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Cycling involved in eight in ten sports-related spinal injuries

Better bike lanes, driver education and helmet advocacy could reduce number of casualties, say authors

Eight ​in ten sports-related spinal injuries involve cycling, according to new research from Harvard University – the vast majority of those resulting from collisions involving motor vehicles, with the authors saying that better bike lanes and driver education, as well as helmet advocacy, could help reduce the number.

The study, published in Journal of Neurosurgery: Spine, also found that one in three patients with sports-related trauma had spinal injuries, including fractured vertebrae and damage to the spinal cord.

Its authors say that the findings of the research can help influence policy in the area, including how to try and prevent such injuries happening in future, with making cycling safer specifically highlighted.

Researchers analysed 80,000 hospital records from 2011-14 relating to patients discharged for rehabilitation following injuries resulting from sport and identified 12,031 cases of traumatic spinal injury.

Men accounted for 82 per cent of those patients, and 81 per cent of the injuries were related to cycling, followed by skiing and snowboarding at 12 per cent, then aquatic sports and contact sports. 9.1 per cent of patients needed spinal surgery on first being admitted to hospital.

Among those patients, there was an increase in hospital stay of 2.3 days on average compared to those with non-spinal sports-related injuries, and in 15 per cent of cases there was damage to the spinal cord – more common in aquatic sports and contact sports at 49 and 41 per cent, respectively, of all spinal injuries, followed by cycling on 13 per cent.

While the study refers throughout to sports-related injuries, the data for cycling encompasses all forms of riding bikes, including on the road for commuting or going to the shops.

“Notably, most sports-related TSIs were from motor vehicle-related cycling accidents in which the patient was not operating the vehicle (81.0 per cent),” the study said.

“Although many cities with a high volume of traffic acknowledge the importance of helmet safety and have initiated measures to curb motor vehicle-related cycling accidents, including protected bike lanes and helmet laws, there is still a clear disparity between policy and TSI occurrence.

“Previous studies reveal a discrepancy between bikers acknowledging the importance of helmet use versus actually choosing to wear helmets, which indicates that helmet advocacy initiatives might improve rates of helmet use. 

“In conjunction with interventions such as improving bike lanes and educating motorists, helmet advocacy may help to reduce the incidence of cycling-related TSIs.”

Lead author Blake M. Hauser told Healio Orthopedics: “Additional research is required to fully understand the implications of these findings, as well as how best to prevent sports-related traumatic spine injuries, in adults.

“However, it is clear that these injuries can have potentially devastating consequences for patients, and improving policies and education regarding participant safety may prove to be effective interventions.

“Counselling adult patients about safety measures might also help to prevent sports-related injuries and could merit further research,” he added.

Simon joined road.cc as news editor in 2009 and is now the site’s community editor, acting as a link between the team producing the content and our readers. A law and languages graduate, published translator and former retail analyst, he has reported on issues as diverse as cycling-related court cases, anti-doping investigations, the latest developments in the bike industry and the sport’s biggest races. Now back in London full-time after 15 years living in Oxford and Cambridge, he loves cycling along the Thames but misses having his former riding buddy, Elodie the miniature schnauzer, in the basket in front of him.

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28 comments

Avatar
Richard D | 3 years ago
10 likes

Ah.  So "cycling" doesn't cause spinal injuries; they're caused by driving (usually bad driving).  It's just that the injury is caused to the person on the bike, not the driver.

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squired | 3 years ago
8 likes

My brother suffered a crushed T12 vertebrae when he was hit by a car on London's CS7 route. The medical professionals kept asking if he was wearing a helmet (no hit head didn't hit the ground, or even the helmet he was wearing), then got him to walk into the ambulance. After standing in A&E for over an hour they did an xray and suddenly had him immobilised and on a back board once they realised his spine was damaged. Once again though he was told he was lucky that he was wearing a helmet...!

