Methods for epidemiological studies in competitive cycling: an extension of the IOC consensus statement on methods for recording and reporting of epidemiological data on injury and illness in sport 2020

The NICA injury surveillance system: results from five years of student-athlete injury data

The National Interscholastic Cycling Association Injury Surveillance System was implemented in 2018 to characterize acute traumatic injuries and identify associated risk factors in interscholastic youth cross-country mountain bike racing in the United States. Designated reporters collected data weekly during the 2018-2022 seasons. Variables collected included demographic information, injury characteristics, and other associated factors. In 119,098 student-athlete years, there were 2,655 injury events (injury event proportion = 2.23%). The wrist/hand was the most common body part injured (23.2%), followed by head/brain (23.0%), and shoulder/clavicle (15.9%). Males experienced a higher proportion of upper limb injuries than females (57.6% and 49.6%, respectively; p < 0.001); females experienced a higher proportion of lower limb injuries than males (29.5% and 24.8%, respectively; p = 0.020). Injury event proportion decreased by 27% (p < 0.001) during the study period. Acute traumatic injuries are common but injury proportion is low. Most injuries are minor but serious injuries do occur, resulting in time-loss from riding.

"Beyond the Finish Line" the Epidemiology of Injury and Illness in Professional Cycling: Insights from a Year-Long Prospective Study

Introduction: Injury and illness rates within cycling are a growing concern for riders, medical personnel, and event organisers. This study is the first to document injury and illness rates in professional cyclists throughout one competitive season including training and racing. Methods: A prospective, longitudinal study was conducted with 47 professional cyclists (30 males and 17 females) over the 2024 season (1 November 2023-31 October 2024). Injuries and illnesses were defined and recorded following the International Olympic Committee (IOC) consensus guidelines for injury reporting in sports and its cycling-specific extension. Data collection utilised a centralised online hub, integrating exposure metrics (e.g., training hours and kilometres) and medical records. All data were processed on a Macintosh computer using the Microsoft Office and R statistics packages epi tools, binom.test function, and ggplot. (V.4.3.2, R Foundation for Statistical Computing, Vienna, Austria). Ethical approval was obtained from Queens University Belfast, number MHLS 23_175. Results: Fifty-five injury events were logged, with 1.15 (±0.359) locations injured per incidence and 1.57 (±1.06) injury types per incident. The overall combined injury rate for racing was 4.14 (95% CI: 2.65-5.79) per 1000 h of exposure, with the overall combined rate for training being 1.23 (95% CI: 0.8-1.7) per 1000 h. The injury risk ratio (RR) for injury during racing and training for females was 11.10 (95% CI: 2.69-37.60), and the RR for males was 10.24 (95% CI: 3.84-43.06), both indicating there is a significantly higher risk of injury during racing compared to training. Abrasions were the most common injury type, with fractures being the most burdensome injury. The most common illness was upper respiratory, 0.63 (95% CI: 0.27-0.99) per year for males and 1.11 (95% CI: 0.64-1.59) per year for females. Saddle sores were the second most common at 0.20 (95% CI: 0.04, 0.36) per year for males and 0.08 (95% CI: 0-0.18) per year for females. Conclusions: This study provides the first comprehensive, season-long surveillance data for injuries and illnesses in male and female professional road cycling, highlighting the significant differences in injury profiles between racing and training. These results underscore the need for targeted injury prevention strategies and the establishment of a standardised injury and illness framework for professional cycling.

ACE I/D Genotype and Risk of Non-Contact Injury in Moroccan Elite Athletes: A Pilot Study

