Thursday, May 23, 2013

In Service Of Others

In Service Of Others

By Stephen Dwyer

Three hours before the start of the first race at this year’s Punchestown Festival, Dr. Adrian McGoldrick will drive through the racecourse gates. He will meet with all personnel including racecourse doctors, The Order of Malta Ambulance Corps, Turf Club officials, Gardaí and racecourse management. The early arrival to Punchestown however is mainly to meet with Racecourse doctors, the Order of Malta under Nigel Kelly and groundsman Andy Coyle . Together with Coyle, they will inspect the track and meticulously plan the ambulance routes for all the races, in particular the cross country races. Due to the nature of the races and the large amount of runners taking part, no less than four doctors will tail the pack, the aim being to deal rapidly with any injuries sustained by riders falling.

Racecourse doctors at Punchestown and other tracks aim to tend to fallen riders, when necessary within sixty seconds of an incident occurring. This is an impressive time frame, second to few sports worldwide. It is as immediate a response time as possible and the doctors must make rapid assessments in ambulances travelling at speed . At times it may be necessary to leave a rider who has had a simple fall in order to keep up with the race in case of more serious injuries. This is no easy feat but when you are a racecourse medical officer, it is exactly what you do.

On New Year’s Eve 2008, Dr. Adrian McGoldrick, a native of Rathangan,Co. Kildare took over the reins as Turf Club Senior Medical Officer from the retiring Dr. Walter Halley, who had pioneered racecourse medical services in Ireland. The role is as diverse as it challenging and few areas of occupational medicine are involved in areas of such risk. It is a seven-year renewable contract and Dr. McGoldrick must spend at least seventy days per calendar year working on track where he will partake in any number of professional and advisory duties. These include meeting with Turf Club officials to check whether or not there are jockeys that need to be passed fit to race and other engagements such as checking the catering facilities in the weigh-room to see if the food is adequate for the jockeys.

In addition to his role with the Turf Club, Dr. McGoldrick is a  practising GP at Moorefield Medical near in Newbridge. Since graduating from UCD Medical School in 1976, Dr. McGoldrick has become one of Ireland’s most experienced sports medicine professionals.  Through the Turf Club Research Group which he co-ordinates jointly with Dr. Giles Warrington, Programme Chair of Sports Science at DCU, they have produced a wealth of peer reviewed medical journal articles and abstracts. His deep research is specifically focussed around the well-being of jockeys and his published reports include such topics as “Bone Mineral Density and Body Composition Characteristics of Top Level Jockeys” and “Acute Weight Loss Patterns By Professional Horse Racing Jockeys In Preparation For Racing”.

Dr. McGoldrick has a deep understanding of the physiological impact of being a professional jockey and explains his motives; “I was very concerned about the lifestyle jockeys were leading so I initiated  the research in an attempt to address it. Prior to our research, there was very little research being carried out but now we work closely with our counterparts in England, Australia and France who are involved in ongoing research projects."

As an example it is only in the recent times that issues such as hydration are being addressed as he explains; "We know from our research that the majority of jockeys are dehydrated on an ongoing basis, but more so during racing. At higher levels of dehydration we do see impairment in cognitive and physiological function. We are addressing this through dietary and exercise education and new approaches such as setting Minimum Riding Weights for Apprentices."

The area of weight too is a huge area for concern. Dr. McGoldrick reveals that “The issue of jockeys 'making weight' has been a matter of great concern to me and has perhaps been the most important factor in my becoming involved in research on racing. In 2004 I made a submission to the Turf Club Safety Review Committee based on the findings of my initial research. This, in turn, led to the establishment of the Turf Club Research Group and has been in existence for the last eight years.. Our research has shown that the vast majority of jockeys have restricted nutritional intake resulting in reduced bone density in up to 50% of them. . Apart from providing nutritional advice and advice on “making weight’ safely, we have been able to liaise with all stakeholders –The Turf Club, H.R.I., The Trainers Association and Jockeys Association, resulting in the minimum and median  riding weights being increased by several pounds in the last few years and  ensuring that the health of our jockeys is being consistently monitored and addressed."

 Given the nature of horse racing, there will be falls, but for the first time in a decade, fall rates are down. This is predominantly due to the weather and resulting soft ground. National Hunt jockeys will still fall on average in 5.5% of their races, rising to 15% in Point to Point riders with associated injuries.. The upside is that when accidents happen, riders are in safe hands. There is now a detailed concussion protocol in place, with baseline assessment of cognitive function before a jockey’s licence is issued. Following a concussion a rider is stood down until their cognitive function returns to their baseline level. The Jockey’s helmets standard, which have changed little  since 1996, is currently being re-written at European level, chaired by Mc Goldrick with a view to producing a higher standard of helmet which may also reduce concussions and work is on-going with organisations in Australia to introduce an improved standard of helmet  which will be available in Ireland when it is ready later this year.

Dr. McGoldrick also adds to that well-founded belief that jockeys have a higher tolerance for pain. “Part of my day job is an occupational physician assessing employees fitness to return to work. But with jockeys they want to get back to work literally the following day, the problem is to try and restrain their enthusiasm, it’s an addiction, they want to get straight back into the saddle again. Their pain threshold is unique to the rest of us, it is way beyond a normal human being"

A reflection of the dedicated and clean lifestyle that the professional jockey lives is reflected in the banned substance rates for 2012. During that year 164 riders were drug tested and just three samples were confirmed as positive. “Drink and drug testing is random but jockeys are elite athletes and rarely misure drugs. There is a very low uptake of drugs but if someone is found positive the Turf Club and I will fund provide  counselling services where neccessary.”. With respect to injured jockeys he would like to see  a centralised holistic rehabilitation centre  built in Ireland. A team headed by McGoldrick and Warrington visited Oaksey House in Lambourn prior to the recent injuries to JT Mc Namara and Jonjo Bright and saw the need for a co-ordinated approach to rehabilitating jockeys. He would like to see this built in Kildare, perhaps as a further development of R.A.C.E., due to its central location and which would provide a further range of services to jockeys and their families.

Perhaps the most ground-breaking plan for jockeys is the new  Jockey Pathway. The Pathway is in the final development stages through the Turf Club Research Group and R.A.C.E and aims to provide support and backup services to jockeys from the time they start their careers in pony racing into retirement. The proactive approach taken by Dr. McGoldrick and his medical team and counterparts truly does cover the entire racing sphere. It is entirely admirable and truly a case of dedicating oneself to the care and service of others. There can be no better calling.   

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