DALLAS (AP) - Fabiano Vieira had hoped to take home the $1 million prize at the Dr Pepper Iron Cowboy V challenge. But now the bull rider was leaning against the chutes at AT&T Stadium, clutching his right arm, his face contorted and ashen.
The event’s medical director, Dr. Tandy Freeman, had advised Vieira not to ride tonight, lest he aggravate a recently dislocated shoulder. But the cowboy showed up anyway.
Each time Vieira whipped his free arm around to help him balance atop a bull, he felt his shoulder popping in and out of position. Now, after two bull rides, the pain had grown too strong, so he drew a line across his throat to indicate he was pulling out. Two trainers accompanied Vieira, still wearing his chaps, boots and spurs, off the arena floor.
Freeman, 56, a Dallas-based orthopedic surgeon, has spent the last 20 years caring for athletes who have traditionally shunned medical care. In a sport that prizes toughness, admitting to pain does not come naturally. And many athletes can’t afford to be sidelined by injury; they depend on the competitions to earn their living.
But Freeman and the doctors and trainers he works with - many of whom are volunteers - have won the athletes’ trust. As a result, rodeo is starting to close the gap with other professional sports when it comes to injury prevention and treatment, including concussion management.
Still, virtually every event requires Freeman to negotiate the tricky territory between what a rider wants to do and what his body can safely accomplish.
In the training room, Freeman, wearing a black Western hat, jeans, a denim shirt and black cowboy boots, pulled up a chair opposite Vieira and looked him in the eye. The rider would need to take at least two weeks off, said Freeman.
“If it don’t hurt, let me come back next weekend,” said Vieira, 31, who is from Perola, Brazil, and, as a top bull rider, makes his living off the sport.
“You try to ride next week, you’ll be back in the training room,” said Freeman, urging Vieira to ice his shoulder the first week and start physical therapy the following week.
This time, Vieira agreed, shook Freeman’s hand, thanked him, and walked off toward the locker room.
“Not all physicians relate to what these guys do,” Freeman told The Dallas Morning News (https://dallasne.ws/1deqckp) one afternoon from his office at Dallas’ Texas Orthopaedic Associates, where autographed photos of celebrity bull riders hang on the walls.
Rodeo is one of the most dangerous organized spectator sports in the world. Among its seven traditional events - which include steer wrestling, bareback riding and barrel racing - bull riding comes with the most injuries. Its injury rate is 10 times greater than football and 13 times greater than ice hockey, according to one of the few published studies on the subject, a 2007 study in the International SportMed Journal. Riders risk severe head injuries, lacerations, paralysis and death each time they get on an animal.
Who could blame a doctor for encouraging an injured cowboy to pursue a safer career path? But Freeman’s approach resonates much better with athletes: He does what it takes to help riders return to competition as quickly as possible.
“Tandy understands what we’re needing to do,” said Scooter Nolen, 46, before mounting a horse and lassoing a steer at the Allen Event Center last fall. “He has a great rapport with everyone, and pretty much everyone in the rodeo - he’s their doctor.”
Cody Lambert, a retired champion bull rider, remembers when cowboy-doctor relationships were less harmonious. When he was a teenager, he avoided the training room at all costs. Even with a broken tailbone, he walked by medical staff two days in a row without asking for help.
“I was a 19-year-old kid, and all my heroes were in that locker room, and I didn’t see them going in there. I didn’t want to be the one that went in there and told them I was hurt,” he said.
Now many riders visit the training room to have aching joints wrapped and sore muscles stretched.
“All the riders know that the staff is there to help them,” said Lambert, who is co-founder, livestock director and vice president of the Professional Bull Riders association, which stages some of the most popular and lucrative bull riding events. “It’s not about whether they’re tough guys; it’s about whether they can help them with a grip, or make it so they can ride three bulls this weekend rather than get sore after the first one so they can’t continue.”
When there’s a competition that Freeman can’t get to, riders now call or text him for advice.
“One time, I went five rides in a row getting knocked out,” recalled Wes Stevenson, 34, a bareback rider from Lubbock who had been competing in Canada. “I called Tandy and said, ’There might be something wrong.’ He put me on a flight to Dallas.”
There are thousands of rodeos across the country each year, and Freeman and his colleagues cover just a tiny percentage of them. The vast majority still have only an ambulance crew to care for the injured.
For that reason, injury prevention in rodeo still lags behind similar programs in the National Football League and other professional sports.
But the organizations Freeman works with - the Professional Rodeo Cowboys Association and the Professional Bull Riders - have made significant improvements. They have started keeping basic electronic records on their athletes. And as research on concussions has advanced, they have revamped and modernized their concussion management programs.
Concussions are the most common rodeo injuries, if not the most life-threatening. Riders can get them by smacking their heads against a bull, by falling to the ground or by hitting their heads on a railing.
Head injuries are tougher to prevent in rodeo than in football. In the last few years, the NFL has restricted some of the most dangerous head-first tackles.
“That can help in sports like football,” Freeman said. “But bulls don’t play by the rules.”
In rodeo, helmets are not required. A slim majority of athletes wear them, but many still favor cowboy hats. Helmets, though, do not prevent concussions, which result from the brain slamming against the inside of the skull after an athlete’s head comes to a sudden stop. But they do help prevent facial and other types of head trauma.