Background and Objectives: The insertion/deletion (I/D) polymorphism in ACE, the gene encoding the angiotensin-converting enzyme (ACE), has been suggested as a genetic variation that can influence exercise performance and risk of injury in elite athletes. The I allele has been associated with enhanced endurance performance and with reduced inflammation, while the D allele has been associated with improved performance in strength and power activities. However, the role of this genetic variant in the incidence of non-contact injury is underexplored. This study investigated the possible association of ACE I/D genotypes with the risk of non-contact injury in elite Moroccan athletes. Materials and Methods: Forty-three elite male athletes (19 cyclists and 24 field hockey players) from the Moroccan national team participated voluntarily. Non-contact injuries were recorded for all athletes and classified according to the IOC consensus statement by the medical staff of the teams. ACE I/D polymorphism genotyping was performed by polymerase chain reaction (PCR) using genomic DNA from blood samples. Results: There were four cyclists (21.05%) and eight field hockey players (33.33%) with a non-contact injury during the season. The distribution of the ACE I/D genotypes was similar in the athletes with vs. without non-contact injury for cyclists (DD/ID/II 25.00/50.00/25.00% vs. 46.67/40.00/13.33% non-injured, respectively; X2 = 0.69, p = 0.70), field hockey players (DD/ID/II 50.00/50.00/0.00% vs. 50.00/43.75/6.25%; X2 = 0.54, p = 0.76) and for the whole group of athletes (DD/ID/II 41.67/50.00/8.33% vs. 48.39/41.94/9.68%; X2 = 0.22, p = 0.89). In the whole group of athletes, neither the dominant (DD + ID vs. II = OR: 1.17, 95% CI: 0.15-16.56, p = 0.89) nor the recessive (DD vs. ID + II = OR: 1.31, 95% CI: 1.31-4.89, p = 0.69) models showed an increased risk of non-contact injury. Conclusions: The distribution of the ACE I/D genotypes was similar in elite cycling and field hockey athletes with or without non-contact injury during the season. These results indicate that there is no significant association between the ACE I/D polymorphism and the susceptibility to non-contact injury in these athletes. Further research is warranted to validate these findings and to investigate their broader implications for advancing knowledge in sports injury prevention and optimizing athlete management strategies.

Snow sports-specific extension of the IOC consensus statement: methods for recording and reporting epidemiological data on injury and illness in sports

The International Olympic Committee's (IOC) consensus statement on 'methods for recording and reporting of epidemiological data on injury and illness in sport' recommended standardising methods to advance data collection and reporting consistency. However, additional aspects need to be considered when these methods are applied to specific sports settings. Therefore, we have developed a snow sports-specific extension of the IOC statement to promote the harmonisation of injury and illness registration methods among athletes of all levels and categories in the different disciplines governed by the International Ski and Snowboard Federation (FIS), which is also applicable to other related snow sports such as biathlon, ski mountaineering, and to some extent, para snow sports. The panel was selected with the aim of representing as many different areas of expertise/backgrounds, perspectives and diversity as possible, and all members were assigned to thematic subgroups based on their profiles. After panel formation, all members were provided with an initial draft of this extension, which was used as a basis for discussion of aspects specific to the discipline, application context, level and sex within their snow sports subgroup topic. The outcomes were then aligned with the IOC's existing consensus recommendations and incorporated into a preliminary manuscript draft. The final version of this snow sports-specific extension was developed and approved in two iterative rounds of manuscript revisions by all consensus panel members and a final meeting to clarify open discussion points. This snow sports-specific extension of the IOC statement is intended to guide researchers, international and national sports governing bodies, and other entities recording and reporting epidemiological data in snow sports to help standardise data from different sources for comparison and future research.

Injuries, Risk Factors, and Prevention Strategies in Bicycle Motocross (BMX): A Scoping Review

CONTEXT

Bicycle motocross (BMX) has become increasingly popular since its inclusion in the 2008 Olympics, but it has some of the highest injury rates (IRs) in multisport studies. To support planning for tailored primary prevention, understanding gaps in BMX injury prevention is crucial.

OBJECTIVE

To examine the evidence on injury incidence, prevalence, risk factors, prevention strategies, and prevention implementation in BMX.

DATA SOURCES

Ovid MEDLINE, Embase, APA PsycInfo, CINAHL, and SPORTDiscus were searched systematically in June 2023.

STUDY SELECTION

Articles including BMX and any injury as the main topic or subtopic were searched across multiple databases.

STUDY DESIGN

A scoping review was designed following the PRISMA Extension for Scoping Reviews (PRISMA-ScR).

LEVEL OF EVIDENCE

Level 4.

DATA EXTRACTION

BMX injury incidences, prevalence, risk factors, prevention strategies, and prevention implementation were extracted. Two reviewers screened all studies and extracted data independently.

RESULTS

Of the 1856 articles screened, 37 met inclusion criteria. Most studies used injury surveillance at elite competitions or emergency departments, and common injuries were contusions, lacerations, and fractures. IRs provided were based primarily on elite competition and were heterogeneous (eg, 2016 Olympics: 37.5 per 100 athletes; 2007 BMX World Championship: 11.7 per 100 athletes; 1989 BMX Euro Championship: 6.6 per 100 athletes). Only 1 study stratified IRs by BMX discipline (BMX freestyle: IR, 22.2 injuries per 100 athletes; BMX racing: IR, 27.1 per 100 athletes). Few prevention strategies have been evaluated, but reducing the number of riders per race could be helpful.

