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The Science of Horsemanship

Working with bone to prevent injury in racehorses


Chris Whitton

BVSc FACVSc PhD

Equine Vet

Research team
Collaborators

Prof Eleanor Mackie, University of Melbourne


Prof Ego Seeman, Austin Hospital
Prof Marcus Pandy, University of Melbourne
Prof Peter Lee, University of Melbourne
Dr Simon Harrison, CSIRO, Victoria
Prof Chris Kawcak, Colorado State University
Prof Sue Stover, University of California, Davis

Funding
RIRDC
Racing Victoria
Victorian Government

Research team
Postdocs and postgraduate students

Dr Michiko Mirams
Gareth Trope
Dr Ebi Bani Hassan
Fatemeh Malikipour
Sandra Martig
Josie Holmes
Babatunde Awodele
Amy Williamson
Megan Thomas

Horsemanship
Observant
Aware of horses needs
Proactive

Racehorse injury
Whats the problem?
How injury occurs
Bone fatigue
Bone adaptation and
repair

Injury prevention

Racehorse
Extreme athlete
500kg
70km/hr

Racehorse
Extreme athlete
Joint loads

4 tonnes (Harrison et al.


2010)

Injury
Bone injury
Fetlock

Injury
Bone injury
Fetlock

Injury
Bone injury
Fetlock

Injury
Bone injury
Fetlock

Injury
Bone injury
Fetlock

Injury
Bone injury
Fetlock

Injury rates
Victoria flat
racing

1 death/2272
starts
69% deaths
due to limb
injuries
92% due to
bone fatigue

Injury rates
Victoria flat
racing

1 death/2272
starts
63% of all
deaths due to
bone fatigue

Injury rates
Prevalence
Joint surface lesions
Hong Kong
70-80%

Victoria
Forelimbs 66%
Hindlimbs 58%

Racing injuries
Bone fatigue
Repeated high
loads

Bone damage

Racing injuries
Bone fatigue
Injuries specific for
racehorses
Accumulation of high
speed exercise a risk factor
Fractures occur
spontaneously
Pre-existing pathology
observed
Microcracks identified at
predeliction sites

Flat racing
Risk of fatality
Longer career duration
Greater number of races in career
Greater number of races in last 30d
Started 1-14 days prior

Accumulation
of damage over
time
Rapid
accumulation
of damage

Flat racing
Risk of joint surface injury
Total lifetime races
Multiple racing seasons
Shorter time between races
Shorter time since last race

Accumulation
of damage over
time
Rapid
accumulation
of damage

Fatigue injuries
Consequences
Fatalities
Jockey injuries
Premature retirement
Poor performance

Fatigue injuries
Jockey injuries

Results: Jockey falls occurred in 24% of TB race-related horse fatalities, and


jockey injury occurred in 64% of falls.
Conclusions: Prevention of the most common catastrophic injuries and
conditions of the racehorse, e.g. fetlock injuries, may be the most effective at
decreasing rates of falls and injuries to jockeys during racing.

Fatigue injuries
Consequences
Bone fatigue in joints
Catastrophic failure
Joint surface failure

Fatigue injuries
Consequences
Bone fatigue in joints
Catastrophic failure
Joint surface failure

Fatigue injuries
Consequences
Bone fatigue in joints
Catastrophic failure
Joint surface failure

Fatigue injuries
Consequences
Bone fatigue in joints
Catastrophic failure
Joint surface failure

Fatigue injuries
Consequences
Bone fatigue in joints
Catastrophic failure
Joint surface failure

Fatigue injuries
Poor performance
Horses with bone injury
identified on bone scan
Performance inferior to
age matched controls

Bone fatigue
Prevalence
Microfractures
46/48 horses had
microfractures in
fetlock
Both 2-year-olds
resting from training

Bone fatigue
Prevalence
Microfractures
Increase with
career duration
Increase with
training duration

Bone fatigue
Fatigue behaviour
Gradual degrading
of mechanical
properties due to
repeated loading
Molecular debonding
Microcracks
Complete failure

1.00

0.80

En/Emax

0.60

0.40

0.20
0.00

0.20

0.40

0.60

n/nf

0.80

1.00

Bone fatigue
Fatigue life
No. of cycles to
failure
Related to load
Load

No. of cycles

Bone fatigue
High loads
Short fatigue life

Bone response
Man made structures
Overengineering

Bone response
Evolution
Minimum amount of
bone to get the job
done
Bone
Heavy
Requires energy

