By Sam Peters, author of Concussed.
It is often purported that the growing band of brothers and sisters championing the need for improved athlete welfare through a more caring culture in professional sport are blind to its number one imperative: winning.
Those of us in rugby who have spent decades calling for greater protections for players as the sport’s risk profile has sky-rocketed have been labelled ‘soft’ or ‘not rugby people’ while the mere mention of ‘player welfare’ is snarled at in certain quarters as evidence of an invidious woke culture creeping into the game.
It is, of course, utter tosh. But that does not stop those whose interests are best served by ignoring the long-term health and wellbeing of those we cheer on from the stands parroting the same old tired lines.
Call for change and be prepared to be shot down by some uneducated but very loud voices. Such is life today, I suppose.
Professional sport is a tough world. Anyone who has been within a cricket ball’s throw of a sports dressing room or training ground knows that. No quarter is ever asked, let alone given.
In the wrong hands, it can be a world where machismo reigns, bullying can fester and being honest about emotions or personal health can be sacrificed on the altar of protecting a contract or your place in the starting line up. Short-termism reigns. The future? It can wait.
Meanwhile, in schools sports, players and parents themselves can be their own worst enemies when pushing for faster return to play times.
Medics can also be pressured into burying their morals by coaches and owners more interested in today than tomorrow while those calling for improved workplace culture are dismissed as romantics who don’t understand the cold, hard reality.
Brain health inevitably suffers as concussions are denied and mental-health problems hidden.
And there are few sports where the participants have traditionally been expected to ‘suck it up’, ‘grin and bear it’ or ‘take one on the chin’ more than in professional horseracing where the owner is king and young, vulnerable jockeys compete for rides.
In a sport where concussion is an everyday risk for jockeys and stable staff tasked with moving the horses around their yard and the country, the temptation to hide symptoms of concussion or mental health concerns is ever present.
“There’s times in my career and I think every jockey has had times where they know and you go into the instant mode where you’ve always got to beat the doctor,” explains Max Kendrick, a seasoned jump jockey with almost 500 rides in the past five years.
“Yeah I think you have to break it down and understand the sport if you think about like every single lad in that change well most lads in that change room are self-employed so I mean if you’re stood down, it’s not like you’re playing for Arsenal or Chelsea if you’re injured.
“There is insurance so you’re getting paid for but you know you miss rides you might not get back on the horse the next day. So automatically the mentality is straight away no matter what the injury is not just head – whatever it is – can I get away with riding. Yeah, so in that sense like I think the power has got to be kind of taken out of the jockey’s hands because like I don’t think I can see a world where you’re ever gonna shift that mentality.”
Kendrick is speaking with me on a crisp December day outside the office of the Grade One National Hunt trainer Fergal O’Brien’s yard in the stunning surrounds of his Ravenswell Farm in the heart of the Cotswolds.
We are in racing country, where tradition and hierarchy are prized. But here, at one of the most successful and well-known yards in the land, there is a real sense of change in the air. Progress even.
I’m here at the invitation of Your Brain Health, an Australian owned company on a mission to improve the education of medics and physiotherapists around the world about the importance of better concussion management, brain health awareness and improved brain function.
Critically, they are seeking to take the guesswork out of return to play protocols following a concussion, where historically decisions have been made either by the subsistence of demonstrable symptoms, or even worse, on the athletes word.
“When we’re treating an athlete with a hamstring injury there are tests we perform so we know precisely when it has returned to full function,’ YBH’s chief operations officer and current Welsh Fire physio David Bartlett tells me.
“Just because the patient is symptom free does not necessarily mean that hamstring has recovered. The same is true of brain injuries but historically we haven’t treated them with the same levels of objectivity and reasoning as other parts of the body.”
Bartlett and his YBH team, include experienced physiotherapists Simon Shepard and Emma Edwards, a chartered physiotherapist and member of the jockey injury management team which looks after professional jockeys on the racecourse, have been invited to the yard by Dr Simon Gillson, a close confident of O’Brien’s founded Concierge Medical and has worked at the yard for nine and a half years.
Gillson describes the concussion risk in racing as ‘an occupational hazard’.
“It would basically be impossible for a jockey to go through their career without sustaining a concussion,” Dr Gillson explains.
“I think the stats on fallers have changed over the years. It used to be one in 10 races you expected to fall off as a race rider. I think that might be down to one in 20. They’ve (authorities) have improved jumps safety and other things which is great and there’s improved equipment but you are still having rotational injuries, you’re falling at speed, horses are rolling on top of you, being kicked in the head, the neck, the chest.
“So your chances of getting through any lengthy career without having a significant head injury and concussion are, I would say, a zero. I mean, absolutely zero.”
Edwards nods in agreement.
“When it comes to testing for concussion so much has been based on some fairly basic orientation questions. As a physiotherapist something I’ve looked at is eye movements, as being something that even when someone’s denying having a concussion, you can pick up on eye movements. It provides an objective measure to tell a jockey, ‘this is what I’ve seen, do you think you’d be safe, seeing the stride to the fence, and making the right decision in that split second?
“More often than not they’ll put their hand up and go, ‘actually, now you’ve said that, I’m not really feeling 100%’.
“They’re not stupid. They know their every move is being scrutinised. They just want to perform well.”
The plan, with O’Brien’s blessing, is for all 37 of his yard staff to undergo a ‘multimodal’ baseline screening of their brains by the Your Brain Health team, with tests ranging from balance, and reaction times to a digital evaluation of the vestibular ocular motor system.
From force plates to measure balance, to a reaction mouse, to the use of a VR headset, the key thing seems to be the use of technology to provide better quality data.
“With multiple functions the brain is a complex organ and what we are doing is not going to cover everything.’ said Shepard. ‘However, put this data alongside other tests and clinical examination, and it may well lead to better understanding, better decision making and a personalised approach to care.”
The tests are carried out in a highly professional but light-hearted manner, which puts the jockeys and yard staff at ease and encourages them to take a full part in the testing. The participants seemed genuinely interested in both the testing and the reasons that sit behind it.
I undergo the tests myself and am pleasantly surprised to read the graph afterwards which shows my eye tracking to be in pretty decent order.
Much more importantly, the presence of the YBH team indicates a shift in mindset which is looking to place the brain health of staff far higher up the priority list than it has been historically in horse racing. It is forward thinking in every sense.
It also has the added benefit of potentially improving the performance of jockeys who after all, need great balance, great eyes and great decision making, if they are to optimise their performance and that of their prized equine assets.
“It’s been shown in cricket there is a correlation between certain helmet strikes and a drop in batting averages,” Bartlett explains.
“By generating more objective data, and adding a ‘gamification’ element, not only do we see better compliance than with historic testing, but we are also being able to identify individuals function, and as such ensure a return to performance, rather than trying to ‘beat’ the system and return before they are ready.”
Improved athlete welfare and improved performance. Now that really is something worth going the extra yard for.