CONCLUSION

Most BMX studies do not use recommended injury surveillance methodology. Studies based on emergency department data may underestimate minor injuries and do not adequately measure BMX exposures. Rigorous community-based prospective studies examining IRs for both BMX racing and freestyle, risk factors, and prevention strategies are needed to inform widespread evidence-based prevention strategies.

A systematic review protocol of injuries and illness across all the competitive cycling disciplines, including track cycling, mountain biking, road cycling, time trial, cyclocross, gravel cycling, BMX freestyle, BMX racing, e-sport, para-cycling and artistic cycling

Introduction

The sport of cycling has witnessed phenomenal growth over the past decade. Globally, over 200 million television hours across five continents watched the recent inaugural World Championships in Glasgow, in 2023. The Union Cycliste Internationale (UCI), the world cycling governing body, has highlighted its mission to "promote and support research in cycling epidemiology and medicine, especially for the benefit of lesser-known disciplines" within its 2030 Agenda. This paper outlines a proposed protocol to conduct a systematic review that comprehensively analyses and synthesises the existing literature about cycling-related injuries and illness across all competitive disciplines.

Methods

The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines will be followed through each stage of this systematic review. Cycling is an umbrella term used for many individual disciplines. Investigation of all types of injuries and/or illnesses sustained during training and/or competition among competitive athletes across all disciplines will be included in this review. A computerised, systematic literature search will be conducted in electronic databases MEDLINE, Scopus, Embase, and Cochrane Library. Independent screening by two reviewers in a two-step process: title/abstract screening followed by full-text review. The reference lists of included articles will be searched to identify any other potentially relevant articles. Narrative synthesis and tabular/charted presentation of the extracted data will be included.

Discussion

This protocol paper outlines the methodology to conduct a systematic review of injuries and illness across all competitive cycling disciplines. The aims of outlining this systematic review protocol are to aid research transparency, help reduce publication bias, prevent selective publication, and prevent the selective reporting of results. Future systematic reviews based on the proposed protocol will summarise the known prevalence, incidences, locations and burden of injury and illness across the sport of cycling.

Trial Registration

This study has been registered with the PROSPERO International Prospective Register of Systematic Reviews (registration number CRD42024502703).

'Downhill race for a rainbow jersey': the epidemiology of injuries in downhill mountain biking at the 2023 UCI cycling world championships-a prospective cohort study of 230 elite cyclists

Objectives

This study aims to understand the prevalence, incidence rate, anatomical sites, injury severity and main medical actions carried out during official training and racing by elite downhill mountain biking (DHMTB) riders during the 2023 Union Cycliste Internationale (UCI) Cycling World Championships.

Methods

The 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, which include the Strengthening the Reporting of Observational Studies in Epidemiology-Sports Injury and Illness Surveillance (SIIS) and the cycling-specific extension. Injuries were defined as 'tissue damage or other derangement of normal physical function due to participation in sports, resulting from rapid or repetitive transfer of kinetic energy requiring medical attention'. All epidemiological data were collected by the local organising committee medical professionals working at the event through an online survey. All data inputted were screened daily by the lead event physician and UCI medical delegate.

Results

Throughout 5 days of the championships, 10.4% of the 230 cyclists sustained at least one injury. The overall injury incidence rate was 3.3 (95% CI 3.1 to 3.5) per 100 rides. The incidence rates were higher in the training 4.3 (95% CI 4.0 to 4.6)/100 rides than in the racing 2.2 (95% CI 2.1 to 2.3)/100 rides. There was a greater incidence of injury in female cyclists in the training 5.8 (95% CI 5.0 to 6.6)/100 rides and racing 4.5 (95% CI 3.9 to 4.9)/100 rides compared with male cyclists. Female cyclists experienced more severe injuries, with an average of 12.6 (±14, 95% CI 5.66 to 19.54) days lost to injury compared with 5.5 (±1.6 95% CI 1.89 to 9.11) seen in male cyclists. The main event medical actions were lifting, immobilisation and helmet removal.

Conclusion

This study provides insights into the risk of injury to athletes within DHMTB. Our findings suggest more focus should be placed on the female DHMTB athlete. Additionally, this study provides unique information about common medical actions required of medical professionals working at DHMTB events and the importance of pre-event scenario training.

