In part two of Jon Bateman’s mountain rescue-themed columns, he expands on what the risks of mountain biking are – and how you should prepare for them… Read more from Jon here.
I think anyone who has been riding for a bit knows that getting hurt is the inevitable consequence of trying harder. It’s a risk we all mentally compute when we’re riding and how much we expose ourselves to it shifts in response to mood, marital status, parental status, employment status, what bike you picked out of the shed, Strava… the list is long. One thing people often don’t do is to plan for when that risk calculation has caught you (or a friend) out and the dice have landed as badly as you just did.
Lies, damn lies and statistics.
I’m the stats man on my mountain rescue team. I collate incident reports and look at all the data we record on training and try to say interesting and useful things about it, sometimes successfully. I’ve trawled through the national mountain rescue statistics (for England and Wales) to see if there’s anything useful or interesting to say about mountain biking and mountain rescue… there’s a few.
Mountain rescue is dealing with more mountain bikers, not just in numbers but as a proportion of all the people we deal with. There’s been a 58% increase in mounting biking’s share of incidents comparing the first five years of last decade with the first five years of this decade. In pure numbers, there’s been an increase of 187% in mountain biking incidents comparing those two periods and an increase in injuries of 155%. From the early 2000s to now, mountain biking moved from being fourth in the rank of activities triggering callouts to second in the rankings. Don’t get too excited, we’re still a long way off the number one spot (hill walking).
As a team, we’re seeing more mountain bike-related call outs. In the last couple of years we have had a wide array covering everything from minor abrasions, through some nasty lacerations and broken bones, all the way through, sadly, to serious spinal injuries and fatal heart attacks. In our area it’s probably the most likely cause of the injuries we deal with.
But is mountain biking a risky activity? Are you likely to get hurt? Yes and no. The England and Wales mountain rescue stats shows that mountain biking consistently accounts for a higher proportion of injuries seen than the incidents it is responsible for, suggesting that if you call on mountain rescue when you’re riding it’s most likely to be because you are injured, rather than lost for instance. Exactly how you’re likely to be injured and how severely is tricky to determine, but I’ll give you some highlights mashed together from a few of the literature reviews and medical studies on mountain biking injuries that might help you assess your personal risks.
A bit of an obvious one to kick off with – you’re nearly 12 times more likely to be injured downhill racing than you are cross-country riding. Perhaps something to bear in mind when you’re entering your next enduro. You’re also more likely to be injured when racing, full stop.
A few gems on scary head and neck injuries next. You’re more likely to get a spinal injury riding off-road than on-road. Serious head and neck injuries are usually caused by going OTB, which means that if you’re female you’re at a higher risk as you’re likely to be lighter and will be launched more easily. This quirk also means that female riders are more likely to suffer a loss of consciousness in an accident. But, in terms of serious injury, everyone is much more likely to break their collarbone than do anything else.
To round off this statistical smorgasbord I can tell you that bar ends are surprisingly dangerous (just don’t do it!) and you’re more likely to be injured riding a red graded trail than a black graded trail. All that considered, most studies show that, in terms of injury, mountain biking isn’t actually any more risky than other comparable outdoor activities (remember how dangerous I said hill walking is!). And these figures aren’t even looking at the other risks we all face in life and in going outdoors, which might rear their ugly heads when you’re out riding – hypothermia, heat illnesses, heart issues (probably your best chance of getting ‘big sick’ as our team doctor calls it), asthma attacks, fits, diabetic attacks (hypo- and hyperglycaemia), allergic reactions. Blimey, life is dangerous isn’t it?
The possibility of some of these things happening might be something you factor into your personal risk assessment. If you’re diabetic or know you can have a severe allergic reaction to something, then it will be something you bear in mind and probably prepare for (carrying emergency sugars, or maybe an Epipen). If you’ve planned for it, make sure your riding mates know too. Hopefully they won’t have to deal with it, but at least it might be top of the list in their mind if it happens.
But look what’s just happened!
