Severe injuries in competitive cycling during an olympic cycle: injury patterns, time loss, and return-to-performance outcomes
7 affiliations
- 1Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Centre, Cologne, Germany
- 2Orthopädie em Veedel, Praxis für Orthopädie, Unfallchirurgie und Sportmedizin, Cologne, Germany
- 3Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- 4Department of Sports Medicine, Charité – University Medical Center Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- 5Department of Orthopedic, Trauma and Hand Surgery, Klinikum Osnabrück, Osnabrück, Germany
- 6Department of Orthopedic Surgery and Sports Traumatology, Sana Medical Centre, Witten/Herdecke University, Cologne, Germany
- 7Department of Biomechanics, University of Freiburg, Freiburg, Germany
Abstract
Background: Cycling is an established Olympic sport associated with a distinct injury profile that has not yet been comprehensively investigated. This study aimed to retrospectively assess and analyze severe cycling-related injuries resulting in ≥ 3 weeks of time loss over a complete Olympic cycle.
Methods: A total of 192 cyclists were included, based on a retrospective online questionnaire assessing injury location, type, context, time loss, and return-to-sport outcomes. Comparisons by sex, discipline, and competitive level were performed at the athlete level using exact tests with 95% confidence intervals and were considered exploratory.
Results: Seventy-two of 192 athletes sustained at least one severe injury over the five-year period, corresponding to a proportion of 37.5% (95% CI 31.0–44.5). A total of 237 injuries were recorded, with the upper extremity (33.8%) and lower extremity (27.8%) being the most frequently affected regions. The most common diagnoses were hand fractures (n = 14), clavicle fractures (n = 13), and non-specific knee injuries (n = 9). Hand fractures (33.3%; p = 0.002) and shoulder dislocations (20.0%; p = 0.002) were most frequent among BMX athletes, while hand fractures also occurred more frequently in competitive athletes than in recreational athletes (13.5% vs. 1.0%; p = 0.001). Clavicle fractures occurred predominantly during competition and non-specific knee injuries during training. Mean time loss ranged from 6.5 weeks for hand fractures to 13.3 weeks for shoulder dislocations. Full return to pre-injury performance ranged from 85.7% after hand fractures to 28.6% after acromioclavicular (AC) joint separations.
Conclusion: Injury patterns differed by discipline and setting, suggesting that prevention strategies should address both. The low rate of full return to performance after AC joint separations despite moderate time loss underlines the importance of distinguishing return to sport from return to performance in rehabilitation.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13102-026-02201-x.
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BibTeX
@article{lambert2026severe,
title = {{Severe injuries in competitive cycling during an olympic cycle: injury patterns, time loss, and return-to-performance outcomes}},
author = {Christophe Lambert and Maxime Lambert and Marlene Galandi and Bernd Wolfarth and Casper Grim and Sven Shafizadeh and Ramona Ritzmann},
journal = {BMC Sports Science, Medicine and Rehabilitation},
year = {2026},
month = nov,
doi = {10.1186/s13102-026-02201-x},
url = {https://doi.org/10.1186/s13102-026-02201-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Severe injuries in competitive cycling during an olympic cycle: injury patterns, time loss, and return-to-performance outcomes
AU - Christophe Lambert
AU - Maxime Lambert
AU - Marlene Galandi
AU - Bernd Wolfarth
AU - Casper Grim
AU - Sven Shafizadeh
AU - Ramona Ritzmann
PY - 2026
DA - 2026/11/03
JO - BMC Sports Science, Medicine and Rehabilitation
DO - 10.1186/s13102-026-02201-x
UR - https://doi.org/10.1186/s13102-026-02201-x
AB - Background: Cycling is an established Olympic sport associated with a distinct injury profile that has not yet been comprehensively investigated. This study aimed to retrospectively assess and analyze severe cycling-related injuries resulting in ≥ 3 weeks of time loss over a complete Olympic cycle. Methods: A total of 192 cyclists were included, based on a retrospective online questionnaire assessing injury location, type, context, time loss, and return-to-sport outcomes. Comparisons by sex, discipline, and competitive level were performed at the athlete level using exact tests with 95% confidence intervals and were considered exploratory. Results: Seventy-two of 192 athletes sustained at least one severe injury over the five-year period, corresponding to a proportion of 37.5% (95% CI 31.0–44.5). A total of 237 injuries were recorded, with the upper extremity (33.8%) and lower extremity (27.8%) being the most frequently affected regions. The most common diagnoses were hand fractures (n = 14), clavicle fractures (n = 13), and non-specific knee injuries (n = 9). Hand fractures (33.3%; p = 0.002) and shoulder dislocations (20.0%; p = 0.002) were most frequent among BMX athletes, while hand fractures also occurred more frequently in competitive athletes than in recreational athletes (13.5% vs. 1.0%; p = 0.001). Clavicle fractures occurred predominantly during competition and non-specific knee injuries during training. Mean time loss ranged from 6.5 weeks for hand fractures to 13.3 weeks for shoulder dislocations. Full return to pre-injury performance ranged from 85.7% after hand fractures to 28.6% after acromioclavicular (AC) joint separations. Conclusion: Injury patterns differed by discipline and setting, suggesting that prevention strategies should address both. The low rate of full return to performance after AC joint separations despite moderate time loss underlines the importance of distinguishing return to sport from return to performance in rehabilitation. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13102-026-02201-x.
SN - 2052-1847
ER -