Accidents and Risk Related Behaviours in Downhill Mountain Biking in Regard to Trail Choice

Health Service Impacts and Risk Factors for Severe Trauma in Mountain Biking: A Narrative Review

Mountain biking is growing in participation but carries risk for severe injury and burden on health systems. Little is known about the impact of these injuries on emergency medical services, definitive healthcare, and factors contributing to accidents. This review aimed to determine the health service impacts of severe mountain bike trauma and risk factors, with a view to understanding critical gaps and needs. A systematic online search was conducted using the databases PubMed and MEDLINE complete and grey literature relating to mountain bike injury since the databases' inception to July 2023. The results show that although mountain biking has relatively high injury rates that are increasing, the impacts on health services were rarely documented, with some evidence indicating that even small increases in injuries from race events can overwhelm local health services. Severe injuries were more common in downhill disciplines. However, the definitions of what constitutes severe injury were variable. Severe injuries were more common in downhill disciplines, influenced by the rider skill level, demographics, participation in competitive events, trail design, environmental factors, and healthcare availability. Further research in these areas is needed, along with the more consistent reporting of injury severity.

Perceived risk for falls and decision-making in riding raised ramps in mountain biking: a pilot study

Mountain biking (MTB) is a challenging activity where riders face constant decisions on whether to attempt technical paths or features (e.g., wooden ramps and jumps) that pose risk for falls and injuries. Risk homeostasis theory posits that riders pursue an optimal non-zero level of risk that balances the rewards of attempting challenging features with the need to avoid unreasonable risk for injury. Little is known on how riders judge risk, and the level of risk that riders deem unacceptable. We conducted experiments with experienced MTB riders (n = 17) to examine how their willingness to ride raised wooden ramps depended on their perceived probability for falling (Pf) and their perceived probability for injury in the event of a fall (Pi) while riding the ramp. In one experiment, participants viewed ramps of varying widths and heights and described their willingness to ride each ramp, along with Pf and Pi. We found that Pf and Pi were independent predictors of willingness to attempt ramps. Moreover, the product Pf*Pi (the perceived risk for injury in attempting the ramp) was a stronger predictor than Pf or Pi alone. In a second experiment, participants viewed ramps of different widths, and reported the maximum (threshold) height where they would ride each ramp, along with Pf and Pi. We found that Pf*Pi at the threshold height, averaging 13%, did not vary with ramp width. We conclude that decisions on riding ramps are based on the product Pf*Pi. On average, riders refused to ride ramps when Pf*Pi exceeded 13%.

Injuries in alpine summer sports - types, frequency and prevention: a systematic review

Introduction

Summer alpine sports, including mountain biking, hiking and airborne pursuits, have experienced a recent surge in popularity. Accordingly, trauma associated with these activities has increased. There is a scarcity of literature exploring clinical aspects surrounding injuries. Specifically, no single article provides a general overview, as individual studies tend to focus on one particular sport. In the present study, we performed a systematic literature review to summarize existing knowledge and explore the potential for prevention and clinical decision making in this group.

Method

Literature searches were performed using the PubMed and Scopus database for the most commonly ventured sports associated with injury: mountain biking, climbing, airborne sports, paragliding, and base jumping. From this search, studies were identified for qualitative and quantitative analyses. These searches were done according to PRISMA guidelines for systematic reviews. Studies were then analyzed regarding epidemiology of injuries, relevant anatomical considerations and prevention strategies were discussed.

Results

A broad spectrum of injury sites and mechanisms are seen in mountain biking, climbing or airborne sports. Mountain biking related injuries commonly involve the upper extremity, with fractures of the clavicle being the most common injury, followed by fractures of the hand and wrist. Scaphoid fractures remain of paramount importance in a differential diagnosis, given their often subtle clinical and radiological appearance. Paragliding, skydiving, and base jumping particularly affect transition areas of the spine, such as the thoracolumbar and the spinopelvic regions. Lower limb injuries were seen in equal frequency to spinal injuries. Regarding relative risk, mountain biking has the lowest risk for injuries, followed by climbing and airborne sports. Male alpinists are reported to be more susceptible to injuries than female alpinists. Generally, the literature surrounding hiking and water-related mountain sports is insufficient, and further work is required to elucidate injury mechanisms and effective preventative measures. A helmet seems to decrease the likelihood of face and head injuries in mountain sports and be a meaningful preventive measurement.

An Investigation into Helmet Use, Perceptions of Sports-Related Concussion, and Seeking Medical Care for Head Injury amongst Competitive Cyclists

The purpose of this study was to investigate competitive cyclists' helmet use, perceptions of sports-related concussion (SRC), and medical-care-seeking behaviors. A mixed-method approach was used with qualitative and quantitative data presented. The study comprised of a cross-sectional analysis of 405 competitive cyclists who completed an online survey. Results indicated that most participants believed a bicycle helmet protects against SRC (79.5%) and considerable numbers of participants would not seek medical care for potential head injury in scenarios where this would be recommended. It was also discovered that marketing of concussion reduction technology influences cyclists' helmet-purchasing behaviors. With the data presented, it is recommended that governing bodies in cycling need to develop educational resources to address gaps in knowledge regarding SRC amongst cyclists. We also suggest that more independent research on concussion reduction technologies in bicycle helmets is needed, with advertising supported by clear scientific evidence to avoid negatively influencing head injury management and reporting behaviors amongst cyclists.