Article, Traumatology

Elite Motorcycle Racing: Crash Types and Injury Patterns in the MotoGP Class

a b s t r a c t

Background: Crashes are a small but regular feature of elite motorcycle racing. These crashes provide a novel op- portunity to benchmark and analyze motorcycle crash mechanics, crash types, and Associated injuries at high speeds in a cohort of riders who are well protected and in a controlled environment.

Purpose: The purpose was to benchmark the prevalence of injuries, categorize crash subtypes, and determine as- sociated injury patterns.

Methods: This was an institutional review board-approved, prospective observational cohort study of MotoGP riders for 1 racing season in 3 venues. Accident type was determined by race-marshal report and visual analysis of race footage for each crash. Accident types were defined as lowside (falling toward the inside of the turn), highside (falling over and toward the outside of the turn), and topside (going over the handlebars of the motor- cycle). Specific injuries and hospital admission data were collected using a standardized data collection form. Basic descriptive statistics were performed on all categorical variables. We used the exact binomial test examine the association between accident type and retirement from race, transport to medical building, transport to hos- pital, and injuries sustained.

Results: Crash prevalence was 9.7 per hundred rider hours. There were 78 crashes: 58 lowsides, 13 highsides, 2 topsides, and 5 indeterminate. In the lowside group (n = 58), 19 (95% confidence interval [CI], 0.21-0.46) riders retired, 0 required emergent transportation to the track facility or to the hospital, and 1 (95% CI, b0.1-0.9) signif- icant injury was noted. In the highside group (n = 13), 10 (95% CI, 0.46-0.95) retired, 9 (95% CI, 0.39-0.91) were transported to the track medical facility, and 3 (95% CI, 0.05-0.54) were admitted to the hospital. In the highside group, there were 7 (95% CI, 0.25-0.81) Significant injuries. In the topside group, both riders were retired with 1 hospital admission. Lowside crashes had a lower rate of retirement from race, emergent transport, and significant injuries compared with highside crashes.

Conclusions: Lowside crashes are lower risk than highside crashes. Most highside crashes are caused by oversteering to prevent an impending lowside crash. Strategies to reduce oversteering to prevent a lowside crash may reduce highside crashes, enhance the safety for riders in MotoGP racing, and be applicable to recrea- tional motorcycle riding.

(C) 2016

Introduction

? This study should be attributed to the Emergency Medicine, Department of Surgery and Perioperative Care, Dell Medical School at the University of Texas at Austin, 1400 Barbara Jordan Blvd, Suite 1.114, Austin, TX 78723.

* Corresponding author. Tel.: +1 512 903 5755.

E-mail addresses: [email protected], [email protected] (J. Bedolla).

Motorcycle racing in the elite MotoGP class attracts millions of spec- tators worldwide. MotoGP riders compete in 18 circuits around the globe each year. Between practices, qualifying heats, warm-ups, and the race, riders spend an average of 4 hours at speeds up to 214 mph (344 km/h) at each event.

http://dx.doi.org/10.1016/j.ajem.2016.07.005

0735-6757/(C) 2016

J. Bedolla et al. / American Journal of Emergency Medicine 34 (2016) 18721875

Methods

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Fig. 1. Lowside crash. Arrows represent strength and direction of force vectors. Copyright DORNA 2015. Reprinted with kind permission.

Crashes are a rare but regular feature of elite motorcycle racing [1-3].

There are 4 basic crash types:

The “lowside” crash: Loss of traction in a turn causes loss of vector forces that keep the motorcycle upright. The rider falls to the lowside of the lean angle and skids out ata tangent to the turn (Fig. 1).
  • The “highside” crash: When the tires start to lose traction in a turn, the rider overcorrects, and the motorcycle flips violently toward the highside of the turn, catapulting the rider from the motorcycle (Fig. 2).
  • The “topside” crash: The motorcycle suddenly decelerates relative to the rider, who is propelled over the handlebars (Fig. 3).
  • The “collision” crash: The rider strikes or is struck by a stationary object or another motorcycle and is subjected to blunt trauma and extreme deceleration forces.
  • The crash prevalence and pattern of injuries associated with each crash type are not well described. This prospective study was undertak- en to benchmark the prevalence of crashes and crash types and to better understand the pattern of injuries associated with each crash type. A sci- entific understanding of crashes and injuries is essential to the safety of the riders and may also provide valuable insights to benefit the larger, noncompetitive motorcycle riding population.

    Fig. 2. Highside crash. Arrows represent force vectors. Copyright DORNA 2015. Reprinted with kind permission.

    This was a multisite prospective observational study. The cohort consisted of the elite riders in all 3 US MotoGP races during the 2013 season of the “American Red Bull MotoGP” series. One race was held at the Circuit of the Americas in Austin, TX, one race at Indianapolis Motor Speedway in Indianapolis, IN, and one race at the Laguna Seca Raceway in Monterey, CA. The Seton Institutional Review Board ap- proved this study.

