Sports Therapy Lambourn

Traumatic brain injuries and the link to depression – focus on the source not the symptoms?

Have you or someone close to you ever suffered a head injury? The effects of even mild concussions can have lasting effects, sometimes more so when you think you’ve fully recovered.

On the 23rd of June Grand National winning jockey Liam Treadwell took his own life. He was the second jockey in as many months to do so. His last post on social media, read, ‘Simpler and happier times in life’. It referenced a photo posted four years previous of him enjoying a beer in Barbados. The photo had him leaning against six crates of beer. I thought it poignant that the crates be labelled ‘Banks’, the surname of Liam’s weighing room colleague, James who died in February under similar circumstances.

Liam had suffered a severe head trauma in 2016 in a fall at Bangor leaving him unconscious for four minutes. The rehabilitation process continued for six months and he was left with a number of side effects. Remarkably he continued his career as a jockey but retired in 2018 after a marital breakdown and other difficulties. Unable to shake his love for riding he took out his licence again in 2019 and rode successfully until Lockdown halted racing in March 2020.

Around 50% of people suffering traumatic brain injuries are affected by depression within a year post injury. This rises to nearly two thirds within the first seven years*. Changes in neurotransmitter levels and damage to emotion centres in the brain can cause the change. And yet we still perceive depression as being a disease of the mind. An area of our being that can’t quite be reached, seen, measured or corrected. An overwhelming prospect to face for sure.

The impact of brain trauma can be physical, life changing and dramatic. Alternatively it can subtly entwine into the existing personality of an individual until the wearer is no longer recognised as their original self. Symptoms take over the life and the life becomes the symptoms as we lose sight of the root cause and the person.

People will say that Liam was depressed and that led to his suicide. I would argue that perhaps his death ultimately was simply due to his head injury. Perhaps we need to recognise and focus on the root cause instead of waiting for the symptoms to engulf the person. This will undoubtedly lead to more prompt supervision of individuals.  

The racing industry is increasingly encouraging jockeys to ‘reach out’ to get help if they are feeling depressed or suicidal. I feel that many will fall through the cracks if this is their principal tactic. Jockeys are tough and face potentially life threatening situations daily. They innately control fearful situations by concealing emotions. Furthermore being a jockey allows them to practice this art until it is not just habitual but ingrained. So you’re dealing with individuals who are profoundly set up to supress emotions. They are literally experts.

Waiting for some jockeys to ‘reach out’ would be like waiting for Trump to lead like Obama. It’s just not going to happen. If you were to remove the onus to step forward away from the jockey and replaced it with compulsory mental health screening for all you’d surely have a better chance of detecting and monitoring those in need. Psychological screening, blood tests and brain scanning are all potential methods for detecting mental health issues.

www.mind.org.uk and www.headway.org.uk are organisations that can help with mental health issues.

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* Fann, J.R., Hart, T., Schomer, KG. Treatment for Depression after Traumatic Brain Injury: A Systematic Review. Journal of Neurotrauma 26:2383-2402, 2009. Cited in http://www.msktc.org

Frankie Naylor Sports Therapy

Being short staffed – the straw that broke the camel’s back!

How many did you muck out today, ride out or feed? Yesterday I heard of someone that mucked out 35 and fed 105. How long can one person sustain this type of workload and what is the impact on their body?

Every day I treat people working in the horse racing industry who have physical jobs. Chronic injuries are part and parcel (to an extent).

Over the last few years I have noticed that workloads have increased significantly due to staff shortages. Chronic injuries are at epidemic levels.

https://www.theguardian.com/sport/blog/2019/may/14/talking-horses-new -study-finds-unsustainable-workloads-in-horse-racing

As a sports therapist the pattern of injury I see specifically is when an individual has to work on their weekend off or work that extra race meeting due to staff shortages and……… ‘Boom’ you’ve guessed it, it’s the straw that really did break the camel’s back! And that’s when they end up on my couch. A significant portion of their wage packet being forked out because they haven’t had that all important day and a half off out of fourteen to recover.

