11 Feb Motocross Medicine

INTRODUCTION
Ernest Hemingway reportedly stated, ‘‘There are only three sports: bullfighting, motor racing, and mountaineering; all the rest are merely games.’’ This comment may have been made at least partially because of the high risk of significant injury and even death from these pursuits when compared with the typical ‘‘stick and ball’’ sports. This article reviews the history of motocross, the relevant medical literature, the unique medical issues, safety equipment, and the expert recommended approach to providing support for such events. Motorcycle racing is generally divided into on-road and off-road. When it comes to off-road motorcycle racing, there are a number of variations of the sport, including the following: motocross, supercross, flat track, supermoto, hillclimb, trials, desert racing, and ATV motocross. This article will focus upon motocross motorcycle racing, which takes place outdoors on a course that combines natural terrain with some human-made obstacles (steep inclines, hairpin turns, jumps, sand, and mud). Supercross motorcycle racing is a variation of motocross that has evolved for the more urban environment and takes place inside stadiums on human-made tracks. Supercross tracks tend to be shorter courses but also tend to have tighter turns and higher jumps because of the limited space inside stadiums.

HISTORY OF MOTOCROSS
Motocross (frequently abbreviated as MX) originated in England in 1924 with bicycles with small internal combustion engines attached. A 2.5-mile course was made that included bogs, hills, rocky sections, stream crossings, and other ‘‘natural terrain.’’ Of the 80 contestants entering the world’s first motocross race, only 40 finished (26). Motocross continued to evolve and became increasingly popular throughout the middle of the 20th century. The first time that a motorcycle race took place on a human-made course inside a stadium was in 1948 at Buffalo Stadium in the Paris suburb of Montrouge. The course included jumps on the straights, switch-backs in the turns, and a steeplechase-type water hazard. In 1969, ABC Wide World of Sports broadcast the first motorcycle race in Pepperell, Massachusetts. In 1972, rock concert promoter Mike Goodwin debuted motocross racing in front of 28,000 fans at the legendary Los Angeles Coliseum during the first ‘‘Superbowl of Motocross.’’ The ‘‘Super Bowl of Motocross’’ was later shortened to Supercross. The motorcycles themselves also evolved across this time. Innovations such as swingarm suspensions, fuel injection, disc brakes, and liquid-cooled engines allow machines weighing less than 225 lb to generate over 50 horsepower. These motorcycles are capable of attaining speeds of over 100 mph and sailing over 100 ft off jumps. When racers take these onto a crowded racetrack over rough and broken terrain, accidents are inevitable.

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