Many people are interested in mountain biking but are hesitant to try for fear of catastrophic injury. Spinal cord injuries with subsequent paralysis are among the most debilitating injuries someone can obtain, and they do occur in mountain biking. Mountain biking is still a relatively new sport that has gained a global following since the late 1960s. Since it is a newer sport, there is limited data collected on its risks. Studies have been conducted worldwide to assess the risks associated with mountain biking. 

In this post, we’ll be diving into one systematic review of mountain bike injuries and the statistics, injury patterns, demographics, variants of injury by mountain biking type, and how new technology has impacted mountain biking. We’ll look specifically at spinal injuries and the data associated with injuries.

Studies and the Systematic Review

MD David C. Fiore and others from the University of Reno, Nevada, conducted a systematic review of all mountain biking research within the PubMed and Engineering Village databases. They pulled information from both databases’ creation until the fall of 2019. With numerous studies referenced, they’ve reviewed the dangers and risks associated with mountain biking. 

Source: Injuries in Mountain Biking and Implications for Care

Injury Patterns 

Unfortunately, there are many limitations on collecting data regarding injury rates, including accurate data on the total number of mountain bikers and their exposure to injury. Due to bike park (ski resort) policies that inhibit sharing information about ticket sales, data collection has been limited. Because of this, there is a wide range of injury rates between 1.5 – 43 injuries per 1,000 hours for downhill mountain bike parks and 2 – 17 injuries per 1,000 hours of cross country bike rides.

The British Columbia Trauma Registry found that out of 399 injured mountain bikers in trauma centers, 12% had head injuries, and another 12% had spinal injuries. Two more studies found that one-quarter of trauma center admissions involving spinal injuries were due to mountain biking accidents. Out of these injuries, 42% of them resulted in complete paralysis.

Most mountain bikers ride responsibly and take all necessary precautions to stay safe, so the number of accidents is likely not nearly as high as you’d maybe expect. The most common types of injuries are:

  • Skin abrasions
  • Pain in the lower back area
  • Knee pain
  • Carpal tunnel syndrome
  • Broken collarbone
  • Wrist fractures
  • Concussion or traumatic brain injury (TBI)


three mountain bikers having a beer after a ride


Mountain biking athletes tend to be younger males, but more women and older riders have also taken up the sport in more recent years. Women tend to suffer spinal injuries and fractures more frequently than men. Some believe this may be due to their lighter average body weight being thrown over the handlebars and the tendency to begin on more advanced terrain than their ability levels. According to one German study, most women involved in an accident attributed it to overexertion, while males attributed injuries to risk-taking behavior and excessive speed. In addition, children and adolescents are at an increased risk for spinal injury by not acknowledging their limitations. 

Types of Mountain Biking 

As mountain biking has continued to evolve, many different varieties have been born. There’s a significant overlap between types, but each type has distinctions involving risk. The table below outlines the different types of mountain biking (disciplines), what they are, their popularity levels, injury rates, and equipment features. 

different types of mountain biking with associated injuries.

Downhill riding has a high injury rate with an increased risk for cervical spine injuries. Heli-biking is one of the newest types not listed. Mountain bikers are airlifted to remote locations and dropped off to ride downhill through varying terrain. Free-riding and heli-biking are considered more extreme, with very high risks associated, including spinal injuries.

New Technology Impacts

New technology is constantly changing the mountain bike landscape, creating safer equipment and making more extreme activities possible (such as airlifting riders to remote locations!). The invention of the dropper seat post has helped decrease over-the-handlebar accidents that can lead to spinal cord injuries. When used properly, dropper seats can help riders stay on their bikes when riding downhill. On the other hand, the use of E-bikes can have unintended consequences. The power of an E-bike can incentivize new riders to try trails and routes that are above their ability level. This is especially true for older, less fit, and less experienced riders. 

mountain bike riders on a beautiful green ridge trail riding into the cloudy ridge

How Can Spinal Cord Injuries Be Prevented in Mountain Biking?

There are a few ways you can prevent spinal cord injuries as a mountain biker:

  1. Learn basic bike maneuvers, skills, and techniques
  2. Know your limits as a rider (and respect those limits!)
  3. Wear proper body and head protection
  4. Have your bike correctly fitted to your body
  5. Use bike components (such as a dropper seat post) that apply to your style of riding
  6. Promote legislation to design safer bike trails and multi-use trail systems
  7. Advocate for bicycle manufacturers to design safer bikes

In conclusion, mountain biking is a sport enjoyed worldwide! It offers great cardiorespiratory benefits but is at a higher risk of injury than other recreational activities. Most injuries are minor abrasions, but there is still a risk of catastrophic injuries, such as head and spinal cord injuries. We can work together to promote research, public awareness, and legislation when needed.

Contact ISMI to learn more about sports injuries and treatment options.