Factors associated with time to return to horse racing following a clavicle fracture in jockeys competing in Great Britain: A review and analysis of medical records.
Abstract: Competitive horse racing is the second largest sport in Great Britain by spectator attendance, employability, and revenue. It is a lucrative yet hazardous sport, with high injury rates, particularly from falls. Clavicular fractures are one of the most common injuries reported, yet their management, especially regarding return to racing, is under-researched. The purpose of this study was to explore the factors associated with the time to return to competition following a clavicular fracture in jockeys competing in Great Britain. Methods: This review of medical records utilised data from the British Horseracing Authority spanning 2011-2018, inclusive. Data included the jockey's age, sex, type of licence, race discipline, location of incident, and fracture management. Descriptive statistics and univariable and multivariable generalised linear models were constructed to analyse the impact of these factors on the time to return to racing. Results: Out of 212 records of clavicular fractures, 169 were analysed. The majority (82.8%) of fractures were managed conservatively, with the remainder requiring surgery. The median time to return to racing was 40 days, with an interquartile range of 34 days. Following a clavicular fracture, the results from the univariable and multivariable models indicated that the management approach, whether the fracture is displaced, and the type of race in which the injury occurred have the greatest influence on extending the time to return to racing. In contrast, professional, conditional and amateur licence types, as well as experiencing the injury at a racecourse, were associated with reduced time to return to racing, which may indicate greater risk-taking behaviour. Conclusions: This study offers unique insights into key medical and contextual factors that influence the time to return to racing among jockeys in Great Britain, contributing to tailoring medical management and return to racing protocols to support jockeys' health and career longevity. Clinicians working within horse racing can use the findings of this study to provide return to racing guidance to trainers, riders and other medical professionals based on the key contextual information reported in this study.
Copyright: © 2025 Newton et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Publication Date: 2025-01-23 PubMed ID: 39847551PubMed Central: PMC11756748DOI: 10.1371/journal.pone.0317724Google Scholar: Lookup
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Summary
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Overview
- This study investigates the factors affecting how long it takes jockeys in Great Britain to return to horse racing after suffering a clavicle (collarbone) fracture.
- The research analyses medical records and uses statistical models to identify influences on recovery time, aiming to improve medical guidance for jockeys post-injury.
Background and Importance
- Horse racing is a major sport in Great Britain, notable for large audiences, significant employment, and substantial revenue.
- The sport is considered hazardous due to a high rate of injuries, especially from falls during races.
- Clavicle fractures are one of the most frequent injuries for jockeys yet lack extensive research regarding recovery and return to competition timelines.
Study Objective and Methods
- The primary goal was to examine factors associated with the time taken by jockeys to return to racing after sustaining clavicle fractures.
- Data were collected from medical records held by the British Horseracing Authority covering the years 2011 to 2018.
- Collected variables included:
- Jockey’s age and sex
- Type of racing licence (professional, conditional, amateur)
- Race discipline
- Location where the injury occurred (e.g., racecourse)
- Type of fracture management (conservative treatment or surgery)
- Statistical analysis involved descriptive statistics and both univariable and multivariable generalized linear models to determine which factors significantly influenced return times.
Key Findings
- Total clavicle fracture records were 212, with 169 cases included in the analysis after exclusions.
- A large majority (82.8%) of cases were managed conservatively (non-surgical treatment), while the others underwent surgery.
- The median time for jockeys to return to racing after their clavicle fracture was 40 days, with variability indicated by an interquartile range (IQR) of 34 days.
- Factors prolonging return to racing:
- Fracture management type: Surgical cases tended to have longer recovery times than conservative treatments.
- Displacement of the fracture: Displaced fractures extended time to return compared to non-displaced fractures.
- The specific race discipline or type where the injury occurred also influenced recovery duration.
- Factors associated with quicker return to racing:
- Jockey licence type—professional, conditional and amateur licences were linked to shorter recovery times, possibly suggesting increased risk-taking or pressure to return sooner.
- Sustaining the injury at a racecourse was correlated with reduced time to return, again suggesting contextual pressures or behavioural differences.
Implications for Medical Management and the Racing Industry
- The study provides valuable insight into how various medical and contextual factors influence recovery timelines for jockeys.
- Understanding that surgical treatment, displacement, and race type prolong recovery can guide clinicians in prognosis and management decisions.
- The observed association between licence type and reduced recovery time may highlight the need to consider behavioural or occupational pressures influencing return-to-play decisions.
- These data allow for the tailoring of medical protocols and return-to-racing advice to better support jockey health and career longevity.
