ISMJ

International SportMed Journal

Letter to the Editor

19 December 2008

 Dear Editor

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Injury severity in mountain bike competitions

Mountain bike racing is a popular and exhilarating competition sport. Potential for injury is, however, inherent with high-speed traverse over uneven terrain.  Evolution of competition formats and safety equipment requires ongoing surveillance of associated injury patterns and severity.

We examined all injuries sustained at the 2006 World Mountain Biking Championships held at the Mount Ngongataha reserve, Rotorua, New Zealand.  All injuries presenting via the on-site medical facility were captured.  Final diagnosis was determined by course doctors when further referral was unnecessary, and from interrogation of medical records in patients’ requiring hospital transfer.  This study was undertaken with the approval of the Northern Y regional ethical committee of the New Zealand Health and Disability Ethics Committee, and written informed consent.

Injury severity scores (ISS) were computed for all injured riders.  The course on which injury was sustained, and requirement for off-site medical care, were collected as additional variables of interest.

A total of 549 (378 male, 171 female) riders from 36 countries participated in the competition.  Male riders completed 121 downhill, 216 cross-country, and 41 four-cross (4X) runs during the course of competition.  Female riders completed 39 downhill, 112 cross-country and 20 4X runs during the course of the event.  An unknown number of practice and seeding runs were completed across the five days of competition.

Twenty-eight (7.4%) male riders sustained 36 competition injuries (mean 1.29 injuries per rider).  Injuries in males were more likely sustained from falls on the downhill course (falls causing injury: 24 downhill, two cross-country, three 4X; p=0.001).  Nine (5.3%) female riders sustained 18 competition injuries (mean 2 injuries per rider).  No statistically significant difference was observed in fall locality for females (four downhill, four cross-country, one 4X; (p=0.223).

Injury severity scores in male riders were low (median 1, range 1-9) with 23 riders sustaining isolated axial or soft tissue trauma (ISS 1). The majority of injuries sustained by female competitors were similarly low (median ISS 1, range 1-26) (see Table 1).  One female rider, however, sustained multiple severe injuries following a fall on the downhill course, including: concussion, atlas fracture, T4/5 fracture dislocation with spinal cord transaction, bilateral multilevel rib fractures with bilateral hemopneumothoracies, and sternal fracture (ISS 26), requiring on scene stabilisation and resuscitation prior to evacuation. Eight male riders and two female riders required hospital transfer for investigation and treatment of injuries sustained during competition.

The majority of injuries sustained at this international mountain bike competition were thankfully of low severity. Isolated reports of severe injury in this and other studies ^1-3, however, mandate provision of site medical responders capable of administering advanced trauma life support interventions at all such competition events. Ongoing surveillance of injury patterns at competitive events is encouraged.

Table 1: Injury Severity Score (ISS)

*¹Dr Martyn Harvey, ¹Dr John Bonning, ²Dr Grant Cave

¹Department of Emergency Medicine, Waikato Hospital, Hamilton New Zealand

²Department of Emergency Medicine, Hutt Hospital, Lower Hutt, New Zealand

Address for correspondence:

Dr Martyn Harvey (FACEM), Emergency Physician, Director Research, Department of Emergency Medicine, Waikato Hospital, Pembroke St, Hamilton New Zealand

Tel.: +64 7 839 8899/6990

Email: harveym@waikatodhb.govt.nz 

References

1.       Pike R, Bonning J, Harvey M. Competitive mountain biking injuries in New Zealand: 2006 Oceania Nationals. NZ J Sports Med 2007; 35(1): 6-9.

2.       Jeys L, Cribb G, Toms A, et al. Mountain biking injuries in rural England. Br J Sports Med 2001; 35(3): 197-199.

3.        Kronish R, Pfeiffer R, Chow T, et al. Gender differences in acute mountain bike racing injuries. Clin J Sports Med 2002; 12(3): 158-164.