“Beyond the Finish Line” the Epidemiology of Injury and Illness in Professional Cycling: Insights from a Year-Long Prospective Study

Introduction: Injury and illness rates within cycling are a growing concern for riders, medical personnel, and event organisers. This study is the first to document injury and illness rates in professional cyclists throughout one competitive season including training and racing. Methods: A prospective, longitudinal study was conducted with 47 professional cyclists (30 males and 17 females) over the 2024 season (1 November 2023–31 October 2024). Injuries and illnesses were defined and recorded following the International Olympic Committee (IOC) consensus guidelines for injury reporting in sports and its cycling-specific extension. Data collection utilised a centralised online hub, integrating exposure metrics (e.g., training hours and kilometres) and medical records. All data were processed on a Macintosh computer using the Microsoft Office and R statistics packages epi tools, binom.test function, and ggplot. (V.4.3.2, R Foundation for Statistical Computing, Vienna, Austria). Ethical approval was obtained from Queens University Belfast, number MHLS 23_175. Results: Fifty-five injury events were logged, with 1.15 (±0.359) locations injured per incidence and 1.57 (±1.06) injury types per incident. The overall combined injury rate for racing was 4.14 (95% CI: 2.65–5.79) per 1000 h of exposure, with the overall combined rate for training being 1.23 (95% CI: 0.8–1.7) per 1000 h. The injury risk ratio (RR) for injury during racing and training for females was 11.10 (95% CI: 2.69–37.60), and the RR for males was 10.24 (95% CI: 3.84–43.06), both indicating there is a significantly higher risk of injury during racing compared to training. Abrasions were the most common injury type, with fractures being the most burdensome injury. The most common illness was upper respiratory, 0.63 (95% CI: 0.27–0.99) per year for males and 1.11 (95% CI: 0.64–1.59) per year for females. Saddle sores were the second most common at 0.20 (95% CI: 0.04, 0.36) per year for males and 0.08 (95% CI: 0–0.18) per year for females. Conclusions: This study provides the first comprehensive, season-long surveillance data for injuries and illnesses in male and female professional road cycling, highlighting the significant differences in injury profiles between racing and training. These results underscore the need for targeted injury prevention strategies and the establishment of a standardised injury and illness framework for professional cycling.