by Dr. Greg Motley

I recently took up mountain biking as a part of my cross-training regimen. My friends say I’m crazy and bound to get hurt. Are injuries common, and how serious?
-Robert F., Greenville, S.C.

Researchers writing in the British Journal of Sports Medicine concluded that the popularity of mountain biking has brought a rising tide of injuries, some of them potentially fatal. Over a one-year period, the orthopedic trauma unit at the researcher’s hospital saw 84 victims from mountain biking accidents. Arm and leg fractures accounted for one in five of the biking injuries recorded. Mountain bike injuries are separated into two categories: acute and overuse injuries. Acute injuries are the everyday mishaps associated with mountain biking and “routine” falls. Aside from cuts and bruises, the most common acute mountain bike injuries are fractures and joint dislocations. These occur most frequently in the hand, wrist, forearm, collarbone, and the shoulder blade, and they’re usually caused from falling on outstretched hands.

But before you lock your bike away, consider that “endos” are also part of the thrill of riding mountain bikes, and don’t have to result in injury. The adrenaline rush of being out of control while still trying to control the situation-that’s why we ride, is it not? Like any adventure sport, the trick is to get ‘the thrill’ while minimizing ‘the spill’. If you are really concerned about taking a tumble, then you might consider cross-training in a different manner-such as water exercising, strength training, or crocheting.

I flipped over my handlebars while riding my mountain bike at Bent Creek last weekend. My wrist and forearm have been hurting ever since. How can I tell if I broke any bones?
-Mike J., Asheville, N.C.

If you’re an avid mountain biker, chances are you’ve flipped over your handlebars at some point. Endos are common, especially on the steep, rugged trails of the area. It usually goes something like this: You’re flying down rocky singletrack, navigating through technical terrain, feeling the adrenaline rush of speeding down a mountain, when suddenly the forward momentum of your bike is stopped, but yours is not. You are flung from the cockpit of your vessel, and your first reflex is to throw your arms out and try to catch yourself.

This reaction is totally normal, but it is also the cause of many mountain biking injuries. It is a good practice to ice the injury as soon as possible and avoid heat. If the pain is not tolerable, or does not improve over several days of icing and over the counter anti-inflammatories the injury should be checked by a physician and possibly x-rayed. It is often difficult to self-diagnosis a fracture versus a deep bruise as both may exhibit swelling and significant pain. In general, if there’s a fracture (other than a hairline fracture), you’re going to know it because its gonna hurt.

I recently fell and mildly injured my collarbone, I was surprised how much it bothered me. Is a collarbone injury serious?
-Heather U., Candler, N.C.

Thankfully you did not break your collarbone. It’s a common injury among fat tire enthusiasts and while it is not ‘serious’ (i.e. life threatening), it can sideline you for 6-8 weeks. If surgery is required, there is an extensive rehabilitation program that follows before you are able to get back on the trails.

There is no real prevention to the acute injuries associated with this sport, unless you want to try to ride your bike with body armor on, which would be both awkward and difficult.

Dr. Greg Motley is a physician at Southeastern Sports Medicine, which provides orthopedic and rehabilitative care to athletes and other active outdoor enthusiasts in western North Carolina.