuries among professional jockeys and to describe where and how these injuries
occur during racing activity. By doing so, we hope to identify areas for further
research and intervention efforts.
All medically treated injuries occurring to licensed jockeys during
official races were recorded on standardized injury report forms. These forms
were initiated and compiled by the insurance broker that provides insurance
for essentially all professional racing facilities in the United States (n
= 114). According to the reporting protocol, 1 report was filed for each injury
event occurring between January 1, 1993, and December 31, 1996. The injury
report forms were completed by medical personnel who provided treatment at
the track. Although many jockeys injured at insured tracks were transported
to a hospital for treatment, injured jockeys were often treated by medical
personnel at the track and not transported to a hospital (Irene Walton, written
communication, October 1999). The injury data collected by the insurance broker
thus include both injuries requiring transportation to a hospital and those
treated at the track, capturing injuries to jockeys at all levels of severity.
From these data, information was abstracted on the cause of injury, the location
on the track where the injury occurred, and the body part injured.
The licensed jockey population was estimated by the Jockey's Guild to
be approximately 2700 and remained consistent during this period. Annual injury
incidence rates were calculated per 1000 jockey-years. Patterns of injury
type, cause, location on the track, and time trends were evaluated through
frequency distributions produced by SAS Version 6.12 statistical software
(SAS Institute Inc, Cary, NC).
A total of 6545 injury events occurred during official races between
1993 and 1996, for a rate of 606 injuries per 1000 jockey-years. Injury rates
steadily decreased by a total of 33% from 1993 to 1996; however, the type
and cause of injuries remained constant. During the study period, 3 jockeys
were fatally injured on the race tracks from which data were available for
Nearly 1 in 5 injuries (18.8%) was to the jockey's head or neck (Figure 1). Other frequent sites of injury
included the leg (15.5%), foot or ankle (10.7%), back (10.7%), arm or hand
(11.0%), shoulder (9.6%), pelvis (4.1%), and chest (3.5%). An additional 16.0%
of injuries involved multiple body sites.
The most frequent location where injury events occurred was entering,
within, or leaving the starting gate (35.1%) (Figure 2). Of all injury events, 14.2% occurred in the turns and
15.9% occurred in the home stretch or at the finish line. The most frequently
reported causes of injury were being thrown from the horse (44.4%), crushed
(9.6%), and flipped and pinned (7.5%). Being struck by the horse's head accounted
for 5.3% of injuries, being jerked accounted for 3.7%, and falls accounted
for 3.3%. The location of the injury event on the track and the cause of injury
were not reported for 18.9% and 8.1% of the injuries, respectively.
Of all head injuries, 29.5% occurred entering, within, or leaving the
starting gate. The remaining head injuries occurred proportionally around
the track. Most head injuries resulted from either being thrown from the horse
(41.8%) or struck by the horse's head (23.2%). Of all head injuries, 11.3%
resulted from the jockey being thrown from the horse in the home stretch or
at the finish line.
Injuries to the upper and lower extremities most commonly occurred at
the starting gate. Fifty-two percent of leg and foot injuries and 39.8% of
arm and hand injuries occurred when entering, within, or leaving the gate.
Of these leg and foot injuries, 36.6% resulted from the jockey being crushed
and 27.2% resulted from the jockey being flipped and pinned by the horse.
These 2 causes of injuries at the starting gate accounted for 33.1% of all
leg and foot injuries. Being thrown from the horse, either in the starting
gate or at various locations around the track, resulted in 31.9% of leg and
foot injuries and 40.8% of arm and hand injuries.
Being thrown from the horse resulted in 55.1% of back and 49.6% of chest
injuries. These injuries occurred proportionally at the gate, around the turns,
and along the home stretch and finish line.
Being thrown from the horse most commonly resulted in multiple injuries
(36.2%). The most common single sites of injury resulting from throws were
legs and feet (18.8%), head (17.7%), and back (13.2%). Although only 5.3%
of injury incidents resulted from being struck by the horse's head, 82.4%
of these injuries were to the jockey's head. Being flipped and pinned (54.5%)
or crushed (64.2%) primarily resulted in injury to the leg and foot.
The starting gate and the home stretch/finish line were the most common
sites for injury events. Jockeys and horses are emotionally and physically
charged at these locations. The starting gate contains an excitable horse
and mounted jockey in a small, confined space, which presents great opportunity
for the jockey to be crushed against a rigid surface by the horse. Injuries
incurred when entering or in the gate may be reduced by padding or altering
the shape of the gate, or by exploring alternate techniques of leading the
horse into the gate.1 Padding the rails around
the track may also reduce some on-track injuries.
Although the final stretch and finish line are otherwise free of obstacles,
the speed and close proximity of the horses and final risk-taking tactics
of the jockeys increase the impact of throws and other undesired dismounts.
Improved personal protective equipment may be the best option to decrease
injuries around the track and at the finish line. The head was the most frequently
injured body part in our data. Helmets are required head protection for jockeys;
however, there have been discussions of improving the technology to create
a lightweight helmet with greater coverage that may offer improved protection
of the head. Chest injuries were not among the most common in this study;
however, the expected severity of injury to the chest led to the introduction
of a protective flak jacket in 1993. This form of chest protection was mandated
for use by all jockeys in professional races in 1994. Although the proportion
of chest injuries reported in this study did not decline from 1993 to 1996,
it is possible that the severity of chest injuries was lessened.
This study reflects a conservative estimate of injury rates, since chronic
injuries that were not apparent on race day and injuries occurring during
training were not included. Information on injury recurrence within an individual,
injury severity, and the clinical presentation of the injury were not available.
While the addition of injury severity data would be useful, it should be recognized
that track-side estimates of injury severity may be influenced by the desire
of the injured jockey to continue racing on the day of injury, and objective
measures of injury severity such as the Abbreviated Injury Scale are not routinely
collected in these insurance data. There was also no available information
on injured jockeys' racing experience, frequency of racing, or other personal
characteristics, or information from a comparison group of noninjured jockeys.
The addition of this information would allow a more in-depth description of
the occupational risks of jockeys. We suspect that the observed decline in
injury rates from 1993 to 1996 is an artifact of underreporting to the insurance
broker, since the type and cause of injuries remained constant, and no changes
in safety practices or equipment were reported during this period.
Despite these limitations, this study provides the first large descriptive
report of injury incidence and the locations on the track that are associated
with injury among professional jockeys. All jockey injuries, irrespective
of severity, were captured in these data. Since the information was obtained
from essentially all professional thoroughbred racing tracks in the United
States, these analyses should accurately reflect the injury experiences of
the vast majority of professional jockeys in the United States.
Although recreational equestrian injuries have been described in recent
the injury experience of professional jockeys is largely unexplored. Head
and neck injuries represented 19% of all injuries in this study. These results
generally support the findings of Press et al,1
who reported 13% incidence of concussions from their 4-month survey of jockeys.
This research also reiterates the call for national jockey injury surveillance,1,8 centrally compiled and annually analyzed,
which would create an opportunity to better understand the injury profiles
of jockeys and develop protocols for their protection.