Relationship Between Historical Lameness, Medication Usage, Surgery, and Exercise With Catastrophic Musculoskeletal Injury in Racehorses

The association between Thoroughbred racehorse training practices and musculoskeletal injuries in Victoria, Australia

Catastrophic musculoskeletal injuries (CMI) in horses are associated with both too little and too much high-speed exercise. In order to advise trainers on training and management strategies that minimize the risk of musculoskeletal injury (MSI), a better understanding of how training practices affect MSI in racehorses is needed. Data from prospective studies relating training data and MSI are complicated by the gradual development of pathology and the effect of this on the ability of horses to train consistently prior to the identification of an injury. To circumvent this, 66 Australian Thoroughbred trainers were surveyed on their intended training practices, including rest, pre-training, and race-fit practices. Associations between intended training practices and catastrophic and non-catastrophic race day MSI outcomes in two-year-old and mature (≥three-year-old) horses were assessed using multivariable negative binomial regression models. The incidence of two-year-old race day MSI was lower for trainers who preferred shorter times (weeks) to trial, less time in fast work pre-trial (p = 0.003), shorter, more frequent rest periods (p < 0.01) and higher amounts of fast work at 15.5-16.7 m/s once race-fit (p = 0.001). The incidence of mature horse race day MSI was lower for trainers who preferred longer rest periods (p = 0.026) and a high-volume pre-trial training strategy comprising a high volume of slower speed gallop training and longer times to trial compared to fast and light training programs (p = 0.004) for their mature horses, in addition to higher amounts of fast work at 15.5-16.7 m/s for their race-fit two-year-olds (p = 0.012). Race day CMI incidence was lower for trainers who preferred lower volumes of fast gallop work for their race-fit mature horses (p < 0.05). These results suggest that two-year-old training practices could affect MSI risk later in a horse's career, and that age and stage in training (pre-trial, race-fit) are important considerations when developing training practices to minimize the risk of MSI.

Catastrophic musculoskeletal injuries in Thoroughbred racehorses in Uruguay, 2011-2017

Catastrophic musculoskeletal injuries (CMI) pose a major welfare concern to horses and their riders, yet limited data is available describing their occurrence in South America. Using a retrospective cohort and case-control design, the objective of the study was to determine the incidence of CMI for Thoroughbreds in training and racing, and associated horse-level risk factors in Uruguay. Seventy-seven Thoroughbreds sustained a CMI; 37 of which were age- and sex-matched to 111 control horses in the same race. Training and racing data from 2011-2017 were collected. Incidence of race day CMI per 1000 race starts and training CMI incidence per 100 horse months were calculated using Poisson regression. Univariable logistic regression was used to assess relationships between race history and occurrence of CMI by fracture location, and multivariably for all fracture locations. Overall race day incidence of CMI was 0.42 per 1000 race starts (95% CI 0.29, 0.60). The incidence of CMI in training was 0.059 per 100 horse months. Most fractures were of the forelimbs (80.3%). There were 32 (41.5%) distal and 39 (50.6%) proximal limb fractures. The risk of CMI was greater for horses with fewer places (P = 0.001), and greater time between the previous race and the race in which CMI occurred (P = 0.020). The rate of race day CMI was low, despite Uruguay being a racing jurisdiction with policies and risk factors associated with higher CMI rates compared to other jurisdictions. Lightly raced horses with long periods since their previous race start should be monitored closely.

Relationship between Thoroughbred workloads in racing and the fatigue life of equine subchondral bone

Fatigue life (FL) is the number of cycles of load sustained by a material before failure, and is dependent on the load magnitude. For athletes, ‘cycles’ translates to number of strides, with load proportional to speed. To improve previous investigations estimating workload from distance, we used speed (m/s, x) per stride collected using 5 Hz GPS/800 Hz accelerometer sensors as a proxy for limb load to investigate factors associated with FL in a Thoroughbred race start model over 25,234 race starts, using a combination of mathematical and regression modelling. Fore-limb vertical force (NKg^-1) was estimated using a published equation: Vertical force = 2.778 + 2.1376x − 0.0535x². Joint load (σ) was estimated based on the vertical force, scaled according to the maximum speed and defined experimental loads for the expected variation in load distribution across a joint surface (54-90 MPa). Percentage FL (%FL) was estimated using a published equation for cycles to failure (N_f) summed across each race start: N_f = 10^{(σ-134.2)/−14.1.} Multivariable mixed-effects linear regression models were generated on %FL, adjusting for horse-level clustering, presented as coefficients; 95%CI. Scaled to the highest joint load, individual starts accrued a mean of 9.34%FL (sd. 1.64). Older age (coef. 0.03; 0.002–0.04), longer race-distances (non-linear power transformed), and firmer track surfaces (ref. Heavy 10: Good 3 coef. 2.37; 2.26–2.48) were associated with greater %FL, and males accrued less than females (p < 0.01). Most variables associated with %FL are reported risk factors for injury. Monitoring strides in racehorses may therefore allow identification of horses at risk, enabling early detection of injury.

