Risk factors for spinal injury in jockeys in British and Irish horseracing

Background Horse racing is a competitive sport with a high risk of falls and injuries. Despite the routine reporting of injury incidence in horse racing, no previous research has explored the aetiology of spinal injuries.

Objective To identify risk factors for spinal injury in jockeys during competitive horse racing.

Design Case-control study.

Setting Televised horse racing in the United Kingdom and Ireland between January 2015 – December 2022.

Participants Professional and amateur jockeys (n=655) who sustained a fall. In cases (n=131), falls resulted in injury; in controls (n=524), falls were non-injurious.

Assessment of Risk Factors Characteristics of falls identified from video analysis; jockey characteristics from routinely collected data.

Main Outcome Measures A random forest algorithm was used to identify the risk factors that best predict the spinal injuries during horse racing falls . A multivariate generalised linear model (MGLM) of the association between retained variables and the likelihood of spinal injury risk.

Results The random forest algorithm identify the best spinal injury predictor which enable to create a MGLM that predict 98% of the variance. The variables that best predict spinal injuries were head impact intensity, sudden landing deceleration, second impact intensity, axial skeleton orientation up impact, field size, head impact location, gross position during impact and second impact location.

Conclusions Based on the risk factors identified, interventions to modify jockey fall technique would be a good target for reducing the risk of spinal injuries in horse racing.