Of course these stats aren’t much help when you’re faced with an injured rider, be that you or someone else. “Obviously that bloke said this was bound to happen one day… but what do I do now?” you might say. When faced with a fallen comrade the first thing you might want to do is rewind a few weeks and get some first aid training. There’s lots of good courses designed just for this sort of need – go on one, get some mates together for one, get your club to run one, it’s not something you’ll ever regret doing. Knowing the ABC (airway, breathing, circulation) basics, CPR and C-spine immobilisation could make a massive difference if something really bad happens on your ride. Here’s not the place to start teaching first aid, but we can look at some tips on dealing with the situation and the decision you may need to make.
Number one – don’t panic. Easier said than done, but when you’re faced with something that looks serious, especially if you witnessed it happen, it’s important to try and keep calm and rational. If you’re with other people then making an effort to talk calmly to each other helps the whole group keep panic in check.
Next you need to assess the casualty – this is the point where you decide whether you need to call for help. I’ll be frank here, often the quickest way to safety is to patch up and carry on, but you need to be sure that it’s a minor enough injury or issue that you can do that and hobble back to the car without making things worse or putting anyone at risk. It’s easy to patch up a superficial wound and set off again without spotting a risk of head or spinal injury. If you’re not sure what’s wrong, if you think it’s serious, if you just watched someone land on their head, then it’s probably time to call for help.
So, do you need mountain rescue? Do you know how to call them out? If you’re up in the hills then it’s easy – you need mountain rescue. If you’re playing in the woods close to home or in a trail centre that is riddled with forestry tracks, then it’s often easy to think you could just call for an ambulance, but think carefully. If you think it will be difficult for a pair of ambulance technicians to get to your mate from where they are, to the nearest they can park their ambulance, then mountain rescue may be your best option. We often get called to assist ambulance crews who can’t find their casualty, can’t get their vehicle through a forest gate, can’t get a casualty that tricky ten metres down a steep bank to their vehicle, etc. We get there in the end, but often it’s been a long uncomfortable wait for the casualty. More often we’re getting called straight away by our local ambulance service if they think it’s a job we can help with, but how well that works will vary across the country. So the rule is if you think you need mountain rescue, call mountain rescue.
Before you call for help, make sure you’ve got all the information you can together to make it go as smoothly as possible. You need ETHANE…
ETHANE?
Exact location: Where are you? Got a grid reference from a map? Got a grid reference from a GPS or a phone app (try Viewranger or the new OS Maps app)? Failing that if you’re at a trail centre what number was the last way-marker post you passed? Where’s the nearest place you actually can pinpoint? Most ambulances navigate by postcode and street addresses, so if you’ve had to use a grid reference for this then it’s a big clue that you might need mountain rescue.
Type of incident: What’s happened, who’s hurt, how are they hurt?
Hazards: Are you on steep ground? Is it wet or icy? Is it really cold?
Access: What’s the best way for help to get to you? If you don’t know then don’t guess – give an accurate location and they’ll sort it out.
Numbers: How many are hurt, how are they hurt, but also how many are in your group – important if you’re in bad conditions or in a remote area.
Emergency services: Who do you need to come? If you think it looks really serious and might need a rescue helicopter or an air ambulance, then it does no harm to say it up front. They won’t come if they don’t think it’s warranted, but that question might get asked earlier if you raise it.
Once you’ve got as much of that as you can together call 999, assuming you’ve got a phone signal of course. If you regularly ride in bad reception areas then try to note the places where you do get reception. If you know one network has better coverage, and it’s not yours, think about carrying an old phone with a free PAYG sim on that network. Also register your phone with emergencySMS (emergencySMS.org.uk) so if you need to you can summon help by text, which can sneak through with dodgy reception.
If you need mountain rescue dial 999, ask for the police and say you need mountain rescue. Give all the information you can and the police will alert the local team and pass on all the details. You might have to think about sending someone to guide them to where you are, or maybe marking the trail entrance (light sticks are great for this). Then you need to think about looking after the casualty and making sure everyone else looks after themselves. Put a jacket on, use what you can to keep the casualty warm. Even in summer you can cool down pretty quickly going from sweaty Strava-chasing pace to lying on a shady forest floor, and it may be a while before help arrives.
The kitchen sink.
