EWS Medical Research published in the International Journal of Sports Medicine

11 January 2021

By Jessie-May Morgan

Back in June 2019 the EWS revealed the results of the largest medical study ever undertaken in mountain biking, and now the work has been published in the International Journal of Sports Medicine.

The article, ‘Enduro World Series (EWS) Mountain Biking Injuries: A 2-year Prospective Study of 2010 Riders’, is the latest publication as a result of a three year program of research into enduro mountain biker health and injury, funded and supported by the Enduro World Series. The study was undertaken to ascertain rider health and track injuries to develop the sport and drive forward safer riding and competition for everyone.

This is the culmination of a three-year program of research into enduro mountain biker health and injury, funded and supported by the Enduro World Series. The study was undertaken to ascertain rider health and track injuries to develop the sport and drive forward safer riding and competition for everyone.

The study is made up of two distinct pieces of research and was headed up by a team of sports scientists from Edinburgh Napier University, led by an expert in sports injury and illness epidemiology, Dr Debbie Palmer. Dr Palmer brings a wealth of experience to the project, having previously helped UK Sport set up their Injury and Illness Prevention Programme and is also an active member of the International Olympic Committee Medical and Scientific research group and worked at the London 2012 and Sochi 2014 Olympic Games.

The first part of the study took injury information from over 2000 athletes at ten EWS races, across the 2017 and 2018 seasons. Just 8.9% of riders over the ten races suffered an injury indicating the sport is safer than the image of racing might suggest. The injury rate is lower than that recorded for the XC MTB events (23.8%) of the Rio 2016 Olympic Games, and lower than injury rates seen in rugby.

Unsurprisingly perhaps, shoulder and collarbone injuries are the most common type of accident to occur at EWS races. These injuries typically involve a long recovery – 25 days on average – and riders should therefore train to build strength around their shoulders to prevent these injuries.

Collarbone and shoulder injuries are the most common injuries in enduro

One of the most interesting findings was that the rate of concussion injury was low – statistically the odds are you’d have to race 263 EWS events to be in with a chance of suffering just one concussion. Despite this, the women’s field suffered three times the number of concussion injuries seen in the men’s field, an important finding that further research could look to explore.

What did stand out from the concussion research was a third of riders don’t take any time off the bike after a concussion, possibly due to a lack of education on head injuries, with only 74% of riders aware of the existence of concussion assessment protocols. To try and address this, the EWS have released freely available Pocket Guide to Concussion for race event staff, organisers and marshals.

A downloadable concussion pocket guide has also been produced for riders – detailing how to spot concussion, and how to get help and advice about how to return to riding after a concussion.

The second piece of research was a rider health and injury survey of almost 2000 riders from over 60 countries. The survey respondents included elite athletes, amateur racers and recreational riders, taking account of all the big injuries collectively suffered throughout their time mountain biking. Again, the research shows that enduro mountain bike riders are more at risk of suffering shoulder or collarbone injuries than any other – highlighting just how important shoulder strength and training is at all levels of the sport.

The EWS has release concussion guides to help riders return to comeptition safely

The research also revealed riders are more likely to suffer an injury on training or social rides than at a race; perhaps not surprising, given most riders do more training and general riding than racing, It’s worth noting that all EWS events have medical professionals on site to help put injured racers back together again, but on training and social rides there is no such support, and riders should be mindful of this when training or riding out with events.

The report itself includes recommendations for improving the management of injuries that occur at organised enduro events and recommendations on injury prevention, many of which the EWS have implemented already, including the release of concussion education documents for event staff and the introduction of more achievement-based qualification criteria to ensure riders are more fully prepared for the challenges posed by an EWS event. Implementation of other recommendations, such as the training of event medical staff to conduct head injury assessments have 

This research, conducted by Edinburgh Napier University and funded and supported by the Enduro World Series, was made possible by EWS Membership contributions. 

The International Journal of Sports Medicine article is available free at the link below:

D Palmer, G Florida-James, C Ball. Enduro World Series (EWS) Mountain biking injuries: A two-year prospective study of 2010 riders. International Journal of Sports Medicine.  DOI: 10.1055/a-1320-1116 

To access all EWS Medical Resources, including the Concussion Pocket Guides, are available here.