The downhill race for a Rainbow jersey. The Epidemiology of Injuries in Downhill Mountain Biking at the 2023 UCI Cycling World Championships using the International Olympic Committee Consensus: A Prospective Cohort Study

IntroductionDownhill Mountain Biking (DHMTB) is one of the more spectacular sub-disciplines of mountain bike (MTB) cycling. The primary aim of our study was to prospectively document the injury rate, severity, aetiology, location and type during official training and racing by elite DHMTB riders during the 2023 UCI Cycling World Championships. MethodsThe participants of this prospective, observational study were elite male and female cyclists competing at the UCI DHMTB World Championships located in the Nevis range in Fort William, Scotland, in 2023. This study followed the injury reporting guidelines established by the International Olympic Committee (IOC), which include the STROBE-SIIS and the cycling-specific extension. ResultsThroughout the championships, 10.4% of riders sustained one injury, with 4.3% of riders injuring more than one location per injury event. The overall injury incidence was 3.3 injuries per 100 rides. The incidence rates were higher in the training group (6.4/100rides) than in the race group (2.3/100rides). There was a greater incidence of injury in females in the training 5.7/100 rides and racing 4.4/100rides compared to male riders. Female athletes experienced more severe injuries, with double the estimated time lost to injury. Additionally, female athletes were found to have a significantly greater risk of head injuries and concussions than males. ConclusionOverall, injuries are more prevalent in training than in competition. Compared with male DHMTB athletes, female DHMTB athletes are more at risk of injury and show a greater incidence of injury within official training and competition as well as more severe injuries. Summary BoxO_ST_ABSWhat is already knownC_ST_ABSO_LIDownhill Mountain Biking (DHMTB) is one of the more spectacular subdisciplines of mountain bike cycling and has been shown to have high injury prevalence. C_LIO_LIThere is a lack of methodological homogeneity amongst the prospective injury surveillance studies conducted within DHMTB and across competitive cycling. C_LIO_LINo Study has currently reported injury incidence within elite DHMTB as per the International Olympic Committee (IOC) cycling extension recommendations. C_LI What this study addsO_LIWithin DHMTB injury incident rates were higher in training (6.4/100rides) compared to racing (2.3/100rides). C_LIO_LIOverall Injury incident rate was significantly higher in females (5.1/100rides) compared to males (2.3/100rides). C_LIO_LIFemale athletes have a 2.89 higher risk of Injury compared to Male DHMTB athletes. C_LIO_LIFemale athletes have significantly higher risk of head/neck (RR 9.5) injuries and concussion (RR 6.34) compared to their male counterparts. C_LI How this study might affect research, practice, or policyO_LIThe IOC Cycling Extension should acknowledge that when reporting injuries per 100 rides, the number of rides completed prior to injury should be collected to improve reporting accuracy. C_LIO_LIFemale athletes may benefit from an extra official training ride to ease pressures during course familiarisation and reduce racing injury incidence. C_LIO_LIFemale athletes may benefit from neck strengthening and resistance training to reduce the number of head and neck injuries. C_LI