UCI study reveals women cyclists are more likely to crash and sustain fractures possibly due to impaired bone health

A Union Cycliste Internationale (UCI) study has revealed that women cyclists crash more often than men and sustain 2.5 times as many fractures, with UCI Medical Director, Xavier Bigard, hypothesising that this could be attributed to impaired bone health in women related to “hormonal disturbances” and “a decrease in energy availability,” specific to cycling because cycling is not a weight-bearing sport.

At the UCI Congress in Montreal, UCI Medical Director, Xavier Bigard, revealed these results from a study conducted in March, beginning with Paris-Nice, an annual professional eight-day cycling stage race in France, known as the “Race to the Sun.”

The study examined 21 men’s races (90 days) and 14 women’s events (37 days), corresponding to 12,951 men’s rider-race days and 4,381 women’s rider-race days, according to Inside the Games. The results showed that when a crash occurred in a women's peloton, 4.7 women fall, compared with 2.7 in a men's peloton.

Bigard stated: “The second finding is that, during these crashes, the number of medical interventions is systematically higher in women's races than in men's races…the rate is 1.5 times higher in women than in men” for medical intervention or surgery.

This number was very similar when crashes that were not classed as serious were included – women had an injury rate 1.55 times higher than men. The injuries ranged from skin abrasions to concussions and fractures.

Bigard voiced: “When comparing the differences in the type and severity of these injuries, we observed that 4.3 times more head injuries occur in women than in men; 2.3 times more concussions in women than in men; and nearly three times more severe skin injuries in women than in men.”

Regarding fractures, Bigard elaborated: “The main hypothesis...is impaired bone health. For me, yes, we are not sure, of course, but it is a clear hypothesis. This is related to hormonal disturbances, a decrease in energy availability, and it is also specific to cycling because cycling is not a weight-bearing sport [like running].” We know that impacts against the ground are essential for improving bone health, which does not occur in cycling. Although this applies to both men and women, the higher number of fractures among women may be explained, at least in part, by hormonal disturbances.”

Bicycle handling and differences in men and women’s bike designs may also impact stability. There’s also the suggestion that there is too much heterogeneity in skill level in the women's races.

Furthermore, crashes on wet roads, although more severe, occurred less frequently possibly due to the “greater caution” demonstrated by male cyclists compared to women. 

“In a highly reproducible finding in both men and women, we found that crashes occurring on descents were the most severe, requiring medical intervention and causing injuries. This once again underlines how speed can be an important factor in injuries in road races,” Bigard expressed.

Additionally, Bigard concluded with an estimate that, “among women, injuries overall could represent a budget shortfall of €891,000, and approximately €2.3 million for men.” There’s also a suggestion that the crashes men endure attract more attention.

The findings were mentioned in UCI’s press release here.

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