Association of Thoroughbred Racehorse Workloads and Rest Practices with Trainer Success

Understanding the relationship between the training practices of Thoroughbred racehorses and race performance is important to ensure advice given to trainers for injury prevention or management is practical and consistent. We assessed associations between intended volume and speed of gallop training (i.e., typical workloads for horses free of injury or other performance limiting conditions) and rest practices on official trainer career and previous season success rates (rate of wins and places, prizemoney per start). Sixty-six Australian Thoroughbred trainers were surveyed. Multivariable negative binomial regression models were employed for the outcomes career and previous season wins and places, and linear regression models for prizemoney per start. Intended training workload was not associated with prizemoney. Pre-trial total galloping distances (≥13.3 m/s) between 7500 m and 15,000 m were associated with a higher rate of career wins, and previous season wins and places per start (p < 0.05). Slow-speed (13.3-14.3 m/s) galloping distance to trial between 5000 m to 12,500 m was associated with higher rate of career placings per start, with reduced performance over 12,500 m (p = 0.003). Greater time between race starts was associated with a greater rate of previous season wins and prizemoney per start until three weeks between starts, with decline in performance thereafter (p < 0.05). Greater frequency of rest breaks was associated with greater prizemoney per start earnt in the previous season (p ≤ 0.01). These results suggest that modifications to training programs aimed at injury prevention, such as avoiding long galloping distances, should not adversely affect trainer success.

A Prospective Study of Training Methods for Two-Year-Old Thoroughbred Racehorses in Queensland, Australia, and Analysis of the Differences in Training Methods between Trainers of Varying Stable Sizes

Simple Summary

Musculoskeletal injuries present significant concerns for the global Thoroughbred racing industry. The development of training and management strategies to reduce injuries has been challenging due to conflicting findings about the risk factors for injury, and limited understanding of the role of different training methodologies. There is little published data on patterns of rest periods and exercise data and how these vary between trainers and between different racing jurisdictions. We describe training methodologies for 535 two-year-old horses providing 1258 training preparations and 7512 weeks of exercise. We investigated the variation in training methodologies between trainers from small, medium and large stable sizes. Significant differences were observed between trainers, with horses from larger stables accumulating a greater high-speed exercise volume, attaining training milestones more frequently and taking less time to reach their training milestones. We also highlight similarities and differences in training methods used in Queensland, Australia, and those previously reported from other geographic locations. A better understanding of training methods is an essential step towards reducing the impact of injuries.

Abstract

Worldwide, musculoskeletal injuries remain a major problem for the Thoroughbred racing industry. There is a strong interest in developing training and management strategies to reduce the impact of musculoskeletal injuries, however, progress has been limited by studies reporting conflicting findings, and a limited understanding of the role of different training methods in preventing injury. There is little data on patterns of rest periods and exercise data and how these vary between trainers. This prospective study of two-year-old racehorses was conducted in Queensland, Australia and involved weekly personal structured interviews with 26 trainers over 56 weeks. Detailed daily exercise data for 535 horses providing 1258 training preparations and 7512 weeks at risk were collected. Trainers were categorised into three groups by the mean number of two-year-old horses that they had in work each week over the study duration: (1) Small stables with five or less, (2) Medium stables with 6 to 15 and (3) Large stables with greater than 15 horses in training. Differences between trainers with small, medium and large stable sizes were evaluated using linear regression, Kruskal–Wallis equality-of-populations rank test if linear models were mis-specified or Chi-squared tests for categorical variables. Significant differences were observed between trainers, with horses from larger stables accumulating a greater high-speed exercise volume (p < 0.001), attaining training milestones more frequently (p = 0.01) and taking less time to reach their training milestones (p = 0.001). This study provides detailed data to which training practices from other locations can be compared. Presenting actual training data rather than trainers’ estimation of a typical program provides a more accurate assessment of training practices. Understanding how training practices vary between regions improves comparability of studies investigating risk factors and is an important step towards reducing the impact of musculoskeletal injuries.

