International registry aims to round up rodeo injuries

In order to improve the health of those who participate in rodeos, physicians and health care personnel who provide care in this setting launched last month a registry to record the most devastating injuries that occur in this sport. Work is also underway to analyze some of the medical-related data that already exist and set up a conference to bring together those who work in this area.

"Rodeo medicine is really in its early stages right now. What we're trying to do is solidify what we have been doing for the benefit of these cowboys and translate the data into something beneficial," said Mark Brandenburg, MD, vice chair of the Dept. of Emergency Medicine at the University of Oklahoma College of Medicine. He is also one of the organizers of the Second International Rodeo Medicine Conference, to be held in Tulsa in January 2008.

Database to track old, new injuries

The Rodeo Catastrophic Injury Registry, based at the University of Calgary, Alberta, will collect data about life-threatening and crippling injuries that have already occurred and those that happen over at least the next four years.

Reports can be filed by rodeo athletes, event organizers, medical personnel and spectators. After the information is finalized, identifying details will be removed in order to make the registry anonymous.

"Anyone, anywhere in the world can access this database and report a catastrophic injury," said Dale Butterwick, the athletic trainer and associate professor of kinesiology at the University of Calgary, who is the driving force behind the registry.

Limited data on this subject do exist. Butterwick has published several papers retrospectively analyzing data from Canadian professional rodeos. In the U.S., the Justin Sportsmedicine Team, which provides care at Professional Rodeo Cowboys Assn. events, has several charts on its Web site outlining the types of injuries treated from 1981 to 2000.

"[The registry] is a great idea. We do not have a very good handle on the incidence of catastrophic injuries," said R. Pepper Murray, MD, the Justin team's medical director and an orthopedic surgeon in Bountiful, Utah.

Those who treat rodeo athletes praised these efforts as part of an overall trend toward creating a medical structure that increases safety in the sport. While its hazards are not fully understood, rodeo is acknowledged to be very dangerous. For instance, a study on Native American professional rodeo competitors published in the July 2006 Clinical Journal of Sport Medicine found that 26% had sustained at least one injury that prevented them from working for an average of 3.2 months.

"Rodeo is not a sport that you get out of without an injury," said Reneé Crichlow, MD, that paper's lead author and director of the Montana Family Medicine Residency in Billings.

These most recent developments are building on some of the early steps working toward increased safety. The First International Rodeo Research and Clinical Care Conference in Calgary in 2004 resulted in guidelines for the clinical management of concussion in rodeo events. The guidelines were published in the May 2005 Clinical Journal of Sport Medicine. Anecdotal reports suggest that rodeo athletes are increasingly wearing chest protection. Helmets are becoming more common, although change has been slow in this area.

"To understand why, you have to take a step back to where this sport comes from and what it means to wear a cowboy hat," said Dr. Brandenburg. "There was some concern that judges were penalizing [cowboys] for wearing a helmet, but things have begun to turn. We've made a lot of progress, and one is not really looked down upon anymore for wearing a helmet."

Those supporting the injury registry expect it will lead to developments that increase rodeo safety even further -- something that has already happened in other sports. For example, ice hockey banned checking from behind, after data from an injury registry demonstrated an associated high risk of paralyzing spinal damage. That registry also made it possible to determine that the rule change had translated to a reduction in such injuries.