An Update on the Six Recommendations from the 2012 IADMS Standard Measures Initiative: Assessing and Reporting Dancer Capacities, Risk Factors, and Injuries

INTRODUCTION

In 2012, the Standard Measures Consensus Initiative (SMCI) of the International Association for Dance Medicine and Science (IADMS) presented 6 recommendations regarding dance injury surveillance, definitions of injury and exposure, dance-specific screening, risk reduction strategies, and collaborative data management. The aim was to standardize risk factor measurement and injury reporting by researchers in dance medicine and science. Since then, numerous reports on the recording and reporting of injury data in sport and performing arts have been published.

METHODS

IADMS commissioned SMCI to update the 2012 recommendations, a process that involved 3 stages: (1) current field experts were invited to join SMCI, (2) SMCI members reviewed recent and relevant sport and performing arts literature, then drafted, discussed, and revised section updates, (3) IADMS invited individuals representing diverse backgrounds in the IADMS community to critically review drafted updates. The final update serves as a bridge from the 6 recommendations in the 2012 report to the current state of evidence.

RESULTS

We continue to encourage use of dance injury surveillance systems and support that surveillance protocols be fit-for-purpose, and that failure to use clear and consistent injury definitions perpetuates a lack of rigor in dance injury research. Based on new evidence, we recommend that some aspects of injury surveillance be self-reported, that the choice of dance exposure measures be dependent on the research question, contextual factors, and type of injury/health problem(s) of interest, and that studies using dance-specific screening articulate specific objectives, validity, and reliability of each protocol.

CONCLUSIONS

Future studies should focus on the development, implementation, and evaluation of strategies to minimize injury risk to improve consistency and rigor in data collection and research reporting on the health and wellness of dancer populations, thus facilitating a future dance injury consensus statement similar to recent statements published for sports and circus arts.

Hyperthermia and Exertional Heatstroke During Running, Cycling, Open Water Swimming, and Triathlon Events

Few previous epidemiological studies, sports medicine position statements, and expert panel consensus reports have evaluated the similarities and differences of hyperthermia and exertional heatstroke (EHS) during endurance running, cycling, open water swimming, and triathlon competitions. Accordingly, we conducted manual online searches of the PubMed and Google Scholar databases using pre-defined inclusion criteria. The initial manual screenings of 1192 article titles and abstracts, and subsequent reviews of full-length pdf versions identified 80 articles that were acceptable for inclusion. These articles indicated that event medical teams recognized hyperthermia and EHS in the majority of running and triathlon field studies (range, 58.8 to 85.7%), whereas few reports of hyperthermia and EHS appeared in cycling and open water swimming field studies (range, 0 to 20%). Sports medicine position statements and consensus reports also exhibited these event-specific differences. Thus, we proposed mechanisms that involved physiological effector responses (sweating, increased skin blood flow) and biophysical heat transfer to the environment (evaporation, convection, radiation, and conduction). We anticipate that the above information will help race directors to distribute pre-race safety advice to athletes and will assist medical directors to better allocate medical resources (eg, staff number and skill sets, medical equipment) and optimize the management of hyperthermia and EHS.

Orchard Sports Injury and Illness Classification System (OSIICS) Version 15

BACKGROUND

Sports medicine (injury and illnesses) requires distinct coding systems because the International Classification of Diseases is insufficient for sports medicine coding. The Orchard Sports Injury and Illness Classification System (OSIICS) is one of two sports medicine coding systems recommended by the International Olympic Committee. Regular updates of coding systems are required.

METHODS

For Version 15, updates for mental health conditions in athletes, sports cardiology, concussion sub-types, infectious diseases, and skin and eye conditions were considered particularly important.

RESULTS

Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in athletes. Two landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology codes. Rugby union protocols on head injury assessment were used to create additional concussion codes.