- Clinicians, trainers, and medical teams can use these findings to inform safer and evidence-based guidance, potentially reducing risks of premature return or re-injury.
Conclusion
- This research enhances the understanding of recovery after clavicle fractures in jockeys by identifying significant factors affecting return to racing time.
- Its findings address an important gap in sports medicine within the horse racing community of Great Britain.
- The study advocates for informed, individualized medical decisions considering both injury-specific and contextual factors, benefiting jockey welfare and the competitive sport.
Cite This Article
APA
Newton LJ, Dobbin N, Goodwin P, Crampton JS.
(2025).
Factors associated with time to return to horse racing following a clavicle fracture in jockeys competing in Great Britain: A review and analysis of medical records.
PLoS One, 20(1), e0317724.
https://doi.org/10.1371/journal.pone.0317724 Publication
Researcher Affiliations
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.
- Cheshire and Wirral Partnership NHS Foundation Trust, Ellesmere Port Hospital, Ellesmere Port, Cheshire, United Kingdom.
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.
- Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom.
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.
MeSH Terms
- Horses
- Clavicle / injuries
- United Kingdom
- Fractures, Bone / epidemiology
- Fractures, Bone / therapy
- Animals
- Male
- Female
- Humans
- Athletic Injuries / epidemiology
- Return to Sport
- Medical Records
- Time Factors
- Sports
- Adult
Conflict of Interest Statement
The authors have declared that no competing interest exist.
References
This article includes 32 references
- House of Commons Library, The future of horseracing [Internet]. England, United Kingdom: UK Parliament; c2023. [cited 2024 Nov 22]. Available from: https://commonslibrary.parliament.uk/research-briefings/cdp-2023-0200/#:~:text=In%202020%2C%20the%20BHA%20said,attended%20racing%20events%20in%202022.
- Frontier Economics [Internet]. England, United Kingdom: Department for Culture, Media and Sport; c2016. [cited 2024 Nov 22]. Available from: https://assets.publishing.service.gov.uk/media/5a80e15d40f0b62305b8dab0/Frontier_Economics-_An_economic_analysis_of_the_funding_of_horseracing.pdf
- Hitchens PL, Hill AE, Stover SM. Jockey falls, injuries, and fatalities associated with thoroughbred and quarter horse racing in California, 2007–2011. 2013;1(1): article number 2325967113492625.
- Turner M, McCrory P, Halley W. Injuries in professional horse racing in Great Britain and the Republic of Ireland during 1992–2000. 2002;36(6): 403–409.
- Legg KA, Cochrane DJ, Bolwell CF, Gee EK, Rogers CW. Incidence and risk factors for race-day jockey falls over fourteen years. 2020;23(12): 1154–1160.
- Davies M, Jackson KA, Mackinnon AL, Turner A, Kuznik K, Hill J. Epidemiology of race day injury in young professional jockeys in Great Britain from 2007 to 2018: a retrospective cohort study. 2021,11(8): e044075.
- O’Connor S, Warrington G, McGoldrick A, Cullen SJ. Epidemiology of injury due to race-day jockey falls in professional flat and jump horse racing in Ireland, 2011–2015. 2017;52(12): 1140–1146.
- Press JM, Davis PD, Wiesner SL, Heinemann A, Semik P, Addison RG. The national jockey injury study: an analysis of injuries to professional horse-racing jockeys. 1995;5(4): 236–240.
- Turner M, Balendra G, McCrory P. Payments to injured professional jockeys in British horse racing (1996–2006). 2007;42(9): 763–766.
- Stanley D, Trowbridge E, Norris SH. The mechanism of clavicular fracture. A Clinical and biomedical analysis. 1998; 70: 461–464.
- Fahy S, Doinn TO, Peters N, Pugh J, Fox C, Kenny P. Return to sport after operative fixation of midshaft clavicle fractures in professional jockeys. 2023.
- Zlowodzki M, Zelle BA, Cole PA, Jeray K, Mckee MD. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. 2005;19(7): 504–507.
- Robinson CM. Fracture of the clavicle in the adult. epidemiology and classification. 1998;80(3):476–484.
- Hill JM, McGuire MH, Crosby LA. Closed treatment of displaced middle-third fractures of the clavicle gives poor results. 1997;79(4): 537–590.
- Jack RA II, Sochacki KR, Navarro SM, McCulloch PC, Lintner DM, Harris JD. Performance and return to sport after clavicle open reduction and internal fixation in national football league players. 2017;5(8): 2325967117720677.