Bone response
Adapt
Net increase or decrease in bone
volume

Repair
Removal and replacement of bone
No net change in bone volume

Adaptation
Increased
loading
Adaptation by
increase in bone
volume

Adaptation
Adaptation
Greater risk of fracture (Parkin et al. 2005)

Horses that do no gallop work prior to racing


Horses in their first year of racing

Adaptation
Adaptation
Condylar
fractures

Bone response
Repair
Normal process
Remodelling
Resorption and
deposition resulting
in replacement of
bone

Repair
Remodelling
Replacement of bone
repairs fatigue damage
Remodelling inhibited
when bone subjected to
high repeated load

Repair
Training

Resting

Repair
Training

Resting

Repair
Subchondral bone repair
Inhibited when training

Bone injury
Subchondral bone
Resting horse

Constantly replacing bone


Repair increased in response to damage

Repair

Damage

Time

Bone injury
Subchondral bone
Galloping horse
Damage accumulating
Repair reduced
Damage

Repair

Time

Bone injury
High load environment

Repair inhibited

Fatigue accumulates
Rest
Resorption

Bone replaced

Failure

Bone injury

Microdamage

Microdamage accumulation

Time

Rest

Rest

Prevention
Why?
Early detection challenging
Many injuries unrepairable
Avoids prolonged rehabilitation
Low grade injuries impair performance

Fatigue
Management
Inspect
Replace with a
safety margin

Fatigue management

Inspection
Prerace veterinary
examination
Hong

Kong - 90% of
fatalities - no
abnormalities

Fatigue
Management
Inspect
Replace with
safety margin

Fatigue
Determining safe level of training

No of
Horses

Joint injury

Fracture

Fatigue damage

Fatigue
Determining safe level of training

No of
Horses

Joint injury

Fracture

Fatigue damage

Fatigue

Performance

Determining safe level of training

Volume of training

Prevention
Military recruits
(Finestone & Milgrom 2008)

Incidence 31% in 1983

Modifications

Incidence 10% in 2003

Prevention
Military recruits
Reduce number of
cycles of load
Reduced stress
fractures by more than
half
Did not impair
performance

Horsemanship
Working with bone
Bone is a dynamic
tissue
Facilitate and maximise
adaptation
Allow bone repair

Working with bone


Adaptation
When first commencing training
When returning to training from a rest period

Prevention
Maximise adaptation
Humans

Greatest potential is prior to


puberty (Kannus et al. 1995)
Benefits persist through
adulthood (Warden et al. 2007)

Horses

Longer career and more starts


with younger age at 1st start
(Bailey et al. 1999, Velie et al. 2012)

Prevention
Maximising adaptation
Most responsive prior to skeletal maturity
Distal MC adaptation with 8 weeks of canter (Boyde & Firth 2005)
When increasing speed reduce distance (Nunamaker 1996)

Prevention
Adaptation

Bone volume

Horses returning from spell

Time

Rest

Rest

Prevention
Adaptation
Horses returning
from spell
5 weeks

8 weeks

Prevention
Adaptation
Potential to develop
highly porous bone
Horse rested for
greater than 10-14
days
Horses in training

2 weeks rest

Full work

Repair
Where we go wrong
Inhibit remodelling too much
Train for too long
Rest periods too short

Repair

Microdamage

Rest periods

Time

Rest

Rest

Repair

Microdamage

Rest periods

Time

Rest

Rest

Prevention
Bone
replacement
Duration of training
Less than 20 weeks

Duration of rest
periods
Benefit maximised in
first 10 weeks

Future
Reducing injuries
Monitor injury rates
Educate the industry
Continuing education mandatory

Invest in research

More work on bone fatigue


Define a safe level of training
What affects loads in joints
How to maximise bone adaptation and repair

Horsemanship
A large proportion
of limb injuries are
due to bone fatigue
Bone fatigue is
preventable
Every injury is a
failure

Horsemanship
Bone can adapt and
repair
Understanding bone
better
Fewer injuries horses
and jockeys
Better performance

Horsemanship
Minimum amount of
work for optimum fitness
Maximise adaptation to
high speed
Allow adequate time for
bone repair