Training Young Horses: The Science behind the Benefits

Simple Summary

Of common debate among equine professionals and enthusiasts alike, is whether entering race training at two years of age is detrimental or beneficial to the animal’s career and growth. This literature review evaluates epidemiological studies to elucidate that two-year-old horses are not at greater risk of injury compared to older horses. Horses which enter race training at two years of age are, in fact, found to have greater earnings and longer race careers. This review also tackles the impact that exercising an animal at two years of age or younger has on bone, articular cartilage, and tendons. Numerous studies on growing animals have found confinement to be detrimental to normal musculoskeletal growth. However, exercise of dynamic nature in moderate distances, such as that attained with pasture access or prescribed sprints, is beneficial to musculoskeletal development and may prevent injuries when entering race training. Based on scientific evidence, the research cited in this review supports the training and racing of two-year-old horses and advises caution in the use of medications such as corticosteroids.

Abstract

Conflicting research and anecdotal evidence have created disagreement among equestrians as to whether two-year-old horses should be trained and raced. The objective of this literature review is to evaluate epidemiological studies, as well as physiological data on equine bone, articular cartilage, and tendons to better determine the impact of training and racing two-year-old horses. The evaluation of numerous studies on the topic provides evidence that a horse which is trained or raced as a two-year-old has a lower risk of injury and better adapted tissues for the rigors of racing. Unfortunately, the current prolific use of pain-mitigating substances in the racing industry does place horses, including young cohorts, at greater risk of injury, and should be used with caution.

The Effect of Combined Training and Racing High-Speed Exercise History on Musculoskeletal Injuries in Thoroughbred Racehorses: A Systematic Review and Meta-Analysis of the Current Literature

Simple Summary

Despite extensive international research, musculoskeletal injuries remain a key problem for the Thoroughbred racing industry, with multiple welfare and ethical consequences. High-speed exercise (HSE) history is an important risk factor for injury. However, studies report conflicting findings concerning the effect of HSE on the risk of injury. Although most injuries and fatalities occur during training rather than racing, many research studies only evaluate injuries reported on race day, which likely underrepresents the injuries acquired by these horses. This study aimed to determine the effect of combined training and racing HSE on injuries in racehorses. We performed a systematic search of the relevant literature and evaluated the effect of seven measures of HSE on injury through meta-analyses. The total career HSE distance significantly affected the odds of musculoskeletal injuries (MSI). With every 5-furlong (1 km) increase in career HSE distance, the odds of MSI increased by 2%. The average HSE distance per day also affected the odds of MSI. With every additional furlong (200 m) of average HSE per day, the odds of MSI increased by 73%. However, the strength of the available evidence is restricted by methodological limitations, which will need to be addressed in the future, to explore the level of risk and mechanisms for injury in more detail.

Abstract

Despite over three decades of active research, musculoskeletal injuries (MSI) remain a global problem for the Thoroughbred (TB) racing industry. High-speed exercise history (HSEH) has been identified as an important risk factor for MSI. However, the nature of this relationship remains unclear, with an apparent protective effect of HSE against injury, before it becomes potentially harmful. Many MSI cases and fatalities occur during training rather than during racing, resulting in an underestimation of injury from studies focused on race day. The objective of this study was to examine the current evidence of the effect of combined training and racing HSEH on MSI in TB flat racehorses, through a systematic review and meta-analysis. A systematic search of the relevant literature was performed using PubMed^®, Scopus^®, Web of Science^®, and Embase^® online databases and the gray literature using sites containing “.edu” or “.edu.au”. Studies included in the review had explored seven different measures of HSE, including total career HSE distance, cumulative HSE distance in the 30 and 60 days before MSI, average HSE distance per day, per event and per 30 days, and the total number of HSE events. The total cumulative career HSE distance significantly affected the odds of MSI, with every 5-furlong increase, the odds of MSI increased by 2% (OR = 1.02; 95% CI 1.01, 1.03; p = 0.004). The average HSE distance per day also affected the odds of MSI, with every additional furlong increasing the odds of MSI by 73% (OR = 1.73; 95% CI 1.29, 2.31; p < 0.001). Other measures of HSE were not found to be consistently associated with risk of MSI, but these results should be interpreted with caution. Significant methodological limitations were identified and influence the comparability of studies. Standardizing the measures of HSE in studies of MSI, and describing training conditions in more detail, would support a more thorough investigation of the relationship between HSE and MSI. An improved understanding of this relationship is critical to mitigating the impact of MSI in the Thoroughbred racehorse.

