Introduction Downhill Mountain Biking (DHMTB) is one of the more spectacular sub-disciplines of mountain bike (MTB) cycling. The primary aim of our study was to prospectively document the injury rate, severity, aetiology, location and type during official training and racing by elite DHMTB riders during the 2023 UCI Cycling World Championships. Methods The participants of this prospective, observational study were elite male and female cyclists competing at the UCI DHMTB World Championships located in the Nevis range in Fort William, Scotland, in 2023. This study followed the injury reporting guidelines established by the International Olympic Committee (IOC), which include the STROBE-SIIS and the cycling-specific extension. Results Throughout the championships, 10.4% of riders sustained one injury, with 4.3% of riders injuring more than one location per injury event. The overall injury incidence was 3.3 injuries per 100 rides. The incidence rates were higher in the training group (6.4/100rides) than in the race group (2.3/100rides). There was a greater incidence of injury in females in the training 5.7/100 rides and racing 4.4/100rides compared to male riders. Female athletes experienced more severe injuries, with double the estimated time lost to injury. Additionally, female athletes were found to have a significantly greater risk of head injuries and concussions than males. Conclusion Overall, injuries are more prevalent in training than in competition. Compared with male DHMTB athletes, female DHMTB athletes are more at risk of injury and show a greater incidence of injury within official training and competition as well as more severe injuries.

The authors have declared no competing interest.

TF is funded by the Department for Education (DfE). No other funding was received for this study.

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Ethical approval for this study was obtained from the Medical Faculty at Queen University Belfast, Northern Ireland (Faculty REC Reference Number MHLS 23_97).

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