Injuries Among Recreational and Competitive Cyclists in Urban and Peri-Urban Bike Parks: A Four-Year Retrospective Cohort Study

Cycling is an increasingly popular recreational and competitive activity, but it also poses a risk for serious and even fatal injuries. Trauma centers located near or connected to biking areas should be aware of the wide range of injuries associated with this activity. A better understanding of local injury patterns can improve trail design, encourage safer riding habits, and increase rider accountability. A retrospective cohort study was conducted utilizing data collected from chart reviews of all adult patients admitted to two Level II urban trauma centers between January 1, 2020, and January 31, 2024. Exclusion criteria included patients under 18 years and pregnant or lactating women. Variables such as age, gender, TISS score, mechanism of injury, and others were analyzed to assess clinical outcomes using descriptive statistics and appropriate statistical tests. The interquartile and median range were used to describe continuous variables, while percentages and frequencies were used for categorical variables. All analyses were conducted using R version 4.5.0. Out of the 230 patients reviewed, only 87 cyclists met the inclusion criteria. The group had a median ISS of 9 and a median age of 48 years, with a male-to- female ratio of 6.9:1. Ground EMS was the mode of arrival for the majority of patients (71%). Falls constituted the most frequent mechanism of injury overall. Bike arenas and trails were nearly equally represented as injury sites. Seventy-four percent of all injuries were sustained during recreational riding. Soft-tissue injuries constituted the majority of cases, accounting for 75% of all injuries observed. Within the category of skeletal injuries, rib fractures were identified as the most prevalent type of skeletal injury. Craniofacial injuries represented 18% of injuries, with spinal injuries following closely at 17%. Internal organ damage was rare. Thirty-five patients required surgical intervention. The most common chronic illness was hypertension, and nearly half of the patients had no comorbidities. Injuries sustained during cycling activities in metropolitan and peri-urban bike parks typically involve high-energy mechanisms and predominantly affect adult male patients. The severity of these injuries is underscored by a high incidence of thoracic, spinal, and craniofacial trauma, often necessitating surgical intervention. These findings emphasize the importance of safer riding infrastructure, targeted injury prevention programs, early trauma detection, and appropriate resource allocation.