    At least 1 author was present at each race. The authors were mem- bers of the medical team and had access to all race control, emergency medical services, and clinical data for each crash. Data were collected using a standardized collection form. Crash type was determined by re- port from the rider and/or race control and/or race marshals, and video footage available for each crash on MotoGP’s Web site (www.motogp. com). Each crash was classified according to primary type: lowside, highside, topside, collision. If a crash type could not be established, it was classified as “indeterminate.”

    For each crash type, we recorded event and clinical outcomes. Event

    outcomes were defined as whether the rider rejoined the ongoing event (practice, qualifying, warm-up, or race) after each crash. Clinical out- comes after each crash were recorded as “transported to track medical facility,” “transported from the track to trauma center,” or “admitted to the trauma center.” For each injured rider, we characterized injuries sustained and calculated an Injury Severity Score (ISS).

    We compared outcomes percentages across crash types using confi- dence intervals (CIs) calculated with the exact binomial test. The statis- tical analysis was performed using Stata Version 11.1 (Statacorp LP, College Station, TX).

    Results

    Including all practices, qualifying heats, warm-ups, and race ses- sions, there were 806.9 rider hours recorded in the 3 US MotoGP races in 2013. There were 78 crashes, for a crash incidence rate of 9.7 crashes per hundred rider hours. The Table (in Appendix) shows the distribu- tion of crash types and outcomes.

    There were 58 lowside crashes, with 39 riders returning to competi- tion and 19 (95% CI, 0.21-0.46) riders retiring after the crash. None of the lowside crash riders were transported to the track medical facility or the trauma center. There was 1 (95% CI, b0.1-0.9) significant injury in the lowside group: a thumb sprain on a rider who presented for ex- amination the day after his crash (ISS = 0).

    There were 13 highside crashes, with 3 riders returning to comple- tion and 10 (95% CI, 0.46-0.95) retiring after the crash. Nine (95% CI, 0.39-0.91) highside crash riders were transported to the track medical facility, and 3 (95% CI, 0.05-0.54) were transported to the trauma center. There were 7 (95% CI, 0.25-0.81) significant injuries in the highside group: 2 clavicle fractures, 3 acromioclavicular separations, and 2 con- cussions. The ISS for the highside injury group ranged from 0 to 2.

    There were 2 topside crashes. Both topside crash riders retired after the crash. One rider was transported first to the track medical facility and then later admitted at the trauma center with a nonoperative verte- bral body fracture and a metacarpal fracture (ISS = 2).

    There were no collisions. Five crashes could not be categorized be- cause of lack of reporting and unavailability on video archive and were categorized as indeterminate. There were no retirements, trans- ports, or injuries in the indeterminate group.

    The incidence of unfavorable outcomes was statistically higher in the highside crashes compared with lowside crashes: The retirement rate was greater in the highside group than the lowside group (10/13 vs 19/58); transport to track medical facility was greater in the highside group than the lowside group (9/13 vs 0/58); transport to trauma cen- ter was greater in the highside group than the lowside group (3/13 vs 0/ 58); and the significant injury rate was greater in the highside group than in the lowside group (7/13 vs. 1/58).

    1874 J. Bedolla et al. / American Journal of Emergency Medicine 34 (2016) 18721875

    MotoGP is a high-stakes sport. There may have been some riders who crashed with injuries but declined medical attention to rejoin the race or hide their injuries from competitors. One rider who declined transport after a lowside crash presented the next day at the track med- ical center with a thumb sprain. No rider declining transport presented in delayed fashion to the hospital trauma centers. The possibility that a rider could seek medical care several days later at a facility outside the United States cannot be excluded.

    At the end of 2013, our findings were relayed to the sanctioning body for MotoGP, the riders, and the race medical teams. Future studies will examine if awareness of our findings results in fewer highsides and lowering the overall injury rate.

    There were no fatalities or life-threatening visceral, central nervous system, or skeletal injuries. Based on our benchmarks, we can estimate about 500-600 crashes per year. There have been only 3 deaths in the last 2 decades, or 10 000-12 000 crashes, in MotoGP. All 3 deaths result- ed from collisions [5-9].

    Compared with recreational motorcycle crash benchmarks, MotoGP

    Fig. 3. Topside crash. Arrows represent strength and direction of force vectors Copyright DORNA 2015. Reprinted with kind permission.

    Discussion

    This study benchmarked the prevalence of crashes, crash types, and injuries in the US MotoGP racing circuit for the 2013 season. The analy- sis demonstrates that highside crashes are associated with a significant- ly higher rate of retirement, transport, and injury.