CONCLUSION

It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international accessibility. The large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

Epidemiology of injuries at the 2023 UCI cycling world championships using the International Olympic Consensus: a protocol for a prospective cohort study

The sport of cycling consists of several individual sporting disciplines. Indeed, the world governing body for cycling, Union Cycliste Internationale (UCI), oversees the various cycling disciplines, with each of these disciplines having a number of subcategories. While several sports have undertaken prospective injury surveillance studies to understand the risks of their sport, plan event medical support and develop prevention programmes, limited high-quality studies have been undertaken within cycling. Indeed, this is the first prospective study of cycling injuries, particularly when considering the whole sport of cycling together. This current study will therefore aim to describe the incidence, severity, burden and nature of injuries within elite cycling in those athletes participating across 13 championship events at the inaugural World Championships, Glasgow, August 2023. Injury and exposure definitions will be in line with the IOC Consensus for injury surveillance in cycling. Injury incidence will be reported per 1000 athlete match hours or per number of athletes/cyclists and injury severity will be assessed via estimated median or mean days lost to training/competition. Meanwhile injury burden will be assessed via days of absence/1000 athlete match hours (or per number of athletes exposed) and all these results will be compared between male and female cyclists. This paper will also report the most common specific injuries for male and female cyclists (per 1000 hours of participation or per number of athletes exposed). Statistical differences will be tested for incidence or severity measures between sexes and will be compared to other sports.

An Urgent Call for Concussion Incidence Measures in Para Sport for Athletes with Vision Impairment: A Narrative Review

Concussion in para athletes with vision impairment (VI) is poorly understood. Recently published studies have suggested that athletes with VI may be more likely to sustain sport-related concussions compared to non-disabled athletes and athletes with other impairment types. There is a critical need for objective concussion incidence measures to determine concussion injury rates and risks more accurately. The aim of this review was to examine the limited available evidence of concussion incidence rates across six different para sports for athletes with VI and encourage the future collection of concussion incidence data and the adoption of injury prevention strategies in VI para sport. A literature search was conducted using four unique databases, which formed the basis of this narrative review. Injury prevention strategies such as modifying sport rules, introducing protective equipment, and incorporating additional safety measures into the field of play have been introduced sporadically, but the effectiveness of most strategies remains unknown. More prospective, sport-specific research examining mechanisms of injury and risk factors for concussion injuries in athletes with VI in both training and competition is needed. This research will help inform the development of targeted injury prevention strategies to reduce the likelihood of concussion for athletes with VI.

Clinical characteristics of gradual onset injuries in recreational road cyclists - SAFER XXVII study over 5 years in 62758 race entrants

OBJECTIVE

Gradual onset injuries (GOIs) in recreational cyclists are common but not well described. The aim of this study is to describe the clinical characteristics of GOIs (main anatomical regions, specific anatomical sites, specific GOIs, tissue type, severity of GOIs, and treatment modalities) of GOIs among entrants participating in a community-based mass participation-cycling event over 5 years.

METHODS

During the 2016-2020 Cape Town Cycle Tour, 62,758 consenting race entrants completed an online pre-race medical screening questionnaire. 1879 reported GOIs in the previous 12 months. In this descriptive epidemiological study, we report frequency (% entrants) of GOIs by anatomical region/sites, specific GOI, tissue type, GOI severity, and treatment modalities used.

RESULTS

The main anatomical regions affected by GOIs were lower limb (47.4%), upper limb (20.1%), hip/groin/pelvis (10.0%), and lower back (7.8%). Specifically, GOI were common in the knee (32.1%), shoulder (10.6%), lower back (7.8%) and the hip/buttock muscles (5.2%). The most common specific GOI was anterior knee pain (17.2%). 57.0% of GOIs were in soft tissue. Almost half (43.9%) of cyclists with a GOI reported symptom duration >12 months, and 40.3% of GOIs were severe enough to reduce/prevent cycling. Main treatment modalities used for GOIs were rest (45.9%), physiotherapy (43.0%), stretches (33.2%), and strength exercises (33.1%).

CONCLUSION

In recreational cyclists, >50% of GOIs affect the knees, shoulders, hip/buttock muscles and lower back, and 40% are severe enough to reduce/prevent cycling. Almost 45% of cyclists with GOIs in the lower back; or hip/groin/pelvis; or lower limbs; or upper limb reported a symptom duration of >12 months. Risk factors associated with GOIs need to be determined and preventative programs for GOIs need to be designed, implemented, and evaluated.

