Jockey Concussions

A concussion results from a head injury that causes damage to the brain. A concussion is most often due to trauma from a direct hit to the head. Jockeys are at high risk for a concussion during a fall from a horse, either from collision with the ground or a horse. However, a concussion may also occur without contact with an object when the head moves suddenly and the brain collides with the inner surface of the bony skull. 

Though a concussion is usually limited to injury of the brain, damage to the major blood vessels around the brain occasionally occurs. Damage to blood vessels around the brain can be life threatening and is not always immediately evident. Continued bleeding from damaged vessels can lead to worsening signs, and potentially coma and death in the 24 hours following injury. Internal bleeding requires treatment at a medical facility. This possibility demonstrates the need to seek evaluation and treatment at a medical facility whenever a concussion is suspected. 

Full recovery from a concussion is common if the jockey receives prompt and correct care. Time to recover is usually a few weeks but can vary. Some cases may require prolonged rest and limitation of activities for months or longer depending on the severity of symptoms and significance of the injury.

Suspecting that a jockey may have sustained a concussion is the most critical first step in diagnosing a concussion. The jockey and those people around them, must be familiar with the signs and symptoms of concussion and should immediately alert a member of the racetrack medical team, as prompt medical evaluation and care is crucial to recovery as well as identifying more severe injury such as blood vessel damage.

All jockeys who fall or are thrown from a horse will be evaluated by the racetrack’s medical team for injury and signs of concussion.

All jockeys witnessed to have sustained a possible head injury by any means, including head-to-head contact with a horse or direct contact with the structure of the starting gate, will be evaluated by the racetrack’s medical team for injury and signs of concussion.

The required evaluation will be documented on the HEADCHECK digital concussion platform. Based on the medical staff’s scope of practice, either the Concussion Recognition Tool or the Sport Concussion Assessment Tool will be conducted.

An accident report is to be submitted on HEADCHECK with a corresponding Health Status update to notify authorized individuals (track staff, staff at other tracks that the jockey frequently races at, emergency contacts).

If after evaluation, the medical team does not suspect a concussion, where all testing is within normal limits and the jockey has no signs or symptoms of a concussion, the jockey will be allowed to return to ride the same day.

• The medical team will notify the clerk of scales and the stewards that the jockey is cleared to ride for the remainder of the day.

  • In the HEADCHECK platform, the concussion assessment that was added at evaluation should reflect that a concussion was not suspected.

  • An accident report is to be logged reflecting that the jockey is eligible to ride (if no other injuries are suspected).

• The jockey must meet with the medical team the next race day for a follow-up evaluation to determine if there are any late-developing concussion symptoms.

  • The HEADCHECK platform is to be used to document the follow-up assessments, including a symptom assessment at minimum.

• If on the day following the traumatic event, the jockey is riding at a different racetrack, then a medical professional at the different track must evaluate the jockey.

  • If authorized, the medical professional may view the jockey’s concussion history (previous concussions, baseline test, initial post-injury assessment, etc.) on HEADCHECK to compare symptom scores.

  • This follow-up evaluation must be reported to the medical team at the racetrack where the jockey sustained the injury and in the HEADCHECK platform, including a symptom assessment at minimum.

If after evaluation, the medical team does suspect a concussion, then the jockey will be removed from riding for a period of time determined by the medical team for observation. The observation period will be no less than 45 minutes and may be extended if the medical team feels additional time is warranted. 

• The medical team will notify the clerk of scales and the stewards that the jockey will be observed for concussion signs or symptoms.

• Following the observation period, should the racetrack medical team determine that testing is within normal limits and there are no signs or symptoms of concussion, the jockey will be allowed to return to ride the remainder of that day.

• The jockey must meet with the medical team the next race day for a follow-up evaluation to determine if there are any late-developing concussion symptoms.

• If on the day following the traumatic event, the jockey is riding at a different racetrack, then a medical professional at the different track must evaluate the jockey. 