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pablo | 3 years ago
5 likes

I always feel road.cc and other publications turn into the daily mail when even the subject of helmets is mentioned. The reality is I can't remember the last time I saw a road cyclist not wearing a helmet you would think from the comments most aren't.
All I can say is as someone that Engineers cars and has had lots of meetings about exterior crash safety, seen the CAE, and tests anything that reduces the g-force to the head will help. On interiors we regularly Engineer expanded foams to reduces femur loads to reduce mangled legs.
Any protection is better than no protection and having to trust a driver. It shouldn't be a thing but it is.

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eburtthebike replied to pablo | 3 years ago
1 like

pablo wrote:

I always feel road.cc and other publications turn into the daily mail when even the subject of helmets is mentioned. The reality is I can't remember the last time I saw a road cyclist not wearing a helmet you would think from the comments most aren't. All I can say is as someone that Engineers cars and has had lots of meetings about exterior crash safety, seen the CAE, and tests anything that reduces the g-force to the head will help. On interiors we regularly Engineer expanded foams to reduces femur loads to reduce mangled legs. Any protection is better than no protection and having to trust a driver. It shouldn't be a thing but it is.

Either a troll or sadly ignorant about helmets.  Should we put him out of his misery or carry on letting him express his opinions as facts?

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Captain Badger replied to pablo | 3 years ago
7 likes

pablo wrote:

I always feel road.cc and other publications turn into the daily mail when even the subject of helmets is mentioned. The reality is I can't remember the last time I saw a road cyclist not wearing a helmet you would think from the comments most aren't. All I can say is as someone that Engineers cars and has had lots of meetings about exterior crash safety, seen the CAE, and tests anything that reduces the g-force to the head will help. On interiors we regularly Engineer expanded foams to reduces femur loads to reduce mangled legs. Any protection is better than no protection and having to trust a driver. It shouldn't be a thing but it is.

Obviously I'm not in a position to say which vehicles you have engineered, however as more vehicles are designed for the SUV market, dispensing with many aspects of 3rd party safety in the process, I'm afraid that for the motor industry ( the ultimate source of vehiclular caused injury and sickness) to say "you wrap a bit of poly round your head, it's better than nowt" shows a despicable abdication of responsibility.

In addition, unsafe vehicles and poor driving is not just a liability for cyclists. The dangers are every bit as bad for pedestrians too - no pious preaching for peds to adorn themselves with similar talismans against misfortune, not yet anyway.

Banging on about poly hats demonstrates a lack of grasp of H&S principles and the wider situation at best, cynical deflection by the motor industry at worst.

 

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brooksby replied to pablo | 3 years ago
5 likes

Just checking, but how much body armour do you wear when cycling? There's no proof it'll help you, but its better than nothing.

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wycombewheeler replied to pablo | 3 years ago
4 likes

pablo wrote:

Any protection is better than no protection and having to trust a driver. It shouldn't be a thing but it is.

What does this last bit even mean? Other than with completely segregated infrastructure trusting drivers will always be required. No amount of body armour can protect against being hit with a 2 tone metal box.

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mdavidford replied to wycombewheeler | 3 years ago
4 likes

wycombewheeler wrote:

No amount of body armour can protect against being hit with a 2 tone metal box.

I beg to differ.

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wycombewheeler replied to mdavidford | 3 years ago
1 like

mdavidford wrote:

wycombewheeler wrote:

No amount of body armour can protect against being hit with a 2 tone metal box.

I beg to differ.

I stand corrected. Reckon I could beat some strava segment times in that too, but I'd need a pretty strong bike.

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Captain Badger replied to wycombewheeler | 3 years ago
1 like
wycombewheeler wrote:

...

I stand corrected. Reckon I could beat some strava segment times in that too, but I'd need a pretty strong bike.

Iron Bike

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CygnusX1 | 3 years ago
5 likes

Quote:

While the study refers throughout to sports-related injuries, the data for cycling encompasses all forms of riding bikes, including on the road for commuting or going to the shops.

