The real risk of racing: Injury insights from the downhill world championships

Downhill mountain biking isn’t just a race against the clock—it’s a test of skill, speed and survival on some of the roughest terrain imaginable. The 2023 UCI downhill world championships in Fort William, Scotland, brought the best riders in the world together to battle for the rainbow jersey. But as a recent study published in BMJ Open Sport and Exercise Medicine revealed, the price of speed can be steep.

This study took a deep dive into the injury risks riders faced during the event and the results might surprise you—even if you already know that crashing is just part of the sport.

Crashes happen, but when do they happen most?

Across five days of racing, 10.4 per cent of the 230 riders suffered at least one injury. That might not seem too bad, but when you break it down further, the numbers start to paint a clearer picture:

• Injury rate in training: 4.3 injuries per 100 rides
• Injury rate in racing: 2.2 injuries per 100 rides

Training was actually more dangerous than the race itself. That’s likely because riders are still figuring out the track, pushing limits and dialing in lines. During the actual race, they’re focused on executing the cleanest, fastest run possible—which means fewer risky moves.

Female riders faced higher risks

One of the most eye-opening takeaways from the study was the injury disparity between male and female riders. Female riders had a 2.2 times higher risk of injury than male riders. Concussions were 6.3 times more likely in female riders. Head and neck injuries were 9.5 times more common in female riders. Females lost an average of 12.6 days to injury, compared to 5.5 for males
So, what’s going on here? A few possible factors:

• Longer exposure time: Female racers generally take longer to complete courses, meaning more time at risk on the track.
• Strength and endurance differences: The physical demands of downhill racing, especially the forces involved in impacts, might affect female riders differently.
• Helmet and neck strength concerns: The study proposes stronger neck muscles could help reduce head injuries, much like in other high-impact sports.

The takeaway? More research is needed, but this study suggests that female downhill racers may benefit from additional training runs, targeted strength work and potentially even gear adjustments.

Where do most injuries happen?

The study also mapped out the most common injury zones for riders. If you’ve spent any time riding downhill, these results probably won’t shock you. The most injured areas include the head (thanks to all those concussions), forearm and shoulder (bracing for impact) and the wrist and hand (classic over-the-bars crash injuries).

The most common injury types are ligament sprains and joint damage (holding onto the bars through brutal terrain), fractures (especially among female riders), muscle contusions and abrasions (because sliding across rocks and dirt hurts). The high rate of concussions and head injuries is especially concerning—this study is yet another reminder that better concussion awareness and safety protocols should be a top priority in downhill racing.

What can be done?

The study didn’t just highlight the risks—it also pointed to ways event organizers, teams and medical staff can make racing safer.
It suggests pre-event medical training: the most common medical actions were helmet removal, immobilization and lifting riders. Medical teams need to drill these scenarios before race day.
Neck strengthening programs. Given the high risk of concussions, especially for female riders, there’s potential for training programs to reduce injury risks (similar to protocols used in rugby and motorsports).

The study also recommends better injury tracking and rule changes. Should female riders get an extra training run to reduce crashes in competition? Should bike setup recommendations change based on injury data? These are the kinds of questions this research could help answer.

Final thoughts: Racing at the edge

Downhill mountain biking is one of the most intense, high-risk disciplines in cycling and this study proves it yet again. Injuries are part of the game, but understanding when, where and why they happen is the first step in making the sport safer without taking away the thrill.

With more research like this, we can give racers the tools, training and medical support they need to push their limits—without paying the price in broken bones and concussions.
After all, winning a rainbow jersey is cool—but making it to the next race in one piece is even better.