see also page 197

The paper highlights the hazards of an increasingly popular form of cycling. I was surprised to discover that, of the 84 patients attending the accident and emergency department, four (5%) had potentially life threatening injuries. From these figures, it may easily be concluded that mountain biking is an extremely hazardous pursuit; however, in my experience the vast majority of falls from all types of cycle fortunately result in nothing more than minor abrasions and do not require attendance at an accident and emergency department.

It is propitious that leisure mountain biking has a culture where the wearing of purpose built protective helmets is the rule rather than the exception—fashion and safety unusually walking hand in hand. Helmets have always been compulsory for all competitive events. The authors suggest the possible use of some form of body armour as a means of reducing injury, and this is currently used only in the downhill racing discipline of mountain biking. In this, competitors carry out an individual time trial from the top to the bottom of a steep hill or mountain via a circuitous, poorly surfaced, and highly “technical” course. In the more popular cross country discipline, considerations of weight, reduced mobility, and decreased heat loss would make contemporary protective clothing impractical.

From the ages of those presenting to the department, it will be apparent that mountain biking is an inclusive sport accessible to a broad range of ages and abilities. The level of skill necessary for some courses is high, and youth may just over reach itself. When the risks of the off road sport are being assessed, it should be noted that many participants are using off road trails in the belief that they are safer. They would contend that tarmac roads have ceased to be a cyclist friendly environment, rather a place where they are obliged to inhale exhaust fumes and put themselves at the mercy of other road users.