Chronic lower back pain and shoulder impingements are of the most common issues I see. Both which require a degree of rest from painful activities – but alas not in racing!

Many people leave racing at least in part because they feel that their bodies just cannot sustain the workloads long term (I know, they’ve told me!). This creates a tougher environment for the individuals left behind as they are having to make up the shortfall. And thus every pursuing injury happens a little sooner than the last as workloads increase and the next staff member hangs up their boots for a less physical role.

In addition as a nation we are seeing a population of young people with lower base fitness levels than ever. This is due to increases in automation coupled with poor diet and lifestyle choices. So the individuals coming into racing are more likely not to be fit for purpose, and are expected to take on greater workloads (as well as being Millennials!)…… and you don’t have to be a rocket scientist to predict the end result.

So what next? Chronic injuries are just one result of the staffing crisis. Housing, pay, amongst other issues all play their part too. Some trainers have confronted these situations head on creating far better working environments like good quality staff accommodation. Although this doesn’t directly impact on injury status. Will trainers have to consider investing in injury prevention for staff like they do for their horses?

Would you welcome injury treatments as part of a stable staff employment package? Let me know your thoughts. Comment, like, share.

If you work in racing and are struggling with an injury you can get in touch with Racing Welfare at racingwelfare.co.uk

Sports therapy rehab

Can sporting success be predicted by an individual’s approach to injury?

Racing has just been given the green light as we work to pull our economy from the brink post lockdown. As always there are some big named jockeys bordering on being fit to ride in some big meetings post injury. This gives high hopes to some of their counterparts coming up through the ranks. But what are the qualities needed to get those jockeys back to full fitness and remain at the top of their game?

I write this with one particular jockey in mind, a jockey that walked into Oaksey House about 10 years ago to (eventually) get (a little) help with a chronic injury. He was a natural athlete, a talented rider (a tamer of bears in fact!), and tough, really tough. And at the time I remember thinking that we were starting this rehab process about 6 years too late. A jockey that was deserving of so much more – RIP Banksy.

So can sporting success be predicted by an individual’s approach to injury? Yes I think it can give a good indication.

Why am I so sure of myself? Because I’ve worked with thousands of people going through the rehab process. Over time I have seen patterns arising differentiating the more successful individuals from the rest of the pack.

Take jockeys, I see particular attributes in the more successful individuals:

  1. They’re tough but not too tough. They don’t complain about every single niggle but when there is something significant to address they address it and sooner rather than later. One of the best indicators of future injury is previous injury. So getting niggles fixed before they become bigger issues enables the jockey to maintain fitness, weight and psychological wellbeing; as well as futureproofing their bodies for the long-haul!
  2. They have a good ‘team’ around them and they accept help from and allocate tasks to ‘the team’. This could be in the form of family members, a spouse, friends and or work colleagues. The team can help with all types of emotional and practical support from being that listening ear to driving them to their rehab sessions. This allows the individual to focus on the practicalities of being a jockey recovering from injury.
  3. And perhaps the biggie, the all-encompassing but rarely discussed aspect of achieving sporting success and staying injury free involves childhood experiences. We’re individuals taught how to ask for help? Were they listened to as children? Were they taught that their feeling we’re important too? A little deep? Not really! Getting the balance correct in the early years will set individuals up for life. Get it wrong and the cracks will start to develop.

So often I meet incredibly tough, capable, hard-working people who lack one or more of these 3 elements of success. Because of this doors just don’t open. The qualities that make them as amazing as they are also stop them from getting right to the top of their game.

So, be realistic about your injuries. Be tactical with your rehab. Build a team around you to help offload pressures both physical and emotional. And ultimately if you aren’t great at asking for help – learn quickly because without this ability achieving your potential will become a very difficult task.

If you’re a jockey and need to start the rehab process get in touch with The Injured Jockeys Fund at ijf.org.uk

What’s your experience? Do you ignore or address your injuries? Comment, like, share.