This is probably the point where you consider what kit you’ve got with you. If you didn’t call for help and are trying to patch-and-go, you’ve probably already emptied your packs to see who’s actually carrying anything useful. How much first aid and emergency stuff you carry when riding is always going to be the result of a complicated equation involving risk, remoteness, desired speed and responsibility. With that in mind it will always be a fairly fluid thing – I certainly don’t think there’s a ‘standard first aid kit’ you should be carrying when riding.
I have a small kit that lurks in my riding bag. Usually all it has in it are a few big field dressings, some Micropore tape, a few pain killers and about 1-2m of duct tape wrapped around an old credit card (there’s a lot you can hold in place with duct tape!) – it’s all I’d need to cover and patch up and it weights very little. If I’m going further than local riding it might have more in it, and depending on the location and weather I might squeeze an emergency shelter in my bag, particularly if I’m riding with the kids. It would be very easy to weigh yourself down with kit. My personal mountain rescue kit is just about enough to hold the fort until the big guns arrive, but I’d be dead if I carried that riding!
Planning to get hurt.
If you’ve been riding a while, the chances are you’ve already got hurt, or been there when someone else got hurt or fell ill when riding. If you haven’t been riding long then the chances are that will happen to you at some point. A bit of planning, a few extra things in your bag, some basic first aid skills, and knowing how to summon help could make all the difference. Oh, and why not make a pre-emptive donation to your local mountain rescue team while you’re at it? You never know when you might need them.
Some links if anyone wants to look at risks more closely!
Roberts DJ, Ouellet JF, Sutherland FR, Kirkpatrick AW, Lall RN, Ball CG. Severe street and mountain bicycling injuries in adults: a comparison of the incidence, risk factors and injury patterns over 14 years.
Can J Surg J Canadien de chirurgie. 2013;56(3):E32–8 doi: 10.1503/cjs.027411
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3672442/
Carmont MR. Mountain biking injuries: a review. Br Med Bull 2008;85:101–12.
doi: 10.1093/bmb/ldn009
http://bmb.oxfordjournals.org/content/85/1/101.full
Aitken SA, Biant LC, Court-Brown CM. Recreational mountain biking injuries. Emergency Med. J. Apr 2011; 28:274-9 doi:10.1136/emj.2009.086991
http://emj.bmj.com/content/early/2010/07/19/emj.2009.086991
I am fortunate in that my company pays for me to be trained in CPR and basic first aid. I do recurrent training annually, although included in that is an AED – now, I am not carrying that around. I do carry a basic first aid kit + ventolin. I am asthmatic so that’s sensible. 😀
Nice. Useful info. Fun with stats, though:
“if you’re female you’re at a higher risk as you’re likely to be lighter and will be launched more easily.”
Shouldn’t that be “if you’re lighter you’re at greater risk”? Or is weight an untested hypothesis as to why that type of injury has greater correlation with female riders?
“you’re more likely to be injured riding a red graded trail than a black graded trail”
You’ve normalised the injury frequency by the number of rider-miles on reds and blacks, then? 😉
Stats are always fun – you know that 😉
The inference chain was (study authors, not mine!) (and IIRC, I’m not rereading it all!) something like women present with a higher incident of head and neck injuries and majority of head and neck injuries result from OTB, therefore inferred that more women go OTB, reasoned that this is because they are statistically lighter than male riders. So the root of the inference is women, rather than lighter riders. Hold on, why am I recapping this? It was just supposed to be a self-declared cherry pick of interesting stats (it’s what I do best)… if you want to mine the sources they’re there for you Bez and actually their stats seem reasonably solid as they’re mostly medical studies. I am obviously riding rough shod over their methodologies though, just to annoy you 🙂
It is tricky as most studies are based on injury presentation rather than rider behaviour, although that red/black stat is, I think, from the Glentress study which uses rider interviews/survey as well as injury presentation.
It’s all good, I was just curious on that point, ie whether it was an inference from a gender correlation or whether it was something with more direct statistics. Mainly I was just trying to ponder other potential correlating factors, eg riding styles or a different riding position on women-specific bikes. I’ve no doubt the stats are solid, but inferences tend to be less so 😉
Nice Craig Ferguson (I think) shower reference 🙂