Interview: Dr. Riccardo Ceccarelli on Motorsports Safety, Mental Health, and the Upcoming Formula 1 Season

Interview: Dr. Riccardo Ceccarelli on Motorsports Safety, Mental Health, and the Upcoming Formula 1 Season Photo: TT
Formula 1 - 2020 Sakhir Grand Prix in Bahrain

In times of COVID-19, many things changed in Formula 1, but the work of Medical Doctor Riccardo Ceccarelli and his task force is as crucial now as in 1989 when he began working in the series.

About to start his 33rd campaign in the pinnacle of motorsport looking after the wellbeing of the Formula 1 paddock, the Italian took time out to talk to Sports Pundit in an extended and revealing interview.

With over 30 years of experience in sports medicine, Ceccarelli is also the CEO & Founder of Formula Medicine. A sports Medicine Centre specialized in the physical and mental training of professional athletes.

The facility includes the Mental Gym, “the first futuristic gym in the world” - as the doctor outlines, entirely dedicated to training the brain.

During the interview, Ceccarelli gave insights into the unusual 2020 F1 season and how his team is preparing for the upcoming campaign, shared his views on Romain Grosjean’s accident, and spoke about mental health.

Alongside this, he discussed safety in motorsport, with an especial focus on the HANS device, as 2021 marks the 20th anniversary of NASCAR legend Dale Earnhardt’s death due to a basilar skull fracture.

How is Formula Medicine preparing for the 2021 racing season with the world still striving with the ongoing pandemic?

Ahh, this is a good question. We thought at this point the pandemic could have been more under control, but it is not.

It is a fact that massive vaccination will improve the general situation in 2021, but before reaching the so-called herd-immunity, we need to deal with the new variants, which seem to be more contagious and might affect the effectiveness of the vaccination; I hope not!

As usual, Formula Medicine can rely on its innate flexibility, taking into consideration all the variables which can upset the initials plans.

The same as last year, Formula Medicine will guarantee a designated doctor per team assisted, consisting of 8 Formula 1 teams and other groups like Pirelli, F1, Sky, and DHL, concerning the bubble structure F1, and FIA put in place to mitigate the risk of transmission.

Each doctor working for Formula Medicine has received, at least, the first shot of the vaccine. When the time of the first race in Bahrain, we will have completed the entire program.

On top of that and based on last season, we are building a worldwide connection with colleagues from all the countries in which the races will take place to guarantee the correct management of positive cases according to local guidelines and regulations.

It is a rather massive effort for my logistics office, considering the high number of Formula Medicine personnel traveling weekly.

Did you happen to be at the circuit in Bahrain when Romain Grosjean’s accident took place? If so, what does your expertise tell you about the incident?

Yes, I was there in Bahrain when Romain suffered that horrible crash. I believe he is blessed; it was simply not his time to go.

The first images we saw were horrific; every one of us thought it was a fatal crash, obviously, not only because of the fire but also for the heavy impact and g-forces he had to face.

I think a combination of different events allowed Romain to survive that day: he did not lose his consciousness, and this was very important as he was able to unfasten the seat belt and exit the car; the HANS, of course, did his job to prevent him from fatal injuries; the fireproof suit made an unbelievable job.

In addition, Dr. Ian Roberts and Alan Van der Merwe’s abilities gave another crucial contribution. But for me, the HALO system was of extreme importance, another fundamental innovation developed by FIA.

It protected the helmet from the impact with the guard-rail; the last ingredient, obviously, a bit of luck, which is always necessary!

How does the HANS device work, and why did it take so long to be introduced in motorsport?

The HANS (Head and Neck Support) device, projected and developed by Dr. Robert Hubbard - professor of biomechanical engineering - is one of the most significant safety measures that FIA put into practice to prevent car racing fatalities.

The system, which basically works like an airbag (clearly without inflating cushion), uses a raised collar and two polyester-fabric tethers, which are attached to the helmet; the driver’s shoulder belts hold the tall, stiff collar securely in place.

In case of an accident, especially a forward impact, these two straps restrain the head from overstretching, preventing injuries to the neck and vertebral column.

It assures the driver’s head moves with his torso so that the vulnerable neck and skull bones are not overloaded.

It is difficult to answer the second part of the question. During the 70s, 80s, race car drivers were considered superheroes, and the risk of death while driving, was universally accepted; it was considered part of the game.

As time went by and, most importantly, with drivers continuing to lose their lives in accidents that only caused minor damage to cars, the attention on safety raised.

Following the death of famous drivers during the 90s due to basilar skull fracture, in addition to the extraordinary efforts done by the FIA, the HANS device started to be highly tested until finally being widely accepted in competition.

What is a basilar skull fracture?

In a car crash, there are numerous external forces that act on the body and could lead to traumatic injuries.

When someone crashes their car, it comes to a sudden stop, but the momentum of the body continues.

The head is not strapped into the seat like the body is. As the car rotates, flips, and moves in any direction, the driver’s head could smash into different parts of the vehicle, and this might lead to a skull fracture.

The skull base forms the floor of the skull cavity, and it is where the brain sits in the head. A basal skull fracture is risky because it can potentially lead to a traumatic brain injury, being the location of the fracture predictive of associated injuries.

It can happen if a piece of the skull breaks off and collides with either the brain tissue or one of the numerous blood vessels in the brain; a cerebral contusion or an intracerebral hemorrhage can result, leading to a host of complications and possibly death.

How did you experience the safety device introduction in Formula 1?

It was not until a tragedy took place - the loss of famous driver Dale Earnhardt’s in the 2001 Daytona 500 - that the HANS gained wide acceptance and eventually introduced [by the FIA] as a compulsory feature in 2003.