Within the bull riders organization, Freeman and the trainers he works with collect baseline cognitive data on each athlete. The tests assess balance, memory and reaction time. After a rider suffers a concussion, trainers administer the tests again and compare the results. If the rider fails, Freeman can block him from competing.
In the rodeo cowboys association, things are different. The association, with which Freeman volunteers in an unpaid position, counts more than 5,000 members, and Freeman and his colleagues can’t track them all.
“They’re like pinballs,” he said. “You never know where they’re going to show up next.” All the organization can do is advise the cowboys about the seriousness of their injuries and the risk of returning to competition before they’ve fully recovered and hope they will listen.
“A lot of these athletes feel like they’re bulletproof,” he said. “And because it’s the head, and it doesn’t look swollen up and you can’t push on it and feel that it hurts, it’s hard to convince them that there’s a problem, especially given that, in the past, in all sports, concussions were treated as something that happened and you shook it off and went on.”
The most serious potential consequence of repeated blows to the head is the rare degenerative disease known as CTE, or chronic traumatic encephalopathy. Once thought to be limited to boxers, CTE has shown up in football players, hockey players, military veterans and, most recently, a soccer player who died at the age of 27. Symptoms typically don’t show up until years after a player retires.
There is little data on rodeo injuries, and those who study the sport say there is not enough information to draw any conclusions about the CTE risks that cowboys might face.
“I have not seen any similar types of trends in rodeo cowboys that have retired,” said Mark Lafave, a sports medicine expert at Mount Royal University in Alberta, Canada, who has published numerous studies on rodeo injuries.
Freeman says a minority of bull riders suffer concussions in any given year. And those who experience concussions suffer no more than one or two.
Christopher Nowinski, co-director of Boston University’s CTE Center, said, “If there are very few subconcussive impacts (symptom-free blows to the head), and you’re only getting one or two concussions a year, in theory you have a lower risk than a football player.”
For the rodeo cowboys association, Freeman presides over the Justin Sportsmedicine Team, which is funded by the Western-wear company Justin Boots. His work for the cowboys and bull riders organizations takes up about 35 weekends a year, which he spends traveling to competitions around the country.
His wife, a Delta flight attendant, often accompanies him. They have no children, but Freeman jokes that on any given rodeo day he has two to three dozen charges for whom he feels a deep sense of responsibility.
A native of Dallas, Freeman did not get involved with the rodeo until he met J. Pat Evans, one of the first sports medicine experts in Texas, with whom Freeman served an elective six-week rotation while completing his residency at UT Southwestern Medical Center.
Evans was the team doctor for the Dallas Cowboys and Dallas Mavericks, and started the Justin Sportsmedicine Team in 1981. He and Freeman became so close that he turned over his practice and eventually his role in the Justin program to Freeman once he retired in the mid-1990s.
“He was kind of my role model in terms of how I wanted to practice medicine and relate to my patients,” Freeman said. “He had lots of patients whom he had taken care of for long periods of time and was taking care of their kids now. In specialties like orthopedic surgery, that’s not what happens today. You end up being a technician. Patients come to you because you’re on their plan, and then you never see them again if their plan changes.”
Freeman liked the sense of community that Evans fostered in his practice, and he has carried on that tradition. Freeman has gone hunting and horseback riding with his patients. And cowboys who have long retired and moved away still call him for medical advice. “I’m a small-town doctor, quite honestly,” he said.
Lafave, who volunteers at Canadian rodeos, echoes that sentiment. He says it’s the athletes who draw him back every year. “You don’t find a lot of arrogant people in rodeo,” he said. “These are salt-of-the-earth kinds of folks.”
Rodeo medicine is still improving thanks to the efforts of Freeman, Lafave and others. Lafave is involved with a research study aimed at improving the protective vest that nearly all bull riders wear. The first one was designed by Lambert, the retired champion bull rider, after a bull gored his friend Lane Frost to death in 1989. The vests protect cowboys from a vengeful bull’s horns but offer little defense in cases where an enraged 1,500-pound animal decides to stomp on its rider.
The goal is to design a vest that can protect a rider’s chest from getting crushed beneath the weight of a bull.
Lafave and his colleagues’ first step has been outfitting bulls with sensors to measure the force with which they buck and stomp. They don’t have final data yet, but “I can tell you that it’s forces beyond anything we typically deal with in a sports setting,” he said. “It’s significantly greater than a speed skater hitting the mats. We’d have to go to bigger things like NASCAR and what happens with cars crashing.”
Lambert’s hope would be to have more personal coaches, like in golf or tennis, who could educate rodeo athletes about the mechanics of riding.
“You don’t get hurt near as often if you make a successful ride, because you get off somewhat on your own terms,” he said. “If you ride better, you get hurt less, because you don’t get stepped on if you’re on top of the bull, and it’s just that simple.”
As earnings for bull riders have increased, thanks to more televised events and more lucrative sponsorships from brands like Monster Energy and Wrangler jeans, so has the motivation for riders to improve their skills and protect their health. Last year, the top bull rider in the PBR, 27-year-old J.B. Mauney, walked away with $1.8 million in winnings.
For now, though, cowboys remain the independent-minded free agents they have always been. And there’s only so much the rodeo can do to provide for their well-being.
“Bull riding is not safe, and it’s not going to be safe,” Lambert said. “If you don’t love it, and you don’t feel like that’s a small price to pay, then you shouldn’t do it.”
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Information from: The Dallas Morning News, https://www.dallasnews.com
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