And I assume all jogging related spinal injuries also included people wearing sweatpants and a pair of trainers that tripped and fell backwards having nipped to the offy for a 4 pack and pack of Marlborough?

The findings are complete bollox. Most of these cycling injuries were RTCs and not related to cycling as a sport at all.  

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Jenova20 | 3 years ago
3 likes

When they've got everyone wearing helmets they'll be calling for us all to wear back braces, then elbow pads, then knee pads, then shin pads, then chin guards...Or we could get people to drive properly?

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Captain Badger | 3 years ago
14 likes

Who knew? Helmets may provide some (disputed, and difficult to quantify) benefit regarding specific types of THI, but these are by no means the only serious injuries inflicted on cyclists (typically by vehicle drivers)

If we can extrapolate the essence of this data towards everyday cyclists, it seems that "more helmets" is a totally inadequate mitigation for reducing death and injury......

Which from an H&S perspective is stating the bleeding obvious. Were I to rely on PPE as prime mitigation for risk in a mechanical work environment I'd be looking at a criminal prosecution on the first occurrence of a serious injury - why is govt policy towards risk on the roads treated differently?

From a personal perspective I'll repeat - I don't want to get hit by  a couple of tons of metal "controlled" by some twunt with their mind on their mobile. Wearing a polystyrene hat does not make me any more amenable to this propositon.

FFS

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eburtthebike replied to Captain Badger | 3 years ago
4 likes

Captain Badger wrote:

Who knew? Helmets may provide some (disputed, and difficult to quantify) benefit regarding specific types of THI, but these are by no means the only serious injuries inflicted on cyclists (typically by vehicle drivers)

If we can extrapolate the essence of this data towards everyday cyclists, it seems that "more helmets" is a totally inadequate mitigation for reducing death and injury......

Which from an H&S perspective is stating the bleeding obvious. Were I to rely on PPE as prime mitigation for risk in a mechanical work environment I'd be looking at a criminal prosecution on the first occurrence of a serious injury - why is govt policy towards risk on the roads treated differently?

From a personal perspective I'll repeat - I don't want to get hit by  a couple of tons of metal "controlled" by some twunt with their mind on their mobile. Wearing a polystyrene hat does not make me any more amenable to this propositon.

FFS

Hear, hear!  Eloquently put sir.

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Mungecrundle | 3 years ago
4 likes

Wouldn't the obvious question to ask from the data be along the lines of: "Of the x number of cyclists with spinal injuries, how many were wearing helmets, how many were not and how do those percentages match the helmet wearing percentages of the general population of un-injured cyclists?"

Then we could argue over other aspects of the study, but at least it might be clearer if there is anything other than some unsupported assumed benefit which this report of the report seems to suggest.

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hawkinspeter replied to Mungecrundle | 3 years ago
3 likes

Mungecrundle wrote:

Wouldn't the obvious question to ask from the data be along the lines of: "Of the x number of cyclists with spinal injuries, how many were wearing helmets, how many were not and how do those percentages match the helmet wearing percentages of the general population of un-injured cyclists?" Then we could argue over other aspects of the study, but at least it might be clearer if there is anything other than some unsupported assumed benefit which this report of the report seems to suggest.

As this is all about spinal injuries, I'd say that a better question would be to determine what percentage of people were wearing back supports, rucksacks or any other back worn object (multitool in the back pocket).

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wycombewheeler replied to hawkinspeter | 3 years ago
0 likes
hawkinspeter wrote:

Mungecrundle wrote:

Wouldn't the obvious question to ask from the data be along the lines of: "Of the x number of cyclists with spinal injuries, how many were wearing helmets, how many were not and how do those percentages match the helmet wearing percentages of the general population of un-injured cyclists?" Then we could argue over other aspects of the study, but at least it might be clearer if there is anything other than some unsupported assumed benefit which this report of the report seems to suggest.

As this is all about spinal injuries, I'd say that a better question would be to determine what percentage of people were wearing back supports, rucksacks or any other back worn object (multitool in the back pocket).

