Like many others in the trail sector, I read with interest the 2024 Canadian research on mountain bike injuries, but did not have much to say on it. The research speaks for itself and was widely and accurately covered in mountain bike media.
But this September I brought this data up in my trail risk
management presentation at the excellent Quebec Mountain Bike Symposium. It landed
poorly. Skepticism and denial would be the words to describe the trail managers’
reaction to it. That is a problem.
To recap the findings: records from the Vancouver General
Hospital (VGH) Level 1 Trauma Centre were examined, and found that between 2008
and 2022, 58 mountain bikers suffered a spinal chord injury. 21 of these injuries
happened in Whistler, with the remaining 37 from across the province. 78% went
over the bars, 12% from collision (including, I assume, hitting trees). From the
records, 44 of the 58 had data on protective gear: 86% (of the 44) wore helmets
only, and a further 9% (4 of the 44) were wearing body protection plus helmet.
2 were not wearing any protective gear (my take: these two were potentially not
‘real mountain bikers’, riding without a helmet, while I assume the others had
at least the commitment to the sport to wear a helmet).
Of those injuries, 67% were cervical spine injuries leading
to severe impairment and life altering injury, with 45% as complete paralysis. Spinal
fractures that did not result in spinal chord injury were not counted (i.e.
broke spinal bones but no nerve damage – how many of the ‘near misses’ were in their
database is not reported).
As a Level 1 Trauma Centre, only severe spinal injuries would
come in their door, with the more normal, less severe injuries handled at local
emergency rooms. Any injury beyond a local ER’s ability to manage it gets transferred
to a trauma centre, backstopping all serious medical injuries in the whole
province.
The Quebec trail crowd’s scepticism started with
comparators, which the research paper addresses: in that same time period, hockey
produced 3 spinal injuries over the 14 years (compared to mountain biking’s
58). In a CBC interview, the lead researcher provided further data that in “more
recent years”, accounting for 21 of the reported mountain bike injuries, there were
3 ski related spinal chord injuries. This puts mountain biking way ahead and in
its own category as far as producing serious injury. A further comparison, across
the whole of the United States, there were 7 amateur football related spinal
injuries per year, compared to this data which works out to be 4.1 mountain
bike injuries per year (just in B.C.).
Dr. Brian Kwon, the lead researcher with the Vancouver Spine
Surgery Institute within the VGH and the Canada Research Chair in Spinal Cord Injury,
told CBC “As a world leading area for mountain biking I think we should be a
world leading area for the safety in that sport.”
Right now, B.C. is providing a Petrie dish for this modern
mountain bike flow trail experiment. The research paper alludes to newer data
from 2022 to 2024 where a further 21 spinal injuries were recorded at VGH – a rate
of 7/yr, consistent with the main data set. B.C. is a unique mountain bike location
and is on the leading edge of jump and flow trails, with its density of commercially
offered and free-to-use trails. Certainly, the crowd I spoke to at the Quebec symposium
did not see these same types of injuries at their trail centres – more enduro and
cross country oriented, but their enduro trails are very gnarly with much rock
and typical Quebec steep lines. However, MSA and other lift serviced mountain
bike centres are well known and very busy. In fact, during the conference group
ride on the MSA lift trails, the group came upon an unconscious rider on a jump
trail and performed preliminary first aid until the trail patrol arrived and
bundled the rider off the mountain (and to the hospital, I presume). Clearly, within
modern mountain biking there are serious things going on that can’t be ignored.
First off, we have a data problem. There is no means of tracking
injuries in this (or any) sport at a public level. Each bike park or trail
centre that offers first aid support knows their own incident data, but (without
surprise) this is not made public, nor is it aggregated to a regional level. One
of my college outdoor program graduates worked at a prominent B.C. bike park
and reported that there were on average two helicopter evacs per day in the
summer. Insurance providers for these trail locations would aggregated data,
but they, too, are not going to be sharing that around.
There is also the ‘base number’ issue. The paper reported 58
spinal injuries, but that is compared to how many person-days of riding over
that same period? Millions, I suspect. The paper refers to some other published
research on mountain bike injury rates, all but one of which were more than 10
years old, which in my opinion makes them obsolete given the advent of modern
mountain bike trails.
While the actual rate of spinal injury may be low (58/xx
million days), the fact is our modern trails are generating serious, life
altering risks. There are practical and moral implications regardless of the
rate of incidence.
Practically, we are riding bikes with more suspension and
capability than ever, yet our modern trails are smoother than ever – a strange
dichotomy. This means more speed. The injury profile for mountain biking moved
from broken collarbones in the old days to injuries more similar to motorcycle
collisions: broken femurs, pelvis, and serious concussions.
Adoption of rider protection has not kept pace with the sport.
Note that this reported data is on cervical spinal injuries. Helmets, and for
the few who wear chest protectors, neither of these provide any measure of offset
to the risk of high speed jump trails and neck injury. Neck protectors (such as
Leatt and others) show promise but are not widely adopted. The research is
scarce of the efficacy of those. We have a long ways to go here.
We are also in the infancy of jump design. There is no agreed
upon difficulty rating system for mountain bike jumps, and there are no good
resources describing the variables in shape and launch trajectory. Research I conducted some years back found no consensus on bike jump design or philosophy.
(This is too big a topic to get into here!). Speed is potentially the greater
variable. If we want to reduce injury severity, we slow the riders down. This
is a trail design issue, but one tempered by rider demand, and demand right now
is looking for fast, smooth jump trails.
So what about riders assuming the risks of the trails they
ride? Nice idea. Easily challenged in court, and the fact is the trail designer
has more say in ‘assumed risk’ than does the rider. If we build trails with
certain features and expect a certain speed to ride them efficiently, then
riders take on those risks we have built into the trail.
And here is the moral imperative. The trails we build will
get ridden. Ridden by people of various skill levels and intentions (regardless
of the signs we post). Do they really understand the difference in rider input
required between jump types? Have we made it easy to find the trail speed
needed for the features we build? Riders do not head out the door expecting to
have a life altering injury that day, and as trail managers we need to make it
exceedingly difficult for that to happen. This is not only a ‘whole of trail’ exercise,
but is a ‘whole of trail risk management’ and ‘whole of sport’ mandate.