Published: October 9, 2024
For Keith Asmussen, it’s a typical day in the office.
A wake-up call before the sunrise, followed by a 4 a.m. drive to the backside of Churchill Downs. Cloaked in darkness, he makes his way to Barn 38 — the one belonging to his father, Steve. He changes clothes, learns his schedule and mounts his first horse. By 5:15 a.m., he’s underneath the bright, fluorescent lights of the 1-mile dirt, oval racetrack.
It’s time for morning exercise rides — a chance for Keith and Steve to prepare their thoroughbreds to race. Early-morning practice, if you will: Keith on horseback, Steve waiting at the rail with a stopwatch.
At 9:30 a.m., Keith dismounts and changes again. This time, it’s out of his riding clothes and into a pair of exercise shorts. He gets back in the car and makes his way to KORT Physical Therapy on Westport Road, across town. Two hours there, rebuilding the strength in his legs, hips and core.
For the past three months, this has been Keith’s routine.
“This whole recovery’s been incredibly smooth,” Keith said. “I’ve been more than well taken care of. It’s just an invigorating feeling to be backed by so many professionals.”
Keith’s preparation and work ethic have been paramount as he prepares to ride in his first race in more than 90 days, returning from the scariest moment of his young career.
June 1, 2024, was supposed to be a big race day for Keith. He was set to ride in five of Churchill Downs’ 11 races.
But his day would come to an early, abrupt end.
In Race 1, Keith’s filly — Singsational — was bottlenecked after the start and clipped heels with another horse. She fell, tumbling to the dirt, but walked off uninjured.
Keith was not as lucky.
In the spill, he fractured his left femur and three ribs and experienced a right hemopneumothorax, a pressure-causing condition in which blood and air enter the cavity between the lungs and underneath the chest wall.
He would require surgery and a weeklong hospital stay.
“I was conscious the entire time,” Keith said. “I had recognized what happened and was fully aware of the circumstances. I don’t think I was ever overly scared and was attended to immediately by the ambulance. Yes it hurts, but I think the thing that hurts the most about getting hurt as a race rider is just the loss of momentum of success. I don’t think any rider is afraid of getting hurt or anything. It’s more just the fear of being away from the sport and the time it takes to get back.”
At that point, the 26-year-old jockey wasn’t sure what his future would hold, or when he’d be able to ride again.
Horse racing is, quite literally, in Keith’s blood.
His grandfather was a jockey. His father is a Hall of Fame trainer. His brother, Erik, is also a jockey. Despite that pedigree, Keith’s journey into the saddle was unlike most in the business.
He was in college at the University of Texas at Austin, in the process of earning his master’s degree in professional accounting. But like millions of people, 2020 turned his career and life around. During the COVID-19 pandemic, his classes went remote. Keith came home and spent more time around the track.
He was bitten by the bug.
“I don’t want to call it a pipe dream, because it was very real situation to me, but I’d always thought of being a race rider, and I was always incredibly infatuated with the profession,” Keith said.
He started riding in June 2020 at Lone Star Park, just west of Dallas. He got his first win nearly a month later, one of his six that season. When the summer ended, he promised his parents he would go back and get his degree.
“As soon as I got that diploma, I sprinted right back to the race track,” Keith said.
He couldn’t stay away.
Keith started riding full time in 2022. Ever since, his career has taken off. He’s tallied more than 130 wins in that time, culminating in his victory in the Steel Valley Sprint in November 2023. Keith’s success earned him his first Kentucky Oaks and Kentucky Derby mounts in 2024, riding both races for Hall of Fame trainer D. Wayne Lukas.
“There’s no feeling like being on a thoroughbred race horse in full flight,” Keith said. “It’s such a profound feeling. It’s impossible to describe, and I’ve been so helplessly addicted to it. I’ve just been so fulfilled by this profession.”
In the world of professional sports, injury management has risen to the forefront of the conversation.
In the NFL, the culture surrounding concussions has changed drastically, as independent neurologists now roam the sidelines, scanning the field for players who may have experienced a head injury during play. In the NBA, “load management” has become a topic of conversation, as teams become more careful with their star players and what injuries they attempt to play through. In MLB, arm care has become a priority, as more pitchers experience shoulder and elbow injuries than ever before.
But thoroughbred horse racing is different.
Unlike other professional athletes, whose health care is provided by their teams, jockeys are responsible for coordinating and overseeing their own medical care. Furthermore, if they’re unavailable to race, they aren’t compensated, meaning a debilitating injury is more than a physical obstacle. It’s also a lost paycheck. That’s why for decades, many jockeys chose not to seek care.
“[It’s] changing and not changing at the same time,” Keith said. “It’s a very fragile profession. It’s kind of a meritocracy, like, ‘What did you do for me yesterday?’ And so there is that fear of getting hurt and losing that momentum, and that’s why the population rushes back [from] injury, or has a propensity to. I feel like the population of jockeys today is way more receptive to receiving medical care and mental wellness care [than in years past]. And I think that’s kind of the general direction we’re headed.”
It’s a trend Norton Sports Health and Churchill Downs recognized and are collaborating to change.