I don't know the data may show more spinal injuries among tge helmet wesrers as drivers give helmetless cyclists more space

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mdavidford | 3 years ago
2 likes

Quote:

Previous studies reveal a discrepancy between bikers [sic] acknowledging the importance of helmet use versus actually choosing to wear helmets, which indicates that helmet advocacy initiatives might improve rates of helmet use.

Doesn't it indicate the exact opposite - that you can convince people that they're important, but it still won't actually make them wear them?

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andystow | 3 years ago
10 likes

A vanishingly small number of traumatic injuries are from jumping off a cliff wearing a wingsuit... but I still feel cycling may be safer.

Needs to be adjusted for the number of participants, or hours spent doing the sport, to meaningfully say one sport is less safe than another.

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eburtthebike | 3 years ago
14 likes

Yet another in the seemingly endless poorly conceived, carried out and reported research.  It should be dismissed out of hand for conflating sporting injuries with utility cycling, but then it goes on to promote helmets with no justification.   Indeed, in the very thing this study seems to focus on, Traumatic Spinal Injury, it seems likely that a helmet would increase the risk of such an outcome.

Extraordinarily poor, and how the hell did this get published in a peer-reviewed journal?

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brooksby replied to eburtthebike | 3 years ago
7 likes

You beat me to it, burt.  I'm not sure that many roadies aiming for their personal best over a hundred kilometres use cycle lanes...  Maybe someone else here can correct me?

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TheBillder replied to eburtthebike | 3 years ago
1 like
eburtthebike wrote:

Extraordinarily poor, and how the hell did this get published in a peer-reviewed journal?

Were the peers doing the reviewing a UK jury?

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wycombewheeler | 3 years ago
29 likes

"Eight ​in ten sports-related spinal injuries involve cycling, according to new research from Harvard University – the vast majority of those resulting from collisions involving motor vehicles"

These are not sports injuries, these are road traffic collsiion injuries.

Lay the blame where it belongs - with cars, not with cycling. 

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rct | 3 years ago
10 likes

Puzzled! How does wearing a helmet prevent spinal injury?

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uglybovine replied to rct | 3 years ago
14 likes

rct wrote:

Puzzled! How does wearing a helmet prevent spinal injury?

by casting its magic polystyrene hat forcefield around the wearer? True fact.

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hawkinspeter replied to rct | 3 years ago
8 likes

Quote:

In conjunction with interventions such as improving bike lanes and educating motorists, helmet advocacy may help to reduce the incidence of cycling-related TSIs.

Sounds to me like they're just bundling in helmets along with things that do work just so that they can say that helmets help prevent traumatic spine injuries in cyclists.

There's also the bit about counselling adult patients about safety measures even though earlier they noted

Quote:

Notably, most sports-related TSIs were from motor vehicle-related cycling accidents in which the patient was not operating the vehicle (81.0 per cent)

Sound like they're just shoe-horning helmets into it without any real justification.

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OnYerBike replied to hawkinspeter | 3 years ago
8 likes

Yeah, I think's it's a classic case of thinking helmets must be a magic solution to keep cyclists safe from all possible harm.

I just had a quick google and found a few studies that suggest wearing a helmet doesn't reduce, and may even increase, the risk of spine injuries:

https://pubmed.ncbi.nlm.nih.gov/33045673/

https://www.tandfonline.com/doi/abs/10.1080/02688697.2020.1731425?journa...

https://www.researchgate.net/publication/318151176_Fatal_Cervical_Spine_...

https://pubmed.ncbi.nlm.nih.gov/29677686/

There was one study (on the first page of google results) that found the opposite effect, albeit it looking at motorcyclists: https://www.sciencedaily.com/releases/2018/03/180306085415.htm 

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Ride On replied to rct | 3 years ago
9 likes

Agreed. Pretty sure helmets are designed to prevent head injuries not spinal injuries. Which makes me wonder why they are approaching their research from this angle at all?

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