Concussion protocol focus of updated ARCI model rule

By: Tom LaMarra

Posted: April 9, 2018

An amended model rule adopted by the Association of Racing Commissioners International Board of Directors April 7 requires that at least one of the medical professionals at racetracks be adequately trained in diagnosing concussions, and also calls for guidelines on clearing jockeys to ride after a fall.

The updated rule is the result of several years of discussion among representatives of The Jockeys’ Guild, the University of Kentucky and MedStar Health, which provides sports medicine services through the Maryland Horsemen’s Health System. There already is a model rule for the minimum emergency services required at each track.

Maryland Racing Commission Executive Director Mike Hopkins, who was elevated to Chairman of the ARCI at the organization’s recent annual convention, said state regulators raised various concerns before the board voted on the model rule update, including liability of paramedics, protocol for when jockeys return to ride after an injury, and how to handle a fall in the paddock or post-race.

“We have to take it one case at a time,” Hopkins said. “Part of the conversation was people saying, ‘We don’t want the liability of having to say (a jockey) is OK to ride.’ This is about communication and education. There is tried and true protocol that works, and you learn from experience.

“We’ve been fortunate in Maryland with MedStar, and we’re learning a lot from it. It works. If people want to try to make a difference, they can come here and look at what’s going on.”

Dr. Kelly Ryan, one of five physicians who rotate being on site on live racing days in Maryland, said MedStar began using baseline concussion protocol when it became part of the Horsemen’s Health System in September 2015. Housed in the Maryland Thoroughbred Horsemen’s Association offices, the program is for backstretch workers, horsemen, Maryland Jockey Club staff and the jockey colony.

“Because we’re sports medicine specialists, we decided as a group to have concussion protocol,” Ryan said. “We talked it over with (MJC Director of Racing Georganne Hale) and the Maryland stewards, and they agreed. Any time a jockey fell off of a horse, he or she had to be evaluated by one of us. We started to learn about the physiology of jockeys and developed a targeted program.”

“Other tracks, like Delaware Park, send us injury reports for their jockeys and have called MedStar to ask us to examine riders when they are in Maryland. It’s not a perfect system but we’re trying to catch as many of them as we can. There is going to be uniformity across racetracks because so many jockeys travel from track to track. We want to improve communication and implement a better electronic medical record system.”

Ryan said the baseline concussion testing required under the updated model rule must include regular conversations with jockeys to explain the often varied symptoms of concussion.

“They may not know they even have a concussion,” Ryan said. “A concussion can be very difficult to diagnose. It’s very specialized, and the symptoms can be different. You really need someone involved who is comfortable managing concussions.”

Keeneland in Kentucky began requiring a baseline concussion assessment for jockeys in the fall of 2017. In a release, the track said it was part of a “pilot project” between the Guild and University of Kentucky that was conceived by Keeneland Medical Director Dr. Barry Schumer and is now overseen by Dr. Carl Mattacola of the UK College of Health Sciences.

(Photo by Tom LaMarra)