Injuries involving off-road cycling
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Updated: Nov 2, 2026

A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
F P Rivara1, D C Thompson, R S Thompson
1Harborview Injury Prevention and Research Center, Department of Pediatrics, Seattle, WA 98104-2499, USA.
Background:
Data on injuries due to off-road bicycling are scarce, but do indicate that injuries in this sport are frequent. We examined the pattern of injuries to off-road riders as part of a larger study of bicycle injuries and helmet use.
Methods:
We undertook a prospective study of bicycle-related injuries identified at seven emergency departments in Seattle, Washington, between March 1992 and August 1994. Hospitalized patients and medical examiners' cases were included. Detailed questionnaires and abstraction of all medical records provided information on crash and rider characteristics and injury type and severity.
Results:
A total of 3390 injured riders participated, representing an 88% response rate. Of all injured cyclists, 127 (3.7%) were injured riding "off road." Seventy-three percent of off-road cyclists were 20 to 39 years of age, and 86.6% were male. Helmet use was 80.3% for off-road cyclists as compared with 49.5% for other cyclists. The number of head and face injuries for the off-road cyclists was only 40% of the number incurred by other cyclists. Four percent of off-road cyclists had severe injuries (injury Severity Score > 8), and 6.3% were hospitalized, compared with 6.8% and 9.4%, respectively, of other cyclists.
Conclusions:
The majority of off-road bicycling injuries are minor. Off-road cyclists are less likely to have head and face injuries than other cyclists and are more likely to wear helmets.
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