Football-specific extension of the IOC consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020

Several sports have published consensus statements on methods and reporting of epidemiological studies concerning injuries and illnesses with football (soccer) producing one of the first guidelines. This football-specific consensus statement was published in 2006 and required an update to align with scientific developments in the field. The International Olympic Committee (IOC) recently released a sports-generic consensus statement outlining methods for recording and reporting epidemiological data on injury and illness in sport and encouraged the development of sport-specific extensions.The Fédération Internationale de Football Association Medical Scientific Advisory Board established a panel of 16 football medicine and/or science experts, two players and one coach. With a foundation in the IOC consensus statement, the panel performed literature reviews on each included subtopic and performed two rounds of voting prior to and during a 2-day consensus meeting. The panel agreed on 40 of 75 pre-meeting and 21 of 44 meeting voting statements, respectively. The methodology and definitions presented in this comprehensive football-specific extension should ensure more consistent study designs, data collection procedures and use of nomenclature in future epidemiological studies of football injuries and illnesses regardless of setting. It should facilitate comparisons across studies and pooling of data.

Surveillance of athlete mental health symptoms and disorders: a supplement to the International Olympic Committee's consensus statement on injury and illness surveillance

In 2019, the International Olympic Committee (IOC) published a consensus statement outlining the principles for recording and reporting injury and illness in elite sport. The authors encouraged sport federations to adapt the framework to their sport-specific context. Since this publication, several sports have published extensions to the IOC consensus statement.In response to a paucity of epidemiological data on athlete mental health, the IOC mental health working group adapted the IOC consensus statement on injury and illness surveillance to improve the capturing of athlete mental health data. In addition to the members of the working group, other experts and athlete representatives joined the project team to address gaps in expertise, and to add stakeholder perspective, respectively. Following an in-person meeting, the authors worked remotely, applying the scientific literature on athlete mental health to the IOC injury and illness surveillance framework. A virtual meeting was held to reach consensus on final recommendations.Practical outcomes based on the analysis of the scientific literature are provided with respect to surveillance design, data collection and storage, data analysis and reporting of athlete mental health data. Mental health-specific report forms for athlete and health professional utilisation are included for both longitudinal and event-specific surveillance.Ultimately, this publication should encourage the standardisation of surveillance methodology for mental health symptoms and disorders among athletes, which will improve consistency in study designs, thus facilitating the pooling of data and comparison across studies. The goal is to encourage systematic surveillance of athlete mental health.

Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport

The IOC made recommendations for recording and reporting epidemiological data on injuries and illness in sports in 2020, but with little, if any, focus on female athletes. Therefore, the aims of this supplement to the IOC consensus statement are to (i) propose a taxonomy for categorisation of female athlete health problems across the lifespan; (ii) make recommendations for data capture to inform consistent recording and reporting of symptoms, injuries, illnesses and other health outcomes in sports injury epidemiology and (iii) make recommendations for specifications when applying the Strengthening the Reporting of Observational Studies in Epidemiology-Sport Injury and Illness Surveillance (STROBE-SIIS) to female athlete health data.In May 2021, five researchers and clinicians with expertise in sports medicine, epidemiology and female athlete health convened to form a consensus working group, which identified key themes. Twenty additional experts were invited and an iterative process involving all authors was then used to extend the IOC consensus statement, to include issues which affect female athletes.Ten domains of female health for categorising health problems according to biological, life stage or environmental factors that affect females in sport were identified: menstrual and gynaecological health; preconception and assisted reproduction; pregnancy; postpartum; menopause; breast health; pelvic floor health; breast feeding, parenting and caregiving; mental health and sport environments.This paper extends the IOC consensus statement to include 10 domains of female health, which may affect female athletes across the lifespan, from adolescence through young adulthood, to mid-age and older age. Our recommendations for data capture relating to female athlete population characteristics, and injuries, illnesses and other health consequences, will improve the quality of epidemiological studies, to inform better injury and illness prevention strategies.

Injuries in elite road cyclists during competition in one UCI WorldTour season: a prospective epidemiological study of incidence and injury burden

METHODS

Fifty-four male athletes from two different teams were involved. Accidents and injuries were recorded immediately after the incident by a team physician present at every race. Exposure, location, type and cause of injury have been recorded. Incidence was calculated. Severity was measured as a cumulative severity score and burden depicted in a risk matrix.

RESULTS

Total time of exposure was 12537 hours over 3524 athlete days and 544002 kilometers of racing. 98 accidents were recorded, with 83 leading to injury. The total number of recorded injuries was 193. Injury incidence for all injuries was 54,8 (±SD 47,7-62,8) /1000 athlete days, 15,4 (±SD 13,4-17,7) /1000 athlete hours and 35,5 (±SD 30,8-40,8) /100.000 km raced. By far the most frequent types of injury were hematomas, contusions and bruising (n = 141, 73%) followed by lacerations (n = 22; 11,4%). Most injuries affected the arm and elbow (n = 34, 17,6%) followed by the shoulder and clavicle (n = 28, 14,5%) and occurred with contact (79%). Fractures pose a high injury burden due to long time loss, whereas hematomas, contusions and bruising showed the highest incidence numbers but comparably less time loss.

