Background Risk factors associated with overuse injuries in cyclists (OICs) in recreational cyclists have not been well-studied.
Objective To determine risk factors associated with OICs in recreational cyclists participating in a mass community-based cycling event.
Design Cross-sectional study.
Setting Cape Town Cycle Tour (CTCT) 2016.
Patients (or Participants) 21824 consenting cyclists (60.8% of 35914). Race entrants (n=35914) completed an online pre-race medical screening questionnaire.
Interventions (or Assessment of Risk Factors) The online pre-race medical screening questionnaire identified 617 cyclists with a history of OICs. Categories of possible risk factors that were explored included demographics, training/racing history, history of chronic disease, and medication use.
Main Outcome Measurements Prevalence ratio (PR) of OICs were explored using multi-variate analyses.
Results The PR of OICs was similar in male and female cyclists, but was significantly higher in older (>50 years) cyclists (vs. <30 yrs PR=1.6; vs. 31 to <40 yrs PR=1.5; vs. 41 to <50 yrs PR=1.4; p<0.0001 vs. age categories). Independent risk factors associated with OICs (adjusted PR for gender and age) were: 1) training/racing variables [increased weekly training/racing (PR=1.1, p=0.0003), increased years of participation in cycling events of >2 hours (PR=1.1, p=0.0189), higher average racing speed category (km/h) (PR=1.04, p=0.0368)], 2) chronic disease history [symptoms of cardiovascular disease (PR=2.3, p=0.0026), respiratory disease (PR=1.6, p<0.0001), nervous system/psychiatric disease (PR=1.5, p=0.0082), and gastrointestinal tract disease (PR=1.4, p=0.0225)], and 3) medication use [prescribed medication use (PR=1.2, p=0.0226), analgesic/anti-inflammatory medication used before or during racing (PR=5.1, p<0.0001)].
Conclusions Increased training, years of participation in endurance cycling events, older age, chronic disease and medication use are novel independent risk factors associated with OICs. However, the causal relationship, including the direction, between OICs and these factors need to be established, before considering these in the design and implementation of prevention programs.
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