Sex- and Age-Specific Analysis of Mountain Biking Injuries: A 10-Year Review of National Injury Data.

Background: Mountain biking (MTB) is a quickly growing sport, with many athletes sustaining high-impact injuries. Current literature has not analyzed the most recent MTB-related national emergency department (ED) injury data.
Hypothesis: It was hypothesized that (1) the total number of injuries presenting to US EDs would significantly increase over the study period, (2) male patients would experience higher rates of shoulder injuries and airborne injury mechanisms than female patients, and (3) youths would present more frequently with injuries of the head and face than adults.
Study Design: Descriptive epidemiology study.
Methods: All data were extracted from the National Electronic Injury Surveillance System (NEISS), a public database representing approximately 100 US EDs. The NEISS was queried for MTB-related injuries between January 1, 2013, and December 31, 2022.
Results: A total of 2543 MTB-related cases presented to US EDs between 2013 and 2022, which extrapolated to a national estimate (NE) of 109,558 injuries using NEISS sample weights. MTB-related injuries increased significantly between 2013 and 2022 ( P = .009), including a 64% increase between 2019 and 2020. The most common injury mechanism was falling off the bike (62.6%; NE = 68,536), and the upper extremity was the most frequently injured body region (22.4%; NE = 24,511). Male patients presented with significantly more shoulder (21.1% vs 7.4%, respectively; P < .001) and trunk (21.4% vs 19.8%, respectively; P < .001) injuries than female patients as well as more airborne injury mechanisms (15.7% vs 10.8%, respectively; P < .001). Female patients sustained significantly more concussions (7.2% vs 3.5%, respectively; P < .001) than male patients. Children presented with higher rates of head/face injuries (34.1%), concussions (6.0%), and airborne mechanisms of injury (19.4%) than any other age group.
Conclusion: MTB injuries increased significantly between 2013 and 2022 likely because of the popularity of outdoor sports during COVID-19. The upper extremity was the most frequently injured body region, and falling off the bike was the most common mechanism. Leading injuries and mechanisms varied significantly by sex and age. This study recommends additional MTB safety measures such as shoulder support for male riders, better coaching on front brake control for youth riders, and an increased emphasis on concussion protocols for female riders.
Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: B.O.P. has received royalties from Arthrex, consulting fees from Arthrex, nonconsulting fees from Arthrex, and education payments from Gotham Surgical. B.R.W. has received nonconsulting fees from Arthrex and Vericel; consulting fees from DePuy Synthes, FH Orthopedics, Medical Device Business Services, and Vericel; honoraria from the Musculoskeletal Transplant Foundation and Vericel; and education payments from Peerless Surgical, Arthrex, and SouthTech Orthopedics. M.J.A. has received consulting fees from Bodycad, DePuy Synthes, and Medical Device Business Services; education payments from Suvon Surgical and Gotham Surgical; and nonconsulting fees from Arthrex. R.M.F. has received nonconsulting fees from Arthrex, Bodycad, and DePuy Synthes; consulting fees from Arthrex; education payments from Gemini Mountain Medical, Arthrex, and Pinnacle; and hospitality payments from JRF Ortho and Smith & Nephew. R.L.P. has received education payments from Gotham Surgical and Arthrex and a grant from Arthrex. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
(© The Author(s) 2025.)