CONCLUSION

Road cyclists' injuries have been underestimated in previous studies. Hematomas, contusions and bruising pose the highest number of injuries with a broad degree of severity and range of injury burden. Fractures are less common but show the highest injury burden. The upper extremities are involved the most.

Factors associated with patellofemoral pain in recreational road cyclists: A cross-sectional study in 59953 cyclists - SAFER XXXIII

OBJECTIVE

Patellofemoral pain (PFP) is a common cycling-related injury, and independent factors need to be identified to enable effective injury prevention strategies. We aim to determine factors associated with PFP in cyclists entering mass community-based events.

DESIGN

Cross-sectional study.

SETTING

2016-2020 Cape Town Cycle Tour.

PARTICIPANTS

Consenting race entrants.

MAIN OUTCOME MEASURES

62758 consenting race entrants completed a pre-race medical questionnaire, and 323 reported PFP. Selected factors associated with PFP (demographics, cycling experience and training, chronic disease history) were explored using multivariate analyses.

RESULTS

Prevalence ratio (PR) of PFP was similar for sex and age groups. Independent factors associated with PFP (adjusted for sex and age) were history of chronic disease [Composite Chronic Disease Score (0-10)(PR = 2.0, p < 0.0001) and any allergies (PR = 2.0, p < 0.0001)].

CONCLUSION

A history of chronic diseases and allergies is associated with PFP in cyclists. Practical clinical recommendations are: 1) that prevention programs for PFP be considered when cycling is prescribed as a physical activity intervention for patients with chronic disease, and 2) that older cyclists presenting with PFP be assessed for the presence of risk factors or existing chronic disease.

Circus-specific extension of the International Olympic Committee 2020 consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport

Indepth knowledge of injury and illness epidemiology in circus arts is lacking. Comparing results across studies is difficult due to inconsistent methods and definitions. In 2020, the International Olympic Committee (IOC) consensus group proposed a standard method for recording and reporting epidemiological data on injuries and illnesses in sports and stated that sport-specific extension statements are needed to capture the context of each sport. This is the circus-specific extension to be used with the IOC consensus statement. International circus arts researchers in injury and illness epidemiology and performing arts medicine formed a consensus working group. Consensus statement development included a review of literature, creation of an initial draft by the working group, feedback from external reviewers, integration of feedback into the second draft and a consensus on the final document. This consensus statement contains circus-specific information on (1) injury definitions and characteristics; (2) measures of severity and exposure, with recommendations for calculating the incidence and prevalence; (3) a healthcare practitioner report form; (4) a self-report form capturing health complaints with training and performance exposure; and (5) a demographic, health history and circus experience intake questionnaire. This guideline facilitates comparing results across studies and enables combining data sets on injuries in circus arts. This guideline informs circus-specific injury prevention, rehabilitation, and risk management to improve the performance and health of circus artists.

The National Interscholastic Cycling Association (NICA) Mountain Biking Injury Surveillance System (ISS): Analysis of 66,588 Student Athlete-Years of Injury Data

Interscholastic youth cross-country mountain bike racing in the United States has grown significantly over the past decade, yet little is known about the risk profile in this age group. Aiming to protect participants, we implemented a prospective, longitudinal injury surveillance system for the purpose of better understanding youth mountain biking injuries and implementing safety measures. Data were collected during competition years 2018–2020, totaling 66,588 student athlete-years. Designated reporters from each team received weekly emails with exposure and incident report forms. Variables analyzed included demographic, rider-related, trail-related, and other data. Injury characteristics during the COVID-19 pandemic in 2020 were compared to the years 2018 and 2019. More student athletes participated in the 2020 season (25,261) than in prior seasons (18,575 in 2018 and 22,752 in 2019). During competition year 2020, overall injury proportion was lower (1.7% versus 3.0% in 2018 and 2.7% in 2019). Variables associated with injury, body part injured, type of injury, time-loss, and disposition following injury were similar between all years. Despite the pandemic and resultant changes to competition, student athletes continued to ride their bikes and become injured, but the proportion of injuries differed. This report details injury characteristics in youth mountain bike racing, including a comparison of before and during the pandemic.