The same happened after [Ayrton] Senna’s fatal accident with the introduction of the headrest around the cockpit.

Nowadays, thankfully, motorsports safety is taken more seriously.

Furthermore, there is a team inside the FIA entirely dedicated to increasing safety standards.

How did the drivers react at the time?

We could say that the system became universally accepted among drivers, who immediately understood the importance of wearing it, even if in the beginning, most of them complained about its lack of comfort, it was quite heavy indeed.

The U-shaped HANS device used today is composed of carbon-fiber weighing only around 360 grams, and no driver would consider racing without wearing it.

Since the introduction of the HANS device, several drivers escaped unharmed [from accidents] due to its use, so I can definitely confirm that this device plays a critical role in increasing safety standards.

Could Roland Ratzenberger’s death at the San Marino Grand Prix in 1994 have been prevented with the HANS?

It is difficult to answer with certainty, but I can say that the use of the HANS, together with the headrest and the current chassis, could have increased a lot Roland’s chances of escaping that horrible crash. The same with Ayrton.

Last season, 29 doctors of 5 different nationalities were involved in your task force.

How did the pandemic affect them psychologically?

Indeed, we had to create a real international task force to react to all the difficulties we had to face. Clearly, even for us as doctors, the pandemic is something new, difficult to deal with, both from a medical and psychological perspective.

We are not immune, so we experienced the same anxieties and fears that ordinary people faced, of course, with a different awareness.

Especially at the beginning, when this virus and its related illness were unknown, the situation was tough to face.

Overall, for my medical team - always traveling around the world - the fear of getting infected and staying confined or hospitalized in a foreign country was high, considering most of them are freelancers and cannot afford to leave their hospitals for too long.

You also revealed that with the introduction of the Mental Training Gym, the number of athletes you work with every year raised from 70 to 180. What does the feedback from the athletes your company assists tell you?

The gradual introduction of our Mental Economy Training inside our facility raised significantly the number of athletes (not only drivers) trained.

Moreover, the compliance of each athlete inside the Mental Gym is almost 100%. Each of them accepts quite well to work 50% of his time on the athletic side and 50% on his mental side.

Most notably, this comes from as a result of how we optimize brain performance, working beyond the pathological aspects, a big step ahead, also thanks to the adding of a sports neuropsychologist, becoming an integral part of our staff.

Our Mental Training is different compared to others: with our instruments and methodology, we can integrate mental performance with body energy consumption (measured with wearable devices), always improving the Neural Efficiency, the ability of our brain to obtain top performance without wasting unnecessary energy.

We demonstrated this concept through scientific research published in respected papers.

The feedbacks are extraordinary. Drivers feel the benefit of our training methodology as they are able to bring to the race track what they learned and experienced about themselves here in our gym.

Big motorsport companies and some leading managers ask us to scout for them using our Mental Economy Training. During a four-day complete check-up in our HQs, our staff is able to understand, among a group of talented drivers, who has the better predisposition, in terms of Neural Efficiency, to become a champion.

The fact that major companies and managers rely on our opinion to invest a considerable amount of money makes us feel very proud but at the same time, sets us under a lot of pressure, as a misjudgment can lead to big problems.

But we like to face pressure; for us, it is adrenaline and motivation altogether!

What does it represent in terms of mental health?

The pandemic also represents a vast challenge in terms of mental health.

We believe our methodology can be applied not just to improve sports performance but also to enhance mental wellbeing in daily life.

Albeit mainly athletes use our Mental Economy Training, we have already started to open up to new horizons, welcoming managers and regular people into our gym.

How do you envision the future of sports and health care in general for the next couple of years?

It will take a long time to go back to what we commonly call normality.

My concern is that for the next 1-2 years, we will not get rid of face masks, hand sanitizers, and social distancing. I hope not, but we have to consider this option.

Gradually, spectators will be allowed into sports events, but it will take a while before every fear is left behind.

From your perspective, what does need to change in health care systems after experiencing COVID-19?

As a doctor, but also as a citizen, I think we have to learn from this experience, avoiding making the same mistakes again during the next pandemic.

First of all, each country must guarantee free medical care to all of its inhabitants.

This pandemic highlighted the importance of a well-built and well-organized National Health System, researchers, digitalization, and the importance of a well-prepared political class. I think these are four key elements to invest money in the future.


As Dr. Ceccarelli mentioned earlier, Dr. Robert Hubbard - a motorsports pioneer in driver safety - invented the HANS device, the world’s first frontal head restraint, in 1981 alongside his brother-in-law and five-time IMSA driving champion, Jim Downing.

Downing’s dear friend Patrick Jacquemart passed away during an IMSA testing accident due to head injuries, which drove them to move forward with the research that would lead to file a patent for their early prototype born in 1986.

CART (IndyCar) became the first series to make it mandatory in 2000.

NASCAR made the HANS device compulsory in 2002, FIA Formula One World Championship followed in 2003, while the FIA mandated its use in all of its main championships running with modern cars from 2008 onwards.

The HANS has been one of the major safety devices introduced in motorsport”, said FIA Head of Competitor Safety, Nuno Costa.

The FIA has studied a number of accidents, and for some of them, we estimate that the drivers and co-drivers would not have survived without the use of Frontal Head Restraint (FHR) devices.”

2021 F1 SEASON

Formula One pre-season testing will be taking place at the Bahrain International Circuit between March 12 to 14.

The 2021 season of the FIA Formula One World Championship will start with the Bahrain Grand Prix on March 28.

Cecilia demartini
Sports Pundit staff writer @ceci_2812
Cecilia is a writer and journalist, passionate about motorsport and tennis.Her articles are published in newspapers and international online publications.

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