- Jack RA II, Sochacki KR, Navarro SM, McCullock PC, Linter DM, Harris JD. Performance and return to sport after nonoperative treatment of clavicle fractures in National Football League players.n. 2017;40(5):e836–e843. doi: 10.3928/01477447-20170719-03nn
- Ahearn BM, Shanley E, Thigpen CA, Pill SG, Kissenberth MJ. Factors influencing time to return to sport following clavicular fractures in adolescent athlete.n. 2021;30(7): S140–S144.n
- Sarkar S, Seshadri D. Conducting record review studies in clinical practice.n.n2014;8(9): JG01–JG04. doi: 10.7860/JCDR/2014/8301.4806nn
- Ortona E, Pagano MT, Capossela L, Malorni W. The Role of Sex Differences in Bone Health and Healing. . 2023;12(7):993. doi: 10.3390/biology12070993 ; PMCID: PMC10376157.n
- Gruber R, Koch H, Doll BA, Tegtmeier F, Einhorn TA, Hollinger JO. Fracture healing in the elderly patient. . 2006;41(11):1080–1893. doi: 10.1016/j.exger.2006.09.008 Epub 2006 Nov 7. .n
- Wollstein R, Trouw A, Carlson L, Staff I, Mastella D, Ashmead D. The Effect of Age on Fracture Healing Time in Metacarpal Fractures.n. 2020;15(4) 542–54. doi: 10.1177/1558944718813730nn
- ElHawary H, Baradaran A, Abi-Rafeh J, Vorstenbosch J, Xu L, Efanov JI. Bone healing and inflammation: principles of fracture and repair. . 2021;35(3):198–203. doi: 10.1055/s-0041-1732334 Epub 2021 Sep 10. ; PMCID: PMC8432998.n
- Ryan K, Brodine J. Weight-Making Practices Among Jockeys: An update and review of the emergent scientific literature.n. 2021;12:87–98ndoi: 10.2147/OAJSM.S235143nn
- Wilson G., Martin D., Morton J. P., & Close G. L.n(2018). Male flat jockeys do not display deteriorations in bone density or resting metabolic rate in accordance with Race riding experience: Implications for RED-S.n. 2024;28(4), 434–439. Retrieved Jul 15, 2024, from 10.1123/ijsnem.2017-0371
- Balendra G, Turner M, McCrory P, Halley W. Injuries in amateur horse racing (point to point racing) in Great Britain and Ireland during 1993–2006.n.n2007. nMar;41(3):162–6. doi: 10.1136/bjsm.2006.033894 Epub 2006 Nov 30. ; PMCID: PMC2465222.n
- O’Connor S., Warrington G., O’Brien S., McDermott E., McGoldrick A., Pugh J., et al. (2021). Injuries outside of horseracing: is it time to focus on injury prevention of jockeys outside of races? The Physician and Sportsmedicine, 49(1), 45–50. doi: 10.1080/00913847.2020.1760693
- Poon ET, O’Reilly J, Sheridan S, Cai MM, Wong SH. Markers of bone health, bone-specific physical cctivities, nutritional intake, and quality of life of professional jockeys in Hong Kong.n.n2018. nJuln1;28(4):440–446. doi: 10.1123/ijsnem.2016-0176 Epub 2018 Apr 28. n
- Irfan SA, Ali AA, Ashkar A, et al. nPredictors requiring special attention to prevent clavicle fracture nonunion: a systematic review of literature. n2023;8:e001188. doi: 10.1136/tsaco-2023-001188nn
- Verborgt O, Pittoors K, Van Glabbeek F, Declercq G, Nuyts R, Somville J. Plate fixation of middle-third fractures of the clavicle in the semi-professional athlete. Acta Orthop Belg. 2005. Feb;71(1):17–21. .
- British Horseracing Authority [Internet] London, United Kingdom: Medical Standards for Fitness to Ride; No date [cited 2024 Nov 22]. Available from: https://media.britishhorseracing.com/bha/Medical/33_NMED_Fitness_to_Ride_Criteria.pdf
- Office for National Statistics (ONS) [Internet]. Newport, South Wales: Incident and Emergency wait times across the UK; c2024 [cited 2024 Nov 22]. Available from https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthcaresystem/articles/accidentandemergencywaittimesacrosstheuk/2024-02-28
- O’Connor S, Hitchens PL, Fortington LV. Hospital-treated injuries from horse riding in Victoria, Australia: time to refocus on injury prevention?n. 2018;4:e000321. doi: 10.1136/bmjsem-2017-000321nn
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