Haeberle HS, Navarro SM, Power EJ, Schickendantz MS, Farrow LD, Ramkumar PN. Prevalence and Epidemiology of Injuries Among Elite Cyclists in the Tour de France.
Orthop J Sports Med 2018;
6:2325967118793392. [PMID:
30202769 PMCID:
PMC6124184 DOI:
10.1177/2325967118793392]
[Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background:
Cycling injuries are increasing, particularly among elite athletes during
major events such as the Tour de France. Many athletes miss considerable
time from sport and require surgical intervention. Little is known about the
epidemiology of injuries to guide practice participation strategies,
return-to-competition expectations, and injury prevention protocols.
Purpose:
To evaluate the injury epidemiology, operative incidence, and
return-to-competition timeline among all elite cyclists participating in the
21-stage Tour de France race over a span of 8 years.
Study Design:
Descriptive epidemiological study.
Methods:
All injuries sustained during 1584 unique rides by cyclists participating in
the Tour de France from 2010 to 2017 were evaluated. In the absence of an
established Tour de France injury database, demographic, injury, surgical,
and return-to-competition details from all athletes who withdrew because of
a traumatic injury were retrospectively compiled using publicly available
data, which were cross-referenced for validity. The inclusion criterion
consisted of any cyclist who withdrew from the Tour de France because of an
injury; cyclists who withdrew for noninjury reasons were excluded.
Independent variables included injury demographics, missed days, and whether
the injury required surgery. Injury prevalence, relative frequency
distributions, and sample proportions were dependent metrics for this
investigation.
Results:
Among the 1584 cycling entries evaluated over the 8-year study period, there
were 259 cyclists (16%) who withdrew (17 cyclists/year). A total of 138
withdrawals were caused by acute trauma, 49% of which were fractures (n =
67), which represented the most common reason for withdrawal. A total of 29
(43%) cyclists with fractures underwent surgery. The most commonly fractured
bones were the clavicle (n = 21), followed by the wrist (n = 6), hand (n =
5), femur (n = 5), humerus (n = 5), and ribs (n = 5). Cyclists who underwent
operative fracture fixation had a longer time between the injury and their
next race compared with those who did not undergo surgery (77 vs 44 days,
respectively; P = .065).
Conclusion:
The most common injury leading to withdrawal from the Tour de France over the
study period was acute fracture, comprising 49% of all injuries. Almost half
of the cyclists with fractures underwent surgery. The clavicle was the most
commonly fractured bone. For cyclists who underwent operative treatment of
their fractures, return to competition was more than 1 month longer than for
those who did not. A prospective database is warranted to catalog injuries
among these elite cyclists.
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