Kentucky Derby Jockey Health Risks: Arthritis, Eating Disorders, Death

May 6, 2011— -- Darrell Haire knows he's one lucky former jockey. Despite breaking both shoulders, both collarbones, a leg, a foot, a wrist, a thumb, and his jaw before hanging up his racing silks at 32, the only thing bothering his 54-year-old body is the left knee kicked by a horse. He'd like to boost the odds that jockeys in Saturday's 137th Kentucky Derby come through relatively unscathed, too, which is why he spent Thursday afternoon making sure none of the cameras on the inside fence at Churchill Downs was sticking out.

"It could cause a horse to trip," said Haire, West Coast regional manager of the Jockeys' Guild of America, and an advocate for jockey health and safety. "I'm always trying to make things safer for these guys."

Despite the considerable beauty associated with thoroughbred racing and the glory for winners of the storied Run for the Roses, Haire never loses sight of what can go terribly wrong when a 115-pound rider mounts a 1,100-pound horse moving at 40 mph.

"I've been in the room three different times when they took riders off life support. Two of them were close friends of mine," he said. "When a horse steps on you, when they hit you, it's like a train. They destroy you."

From 1992-2006, there were 26 fatalities among jockeys in the thoroughbred and standardbred industry – an average of 5.6 deaths each year, according to an April 2009 report compiled by the National Institute for Occupational Safety and Health (NIOSH). The authors said the figure likely was an underestimate. The Jockeys' Guild reported that more than 100 jockeys were killed from 1950 through the mid-1980s.

Dr. James Tibone, an orthopedic surgeon with the Kerlan-Jobe Orthopedic Clinic in Los Angeles, who treats jockeys at Hollywood Park, called horseracing "probably the highest-risk sport for dying."

Yet, jockeys are a resilient bunch: "They're tough. They don't complain about stuff. They hurt and they ride," said Tibone, a specialist in repairing shoulders, elbows and knees.

Although jockeys are small, ranging from 4-foot-10 to 5-foot-7, "they're very fit," he said. "They have no body fat. They're toned and they're in great aerobic shape." Tibone recalled that the late sports medicine pioneer Dr. Robert Kerlan, team physician for the L.A. Rams, Dodgers, and Lakers, as well legendary jockey Bill Shoemaker, "used to say they were the best-conditioned athletes he took care of."

These men and women (this weekend, Rosie Napravnik hopes to become the first female Derby winner) endure years of fractures, concussions, bruises and sprains, always aware that they could become paralyzed or die. Said Haire: "Riders know that's the risk they take and they just go with it."

As for pain, "they just block it out," Haire said. Fueled by a combination of fitness and adrenaline, "they go on with it."

JAMA Study: 1 in 5 Jockey Injuries Involved Head or Neck

Researchers at the University of North Carolina, Chapel Hill, looked at 6,545 injuries and three deaths among 2,500 licensed U.S. jockeys from Jan. 1, 1993, to Dec. 31, 1996. During that period, nearly 1 in 5 injuries involved the jockey's head or neck, followed by injuries to the leg, foot and ankle, back, arm and hand, and shoulder. More than half the injuries occurred while entering, within or leaving the starting gate.

As Haire explained it, horses repeatedly slam riders into the sides of sparsely padded gates and sometimes subject them to severe head and brain injuries. On Feb. 18, 2007, Manuel Caraballo, a 65-year-old jockey from Puerto Rico, was thrown from his mount at the start of a race in St. Croix after a horse a few stalls away reared and struck the door of the starting gate. Caraballo died during surgery.

The Chapel Hill researchers reported that the second most-frequent locale for rider injuries was around the finish line. Their study, published in the March 8, 2000, issue of the Journal of the American Medical Association, found that being thrown by the horse accounted for 55.1 percent of back injuries and 49.6 percent of chest injuries.

Tibone, who also is an orthopedics professor at USC and medical director for USC sports, estimated that jockeys suffer five to 10 fractures in a career, most commonly affecting the collarbone, or clavicle, which heal on their own. In a 35-year career that included a 1984 Kentucky Derby win, jockey Laffit Pincay Jr., broke his collarbone more than a dozen times, Tibone noted. Less common fractures of major leg bones, the tibia or femur, require surgical repair with rods or plates and keep riders off their mounts until they've fully recovered.

Some types of repeated injuries can set the stage for arthritis, such as fractured joints, stressed knees, tears of knee cartilage and dislocated shoulders, Tibone said. "It's really individual."

Some health hazards have to do with how jockeys take care of themselves. The enormous pressure to "be strong…and look small," has been linked to high rates of eating disorders, Haire said. In the name of weighing less at post time, jockeys abuse laxatives, diuretics, diet pills and steam rooms (sweat boxes). They smoke cigarettes to curb their appetites, vomit up meals, and try extreme diets.

"I have one rider that has major problems now, Manny Romero. He's known to have abused his body – hitting the box and heaving (vomiting)," Haire said.

Haire, who is 5-foot-6, said he never made himself vomit or spent prolonged periods in a sauna to maintain his 112-pound weight. However, he smoked to suppress his appetite, and took the diuretic Lasix. "When I think about taking one of those, I get a little pain just thinking about how it used to hurt my kidneys," he said. Fortunately, he didn't suffer permanent kidney damage.

Haire has proposed that weight formulas be overhauled to recognize the need for weight minimums that allow jockeys to be healthy.

Asked whether any of his children had followed him into the risky, but potentially rewarding racing world, Haire said: "I kept my kids away from it. My son just graduated from Juilliard. He dances and acts."