Appraising the Welfare of Thoroughbred Racehorses in Training in Queensland, Australia: The Incidence and Type of Musculoskeletal Injuries Vary between Two-Year-Old and Older Thoroughbred Racehorses

Simple Summary

Musculoskeletal injuries (MSI) remain a concerning cause of racehorse morbidity and mortality with serious ethical and welfare consequences. Previous research examining risk factors for injuries report inconsistent findings. Age is thought to affect the risk of injury, but, to date, there have been no prospective studies specifically comparing injuries between two-year-old versus older horses. We aimed to: (1) determine the incidence of injuries for two-year-old and older horses, and whether this was affected by training track, season, or rainfall, and (2) determine the types of injuries affecting two-year-old and older horses, and whether horses trialled or raced after injury. Data were collected through personal structured weekly interviews with participating trainers over a 13-month period. Data were analysed using Poisson regression. The incidence of MSI in the current study was low (0.6%). The incidence of MSI in two-year-old horses was higher than older horses. Types of MSI varied between two-year-old and older horses and affected whether horses subsequently trialled or raced from 11 to 23 months after injury. A larger proportion of two-year-old horses had dorsal metacarpal disease and traumatic lacerations. A smaller proportion of two-year-old horses had suspensory desmitis, superficial digital flexor tendonitis, proximal sesamoid bone fractures, and fetlock joint injuries than older horses. Training track and rainfall did not affect the incidence of injuries. The season affected the incidence of injuries in two-year-old horses but not in older horses.

Abstract

Musculoskeletal injuries (MSI) remain a concerning cause of racehorse morbidity and mortality with important ethical and welfare consequences. Previous research examining risk factors for MSI report inconsistent findings. Age is thought to affect MSI risk, but, to date, there have been no prospective studies comparing MSI in two-year-old versus older horses. This study aimed to: (1) determine the incidence of MSI for two-year-old and older horses, and whether this was affected by training track, season, or rainfall, and (2) determine the types of MSI affecting two-year-old and older horses, and whether horses trialled or raced after injury. A prospective survey was conducted with data collected through personal structured weekly interviews with participating trainers over a 13-month period. Data were analysed using Poisson regression. The incidence of MSI in the current study was low (0.6%). The incidence of MSI in two-year-old horses was higher than older horses (p < 0.001). Types of MSI varied between two-year-old and older horses (p < 0.001) and affected whether horses subsequently trailed or raced from 11 to 23 months after injury (p < 0.001). A larger proportion of two-year-old horses had dorsal metacarpal disease and traumatic lacerations. A smaller proportion of two-year-old horses had suspensory ligament desmitis, superficial digital flexor tendonitis, proximal sesamoid bone fractures, and fetlock joint injuries than older horses. Training track and rainfall did not affect MSI. The season affected MSI in two-year-old horses (p < 0.001) but not older horses. The major limitation was that trainers in this study were metropolitan (city) and our findings may not be generalisable to racehorses in regional (country) areas. Another significant limitation was the assumption that MSI was the reason for failure to trial or race after injury. In conclusion, the incidence of MSI was low in the current study and the types and the risk factors for MSI are different for two-year-old and older horses.

Measuring Volumetric Changes of Equine Distal Limbs: A Pilot Study Examining Jumping Exercise

Simple Summary

When horse athletes exercise, forces are applied to their legs during each step. Repetitive loads applied during training and competition contribute to stress of leg structures. Swelling (i.e., local fluid accumulation) in the legs is a sign of increased stress in these structures. Currently, horse riders and trainers make training decisions based on visual observations of horse leg swelling, which are potentially subjective and imprecise. The aim of this study was to develop a low-cost, noninvasive method to measure lower leg volume in horses, as well as to assess the ability to detect differences before and after exercise. The tablet-mounted scanner measured increased lower leg volume after jumping, compared to scans before exercise. This method may serve as an objective tool for horse riders and trainers to prevent injury by modulating horse training frequency and intensity in response to physiological signs of stress, like leg swelling. Scans may also be used to seek veterinary consultation and treatment, as well as to guide rehabilitation from injury.

Abstract

Equine athletes can incur musculoskeletal injuries due to repetitive loading during training and competition. Prior to signs of lameness, horse trainers and veterinarians may observe swelling in the distal limbs, where injuries most frequently occur. Early observations may guide modulation of training to manage physiological stress and mitigate risk of injury. However, these observations of changing limb volume can be subjective and imprecise. The aim of this study was to assess the accuracy and applicability of a tablet-mounted, 3D scanner to measure and record distal limb volumes of horses before and after exercise. Users recorded scans of a cylinder of known volume with errors up to 8%. Experienced users’ measures were biased (i.e., consistently overestimated). The scanner was able to detect statistically significant increases in volume for both fore and hind limbs after one jumping session (310–2058 cm³). Age and intensity of workload may play a role in magnitude of limb swelling, but had mixed conclusions between fore and hind limbs. More studies with additional horses must be performed to solidify these relationships. The evaluated 3D scanner is a low-cost, accessible tool that was able to detect changes in limb swelling as a result of exercise and mechanical stress. With continued research, this information may guide training programs to decrease injury and maximize performance of equine athletes in the future.