    The most common mechanism for a highside crash is oversteering to avoid a lowside crash. In the split-second the rider senses loss of traction and an impending lowside crash, he can choose to let the lowside crash happen, or he can try to recover by countersteering. When the rider countersteers, he risks oversteering, which results in sudden gain in traction which rights the bike violently and throws him off over the highside of the turn. This study provides riders with data to help them make an informed choice. In the setting of practice, qualifying heats, or warm-up, letting the lowside crash occur is probably the best choice. The rider in a lowside crash has a near-zero chance of serious injury and a 69% chance of being able to quickly rejoin the event. In a highside crash, the rider has a 50% chance of significant injury. When riders are in the actual race, they will face the same odds, but because any crash during a race guarantees a poor finish, they will almost always try to save lowside crashes. For riders in already poor placement, a lowside crash may still be preferable because it gives them better odds for emerging unharmed for the next race. There are also complex and pro- prietary adjustments that can be done to the steering and “tuning” of the motorcycle to make it harder or easier to oversteer.

    There were 5 indeterminate crashes. No rider in the indeterminate group retired or required transport, and there were no injuries. It is un- likely that the indeterminate crashes were highside crashes. To safe- guard against a systematic bias from the indeterminate group, we conducted a post hoc sensitivity analysis in which all indeterminate crashes were added to the highside crash group. Highside crashes remained more likely than lowside crashes to result in treatment at the track medical facility, transport to the trauma center (Pb .05), and significant injury.

    Our study has limitations. We confined our data races in the United

    States, where we could join the track medical team and have full access to race control, emergency medical services, track medical facility, and trauma hospital data. There could be variability for crash types and inju- ries for different countries, which this study would not elucidate. Crashes and injury patterns may also vary for different track configura- tions and surfaces [4]. Our study numbers were not large enough to de- tect intertrack differences.

    crashes are more prevalent but less dangerous despite occurring at rac- ing speeds [10-13]. The MotoGP rider is better protected, with fitted carbon-fiber full-face helmets, full protective kangaroo leather armor, back braces, boots, gloves, and a CO2 powered self-inflating shoulder, chest, and neck protector that deploys when it senses the rider falling violently. Virtually every element of their safety kit has been validated for injury reduction [14-19]. MotoGP riders are elite, highly trained ath- letes with a great deal of practice crashing at high speeds. For recrea- tional motorcyclists, the lessons are clear: physical fitness, training, and safety equipment–especially helmets–prevent Serious injuries and deaths even in crashes at racing speeds [20]. In 78 accidents, there were only 2 concussions and no life-threatening head injuries. Educating recreational motorcyclist on the risks of highside crashes may also improve their safety. Recreational motorcyclists in an impending lowside crash may also be better off by letting the lowside crash happen than by trying to countersteer and risking a more danger- ous highside crash.

    Not all motorcycle racing has the safety profile benchmarked in this study. MotoGP races are held only in tracks sanctioned by the Federation Internationale de’l Motocyclisme. By contrast, the unsanctioned Isle of Man Trophy Tour causes multiple rider deaths every year despite similar protective equipment [21-23]. Club racing, which is also unsanctioned, is replete with severe and disabling injuries GP [24]. The sanctioning criteria, which require safe track design and stipu- late medical coverage standards, contribute to MotoGP’s superior safety profile [25].

    Conclusion

    This is the first study to prospectively benchmark crash prevalence, crash types, and associated injuries for motorcycle racing in the elite motorcycle racing. The prevalence of crashes was 9.7 per hundred rider hours. Injuries were uncommon, occurring in only 9% of crashes (7/78). The injuries were minor, with a maximum ISS of 2. There were no serious injuries and no deaths.

    Compared with lowside crashes, highside crashes have a higher rate of retirement, transport to track medical facility, transport to the trauma center, and significant injuries. Strategies to decrease the incidence of highside crashes should be adopted to improve the already excellent safety profile of MotoGP.

    The prevalence of crashes was higher than that in recreational motorcycling, but no Major injuries or deaths occurred, in stark contrast to recreational motorcycling crashes. MotoGP safety training, road de- sign, and safety equipment are best practices that could be applied in other motorcycle racing divisions and in recreational motorcycling to improve their safety profile.

    Appendix A

    J. Bedolla et al. / American Journal of Emergency Medicine 34 (2016) 18721875

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    Table

    Incidence and outcomes for each crash type.

    Lowside

    Highside

    Topside

    Indeterminate

    n= 58

    n= 13

    n=2

    n = 5

    Retired

    Track medical facility

    19/58

    (95% CI, 0.21-0.46)

    0

    10/13

    (95% CI, 0.46-0.95) 9/13

    2

    1

    0

    0

    Trauma center

    0

    (95% CI, 0.39-0.91)

    3/13

    1

    0

    (95% CI, 0.05-0.54)

    ISS: median

    0

    1

    1

    0

    (range)

    (N/A)

    (0-2)

    (0-2)

    (N/A)

    Significant injury

    1/58

    (95% CI, b0.1-0.9)

    Thumb sprain

    7/13

    (95% CI, 0.25-0.81)

    2 Clavicle fractures

    3 acromioclavicular joint separations 2 Concussions

    1

    1 Vertebral fracture

    0

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