In April 2022, Norton Sports Health became the official medical provider of Churchill Downs, as the racetrack was looking for a partner to help elevate jockey safety and welfare. This partnership coincided with new regulations from the Horseracing Integrity and Safety Authority (HISA), which went into effect July 1, 2022, with the goal of making the industry safer as a whole. Those changes included mandatory baseline concussion and physical exams for jockeys. They also required a physician be present at all live race days.
“It’s crucial that we provide the care these athletes need,” said Tiff L. Haub, M.S., ATC, director of Norton Sports Health. “Anytime you have a horse going 40 miles per hour on a track with someone on top, you know it can be dangerous. And we know concussions can have long-lasting effects. So, giving the jockeys that peace of mind prerace, letting them know they’re physically and mentally fit to race, is critical to their success and safety.”
Norton Sports Health has taken those mandates a step further, providing comprehensive care for the jockeys, coordinating and scheduling primary care and specialty visits, based on the athletes’ needs. Norton Sports Health physicians, nurses and certified athletic trainers are stationed at Churchill Downs for all 75 live race days each year. In addition, Norton Sports Health has supplied a performance dietitian and mental health professionals to provide care for the whole person. In spring 2023, Norton Sports Health began hosting jockey educational seminars, providing the riders with in-depth information on a variety of topics, including mental performance, nutrition and weight management.
“We want to make a positive impact on their lives, in any way we can,” Tiff said. “We always educate and emphasize to the jockeys, owners and trainers that the goal is for the jockey to ride, but only if they’re safe to do so. We want to support them being their best selves, so they can have their best ride.”
Furthermore, Norton Sports Health has initiated communication and training with other health care providers across the country, in an attempt to elevate care and safety at every American Thoroughbred racetrack. Finally, before each season, Norton Sports Health collaborates with Churchill Downs and Alpha Event Medicine to discuss and revisit the track’s emergency action plan, in the event of a trackside emergency.
“Since we’re the ones overseeing care at a racetrack as prestigious as Churchill Downs, we feel like it’s our duty to collaborate and elevate care across the country, to improve the health and safety of all jockeys, no matter where they’re riding.”
The overall goal is to bring horse racing in line with America’s other major sports.
After a week in the hospital following his on-track spill, Keith was discharged.
He connected with Tiff, who introduced him to Tyler Curry, P.T., DPT, OCS, physical therapist with KORT Physical Therapy. Together, the three created Keith’s physical therapy (PT) program. He started PT two weeks after discharge, beginning with light balance exercises, range-of-motion exercises and strength training. Eventually, he folded in cardiovascular exercises — jogging, swimming and biking.
“Around the month-and-a-half or two-month mark, we realized he was progressing enough in his goals and that he was driven and motivated enough that we could discuss a return-to-ride protocol and how we were going to attack that goal,” Tiff said.
“Keith’s been one of the most motivated athletes I’ve worked with,” Tyler said. “It was a learning experience for all three of us, in terms of trying to determine what Keith needed and understanding how to work him through a major injury. But he stayed focused on his end goal, and that made everything easy for us to work backward and put together a plan for each step in his recovery.”
When the calendar turned to August, Keith graduated to sport-specific exercises, with the goal of getting back on a horse. He started with basic galloping and exercise riding. The work was minimal and supervised. He would self-report his progress to Tiff and Tyler, and worked with them to create goals for his next ride.
“It was very uplifting,” Keith said. “I’ve worked with such a professional staff at Norton Sports Health and KORT — people who were well-versed in the sport — that I was able to give feedback and they were malleable enough to alter our progress. If that meant I needed more balance here, and a little less muscle mass there, they were always receptive to my feedback. It made me feel like we were working together.”
Two weeks later, Keith was cleared for a faster pace and for short-race simulations. The return to real racing was getting close.
Then on Sept. 12, a little more than 90 days after his spill, Keith was medically cleared to race again. He took his first mount Sept. 21, on a horse appropriately named Payne.
He finished fifth, but more importantly, came away from the race in good health.
“You heal as most appropriately and just find the optimal way back to the sport,” Keith said. “You get paid for what you do, but you pay for what you do. There are consequences to rushing back [from] injuries. And there’s a very strong propensity to do that. I feel like I’ve been attended to with extreme professionalism, and I feel like I’ve taken this injury incredibly seriously and focused on how to optimally return so that I’m 100% when I get back.”
“We were just as motivated to have Keith return to ride as he was,” Tiff said. “We wanted to make sure he didn’t ever have to feel like he was on his own. We wanted him to feel like we were on his team, guiding him through every step of the process. That way he could truly be physically and mentally 100% before he returned to race.”
Now with a few races under his belt, Keith can reset his sights on his goals, both short and long term. And while he tries to stay in the moment, it’s hard not to allow his mind to wander, about what a victory might look like on the first Saturday in May, riding one of his dad’s horses across the finish line.
But until he gets to next spring, he takes comfort in knowing he’s where he needs to be, surrounded by those who want to see him succeed.
“It’s impossible not to be that sentimental,” Keith said. “But right now, I’m trying to stay in the present. [We’ve made] very targeted progress. I don’t feel like we were ever guessing. We’ve constantly addressed what needs to be improved and what’s doing well and just refocusing, refocusing, refocusing to where it’s all progress. And I don’t feel like I ever plateaued. Even if it was one more rep, one more step each day, if it was a step in the right direction, it was something to be excited about.”
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