Jockeys don't need to be racing to take a spill. Last month, during a post parade at Laurel Park, Trevor McCarthy's horse reared up and tossed the 22-year-old rider, who slammed into the ground.
Immediately, McCarthy, one of Maryland's top jockeys, underwent a battery of tests at the track administered by a sports medicine physician and was told he'd suffered a concussion. Last fall, the state became the first in the nation to establish a concussion protocol for jockeys and, as such, McCarthy was required to rest for as long as a week before being cleared to ride again in Maryland.
The jockey mulled his options. No mounts meant no money, and McCarthy was to ride the next day at Keeneland (Ky.), which has no concussion policy. In the end, he followed doctor's orders. Six days later, having recovered, he was back in the saddle.
"It was tough to sit," said McCarthy, who's now riding at Pimlico Race Course. "It stinks that you lose money. Yeah, I was dizzy [from the fall], but your natural instinct is to say, 'I want to ride, I want to ride.'"
Without Maryland's new mandate, he conceded, "I would have gone right back to the track. But when a [medical] professional says, 'We're looking out for your future just like we do on Sundays for NFL players' ... I took him at his word."
Horse racing is a contact sport steeped in risk: men and women hunched on 1,000-pound animals thundering around tight turns at 40 mph. Falls are inevitable; injuries, a given.
According to a 2016 study by the University of Kentucky, there were 36 reported concussions among jockeys (29 males, seven females) at tracks in the United States between 2012 and 2015. But a number of concussions still go unreported, said Dr. Carl Mattacola, author of the study.
Mattacola said 8 to 10 percent of all jockey falls result in concussions.
Head trauma has long been shrugged off by the industry. Jockeys often ride out concussions rather than forgo a paycheck. And track owners have largely ignored the more subtle but sinister injuries in a community they consider a transient hodgepodge of independent contractors.
"Experts have said that girls high school soccer teams are more prepared to deal with concussions than the thoroughbred industry," said Terry Meyocks, national manager of The Jockeys Guild. "Most tracks have doctors, but some of them care more about betting on the races. Some have even been dermatologists. You want doctors trained in trauma.
"This country is 15 years behind England in addressing the problem. We applaud what the Maryland Jockey Club [which owns Pimlico and Laurel] is doing; they are taking the lead so, hopefully, things are changing."
Last September, the MJC teamed with MedStar Sports Medicine to create The Horsemen's Health System, which provides routine and critical care to jockeys, backstretch workers and other track employees.
"We'd had an old retired doctor at the track, but he wasn't up to date on concussion protocol," said Dave Richardson, executive director of the Maryland Thoroughbred Horsemen's Association. "We blew up the old program and started from scratch. We took old barbershops at both tracks and turned them into doctors' offices."
Now, a rotation of four physicians, all skilled in head trauma, serve Pimlico on race days. When a jockey falls, he or she is examined on the spot. Those who are flagged for concussions must undergo four days of testing, from a 30-minute jog to a simulated ride, before returning to racing.
To date, three jockeys have been benched. Alberto Delgado sat out five weeks after an accident during a workout at Pimlico on April 4 in which he and his mount butted heads.
"My horse wanted to go faster, got mad, acted up and whacked me in the forehead," said Delgado, 50. "I was dizzy and weak, and had issues sleeping. At one point I didn't think I'd ever feel normal again, but the doctors assured me that if I continued to rest, everything would be OK. Without them, I probably would have gone crazy."
Psychology plays into a jockey's recovery from concussion, said Dr. Kelly Ryan, one of those who treated Delgado.
"It's like taking care of pregnant women," she said. "They have all of these signs but if they've never been pregnant, they don't know what to look for. Reassurance is important."
At first, jockeys at Laurel were wary of both the physicians and their protocol.
"They ignored us [doctors] for about two months," Ryan said. "Once they realized we were there for their safety, they welcomed us. Educating them is important. I tell them, 'I'm not taking you out because I want another jockey to win, but because of what can happen if I don't.' Imagine if you rode with a concussion — dizzy, with no depth perception or sense of balance. It's like driving drunk."
Not all jockeys embrace the new regimen. Two years ago, at Delaware Park, Jevian Toledo fell during a race and was kicked in the head. He woke up the next day in the hospital and couldn't ride for a week. So Toledo, 21, understands the risks of his job.
"This is my career that's at stake," he said. "But I can't lie. If I was told [to sit out] and I felt I could ride, I would go to another state and race."
With one last workout on the track for Nyquist at Pimlico Race Course on Friday, trainer Doug O'Neill had a final chance to identify a hiccup with the 3-5
By By Jake Lourim
May 20, 2016 | 10:50 AM
A scarred and dented helmet is on display in Edgar Prado's home in Florida. In 2014, in the first turn of a race at Gulfstream Park, Prado's mount went down. A trailing horse kicked the fallen jockey in the head.
"Of all the trophies I've won through the years, that helmet is my most precious because it saved my life," said Prado, 48. Yet the Hall of Famer won't rush to judgment on the new mandate.
"It is very important not to ride with a concussion," he said. "But I think we should be allowed to get a second opinion. These doctors have the rider's safety at stake, but we need specialists qualified in [head trauma]."
Dr. Frank Dawson understands such concerns. He is medical director of the Horsemen's Health System, director of sports medicine at Franklin Square Medical Center and an associate team physician for the Ravens.
"The key to jockeys being receptive to our care is trust and education," Dawson said. "Trevor and Alberto are great ambassadors for us. When horsemen see that they are being treated the same way as other pro athletes, that's huge. The difference is that if a Raven has a concussion, he still gets paid. A jockey doesn't."
For apprentice Kali Francois, it's not about the money.
"I'm a competitive athlete. I don't want to sit on the bench and I have to be told that I can't ride," Francois said. At 25, she has already suffered two concussions, most recently at Laurel in December.
"The headache afterwards was tremendous; it came on like a wave," Francois said. "It was scary."
She's glad to be riding nowadays, with medical support close at hand.
"In the 1950s when a jockey went down, they took him off in a pickup truck. That's terrifying," Francois said. "The Maryland colony is at the forefront [of concussion concerns]. It's about time somebody made an example for the rest of the nation."