  • If authorized, the medical professional may view the jockey’s concussion history (previous concussions, baseline test, initial post-injury assessment, etc.) on HEADCHECK to compare symptom scores.

  • This follow-up evaluation must be reported to the medical team at the racetrack where the jockey sustained the injury and in the HEADCHECK platform including a symptom assessment at minimum.

If following the observation period, the racetrack medical team continues to suspect a concussion, then the jockey will be removed from riding for the remainder of the day and may be transferred to a hospital emergency department if the racetrack medical team determines it is warranted.

• The racetrack medical team will notify the clerk of scales and the stewards that the jockey is ineligible to ride until a qualified medical provider knowledgeable in concussion management and familiar with the skills needed to perform the job of a jockey provides a written release for the jockey to return to ride.

• The written release must be presented to the racetrack medical team, the stewards and the clerk of scales.

  • The written release must be uploaded to the HEADCHECK platform as a “clearance to ride” note.

  • The addition of a “clearance to ride” note will update the jockey’s health status to “eligible” (if all requirements have been met, otherwise, the health status will update to “missing requirements”).

• The jockey must meet with the racetrack’s medical team for a follow-up evaluation, once per day, prior to riding, for a period determined by the racetrack’s medical team.

• If authorized, the medical professional may view the jockey’s concussion history (previous concussions, baseline test, initial post-injury assessment, etc.) on HEADCHECK to compare symptom scores.

• This follow-up evaluation must be reported to the medical team at the racetrack where the jockey sustained the injury and in the HEADCHECK platform, including a symptom assessment at minimum.

Any jockey with a confirmed concussion as determined by the racetrack’s medical team will be ineligible to ride the remainder of that day and will be transferred to a hospital emergency department. 

• The racetrack medical team will notify the clerk of scales and the stewards that the jockey is ineligible to ride until a qualified medical provider knowledgeable in concussion management and familiar with the skills needed to perform the job of a jockey provides a written release for the jockey to return to ride.

•  The written release must be presented to the racetrack medical team, the stewards, and the clerk of scales.

  • • The written release must be uploaded to the HEADCHECK platform as a “clearance to ride” note.

    • The addition of a “clearance to ride” note will update the jockey’s health status to “eligible” (if all requirements have been met, otherwise, the health status will update to “missing requirements”).

• The jockey must meet with the racetrack’s medical team for a follow-up evaluation, once per day, prior to riding, for a period determined by the racetrack’s medical team.

  • • If authorized, the medical professional may view the jockey’s concussion history (previous concussions, baseline test, initial post-injury assessment, etc.) on HEADCHECK to compare symptom scores.

    • This follow-up evaluation must be reported to the medical team at the racetrack where the jockey sustained the injury and in the HEADCHECK platform, including a symptom assessment at minimum.

Jockeys with a suspected concussion: 

• Should not be left alone.

• Should have their family and friends involved and educated about concussions, how to care for and recognize symptoms and to report worsening conditions to medical professionals.

Physical rest and relative cognitive rest for a few days will usually result in a reduction in symptoms.

The early phase of recovery is especially important. Returning to a demanding physical activity, like horse racing, too soon after a concussion can result in cumulative brain damage that increases the risk of permanent loss of physical or cognitive functions.

In most cases, a gradual increase in daily activity level is allowed if symptoms do not worsen. 

Once usual daily activities can be conducted without concussion-related symptoms returning, a medically managed progressive exercise program supervised by a health care provider may be appropriate. If symptoms return, physical and relative cognitive rest should be resumed until concussion related symptoms have resolved. Once symptoms are resolved, a progressive exercise program is initiated to recondition the rider for the vigorous demands of horse racing.

When returning to ride, a jockey, like all athletes, should follow a graduated, medically managed exercise sport specific progression, with increasing amounts of exercise supervised by a healthcare provider

• SCAT5

• SCAT5 Spanish Supplemental Sheet

• SCAT5 demonstration video

• Baseline Testing FAQs

• SCAT6 - English

• Baseline Testing FAQs